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Photographic 

Sciences 

Corporation 


23  WEST  MAIN  STREET 

WEBSTER,  N.Y.  14580 

(716)  872-4503 


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CIHM/ICMH 

Microfiche 

Series. 


CIHM/ICMH 
Collection  de 
microfiches. 


Canadian  Institute  for  Historical  Microreproductions  /  Institut  Canadian  de  microreproductions  historiques 


i 


MMMRT- 


wamd 


Technical  and  Bibliographic  Notes/Notes  techniques  et  bibliographiques 


The  Institute  has  attempted  to  obtain  the  best 
original  copy  available  for  filming.  Features  of  this 
copy  which  may  be  bibliographically  unique, 
which  may  alter  any  of  the  images  in  the 
reproduction,  or  which  may  significantly  change 
the  usual  method  of  filming,  are  checked  below. 


D 


Coloured  covers/ 
Couverture  ie  couleur 


I      I    Covers  damaged/ 


Couverture  endommag^e 

Covers  restored  and/or  laminated/ 
Couverture  restaurde  et/ou  pellicuide 

Cover  title  missing/ 

Le  titre  de  couverture  manque 


D 

□    Coloured  maps/ 
Cartes  gdographiques  en  couleur 

□    Coloured  ink  (i.e.  other  than  blue  or  black)/ 
Encre  de  couleur  (i.e.  autre  que  bleue  ou  noire) 

|T^    Coloured  platbs  and/or  illustrations/ 
^aJ    Planches  et/ou  illustrations  en  couleur 


D 
D 


D 


D 


Bound  with  other  r?aterial/ 
Reli^  avec  d'autres  documents 


Tight  binding  may  cause  shadows  or  distortion 
along  interior  margin/ 

La  reliure  serr^e  peut  causer  de  I'ombre  ou  de  la 
distortion  le  long  de  la  marge  int6rieure 

Blank  leaves  added  during  restoration  may 
appear  within  the  text.  Whenever  possible,  these 
have  been  omitted  from  filming/ 
II  se  peut  que  certalnes  pages  blanches  ajoutdes 
lors  d'une  restauration  apparaissent  dans  le  texte, 
mais,  lorsque  cela  dtait  possible,  ces  pages  n'ont 
pas  6t6  filmdes. 

Additional  comments:/ 
Commentaires  suppl^mentaires; 


L'Institut  a  microfilm^  le  meilleur  exemplaire 
qu'i!  lui  a  6td  possible  de  se  procurer.  Les  details 
de  cet  exemplaire  qui  sont  peut-dtre  uniques  du 
point  de  vue  biblfographique,  qui  peuvent  modifier 
une  image  reproduite,  ou  qui  peuvent  exiger  une 
modification  dans  la  methods  normale  de  filmage 
sont  indiquds  ci-dessous. 


I      I   Coloured  pages/ 


Pages  de  couleur 

Pages  damaged/ 
Pages  endommag^es 

Pages  restored  and/oi 

Pages  restaurdes  et/ou  pelliculdes 

Pages  discoloured,  ..iiained  or  foxec 
Pages  ddcolordes,  tachet^es  ou  piqudes 

Pages  detached/ 
Pages  d6tach6es 


I  I  Pages  damaged/ 

I  I  Pages  restored  and/or  laminated/ 

I  I  Pages  discoloured,  ..iiained  or  foxed/ 

I  I  Pages  detached/ 


D 
D 
D 
D 


Showthrough/ 
Transparence 

Quality  of  print  varies/ 
Qualitd  in^gale  de  I'impression 

Includes  supplementary  material/ 
Comprend  du  materiel  suppl^mentairu 

Only  edition  available/ 
Seule  Edition  disponible 

Pages  wholiy  or  partially  obscured  by  errata 
slips,  tissues,  etc.,  have  been  refilmed  to 
ensure  the  best  possible  image/ 
Les  pages  totalement  ou  partiellement 
obscurcies  par  un  feuillet  d'errata,  une  pelure, 
etc.,  ont  6x6  filmdes  d  nouveau  de  fapon  d 
obtenir  la  meilleure  image  possible. 


This  item  is  filmed  at  tta  reduction  ratio  checked  below/ 

Ce  document  est  filmd  au  taux  de  reduction  indiqu^  ci-dessous. 

10X  14X  18X  22X 


12X 


16X 


20X 


24X 


26X 


30X 


28X 


32X 


ils 

u 

lifier 

ne 

ige 


The  copy  filmed  here  has  been  reproduced  thanks 
to  the  generosity  of: 

Library  of  Congress 
Photoduplication  Service 

The  images  appearing  here  are  the  best  quality 
possible  considering  the  condition  and  legibility 
of  the  original  copy  and  in  keeping  with  the 
filming  contract  specifications. 


L'exemplaire  filmd  fut  reproduit  grdce  d  la 
g6n6rosit6  de: 

Library  of  Congress 
Photoduplication  Service 

Les  images  suivantes  ont  6t6  reproduites  avec  le 
plus  grand  soin,  compte  tenu  de  la  condition  et 
de  la  nettet6  de  l'exemplaire  filmd,  et  en 
conformity  avec  les  conditions  du  contrat  de 
filmage. 


Original  copies  in  printed  paper  covers  are  filmed 
beginning  with  the  front  cover  and  ending  on 
the  last  page  with  a  printed  or  illustrated  impres- 
sion, or  the  back  cover  when  appropriate.  All 
other  original  copies  are  filmed  beginning  on  the 
first  page  with  a  printed  or  illustrated  impres- 
sion, and  ending  on  the  last  page  with  a  printed 
or  illustrated  impression. 


The  last  recorded  frame  on  each  microfiche 
shall  contain  the  symbol  -^(meaning  "CON- 
TINUED "},  or  the  symbol  V  (meaning  "END"), 
whichever  applies. 


Les  exemplaires  originaux  dont  la  couverture  en 
papier  est  imprim6e  sont  film6s  en  commenqant 
par  le  premier  plat  et  en  terminant  soit  par  la 
dernldre  page  qui  comporte  une  empreinte 
d'impresslon  ou  d'illustration,  soit  par  le  second 
plat,  selon  le  cas.  Tous  les  autres  exemplaires 
originaux  sont  film6s  en  commenpant  par  la 
premidre  page  qui  comporte  une  empreinte 
d'impresslon  ou  d'illustration  et  en  terminant  par 
la  dernidre  page  qui  comporte  une  telle 
empreinte. 

Un  des  symboles  suivants  apparaftra  sur  la 
dernidre  image  de  cheque  microfiche,  selon  le 
cas:  le  symbole  — ►  signifie  "A  SUIVRE",  le 
symbole  V  signifie  "FIN  ". 


iVIaps,  plates,  charts,  etc.,  may  be  filmed  at 
different  reduction  ratios.  Those  too  large  to  be 
entirely  included  in  one  exposure  are  filmed 
beginning  in  the  upper  left  hand  corner,  left  to 
right  and  top  to  bottom,  as  many  frames  as 
required.  The  following  diagrams  illustrate  the 
method: 


Les  cartes,  planches,  tableaux,  etc.,  peuvent  dtre 
film6s  d  des  taux  de  reduction  diffdrents. 
Lorsque  le  document  est  trop  grand  pour  dtre 
reproduit  en  un  seul  cliche,  il  est  film6  d  partir 
de  Tangle  sup6rieur  gauche,  de  gauche  d  droite, 
et  de  haut  en  bas,  en  prenant  le  nombre 
d'Images  n^cessaire.  Les  diagrammes  suivants 
iilustrent  la  mithode. 


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NEW 

WAEEEN'S 


HOUSEHOLD  PHYSICIAN, 


ENLAKGED   AND   KEVISED, 

BGIirO   A 

BBIEF  DESCEIPTION,  IN  PLAIN  LANGUAGE, 


or  AUiTHX 


Diseases  of  Men,  Women  and  Children, 

WITH  THB 

LATEST  AND  MOST  APPROVED  METHODS  OF  TREATMENT. 


ALLOPATHIC  DEPARTMENT 
/ 

IRA  WARREN,  A.M.,  M.D., 

Pellow  of  the  Maiiachuietts  Meilical 
Society,  etc. 

BEVIgBD  BT 

WILLIAM  THORNDIKE,  M.D., 

fellow  of  Mansachusetts  Medical  Society,  and 

Member  of  Boston  Society  for  the  Improve- 

ment  of  Medicine,  etc.,  and  others. 


HOM(EOPATHIC    DEPARTMENT 

A.  E.  SMALL,  A.M.,  M.D., 

President  of  the  Hahnemann  Medical 
College,  Chicago,  111. 

BEVI8ED  BT 

J.  HEBER  SMITH,  M.D., 

Professor  of  Materia  Medica.  Boston  University 

School  of  Medicine,  and  laie  President  of  Ma»- 

lachusetts  Homaopathio  Society, 


And  insny  others  on  special  subjects. 


FULLY  ILLUSTRATED. 


By  86  Figures  on  i6  Splendid  Colored  Lithograph  Plates,  262  ENk^KAviNGs,  and 

Two  Full-Page  Manikins. 

TAit  ieok  is  published  strictly  as  a  Suhtcription  Book,  and  to  he  sold  only  as  such,    A  ny  person  or 
persons  infringing  upon  these  rights  will  be  held  liable. 

THB  RIOHT  OF  TRANSLATION  IS  RESERVED. 


BOSTON : 
A.  I.  BRADLEY  &  COMPANY, 

234  AND  236  COMORBM  STBBBT, 

1898. 


\mmmm^ 


'■'-■''■' •''iiiirfiiiahii'fn    1'"' 


TW.Wnrs  ffKEfVED 


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:^57;5 


Entered  occonling  to  Act  of  Congreu,  in  the  year  1859,  by 

IRA  WARREN, 

In  the  Clerk's  Office  of  the  District  Court  of  the  DIf  trict  of  Man. 


Entered  according  to  Act  of  Congreis,  in  the  year  1(63,  by 

IRA  WARREN, 

In  the  Clerk's  Office  of  theDistrlctCourt  of  the  District  of  Mass. 


Entered  according  to  Act  of  Congress,  In  the  year  1870,  by 

CHARLES  ROBINSON,  JB., 
In  the  Office  of  the  Librarian  of  Congrers,  at  Washington. 

Entered  according  to  Act  of  Congress,  in  the  year  1885,  by 

CHARLES  ROBINSON,  JR., 
In  the  Office  of  the  Librarian  of  Congress,  at  Washington. 

Entered  according  to  Act  of  Congress,  in  the  year  1880,  by 

CHARLES  ROBINSON,  Jr.. 
In  the  Office  of  the  Librarian  of  Congress,  at  Washington. 

Entered  according  to  Act  of  Congress,  ir  the  yaar  1807,  by 

GEO.  A.  BLANEY,  Admstr.  Estate  of  Ira  Warren, 
In  the  Office  of  the  Librarian  of  Congress,  at  Washington. 


KIOBT  OP  TRANSLATION  IB  RESERVED. 


This  work  Is  published  strictly  as  a  Subscription  Book, 
and  to  be  sold  only  as  such.'  Any  person  or  persons  in- 
fringing upon  these  rights  will  be  held  liable. 


H.  M.  PLIMPTON  A  CO.,  PRIN-.ER8  A  BINDERS, 
NORWOOD,  MASS.,  U.S.A. 


PEEPACE. 


This  book  is  written  for  the  people.  It  is  based  on  the  assump- 
tion that  every  man  — the  mechanic,  the  farmeiMind  the  day  laborer, 
as  well  as  the  professional  man  — has  a  right  to  all  the  knowledge 
he  18  capable  of  acquiring,  on  all  subjects,  —  medicine  not  excepted. 
1  he  book  aims,  therefore,  to  popularize  and  adapt  to  the  many  what 
Has  been  claimed  as  belonging  only  to  the  few. 

I  do  not  hesitate  to  avow  that  my  sympathies,  as  a  man,  are  with 
the  great  masses,  who  maybe  called  the  bone  and  muscle  of  the  race. 
Ihey  are,  in  the  main,  more  shrewd,  more  endowed  with  common 
sense,  more  simple  and  true  in  their  natural  instincts,  and  conse- 
quently less  perverted,  than  those  who  claim  more  refinement  and  a 
nigher  place  m  the  social  scale. 

"  ^n  men,"  says  Hippocrates,  one  of  the  great  fathere  of  medicine, 
"ought  to  be  acquainted  with  the  medical  art.  I  believe  that  knowl- 
edge ot  medicine  is  the  sister  and  companion  of  wisdom."  Such 
knowledge  would  shield  the  many  from  the  impositions  of  quackery. 
No  one,  I  venture  to  say,  who  reads  this  book  thoroughly,  will  be 
often  imposed  upon  thereafter  by  quack  nostrums,  or  quack  doctora. 
Jivery  man  s  physical  organization  is  his  own  ;  and  he  is  charged  with 
the  responsibility  of  taking  care  of  it.  To  do  this  properly,  he  needs 
knowledge  of  it;  and  to  withhold  this  from  him  is  another  form  of 
the  old  oppression,  which  decreed  knowledge  and  power  to  the  few, 
and  Ignorance  and  obedience  to  the  many. 

In  accordance  with  the  design  of  the  work,  it  has  been  written  in 
plain  simple  English,  and  brought  within  the  comprehension  of  all 
who  have  medium  powers  of  mind. 

In  preparing  this  book,  a  great  number  of  authors  have  been  care- 
tully  consulted,  to  whom  I  acknowledge  large  indebtedness;  yet  the 
work  is  not  a  mere  compUation.  In  dealing  with  each  disease,  I 
have  aimed  to  sketch  a  brief  pen-and-ink  portrait,  so  like  it  that 
every  reader  shall  know  the  original  whenever  he  sees  it;  and  then 
V  give,  in  the  fewest  words,  the  best  treatment. 
•  No  work  of  the  sort  has  ever  explained  the  reasons,  or  given  the 
whys  and  wherefores  of  medicine  to  anything  like  the  extent  of  this  : 
nor  has  any  one  been  so  extensively  illustrated.  The  engravings 
have  ^en,  with  fp-  exceptions,  done  expressly  for  this  work.  The 
colored  lithographs  and  manikins  are  inserted  at  great  expense,  and 
add  much  to  the  value  of  the  book. 

I.  W. 


SECOND  PREFACE. 


The  Household  Physician  was  written  in  the  belief  that  the  people  were 
ready  and  waiting  for  a  popular  medical  work  based  on  liberal  principles ; 
and  that  one  hundred  and  forty  thousand  copies  have  already  been  sold 
is  a  sufflciont  evidence  that  the  belief  was  well-founded  —  many  persons 
assuring  the  publishers  that  fifty  or  one  hundred  dollars  would  be  no  temptar 
tion  for  them  to  part  with  the  copy  they  have  if  they  could  not  obtain 
another.  Such  an  extensive  sale  of  so  large  a  book,  with  the  demand 
constantly  increasing,  shows  its  value. 

For  these  evidences  of  public  favor  the  Publishers  are  not  ungrateful  or 
unmindful  of  corresponding  duties  on  their  part.  A  chapter  is  now  added, 
therefore,  on  "Old  Age  and  its  Diseases,"  —  a  subject  never  before  intro- 
duced into  any  popular  treatise  on  medicine,  and  very  rarely,  indeed,  into 
any  medical  book.  Great  pains  have  been  taken  in  preparing  it,  and  we 
sincerely  hope  that  many  fathers  and  mothers  will,  in  future  years,  be 
kindly  remembered  in  consequence  of  the  suggestions  it  contains.  Also  a 
chapter  oa  new  popular  Gymnastics,  illustrated  with  many  cuts. 

The  Publishers. 


THIRD  PREFACE. 


The  Household  Physician,  now  so  well  known  throughout  the  English 
and  German-speaking  world,  again  appears  before  the  public,  printed  from 
entirely  new  plates,  revised  and  improved  in  accordance  with  the  progress 
of  medical  science  of  the  present  day. 

Old,  obsolete  matter  has  been  discarded,  and  only  those  methods  and 
remedies  of  olden  times  have  been  preserved  to  which,  though  numerous, 
recent  discoveries  have  found  nothing  superior. 

Much  new  information  has  been  added,  including  articles  on  Russian 
and  Turkish  baths  at  home.  Drowning,  and  on  Diseases  of  the  Nervous 
System  peculiar  to  modern  times.  The  illustrations  have  been  supple- 
mented by  fine  colored  plates  and  manikins  showing  the  arrangement  of  the 
various  organs  of  the  body,  the  muscles,  arteries,  veins,  and  nerves.  New 
colored  plates  of  medicinal  herbs  have  also  been  added,  thus  giving  a  dis- 
tinct idea,  not  only  of  the  pathological  seat  of  many  maladies,  but  of  many 
of  the  sources  from  whence  are  derived  their  specific  remedies. 

The  prescription  list  has  been  most  carefully  revised,  and  the  old  heroic 
doses  of  opium  in  its  various  forms  have  been  superseded  by  milder  nar- 
cotics and  sedatives.  Mercury  no  longer  shows  its  hideous  features  on 
these  pages,  except  as  it  is  to  be  given  in  syphilitic  affections.  The  work 
now  airly  competes  in  rich  information  with  any  newer  system  of  popular 
medicine,  and  may  be  relied  on,  as  ever  before,  for  accuracy,  best  advice, 

aud  the  most  modern  medical  customs. 

The  Publishbbs. 


i 


TABLE   OF   CONTENTS. 


Preface ^      • 

General  Introductory  Remarks 

Anatomy 

Physiological  Laws  of  Life  and  Health  —  Hygiene 
Temperaments,  Constitution  and  Symptoms 

Skin  Diseases 

Diseases  of  the  Brain  and  Nerves 

Diseases  of  the  Throat 

Diseases  of  the  Chest  .... 

Heart  Diseases 

Diseases  of  the  Abdominal  Cavity 

Venereal  or  Sexual  Diseases 

Female  Diseases  .... 

Married  Ladies'  Perpetual  Calendar    . 

Care  of  Children  and  their  Diseases    . 

Diseases  of  the  General  System  and  MisceHaueous  Di 

Diseases  Peculiar  to  Modem  Times 

Old  Age  and  its  Diseases 

Accidents    ...... 

Surgical  Diseases         .... 

Homoeopathic  Treatment  of  Diseases  . 

A  Treatise  by  A.  E.  Small,  M.D. 

Diseases  of  the  Head    . 

Diseases  of  the  Brain  and  Nerves 

Diseases  of  the  Eye  and  Lids 

Diseases  of  the  Ear 

Disorders  of  the  Nose  . 

Diseases  of  the  Respiratory  Organs 

Diseases  of  the  Urinary  Organs    . 

Diseases  of  the  Organs  of  Generation 

Diseases  of  the  Skin 

Diseases  of  the, Organs  of  Circulation 

Diseases  involving  the  Various  Organs 

Diseases  of  Various  Organs  and  Regions 

Dropsies,  Hydropsies    .... 

Insidious  Diseases         .... 


seases 


L 


Paob 

3 

S 

14 

64 
122 
134 
164 
208 
229 
274 

'jm 

360 
379 
443 
445 
469 
493 
496 
509 
317 
608 
608 
613 
615 
622 
625 
62" 
628 
634 
638 
642 
651 
653 
665 
684 
686 


i 


TABLE  OF  CONTENTS. 

Homoeopathic  Treatment  (continued).  VAa* 

MiscellaneouH  Diueases 600 

Affections  of  the  Mind 692 

Surgical  Diseases 700 

Diseases  of  Infants 706 

,       DiBe<\8eH  of  Women 713 

Labor,  Parturition 716 

Speciflc  Indicr  aons  for  Remedies  in  Fevers         ....  720 

Poisons  and  their  Antidotes 726 

Processes  of  the  Hydropathic  Treatment     ..,,.*.  732 

Domestic  Management  of  the  Sick-Room 766 

Cookery  for  the  Sick-Room 789 

Dieting  in  regard  to  Health         .        .       ' 798 

Dieting  in  Disease 801 

Bathing 803 

Proofs  of  Death 807 

Medicines  and  their  Preparation^  —  Materia  Medica  ....  808 

Prescriptions — Recipes 920 

Proprietary  and  Patent  Medicines 944 

Physical  Culture  —  Gymnastics 960 

Pronouncing  Dictionary 961 

General  Index 965 

Index  to  Homoeopathic  Department  .        .        .        .        .        .        .  982 


LIST   OF  COLORED  AND   FULL-PAGE  PLATES. 


Portrait  of  Dr 

Plate  I. 

II. 

"  III. 

IV. 

"  V. 

"  VI. 

VII. 

"       VIII. 

"  IX. 

»'  X. 

«'  XI. 

"  XII. 

XIII. 

"        XIV. 

XV. 

"        XVI. 

"      XVII. 

"    XVIII. 

"        XIX. 


.  Ira  WaiTen 

Sectional  Manikin  of  Human  Head 
The  Human  Skeleton    .        .        .        . 
Muscles  of  the  Human  Body 
Arteries  and  Veins  of  the  Human  Body 
Fig.  1,  Measles  ;  Fig.  2,  Scarlet  Fever 

Small-Pox 

Erysipelas 

Sectional  Manikin  of  Human  Trunk 
Internal  Organs  of  Human  Body  . 
Syphilitic  Eruptions 
Syphilitic  Affections  of  Throat 
Medicinal  Plants  (Aloes,  etc.) 

"  "      (Bittersweet,  etc.) 

"  "      (Dandelion,  etc.) 

"  "      (Ground  Ivy,  etc.) 

"  "      (Hemlock,  etc.) 

"  "      (Mullein,  ete.) 

"  "      (Plantain,  etc.) 

"  "      (Thoroughwort,  etc.) 


Frontispiece. 

Facing  Preface. 

.      p.  19 

Facing  p.    27 

37 


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"  840 

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699 
700 
706 
718 
716 
790 
796 
789 
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780 
796 
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Copyright,  by  Bradley  &  Woodruff,  1892. 


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IK'J 


GENERAL  INTRODUCTORY  REMARKS. 


Progress  of  Medicine. 

Medicine  may  be  divided  into  a  science  and  an  art.  It  is  a  science 
as  it  presents  facts  and  evolves  principles ;  an  art  as  it  consists  of 
rules  for  practice.  For  its  present  attainments,  it  is  indebted  partly 
to  researches  scientifically  conducted,  and  partly  to  empirical  and 
haphazard  discovery. 

As  a  science,  medicine  is  chiefly  indebted,  and  must  ever  be,  to  the 
members  of  what  is  called  the  "  regular  profession."  This  body  of 
men,  while  it  contains  numerous  persons  whose  talents  and  attain- 
ments do  not  raise  them  above  the  mei'est  quacks,  does  yet  embrace 
large  numbers  of  men  who  are  alike  ornaments  of  the  race,  and  lights 
of  their  profession.  It  is  to  the  writings  of  this  class  that  every  stu- 
dent must  go  who  would  qualify  himself  for  the  proper  discharge  of 
the  duties  of  a  physician ;  and  he  who  attempts  the  practice  of  medi- 
cine without  a  knowledge  of  standard  medical  writings  is  either  a 
fool  or  a  knave  —  either  without  the  brains  to  understand  science,  or 
destitute  of  the  honesty  to  deal  fairly  with  men. 

While  this  is  said,  however,  it  must  be  granted  that  a  respectable 
portion  of  the  facts  which  make  up  the  science  of  medicine  have  been 
contributed  by  the  industry  of  men  who  have  not  had  what  is  called 
a  regular  standing  in  the  profession.  I  am  sorry  to  be  obliged  to  add 
that  the  great  body  of  this  class  have  been  quacks  and  charlatans, 
while  only  a  few  of  them  have  had  talents  and  acquirements. 

Nevertheless,  they  have  been  too  indiscriminately  condemned. 
Their  labois  have  been  useful  in  various  ways,  and  have  contributed 
to  the  advancement  of  medical  knowledge.  A  regard  for  truth,  not 
less  than  justice  to  these  persons,  requires  this  statement. 

One-Idea  Men. —  The  "  irregulars,"  as  they  have  been  called,  have 
generally  had  their  hobbies,  which  they  have  ridden  with  singular 
diligence,  and  often  in  little  better  than  John  Gilpin  plight.  Yet  they 
have  di-awn  attention  to  great  truths,  which  the  regular  profession 
either  did  not  see,  or  would  not  commend  ;  and  they  have  done  this 
by  dwelling  incessantly  upon  some  single  idea. 

The  one-idea  men,  of  every  class,  have  been  ridiculed  in  all  ages  ; 
and  indeed  have  always  exhibited  some  singular  obliquities.  Yet 
when  they  have  been  men  of  learning  and  talents,  they  have  accom- 
plished great  things,  either  for  good  or  evil. 


\' 


mm 


0  -  OENKKAI,    INTRODUCTOKY    KKMAUKS. 

Martin  Luther  was  strictly  fv  one-idea  man.  The  wliolo  forro  of 
liis  extraordinary  eharactor  was  jriventothe  ()r()|)ajfation  of  the  sinjirlo 
doctrine  of  justification  by  faith;  and  by  the  incessant  efTortH  he  made 
for  this  purpose,  ho  sank  the  doctrine  deeper  into  the  heart  of  Europe 
than  a  hundred  ecpially  powerful  men  could  have  done  by  giving  it 
only  an  ordinary  share  of  attention. 

William  Ellery  ('banning  was  a  one-ideaist.  Matu  the  noblest 
work  of  creation,  to  be  developed,  educated,  adorned,  loved,  made 
like  unto  (iod,wa8  the  thought  of  his  life,  —  a  thought  which  ho  em- 
bellished and  moulded  into  all  the  forms  of  beauty  which  our  flexible 
language  is  capable  of  producing.  Under  the  mild  promptings  of 
his  genius,  and  the  workings  of  this  thought,  philanthropy,  quick- 
ened into  a  new  life,  spread  out  her  aims,  and  embraced  the  world. 

Sir  Isaac  Newton  was  a  one-ideaist.  So  entirely  did  he  devote  his 
great  powers  to  astronomy  and  the  liigher  mathematics,  that  he  be- 
came unfitted  for  the  duties  of  social  and  domestic  life  —  so  unfitted, 
that  when  induced  by  his  friends  to  give  a  little  attention  to  courtship, 
he  fell  into  one  of  his  abstractions,  and  detected  himself  in  using  his 
lady-love's  fore-finger  to  poke  down  the  ashes  in  his  pipe  I  But  Sir 
Isaac  advanced  mathematical  science  to  a  point  far  beyond  its  previ- 
ous attainments,  and  laid  it  under  such  obligations  as  no  general 
scholar  could  have  done. 

It  is  in  this  way,  though  in  a  vastly  less  degree,  and  without  tlie 
scientific  method,  that  one-ideaists  in  medicine  benefit  the  world. 
They  seize  upon  some  single  remedy,  —  generally  one  which  has  been 
overlooked  —  and  using  it  themselves  to  the  exclusion  of  all  others, 
they  press  it  upon  the  world  as  the  panocba  for  all  its  ills.  With 
them  disease  is  a  unit,  and  they  have  found  its  one  all-important 
remedy.  Thus  convinced,  they  jn-ess  it  upon  others  with  the  enthu- 
siasm of  fanatics.  Testing  it  in  all  cases,  they  develop  all  its  virtues. 
Those  who  have  the  good  sense  to  turn  their  attention  to  it  have 
only  to  use  it  in  those  cases  for  which  its  adaptation  is  proved. 

It  is  in  this  way  that  these  men  become,  incidentally,  medical  dis- 
coverers ;  and  not  being  burdened  with  modesty,  they  never  with- 
hold their  importunities  till  the  world  acknowledges  whatever  value 
there  is  in  their  discovery.  And  although  they  may  do  some  mis- 
chief with  the  single-edged  tool  which  they  handle  so  industriously,  I 
doubt  if  they  do  much  more  than  many  better  workmen  who  use  too 
many.  At  all  events,  wise  and  generous  men  thank  them  for  their 
gift  to  the  profession,  small  though  it  may  be,  and  use  it  in  the  light 
of  a  clearer  knowledge. 

Hydropathy.  —  As  an  illustration  of  what  I  have  just  been  saying, 

1  may  refer  to  hydropathy,  or  the  plan  of  treating  all  diseases  by  water. 

The  singularly  careful  avoidance,  by  the  whole  medical  faculty,  for 
many  ages,  of  the  article  of  pure  water  as  a  medicinal,  or,  rather, 
health-imparting  agent,  was  anything  but  creditable  to  the  profession. 

It  is  now  admitted  by  all  sensible  men  that  water,  cold  and  warm, 


ORNKRAF,    INTRODUCrORY   RKMARK8. 


0  force  of 

tllU  Hlll^lo 

tH  he  inadu 
of  Europe 

1  giving  it 

lio  noblest 
ved,  made 
ich  ho  em- 
lur  flexible 
nptings  of 
ipy,  quick- 
ie world, 
devote  his 
hat  he  be- 
io  unfitted, 
•  courtship, 
a  using  his 
I     But  Sir 
d  its  previ- 
no  general 

irithout  tlie 

the  world, 
ch  has  been 
E  all  others, 
ills.  With 
ll-important 
t  the  enthu- 

its  virtues. 

to  it  have 
roved. 

medical  dis- 
never  with- 
itever  value 
3  some  rais- 
ustriously,  I 

who  use  too 
era  for  their 

in  the  light 

been  saying, 
868  by  water. 
1  faculty,  for 
1,  or,  rather, 
\Q  profession, 
d  and  warm, 


used  at  jH-oper  times  and  to  a  reasonable  extent,  huH  great  power  over 
several  diseases,  and  is  a  powerful  promoter  of  li'eiilth.  No  physiinaiis, 
except  those  who  arc;  too  ii  lolciit  to  know  what  is  going  on  in  the 
world,  or  too  fast  lu(;k(!d  in  old  pnijudicos  to  touch  new  things,  now 
oniit  ita  use  in  tmujf  cases,  I  low  warm  anctsincere  my  own  approval 
of  water  iw  a  r  nedy  is,  almost  every  page  of  this  volume  will  attest. 

Indeed,  it  may  honestly  be  allowed  that  the  hydropathists  have 
fairly  droicni'd  the  almost  criminal  professional  prejudice  against 
water.  They  are  in  all  tlio  more  need  of  this  (concession,  since  in 
their  absurd  zeal  to  cure  all  diseases  l)y  water,  and  make  aquatic;  an- 
imals of  men,  they  have  also  drowned  their  own  common-sense. 

Homoeopathy — This  mode  of  practice  is  of  comparatively  recent 
origin  ;  but  it  has  already  sunk  itself  deep  into  the  popular  heart, 
and  has  drawn  to  its  support  many  of  the  wealthy,  the  cultivated, 
and  the  intelligent,  in  our  most  refined  communities.  I  do  not  pro- 
fess to  comprehend  and  appreciate  its  principles,  nor  would  it  bo 
honest  in  me  to  pretend  to  see  how  its  infinitesimal  doses  can  pro- 
duce the  results  which  it  often  shows,  and  which  it  is  fair  to  confess 
look  like  singular  success ;  and  saying  this,  I  can  neither  adopt  nor 
approve  the  violent  denunciations  and  censures  which  so  many  are 
induced  (by  fashion,  I  fear)  to  employ  towards  this  generally  well- 
cultivated  class  of  practitioners.  I  hold  them  as  useful  members  of 
the  profession,  and  mean  ever  to  cultivate  towards  them  fraternal 
feelings.  They  give  great  attention  to  exercise,  diet,  the  use  of 
water,  etc.,  —  things  which  contribute  very  powerfully  to  preserve 
health,  and  to  restore  it  when  lost.  In  this  thing,  the  oUUchooI 
practitioners  ought  to  learn  a  most  important  lesson  from  them.  In 
truth,  they  are  learning  it,  but  very  slowly  and  reluctant! i/,  I  am 
sorry  to  say. 

The  centml  idea  of  the  homoeopathist,  that  "  like  cures  like,"  the 
"  great  law  of  cure,"  as  he  styles  it,  I  do  not  feel  called  upon  to  dis- 
cuss—  theories  being  of  much  less  consequence  than  rules  of  prac- 
tice. The  old-school  men  have  certainly  much  to  learn  from  him 
respecting  the  augmented  power  of  medicine  from  the  greatest  possi- 
ble division  by  trituration.  We  have  learned  from  him,  too,— 
though  many  are  too  ungenerous  to  confess  the  source  of  the  infor- 
mation, —  that  we  may  gain  our  purposes  with  much  less  medicine 
than  we  were  once  in  the  habit  of  giving. 

Eclectics. —  There  is  a  large  and  growing  class  of  physicians,  called, 
at  first,  after  the  founder  of  the  school,  Thomsonians.  Subsequently, 
they  were  generally  known  as  Botanic  Physicians.  Now  they  pass 
under  the  title  of  Eclectics. 

These  men,  directing  their  attention,  at  first,  chiefly  to  cayenne 
and  lobelia,  have  gradually  extended  their  zealous  researches  over 
the  vegetable  kingdom,  and  have  gathered  much  information  worthy 
to  be  preserved.  These  researches  have  revealed  a  sadly  neglected 
duty  on  the  part  of  old-school  practitioners. 


TS^ 


WT^^^^S?*?***" 


I 


8  OKNERAL  INTUODUCTORY    RRMAKKS. 

Tho  iHlncatioi)  niid  tiiltMitM  of  tliiH  cIohh  of  pnictitioiuM'H  have  grad- 
ually risen,  year  by  ^ear,  until  tliey  liavo  Heveral  medical  hcIiooIh, 
where  HliidenU  an;  well  inHtrueted  in  the  principles  of  ni(;(li(Mne,  hy 
men  of  real  ahility.  They  have  also  a  liUiraturr  of  no  mean  si^ni- 
ticance,  espceially  in  the  department  of  materia  niedieu.  The  liut 
of  renjcdies  they  liavo  ffivnn  to  the  w(»rld,  drawn  from  our  home 
plantH,  are  a  l>oon  of  no  small  value.  I  regard  them  an  equal  in 
value  to  all  we  were  previounly  in  possession  of  from  the  vegetable 
kingdom.  The  sulwtitution  of  'ngetiible  remedies,  in  most  ciiHes, 
for  mercurials,  can  hardly  be  too  highly  prized. 

Physiologists. —  Besides  these  various  direct  privctitionera  of  medi- 
cine, there  is  the  large  and  (}uite  intelligent  :;laH8  of  physiologists, 
including  the  phrenologista,  who  nearly  discard  medicine,  and  ai>- 
pealing  to  the  laws  of  life  established  by  the  (Creator,  urgt  temper- 
ance in  eating  and  drinking  ;  exercise  in  the  oj)en  air ;  securing  of 
pure  air  by  ventilating  dwellings,  school-houses,  and  (ihurches ;  lath- 
ing in  cold  and  wa'-m  water;  cheerfulness  of  mind  ;  and  the  cultiva- 
tion of  tlie  Christian  virtues,  as  the  only  mtional  modes  of  securing 
health  and  life. 

I  confess  myself  inclined  to  forgive  this  class  their  error  in  Ikvu- 
ishing  medicine,  in  view  of  their  zeal  and  success  in  disseminating 
hygienic  information  of  the  utmost  value  and  importaiice  to  man- 
kind. Put  man  into  harmony  with  nature,  and  establish  over  him 
the  empire  of  reason,  and  their  theory  would  be  excellent;  but  as 
tilings  are,  medicines,  like  prisons,  and  alms-houses,  and  large  cities, 
are  "  necessary  evils." 

Other  Practitioners. —  Finally,  we  have  Mesmerists,  Pathetists, 
Electro-biologists,  Spiritualists,  Nutritivists,  and  what  not,  all  pre- 
tending to  cure  disease  by  processes  peculiar  to  themselves.  They 
are  all  experimenters  in  different  departments  of  nature,  —  now 
spreading  over  oiir  eyes  a  large  plaster  of  humbuggery,  and  now 
drawing  a  small  curtain  and  giving  -us  a  peep  into  the  large  and 
well-furnished  rooms  which  nature  has  fitted  up  for  our  reception,  b}' 
and  by,  when  we  are  better  instructed. 

All  Useful  in  a  Degree. —  On  the  whole.  I  am  disposed  to  regard 
all  the  operators  in  the  different  departments  of  medicine  a*  useful 
in  their  degree  ;  excepting  always  those  mercenary  quacks,  who  lie 
about  their  remedies  to  make  money.  Each  of  all  these  (I  mean  all 
sincere  and  true  men  who  believe  what  they  teach)  is  aiding  in  some 
measure  the  general  advancement.  And  though  the  truths,  as  they 
gather  and  present  them,  are  but  fragmentary,  they  are  useful  in  the 
hands  of  those  true  Eclectics,  who  have  the  wisdom  and  independence 
to  select  the  best  things  out  of  all  systems. 

General  Conclusion. —  This  brings  me  to  remark  that  there  is  but 
one  truly  libera'  and  piulosoTjlvical  school  oi  medicine.  It  is  the  Ec- 
lectic, —  composed  of   those  who  have  liberality  enov  gh  to  reject 


rM 


niNKKAI,    r».TKOI)trCTOUY    KKMARKS. 


9 


prnvd- 
iooIh. 
e,  1>.V 

i     \\ni 

home 
ml  ill 
i  table 
caseH, 

medi- 
ogiste, 
lul  a\y- 
iMuper- 
ring  of 

;  bath- 
•ultiva- 
3curing 

in  l)an- 
linating 
to  man- 
VQV  him 
but  as 
e  cities, 

.thetists, 
till  inv- 
They 
now 
nd  now 
r^e  and 
)tion,  by 

lo  regard 
|ih  useful 
who  lie 
Imean  all 
in  some 
L  as  they 
lul  in  the 
pendence 

tre  is  but 
Is  the  Ec- 
Ito  reject 


(•very  frcliifiiu'  iii/iiti'm,  and  to  Hulect  out  of  all  HyHteins  thone  thingH 
vvliicli  iiH'  a|i|iroved  by  t'xpcrionce  and  reason. 

I  liave  alrrady  Hpokcn  (if  the  school  of  practitionei's  callt'd  KchHttic. 
To  a  certain  extent  tliey  an*  (entitled  to  tlu*  name,  but  I  tliink  not 
entirely.  They  have  formed  a  separate  and  exclusiv»t  Hcbool.  They 
have  turned  some  articles  out  of  the  materia  medica  /loioti/ili/  for  no 
letter  reasoji  than  iM'cause  their  jiarty  is  conunitted  to  th.ar  rejec- 
tion ;  whereas  tliey  should  have  no  party,  but  allow  each  man  to  act 
as  if  he  were  a  citizen  of  the  world  only,  and  not  a  member  of  any 
restricttnl  association.  But  I  will  not  ([uarrel  with  them  on  this 
point.     I  think  they  are  hefoinin</  .  .dectic. 

Progress  of  Medicine. —  There  :;.  ra  been  long  periods  when  the 
science  and  the  art  of  mcdiciiu'  made  scarcely  any  i)rogress.  They 
are  now  advancing,  —  in  sonu!  departments  quite  rapidly. 

The  Chemistry  of  Man,  commonly  called  Animal  (.'hemistry,  is 
opening  new  sources  of  light. 

The  writer  was  in  the  habit  of  asserting,  many  yeai-s  ago,  that 
most  of  the  true  progress  in  mediiune  must  come  through  Animal 
('hemistry;  and  the  developments  of  the  last  few  yeare  Imve  made 
good  the  assertion.  Liebig,  a  diligent  student  in  chemistiy,  has  done 
much  to  open  the  way  for  inquirei-s  in  this  department.  Simon  has, 
per'iaps,  done  nmre.  Mialhe  is  a  yet  later  explorer,  and  has  made 
valuable  discoveries. 

The  result  is  that  students  have  now  before  i.  ^ir  minds,  and  are 
endeavoring  to  solve  and  act  upon  as  fast  as  possible,  inquiries  and 
propositions  like  these  :  — 

What  is  the  chemical  composition  of  the  solids  and  fluids  of  the 
healthy  human  body  ? 

What  is  the  nature  of  the  changes  which  occur  in  the  composition 
of  the  solids  and  fluids  during  disease? 

What  alterations  in  the  chemical  composition  of  the  solids  and 
fluids  take  place  during  the  operation  of ,  medicines  ? 

Before  it  can  exert  any  remote  action  on  the  animal  economy,  a 
remedy  must  be  absorbed. 

Before  it  can  be  absorbed,  it  must  be  soluble  in  the  fluids  of  the 
living  body. 

Medicines  are  subject  to  chemical  changes  during  their  passage 
through  the  system. 

These  changes  are  regulated  by  ordinary  chemical  laws,  and  may 
therefore,  to  some  extent,  be  foretold  and  made  available  in  the  cure 
of  disease. 

These  chemical  laws  are  disturbed  and  varied,  to  some  extent,  by 
the  law  of  vitaliuy, — just  as  the  magnetic  needle  is  made  to  vary  by 
disturbing  forces. 

What  are  those  disturbances,  and  to  what  extent,  and  under  what 
circumstances,  dc  ';hey  occur? 

With  these  and  similar  inquiries  and  propositions  before  his  mind. 


10 


fihNERAL   INTRODUCTORY    REMARKS. 


diligently  studied,  a  iniui  will  in  time  learn  tt>  picsciil)u  with  sonic 
intelligent  aim.  Me  will  not  know  'everything,  to  be  sure,  but  what 
he  does  know,  he  will  have  a  reason  for  knowing.  If  he  give  a 
medieine,  he  will  have  in  view  the  el  emieal  (dianges  of  the  solids 
and  llnids  of  the  body,  known  to  be  produced  by  the  disease  he  is 
combating.  He  will  also  kee]>  in  mind  the  solution  of  the  medicine 
in  the  fluids  of  the  body,  and  the  chemical  reaction  between  its  com- 
ponents and  the  acids,  alkalies,  etc.,  found  in  the  alimentary  tube 
and  elsewhere. 

As  the  science  of  medicine  advances,  and  becomes  liberal  and  ec- 
lectic in  its  character,  gathering  from  all  systems  the  best  attested 
facts,  and  using  them  to  the  exclusion  of  all  mere  theories,  these 
facts  must  not  themselves  degenerate  into  mere  pettsd  theories,  but 
must  be  held  in  subordination  to  future  experience.  Medical  prac- 
titioners, who  would  meet  the  wants  of  the  age,  must  be  men  of 
progress.  The  light  of  to-morrow,  with  them,  must  nKwlify  and  im- 
prove the  light  of  to-day.  They  rv  iit  knock  CN'ery  hour  for  admis- 
sion into  sqme  new  apartment  of  nature. 

Need  of  Liberality.  —  That  medical  progress  may  be  real,  physi- 
cians mu3t  be  free  from  bigotry.  They  must  have  no  narrow  preju- 
dices against  any  man,  or  class  of  men ;  but  be  ready  to  examine 
candidly  any  new  thought  or  new  remedy  brought  to  their  notice, 
from  whatever  source  it  may  come. 

They  should  not  hedge  themselves  about  with  such  restrictive  by- 
laws and  Bocietiiry  rules  as  are  calculated  to  fetter  their  thoughts, 
and  turn  their  investigations,  by  a  sort  of  moral  necessity,  into  the 
narrow  channels  of  party  conservatism ;  remembering  that  he  who  is 
once  enclosed  by  such  restrictio'.is  must  hew  a  path  for  his  feet 
through  bigotry,  and  even  malevolence  itself,  before  he  can  escape 
them,  or  be  a  free  man  in  any  node  sense. 

The  members  of  medical  societ'.es  do  themselves  no  credit,  in  the 
nineteenth  century,  by  putting  on  airs,  and  telling  others  to  stand  at 
a  distance.  This  Avould  do  better,  had  medicine  become  an  exact 
science  ;  but  while  the  primary  effects  of  even  opium  are  not  settled 
—  some  physicians  considerint^  it  as  ^irimarily  stimulant,  others  as 
sedative,  others  as  stimulant  to  tl^e  nerves  and  sedative  to  the 
muscles,  others  as  neither,  and  still  c  thers  as  alterative,  —  such  ex- 
clusiveness  seems  neither  wise  nor  modest.  When  the  professors  of 
the  iiealing  art  can  hoard  medical  knowiedgre  as  misers  hor>rd  gold, 
and  can  submit  its  purity  to  equally  certain  tests,  it  will  appear  in 
better  taste  for  them  to  grow  exclusive.  Until  then,  the  most  be- 
coming badge  they  can  wear  is  the  Christian  direction  :  "  Let  each 
esteem  others  better  than  himself." 

Medical  societies,  with  liberal  by-laws,  are  fitted  to  do  good ;  but 
it  would  be  hard  to  show  that  those  with  stringently  restrictive  '"lies 
can  operate  otherwise  than  as  checks  upon  progress.  In  truth,  they 
are  apt  to  become  mere  catacombs  in  which  to  embalm  dead  ideas . 


^Mm 


GKNKRAIi   INTKOUUCTORY    KEMARK8. 


11 


3od;  but 

live  ■^'iles 

ith,  tliey 

id  ideas. 


They  are  very  liable  to  Im  made  the  instruments  for  iwcoinplishiiig 
the  ambitious  purposes  of  a  few  leading  men.  They  tenil  to  suppress 
all  sympathy  with  everything  outside  their  orgauization  ;  and  they 
Ijeget  a  feeling  like  that  which  would  forbid  the  lixed  stars  to  drop 
their  light  into  our  atmosphere  without  first  coming  down  and  joining 
the  solar  system. 

Conservative  Leaders.  —  There  are  no  influences  which  hold  so 
steady  a  check  upon  medical  progress  as  the  conservative  leaders  in 
many  of  our  medical  association  ,  Not  that  they  are  oi)posed  to  im- 
provement in  the  medical  art,  t  /ould  object  to  any  amount  of  dis- 
covery, if  it  could  come  to  the  profession  through  channels  which  they 
have  the  honor  of  opening.  But  against  all  light  from  outside,  or 
from  obscure  sources,  they  will  draw  down  the  curtains,  and  close  the 
doors ;  and,  if  it  chance  by  any  means,  in  spite  of  them,  to  get  within 
the  sacred  enclosure,  they  will  call  it  darkness,  and,  as  priests  of  the 
temple,  will  attempt  to  atone  for  the  indignity  offered  to  the  god  of 
medicine,  and  fill  the  whole  sky  with  murky  clouds  from  their  altivrs. 

These  men  have  strong  faith  in  caste,  and  in  the  right  of  the  few 
to  govern  the  many.  In  the  low  places  of  society,  they  look  for 
nothing  but  ignorance  and  poverty.  Notwithstanding  that  the  light 
of  every  natural  day  breaks  in  the  horizon,  and  ascends,  they  so  far 
despise  analogies  as  to  insist  that  all  medical  light  breaks  at  what 
they  call  the  zenith  of  the  profession,  and  comes  dovm.  With  them 
the  temples  of  Esculapius  are  all  rebuilt,  and  tLcy  are  the  priests ; 
and  to  offer  in  sacrifice  the  smallest  medicinal  plant  is  a  sacrilege, 
unless  it  be  entrusted  to  their  hands. 

Such  persons  measure  and  weigh  a  man  by  the  amount  of  money 
he  has.  Property  is  their  god,  which  gives  laws  to  everything. 
With  them,  knowledge,  like  property,  goes  to  posterity  by  will,-  — 
they  being  the  principal  testators.  Like  their  money,  t'  \  it  goes 
chiefly  to  their  sons,  and  to  certain  favored  institutions,  by  .vhoni  and 
in  whicli  it  is  to  be  hoarded,  and  whence  it  is  to  go  out  only  ux  certain 
appi'oved  channels,  weighed  and  stamped,  like  coin  from  the  mint. 

These  are  the  men  who  regard  knowledge  as  a  contraband  article, 
unless  regularly  entered  at  the  custom-house,  with  bills  of  lading 
properly  certified  by  the  conservative  magnates  at  some  other  me- 
tropolis. With  them,  knowledge  is  not  like  the  west  wind,  fanning 
the  brow  of  the  peasant  as  gently  as  that  of  the  king  —  not  like  the 
light  of  heaven,  entering  the  small,  clean  window  of  the  hut,  as 
readily  as  the  larger  one  of  the  palace  ;  not  a  boon  which  comes  alike 
freely  to  all,  and  which  is  to  be  everywhere  amplified,  changed  sus 
circumstances  and  conditions  require,  and  especially  adapted  to  the 
present  hour.  It  i,?  rather,  as  they  too  often  view  it,  like  litho- 
jrraphed  letters  '-i  advice,  printed  upon  stamped  paper,  and  carefully 
sealed  up  and  addressed  to  posterity.  And  then,  if  they  can  be 
made  the  mail  carriera,  and  be  permitted  to  pass,  unchallenged,  with 
the  precious  bag,  from  post  to  post,  and  pass  it  over,  carefully  sealed, 


II!  "Til 


■     '■. 


12 


(iENEKAL   INTKOnUCTOllY    RKMAKKS. 


to  the  next  generation,  they  will  think  it  has  done  its  work,  and  that 
they  have  fulfilled  their  mission. 

I  would  not  be  unjust  or  severe,  but  I  cannot  but  remark  fui-ther, 
that  these  men  present  but  one  view  of  humanity.  They  are  monot- 
onous objects  of  inspection.  Look  at  them  a  thousand  times,  and 
you  see  only  the  same  unaltered  phase  of  life.  To  the  mariner  on 
life's  ocean,  they  are  not  safe  lights.  If  he  approach  them  on  the 
dark  side  they  remain  black  as  night  to  him,  until  he  comes  round  to 
their  shining  front.  Th^y  are  not  revolving  lights.  They  have 
light :  it  may  be  bright  and  genial ;  but  it  gleams  out  upon  the 
watei-s  only  in  one  direction.  It  does  not  sweep  round,  and  throw  its 
rays  upon  every  mariner's  path. 

Such  men  are  useful,  but  only  to  a  certain  class.  They  have  in 
them  no  true  omnilogy  —  they  are  not  all-teaching.  Their  lives  are 
ins  ructive  to  their  friends,  their  clique,  their  party,  their  school ; 
but  a  stumbling-block,  a  hindrance,  an  oppression,  an  offence  to  evei-y- 
body  else.  They  are  like  porcupines,  with  fronts  smooth  and  easy 
of  access ;  but  their  backs  bristle  with  quills  to  stick  into  those  on 
the  wrong  side.  They  are  not  whole  men.  Humanity  has  infused 
into  them  only  one  or  two  of  its  elements.  They  have  length,  but  no 
breadth.  They  are  citizens  of  Boston,  New  York,  Philadelphia,  or 
Cincinnati,  but  not  of  the  world.  Within  certain  circles,  they  are 
genial  friends,  but  cynics  and  haters  outside  of  them  From  their  high 
places  they  come  down  to  their  humble  followeid  with  tokens  of 
friendly  recognition  ;  upon  others  they  frown  and  lower  like  armed 
castles. 

The  True  Physician. — How  different  the  character  of  the  true  man 
and  physician !  He  is  genial  in  his  disposition.  He  has  no  dislikes 
and  antipathies,  and  hates  no  men  except  tyrants.  He  accepts  knowl- 
edge, though  it  come  from  the  humblest  source  ;  believing  th(  ve  is  no 
experience  but  will  repay  a  study  of  it,  and  no  husbandman's  plough- 
share but  turns  up  a  soil  worth  analyzing.  He  belongs  exclusively 
to  no  party,  and  can  be  approached  easily  by  respectable  men  of 
every  stamp.  Whether  belonging  to  the  same  society  with  him  or 
not,  you  may  take  hold  of  liis  nature  and  draw  it  out,  without  hav- 
ing it  slip  from  your  fingers,  and  spring  back  from  your  presence  into 
a  thousand  kinks,  like  an  overtwisted  thread.  He  is  a  whole  man. 
God  made  him  for  the  world,  and  not  for  a  party.  By  some  strong 
influence  you  may  possibly,  for  a  time,  draw  him  from  the  world  into 
some  iiarrower  sphere,  but  not  only  will  his  reluctant  nature,  like  a 
retiring  tide,  run  back  continually  to  embrace  the  continent,  but  will 
soon  break  from  its  confinement,  and,  like  a  full  sea,  come  back,  boil- 
ing and  running  over. 

What  is  now  Wanted. —  The  foregoing  remarks  indicate  one  great 
leading  want,  in  order  that  medical  knowledge  may  increase.  It  is 
liberality  in  the  true  and  full  sense.  We  want  true  men  in  high 
places,  who  will  not  only  let  their  otmi  light  shine  everywhere,  but  mil 
cease  to  hinder  otfier  meiCs  light  from  shining. 


GENKHAL    INTKOltUCTORY    KEMAKKS. 


13 


man. 
Itrong 
into 
like  a 
It  will 
boil- 
great 
It  is 
higli 
it  mil 


Beyond  this,  find  of  nearly  equal  importance  with  it,  we  want  med- 
ical knotvledge  diffused  among  the  people.  We  want  —  what  the 
world  has  never  seen  —  a  popular  medical  literature.  We  want  the 
temples  of  Esculapius  pulled  down,  and  the  priests  turned  into  the 
streets  to  bersome  teachers  of  the  multitude,  rather  than  worshippers 
in  the  inner  sanctuary. 

I  know  this  want  will  be  stoutly  denied,  but  not,  I  think,  on  well- 
considered  grounds.      We  do  not  think  it  necessary  to  confine  a 


'•M, 


'lere  is  no 
.aymen  to 
ol)8curest 
or  push  the 
Why  should 
body?   They 


knowledge  of  the  soul  to  the  ministers  of  religion. 

branch  of  theology  which  we  do  not  deem  it  proper 

study;    we  even  popularize  it  for  our  children,     in 

towns  of  New  England,  laymen  who  follow  the  plough 

plane,  become,  in  many  cases,  eminent  theologians. 

they  not  study  the  lower  science  which  relates  to  the 

liave  not  been  able  to  heretofore,  because  its  mysteries  have  been 

purposely  hidden  under  technicalities.     These  coverings  should  be 

torn  off. 

It  is  said  that  those  who  begin  to  read  upon  medicine  are  very  apt 
to  imagine  themselves  afflicted  with  the  various  symptoms  they  find 
described.  To  some  small  extent  this  is  true ;  but  it  is  also  true 
that  the  light  they  obtain  relieves  them  from  many  apprehensions 
which  their  previous  ignorance  allowed  to  prey  upon  them ;  as  boys 
lose  their  feara  when  the  light  of  the  morning  changes  to  some 
familiar  object  the  ghost  of  the  preceding  night. 

Physicians  oppose  the  popularizing  of  this  kind  of  knowledge  too 
often,  I  fear,  upon  the  sordid  ground  of  self-interest.  They  think 
their  own  services  will  be  less  sought. 

We  do  not  dispense  with  the  services  of  ministei-s  because  the 
people  study  theology,  neither  shall  we  cease  to  employ  teachers  and 
practitioners  of  medicine  when  each  man  and  woman  is  wise  enough 
to  study  the  healing  art.  The  principal  change  we  shall  witness  will 
be  much  larger  attainments  in  knowledge  among  practitioners,  — 
just  as  the  ministers  of  religion  now  know,  and  are  obliged  to  know, 
ten  times  as  much  as  in  those  darker  periods  when  the  people  re- 
ceived all  spiritual  knowledge  from  their  mouths.  The  teachers  of 
any  art  or  science  are  obliged  to  keep  in  advance  of  their  pupils. 
Let  medicine  become  a  popular  study,  and  we  shall  have  very  few 
io^norant  physicians,  and  quackery  will  become  one  of  the  impossi- 
liilities.  Homoeopathists,  Eclectics,  Hydropathists,  and  Physiolo- 
jifists,  believe  in  scattering  medical  books,  stripped  of  their  techni- 
calites,  among  the  multitude,  and  their  people  purchase  very  few 
secret,  advertised  medicines  ;  —  these  being  cliiefly  bought  and  con- 
sixmed  by  the  followers  of  those  who  believe  this  kind  of  reading 
fosters  quackery  1 


ANATOMY. 


Anatomy  describes  the  structiu'e  and  organization  of  living  be- 
ings. 

Special  Anatomy  treats  of  the  weight,  size,  shape,  color,  etc.,  of 
each  organ  separately. 

General  Anatomy  investigates  the  tissues  or  structures  from  which 
organs  are  formed. 

Surgical  Anatomy  or  Regional  Anatomy  (jonsiders  the  relations  of 
organs  to  one  another. 

Physiological  Anatomy  treats  of  the  uses  or  functions  of  organs  in 
health. 

Pathological  Anatomy  describes  the  alterations  made  upon  dif- 
ferent organs  by  disease. 

We  shall  here  introduce  a  very  brief  compendium  only  of  Sj)ecial 
Anatomy. 

It  is  of  great  consequence  that  everj'  person  should  have  some 
knowledge  of  anatomy  and  physiology.  Self-knowledge  ought  to 
extend  to  the  Iwdy  as  well  Jis  the  mind.  To  know  one's  self,  physi- 
cally, is  to  gain  a  new  insight  into  that  wonderfully  skilful  adjust- 
ment of  means  to  ends  which  is  never  absent  from  the  works  of  God. 
Without  this  knowledge,  one  cannot  know  how  to  take  care  of  the 
health ;  and  without  health,  life  loses  most  of  its  value. 

Structure  of  the  Body. 

The  human  body  is  composed  of  solids  and  fluids. 

The  fluids  are  most  abundant  in  cliildren  and  youth.  It  is  this 
which  gives  softness  and  pliancy  to  their  flesh.  In  old  age  tlie  fluids 
are  less  abundant,  and  the  flesh  is  more  hard  and  wrinkled. 

The  fluids  contain  the  whole  body,  as  it  were,  in  a  state  of  solu- 
tion ;  or  rather,  they  hold  the  materials  out  of  which  it  is  manufac- 
tured. 

Chemical  Properties  of  the  Body. 

The  four  elements,  oxygen,  hydrogen,  carbon,  and  nitrogen,  make 
up  nearly  the  whole  bulk  of  the  fluids  and  soft  solids  of  the  human 
body.  A  numljer  of  other  elements,  cliiefly  in  a  state  of  combina- 
tion, and  in  much  smaller  quantities,  enter  into  several  of  the  tissues. 

Binary  Compounds.  —  Thus,  we  ha/e  carbonic  acid  in  blood,  urine 
and  sweat;  and  we  have  water  univei-sally  diffused  through  the  sys- 
tem, —  each  of  these  substances  l)eing  a  binary  compound,  that  is, 
composed  of  two  elements. 

Compounds  of  more  than  two  Elements  are  widely  distributed 
over  the  body ;  as, 


eellu 

watei 

fi'oin 

iinoth 

of  hid 

silk, 


Fat 

"id  con 
lias  110 
'''«  oIei( 
^'it  is  us 


ANATOMY. 


15 


this 
uids 


,  urine 

le  sys- 
hat  is^ 

ibuted 


Carbonate  of  Soda  in  serum,  saliva,  bile,  mucus,  sweat,  and  tears. 
Carbonate  of  Lime  in  cartilage,  bone,  and  teeth. 
Phosphate  of  Lime  in  Iwnes,  teeth,  and  cartilage. 
Phosphate  of  Iron  in  blood,  gastric  juice,  and  urine. 
Chloride  of  Sodium  in  blood,  brain,  muscle,  bone,  cartilage  and 
pigment. 

Chloride  of  Potassium  in  blood,  gastric  juice,  milk,  and  saliva. 

Chloride  of  Calcium  in  gaatric  juice. 

Sulphate  of  Potassa  in  urine,  gastric  juice,  and  cartilage. 

Sulphate  of  Soda  in  sweat,  bile,  and  cartilage. 

Sulphate  of  Lime  in  bile,  hair,  and  scarf-skin.  , 

Oxide  of  Iron  in  blood,  black  pigment,  and  hair. 

Organized  Compounds.  —  Besides  the  above  inorganic  elements 
and  compounds,  several  organized  substances,  or  proximate  elements,  as 
they  are  called,  exist  largely  in  the  body.  The  chief  of  these  are 
albumen,  fibrin,  gelatin,  mucus,  fat,  and  casein.  Others  need  not  be 
named. 

Albumen  is  found  in  great  abundance  in  the'human  body.  It  is 
the  mw  material  out  of  which  the  flesh  and  other  tissues  are  made. 
The  white  of  an  egg,  which  is  nearly  pure  albumen,  is  a  good  speci- 
men of  it. 

Fibrin,  when  removed  from  the  human  body,  changes  from  a  solu- 
ble to  an  insoluble  state.  In  other  words,  it  coagulates  in  a  kind  of 
net- work.  Nearly  the  same  thing  takes  place  constantly  in  the  living 
body,  when  the  liquid  fibrin  leaves  its  soluble  state,  and  is  deposited 
as  solid  flesh.  Fibrin  bears  the  same  relation  to  albumen  that  wool- 
len yarn  does  to  wool ;  it  is  spun  from  it  in  the  busy  wheel  of  or- 
ganic life.  And  the  flesh  or  muscle  is  related  to  fibrin  as  the  cloth 
is  to  yarn  ;  it  is  woven  from  it  in  the  vital  loom.  Fibrin  has  been 
called  liquid  flesh. 

Qelatin  exists  largely  in  the  ligaments,  cartilages,  bones,  skin,  and 
cellular  tissue.  When  dissolved,  five  parts  in  one  hundred  of  hot 
water,  it  forms  a  thick  jelly.  Isinglass  is  a  form  of  gelatin  obtained 
from  the  air-bladder  of  the  sturgeon  and  the  codfish.  Glue  is  still 
another  form  of  gelatin.  It  is  extracted  from  the  bones,  and  parings 
of  hides,  and  the  hoofs  and  ears  of  cattle,  by  boiling  in  water.  Black 
silk,  varnished  over  with  a  solution  of  gelatin,  forms  court-plaster: 

Mucus  is  a  sticky  fluid  secreted  by  the  gland-cells.  It  is  spread 
over  the  surface  of  the  mucous  membranes,  and  serves  to  moisten  and 
•Iffcnd  them  from  injury. 

Fat  consists  of  cells  held  together  by  cellular  tissue  and  vessels, 
iinil  contains  glycerin,  stearic  acid,  margaric  acid,  and  oleic  acid.  It 
liiis  no  nitrogen.  If  the  stearic  acid  be  in  excess,  the  fat  is  hard  ;  if 
till!  oleic  acid  preponderate,  it  is  soft.  The  stearine  extracted  from 
tat  is  used  for  making  very  hard  candles. 


16 


ANATOMY. 


t     I 


CaAeIn  is  abundant  in  milk  and  constitutes  its  curd.  It  is  held 
in  solution  in  milk  by  a  little  soda.  When  dried,  it  is  cheese.  It  is 
found  in  blood,  saliva,  b  and  the  lens  of  the  eye.  It  forms  the 
chief  nourishment  of  thos  ig  animals  which  live  on  milk.     It  is 

found  in  peas,  beans,  and  i^  s.  Vegetable  and  animal  casein  are 
precisely  alike  in  all  their  properties.  Fibrin  and  albumen  contain 
almost  exactly  the  same  amount  of  oxygen,  hydrogen,  cail)on,  nitro- 
gen, and  sulphur,  whicli  i»  found  in  casein.  This  Litter,  wlien  taken 
into  the  stomach,  therefore,  goes,  without  much  change,  to  the  forma- 
tion of  the  albumen  and  fibrin  of  the  body. 

Physical  Properties  of  tlie  Body. 

The  Tissues. — The  solid  organized  substances  of  which  the  human 
body  is  composed,  are  called  tissues.  There  are  various  kinds  of  tissues. 

The  Cellular  Tissue,  commonly  called  areolar,  is  made  up  of  small 
fibres  and  bands  woven  together  into  a  sort  of  ne^work,  with  numer- 
ous little  spaces  opening  into  each  other.  These  spaces  are  filled  with 
a  watery  fluid ;  and  When  this  is  greatly  increased  by  disease,  so  as 
to  cause  the  parts  to  swell,  and  the  skin  to  shine,  the  person  has  ana- 
sarca, or  cell-dropsy.  The  uses  of  this  tissue  are  to  give  parts  and 
organs  a  kind  of  elastic  cushion  to  rest  upon,  so  that  they  may  not  be 
bruised  and  injured  by  the  shocks  of  life ;  to  make  a  kind  of  safe 
highway  for  delicate  vessels  to  pass  from  one  part  of  the  body  to 
another ;  and  to  furnish  a  beautifully  arranged  lodgment  for  the  wa- 
tery fluid  which  gives  such  roundness,  smoothness,  and  grace  to  the 
human  form.  The  opening  of  the  cells  into  each  other  exjjlains  the 
reason  why  feeble  persons  have  swelled  feet  and  ankles  in  the  even- 
ing, and  not  in  the  morning  —  the  fluid  settling  down  from  cell  to  cell, 
into  the  lowest  parts,  while  they  are  up  during  the  day,  and  running 
back  to  its  proper  place  while  they  are  Ij'ing  down  during  the  night. 

The  Mucous  Tissue,  or  nviicous  membrane,  lines  all  the  cavities 
which  communicate  with  the  air,  as  the  month,  stomach,  bowels,  liuigs, 
etc.  It  is  supplied  with  numerous  small  glands  which  secrete  a 
sticky  kind  of  fluid  called  mucus,  to  protect  the  surface  from  any 
injury  which  might  be  inflicted  by  air,  or  by  instating  substances 
suspended  in  it. 

The  Serous  Tissue,  or  membram,  lines  all  the  cavities  which  do  not 
communicate  with  the  air,  that  is,  all  those  which  are  shut,  and  have 
no  outward  opening.  The  skull,  the  chest,  and  the  belly  are  lined  by 
this  kind  of  membrane.  The  membrane  itself  forms  a  closed  sac. 
— one  layer  of  it  being  attached  to  the  cavity  it  lines,  while  the  other 
is  folded  back  upon  and  around  the  contents  of  the  cavity,  which  are 
left  outside  of  the  sac.  A  watery  fluid  oozes  from  the  inner  surfati- 
of  the  sac,  to  make  its  sides  glide  easily  upon  eacjli  other.  When 
some  disease  causes  this  water  to  Ije  poured  out  too  freely,  so  as  to 
fill  or  partly  fill  the  cavity,  we  have  dropsy  of  the  brain,  or  chest,  or 
abdomen,  as  the  case  may  be. 


ANATOMY. 


17 


lo  not 

have 

led  by 

Id  sac. 

1  other 

[oh  are 

lurfai'i' 

IWhPii 

b  aH  to 

liest,  or 


The  Dermoid  Tissue  covei-s  the  whole  outside  of  the  body.  We 
call  it  the  akin,  or  eutia.  It  is  Himiliar  in  Htnicture  to  the  mucous 
lueinlmines,  which  are  a  mere  continuation  of  it.  It  is  harder  than 
the  mucous  membrane,  liecause  more  exposed  to  injury.  In  health, 
it  never  ceases  to  secrete  and  throw  off  a  fluid  which  we  call  insen- 
sible pei-spiration  while  it  is  in  the  form  of  an  invisible  vapor,  and 
pei'spiration,  or  sweat,  when  it  is  so  increased  as  to  be  seen.  So 
^reat  is  the  sympathy  between  this  dermoid  covering  of  the  Iwdy 
and  the  mucous  membranes,  that  when  it  is  eJulled  so  as  to  stop  the 
invisible  perspimtion,  the  internal  membrane  becomes  affected,  and 
we  have  a  sore  throat,  or  diarrhoea,  or  running  at  -the  nose ;  that  is 
to  say,  when  the  skin  cannot  sweat,  the  mucous  membrane  begins  to 
sweat. 

The  Fibrous  Tissue  consists  of  closely  united  fibres,  and  for  what- 
ever purpose  used,  forms  a  fine,  dense,  and  enduring  body.  In  some 
cases  it  takes  the  form  of  a  membrane,  as  the  dura  mater,  which  lines 
tlie  interior  of  the  skull  and  spinal  coluimi.  The  li(/ament8  which 
liold  the  lx)nes  together,  and  the  tendons  or  cords,  which  fasten  the 
lunscles  to  the  Ixmes,  are  fibrous  Inidies.  It  is  this  firm  substance  of 
which  rheumatism  frequently  takes  hold,  and  this  is  the  reason  why 
it  lingers  so  much  about  the  joints.  It  sometimes  tiikes  hold  of  the 
ligament  which  fivstens  the  deltoid  muscle  to  the  bone  of  the  upper 
arm,  about  two-thirds  of  the  way  from  the  ellwjw  to  tlie  shoulder. 
This  muscle  lifts  up  the  arm.  In  this  form  of  rheumatism,  therefore, 
the  arm  hangs  helpless  at  the  side. 

The  Cartilaginous  Tissue  covers  the  ends  of  the  bone^  where  they 
come  together  to  make  a  joini.  It  is  well  fitted  to  make  the  joint 
work  easy,  being  smooth,  hard,  and  elastic. 

The  Osseous  or  Bony  Tissue  varies  in  its  composition,  density, 
and  strength,  according  to  the  age  of  the  person,  and  the  uses  of  the 

lM)ue. 

The  Muscular  Tissue,  or  muscle,  he'mg  made  for  a  great  deal  of 
pulling  and  lifting,  is  formed  something  like  a  rope,  except  that 
there  ia  no  twisting.  Many  small 
fil)ies  or  filaments  unite  to  form 
fasciculi.  A  fasciculus  is  a  bundle 
of  fibres  surrounded  by  a  delicate 
layer  of  cell-tissue  called  sarcolemma, 
—  just  as  a  cord  is  a  number  of 
smaller  threads  of  cotton  or  hemp 
bound  together.  A  number  of  these 
fiusciculi  united  together  make  a 
muscle,  —  just  as  several  cords,  called 
strands,  twisted  together,  inake  a 
i()l)e.  Figure  1  gives  us  a  good  view  of  the  fibres  and  bundles, 
liighly  magnified. 


FlO.  1. 


18 


ANATOMY. 


& 


The  Adipose  Tissue  is  the  material  which  the  human  Iwdy  works 
up  into  pots  and  cells  contivining/n^  It  is  found  chiefly  under  the 
skin  and  muscles  of  the  belly,  and  around  the  heart  and  kidneys, 
liy  the  increase  of  this  tissue,  persons  may  Iwcome  enormously  en- 
larged without  having  their  muscles  at  all  increased  in  size.  Such  a 
condition  is  to  he  deplored,  —  the  body  having  become  merely  the 
storehouse  or  depot  of  myriads  of  pots  of  fat. 

Tlie  Nervou.»  Tissue  i»  composed  of  two  distinct  kinds  of  matter, 
—  the  one  gray  and  pulpy,  called  eineritious,  the  other  white  and 
fibrous,  called  medullary.  The  external  part  of  tlie  brain  and  the  in- 
ternal portion  of  the  spinal  cord  are  composed  of  the  gray  or  ash- 
colored  tissue ;  the  nerves  are  made  only  of  the  white  or  flbrous 
matter,  and  are  inclosed  in  a  delicate  sheath  called  neurilemma. 

Vital  Properties  of  the  Body. 

Bodies  begin  their  growth  with  a  simple  cell,  which  is  a  delicate 
little  bladder  or  shut  sac.  Cells  take  their  rise  in  that  portion  of 
the  blood  which  is  capable  of  being  organized,  and  which  is  called 
blastema. 

In  animal  Iwdies  each  cell  generally  begins  as  a  minute  point  in 
the  blastema,  and  grows  until  a  transparent  bladder  or  vesicle  spjings 
out  from  one  side  uf  it,  and  soon  appears  to  enclose  it.  The  bladder 
is  then  called  the  cell,  and  the  point  or  dot  is  its  nucleus.  Within 
this  nucleus  appears  another  dot,  which  is  called  the  nucleolus. 
When  fully  ripened,  the  cell  bursts  and  sets  the  nucleus  free,  and 
this,  in  its  turn,  matures  and  yields  up  its  contents.  Thus  all  cells 
have  their  origin  in  germs  produced  by  previously  existing  parent- 
cells.  They  are  multiplied  with  great  rapidity.  Having  grown  to 
a  certain  extent,  they  lose  their  fluid  contents,  and  their  walls  col- 
lapsing or  coming  together,  they  form  simple  membraneous  discs. 
In  this  way,  with  some  variations,  the  simple  tissues  of  the  body  be- 
gin to  be,  and  the  foundation  is  laid  for  the  noble  structure  of  man. 

Anatomy  of  the  Bones. 

The  human  skeleton  is  composed  of  two  hundred  .and  eight  bones, 
the  teeth  not  included. 

When  fastened  together  by  natural  ligaments,  the  bones  are  said 
to  form  a  natural  skeleton;  when  attached  by  wires,  an  artificial  skele- 
ton. 

In  Figure  2,  —  1,  1,  represent  the  spinal  column;  2,  the  skull;  3. 
the  lower  jaw ;  4,  the  breast-bone  (sternum)  ;  6,  the  ribs ;  7,  the  col- 
lar-bone ;  8,  the  bone  of  the  upper  arm  (humerus)  ;  9,  the  shoulder- 
joint ;  10,  the  radius;  11,  the  ulna;  12,  the  elbow-joint;  13,  the 
wrist;  14,  the  hand;  15,  the  haunch-lxme ;  16,  the  sacrum;  17,  the 
hip-joint;  18,  the  thigh-bone;  19,  the  knee-cap  (patella);  20,  tlie 
knee-jt)int;  21,  the  fibula;  22,  the  tibia;  23,  ankle-joint;  24,  the 
foot;    27,  28,  29,  the  ligaments  of  the  shoulder,  elbow,  and  wrist; 


A 

18 

1» 
80    ■ 

21  ._..J 

22  ■ 

23  . 
M 


20 


ANATOMY. 


5J0,  tlie  liir^e  iirtiTv  ot"  tlu!  iirin ;  J^l,  the  ligiimentB  of  the  lup-joint; 
•\2,  tlie  liiij^e  hl(i(i(l-V('S8('lH  of  the  thigh;  ."{;{,  tlie  artery  of  the  It-g ; 
•i4,  .iij,  80,  the  ligiiiiieiitH  of  tlio  knee-cap,  knee,  and  ankle. 

'rh(!  piotnherances  itr  swellingH  in  certuin  parts  of  the  hones  are 
called  proeeHtu-s,  and  are  the  puinUt  to  whii-h  ninHcieH  and  li^iamentH 
are  ftwtened. 

The  iMineH  are  Hnjtplied  with  nntritive  vesm-ls,  and,  like  other  parts 
of  tlie  JKid'. ,  are  formed  from  the  hlood.  At  liist  they  are  compurH- 
tively  Hoft  and  eartilaginonH.  After  a  time,  in  the  y(»nng  animal, 
they  hegin  to  change  to  lM)ne  at  certain  places,  called  pointti  of  onniji- 
nation.  They  are  covered  with  a  strong,  fihroUs  membrane  (tailed  the 
perionteum.  A  sonufwhat  similar  covering  upon  tlie  cartilages  has 
the  name  of  /n-rii'/iondrium,  and  that  which  covers  the  skull  is  the 
pfrioranium. 

The  hones  are  compounded  of  earthy  and  animal  matter.  From 
the  former  —  phosphate  and  carbonate  of  lime  —  they  receive  their 
strength;  from  Llu'  latter  —  cartilage  —  they  derive  their  life. 

''ut  a  bone  for  a  few  days  into  diluted  nnuiatic  acid,  —  one  part 
of  acid  to  six  of  water,  —  and  the  i)ho8i)hate  and  carlK)nate  of  lime 

will  all  l)e  removed,  while 
the  bone  will  remain  the 
same  in  shape.  It  will  now 
l)e  comparatively  soft,  and 
may  l)e  bent,  or  even  tied 
into  a  knot  without  break- 
ing. Place  a  similar  lK)iie 
in  the  tire  for  a  few  houix, 
and  it  will  also  retain  its 
shape,  but  the  cartilaginous 
portion  will  Ite  gone.  It  is 
now  brittle,  and  may  Ih; 
picked  in  pieces  with  the  fingers. 

The  bones  are  divided  into  those  of  the  head,  thirty  ;  of  the  body, 
fifty-four;  of  the  upper  limbs,  «ixiy;foMr ;   and  of  the  lower  limtjs, 

xixty. 

i 

I 

Bones  of  the  Head. 

The  bones  of  th  head  are  divided 'into  those  of  the  »kull,  the  ear, 
and  the/fflrv. 

The  skull  has  eight  bones.  They  are  composed  of  two  plates,  one 
above  the  other,  with  a  porous  partition  between.  These  two  plates 
are  capable  of  giving  the  brain  very  powerful  protection  against  in- 
jury, the  outer  one  being  fibrous  and  tough,  —  the  inner  one,  hard 
and  glass-like,  and  hence  called  vitreous. 

The  middle  layer  has  the  name  of  diploe.  Its  spongy  nature 
deadens  the  jar  from  a  blow  inflicted  upon  the  outer  table.  In  euily 
life,  when  the  bones  are  tender  and  yielding,  tlxis  porous  layer  is  not 
needed,  and  is  not  found. 


Fio  s. 


In  the 
backbon( 
Ijieast-bo 
ealled 
cavities, 

TJie 
»>  front, 


ANATOMY. 


91 


1)6 


in,  one 
pliites 
i8t  iii- 
j,  hiivd 

I  nature 

eiivly 
is  not 


Fio.  4. 


That  the  bonps  of  the  skull  may  not  eiwily  Hlip  by  eiioh  otlier,  and 

^'t't  out  of  place,  tlicy  arc  ilovftailiil  tojrcther  in  curiouH  lineH  called 

HiUium.     In  advanced  yeui'H,  tlieHe  gen- 
erally cloHc   .ip,  the  ItoiieH  uniting  (irmly 

together.      In    early   life  they  are   <|nito 

open,   the   Hrin  iKtncH    nut  covering  the 

whole     hniiii.       The    ojM'iiinj,'     of     the 

coronal  suture   in  childhood   in  called  a 

fontanelle.       It    present*    a    soft    place 

upon    tlie   top    of    the   head,   where    the 

tinker  could  l)e  jjreHsed    down  into    the 

liniin.      In   Figure  4,  —  1,  1,  hIiow  the 

coronal  HUture  on   the  front  and  upper 

part  of  the  skull ;  2,  the  Hagittid  Huturo 

on  the  top  of  the  skull ;    and  8,  3,  the 

liiM»hdoi(hvl     suture,    nuining    down    on 

each  side  of  tiie  l«vck  part  of  the  skull. 

Figure  5  shows  the  skull-bones  sepamted  from  each  other  at  the 

sutures  :  1,  the  frontid  bone  ;  2,  the  parietivl ;  2,  the  occipitjil :  4,  the 

toiupond  ;  5,  the  niwal ;  6,  the  malar ;  7,  the  superior  maxillary ;  8, 

the  unguis ;  9,  the  in- 
ferior maxillary.  Ar- 
nott  has  demonstrated 
that  the  form  of  the 
skull  is  the  best  possible 
for  sustaining  weights, 
and  resisting  blows.  The 
oummit  of  the  head  is  a 
complete  arch,  like  that 
of  a  bridge. 

The  ear  has  .our 
small  l)one8,  whi^^h  aid 
the  sense  of  hearing. 

The  bones  of  the  face 

are  fourteen  in  number. 

They  hold  the  soft  part« 

in    place,    and    aid    in 

F.O.  B.  grinding  the  food. 

Bones  of  the  Trunk. 

In  the  trunk  there  are  twenty-four  ribs ;  twenty-four  pieces  in  the 
backbone  or  spinal  colunui ;  four  bones  in  the  pelvis  and  hips  ;  one 
breast-bone,  called  sternum ;  and  a  bone  at  the  base  of  the  tongue, 
called  08  hyoides.  They  are  so  put  together  as  to  form  two  great 
cavities,  namely,  the  thorax  or  chest,  and  the  abdomen  or  belly. 

The  n'6«,  connecting  with  the  backbone  behind  and  the  breast-bone 
in  front,  form  the  thorax,  wliich  contains  the  lungs  and  heart.     Fig. 


W. 


' 


"m 


Fl<l.  6. 


B  ANATOMY. 

<i  hIiowm  tho  natural  form  of  the  lunilthy  f  l>08t :  1,  is  the  flpino  ;  2,  2, 
tliH  cnllai'-ltoiiuH ;  8,  !l,  the  hcvcii  upjK!!.  or  tnut  lilw;  4,  4,  th«  five 
lower  or  fiilw  rWm;  f),  tho  lirciiHt-lMJiic,  i.»  which  tho  tnio  lilw  arc 

united ;  (),  the  sword-Hhaped 
«artilapo  whir.li  conHtitutos  tin- 
lowor  (Mill  of  tiic  hroaut-liono. 
called  enxifonii  rartilage. ;  7,  7, 
the  upper  part  (»f  two  lungs  ;  8, 
H,  the  right  luug,  scon  hotwoen 
tho  ril»H  ;  9, 1>,  tho  left  lung  ;  10. 
10,  the  heart;  11,  11,  the  dia- 
phragm, or  midriff;  12,  12,  the 
liver;  IH,  18,  the  stomach,  14, 
14,  the  second  stomach,  or 
duodenum ;  li),  the  transverse 
colon;  IH,  tho  upper  part  of  the 
colon  on  right  side ;  1 7,  upper 
part  of  colon  on  left  side. 

Fdch  piece  of  the  spinal  col- 
umn is  called  a  vertebra.  Upon 
every  one  of  these  are  seven 
projections,  called  processes  —  a  part  of  which  are  for  linking  the 
bones  together,  and  the  rest  to  furnish 
attachments  for  tho  muscles  of  the  back. 

The  projections  are  linked  together  in 
such  a  way,  that  a  continuous  channel  or 
opening  runs  down  through  the  whole, 
in  which  is  lodged  the  spinal  cord,  or 
medulla  spinalis.  This  nervous  cord  is 
'jonnected  with  the  base  of  the  brain,  and 
is  u  kind  of  continuation  of  it. 

Between  all  the  vertebrae  are  certain 
cartilaginous  cuBhions,  which,  when  com- 
pressed, spring  back,  like  India  rubber, 
and  thus  protect  the  brain  from  being  injuriously  jarred  by  running, 

leaping,  or  walking. 

The  pelvis  has  four  bones  : 
the  two  nameless  bones  —  iih 
nominata,  the  sacrum,  and  the 
coccyx.  In  the  side  of  each  of 
the  nameless  bones  is  a  deep, 
smooth  cavity,  called  the  aite- 
tabulum.  Into  this  the  round 
head  of  the  thigh-bone  is  nicely 
fitted.  When  the  bone  is 
thrown  out  of  this  cavity,  the 
hip  is  said  to  be  out  of  joint. 
*'"'•  *•  The    sacrum   took    its    name 


FlO.  7. 


froi'i 
llieiu, 
•  if  (ho 
ilie  in 
",  a,  t 
PdIh'n 
culunii 


FlO.  9, 

ened  in  tl 
nieut,  form 
•iieubs.     A 
fore-arm. 
%9:  1, 
head  which 
which  unit< 
Of  the  t\ 
"»ites  with 
"fher  bone 
—  o'l  the  sf 
^[« ««},  witi 
"'e  ulna ;  2 
wJ'ich  the  ll 
!'f  the  ulna 
J"'"t;  6,  tlu 


MHi 


AK  ATOMY. 


98 


lies  : 
ill'- 
1  the 
of 
leep, 
1  ace- 
luiul 
cely 
is 
the 
bint, 
line 


froi'i  the  (net  tliiit  tlio  hciithuim  iiHcd  to  offer  it  in  siicriflcu'.  With 
iht'iii,  it  wiiM  the  hiujimi  hoiii;.  Thu  iMxicyx  is  tlic  h)wur  teiiniMiitioti 
(if  tlio  iMukfK)!!!!.  Tlit'Ht)  Imhuih  iiiM!  lepreHoutJMl  ill  Vi^r.  H:  1,  1,  lM'illJ» 
I  hit  iiinniiiiiiat^i,  2,  thi*  Hiutruni ;  8,  the  coccyx  ;  4,  4,  the  iicotuhuluni : 
II,  II,  i\w  (tiihic  portion  of  the  niiineUm.s  iKUieH ;  d,  the  arcli  of  tlie 
|)iih(>H ;  (\  thu  union  of  thu  mierum  and  the  lower  end  of  the  upinul 
cohiinn. 

Bones  of  the  Upper  Extremities. 

Thk  should fr-hlaile  (seapuhi),  the  collar-hone,  (clavicle),  the  h<yne  of 
the  upper  arm  (humerus),  tho  two  hones  of  the  forearm  (ulna  and  ra- 
dius), the  hones  of  the  wrist  (carpal  Ixmes),  the  hones  of  the 
\pnlms  of  the  hand   (inetivcarpal    Iwnes),  the  hones  of  the 
thuinh  and  Jini/ers  (phalanges),  —  these  are  the   bones  of 
the  upper  limbs. 

The  eollar-hone  is  fastened  at  one  end  to  the  breast-bone, 
at  the  other  end  to  the  shoulder-blade.  It  keeps  the  shoul- 
ders from  dropping  forward.  Many  persons  allow  it  to  fail 
of  this  end  by  getting  very  much  bent  in  early  life.  This 
happens  at  school,  when  children  are  allowed  to  sit  in  a 
stooping  posture.  In  the  French,  a  race  re- 
markable for  a  straight,  upright  figure,  this 
bone  is  said  to  be  longer  than  in  any  other 
people. 

The  shoulder-hlade  lies  upon  the  upper  part 
of  the  back,  forming  the  shoulder.     It  has  a 
shallow  cavity  (glenoid  cavity),  into  which  is 
inserted  the  head  of  the  upper  arm-lK)ne.     Sev- 
eral strong  muscles  are  attached  to  the  eleva- 
tions of  this  bone,  which  keep  it  in  its  place, 
and  move  it  about  as  circumstances  require. 
The  upper  arm-hone  has  its  round  head  fast- 
ened in  the  glenoid  cavity,  by  the  strong  capsular  liga- 
ment, forming  a  joint  capable  of  a  preat  number  of  move- 
ments.    At  the  elbow  it  is  united  with  the  ulna  of  the 
fore-arm.     It  is  a  long,  cylindrical  bone,  represented  by 
l^'ig.  9:  1,  is  the  shaft  of  the  bone ;  2,  the  large,  round/ 
head  which  fits  into  the  glenoid  cavity;  8,  the  surface! 
whieh  unites  with  the  ulna. 

Of  the  two  bones  of  the  fore-arm,  the  ulna  is  on  the  inner  side,  and 
unites  with  the  humerus,  making  an  excellent  liinge-joint.  The 
otlier  bone  of  the  fore-arm,  the  radius,  lies  on  the  outaide  of  the  arm, 
—  on  the  same  side  with  the  thumb,  —  and  unites,  or  articulates,  as 
we  sa),  with  the  bones  of  the  wrist.  In  Fig.  10:  1,  is  the  body  of 
the  nlna ;  2,  the  shaft  of  the  radius ;  4,  the  articulating  surface,  with 
whieli  the  lower  end  of  the  humerus  unites ;  5,  the  upper  extremity 
of  the  ulna,  called  the  olecranon  process,  which  forms  the  elbow- 
j'>int ;  6,  the  point  where  the  ulna  articulates  with  the  wrist. 


Fio.  9. 


FlO.  10. 


ANATOMY. 

The  eight  bones  of  the  wrist  or  carpus  are  ranged  in  two  rows,  and 
being  bound  close  together,  do  not  admit  of 
very  free  motion.  In  Fig.  11 :  8,  is  the  scaphoid 
bone  ;  L,  the  semilunar  bone ;  c,  the  cuneiform 
bone ;  P,  the  pisiform  bone ;  T,  T,  tlie  trapezium 
and  trapezoid  bones  ;  M,  the  os  magnum  ;  u,  the 
cuneiform  l)one.  The  last  four  form  the  sec- 
ond row  of  carpal  bones.  11,  11,  are  the  meUi- 
carpal  bones  of  the  hand ;  2,  2,  the  first  mnge 
of  the  finger-bones ;  3,  3,  the  second  mnge  of 
finger-bones ;  4,  4,  the  third  range  of  finger- 
bones  ;  5,  6,  the  bones  of  the  thumb. 

Of  the  five  metacarpal  bones,  four  are  atr 
tsiched  below  to  the  first  range  of  the  finger- 
bones,  and  the  other  to  the  firat  bone  of  the 
thumb,  while  the  whole  are  united  to  the  second 
range  of  the  carpal  bones  above. 

Bones  of  the  Lower  Extremities. 

These  are  the  thigh-hone  (femur),  the  knee-pan  (patella),  the  shin- 
bone  (tibia),  the  Hviall  hone  of  the  leg  (fibula),  the  bones  of  the  instep 
(tarsal  bones),  the  hones  of  the  middle  of  the  foot  (metji- 
tarsal  bones),  and  the  hones  of  the  toes  (phalanges). 

The  thigh-bone  is  the  longest  bone  in  the  system.  Its 
head,  wliich  is  large  and  round,  fits  admirably  into  the 
cavity  in  the  innominatum,  called  acetabulum,  and  forms 
what  is  called  a  ball-and-socket  j  int.  In  Fig.  12 :  1,  is 
the  shaft  of  the  thigh-bone  (femur)  ;  2,  is  a  projection 
called  the  trochanter  minor,  to  which  some  strong  mus- 
cles are  attached;  3,  is  the  head  of  the  femur,  which  fits 
into  the  acetabulum ;  5,  is  the  external  projection  of  the 
femur,  called  the  external  condyle ;  6,  the  internal  con- 
dyle ;  7,  the  surface  which  articulates  with  the  tibia, 
and  on  which  the  patella  slides. 

The  knee-pan  or  knee-cap  (patella)  is  placed  on  the 
front  of  the  knee,  and  being  attached  to  the  tendon  of 
the  extensor  muscles  above,  and  tf)  the  tibia  by  a  strong 
ligament  below,  it  acts  as  a  pulley  in  lifting  up  the  leg. 

The  shin-hone  (tibia)  is  the  largest  of  the  two  in  the 
lower  leg,  and  is  considerably  enlarged  at  each  end. 

The  email  bone  Oi  the  leg  (fibula)  lies  on  the  out- 
side, and  is  bound  to  the  larger  bone  at  both  ends.    Fig., 
13  shows  the  two  bones  of  the  leg:    1,  being  the  tibia ;| 
5,  ihe   fibulo  ;   8,  the  space  between  the   two ;   6,  the 
junction  of  the  tibia  and  fibula  at  the  upper  extrem-         '"■ 
ity ;  8,  the  internal  ankle ;  4,  the  lower  end  of  the  tibia  that  unites 


That  he 
Joints  are 
«o  coustrucl 
«ach  other, 
tilings,  a 


ANATOMY. 


25 


with  one  of  the  tarsal  lx)ne8  to  form  the  ankle-joint;    7,  the  upper 
end  of  the  til)ia,  which  unites  with  the  femnr. 

The  instep  (tiiraus)  has  seven  Iwnes,  which,  like  those  of  the 
wrist,  are  so  firmly  l)oun(l  together  as  to  allow  but  a  limited  motion. 

The  metatarsal  houi's,  corresponding  with  the  palm  of  the  hand,  are 
five  in  number,  and  unite  at  one  end  with  the  tarsal  l)ones,  and  at 
the  other  witli  the  first  range  of  the  toe-bones. 

The  tarsal  and  mebitjirsal  bones  are  put  together  in  the  form  of 
an  arch,  the  spring  of  which,  when  the  weight  of  the  body  descends 
upon  it  in  walking,  prevent**  injury  to  the  organs  above.    (Fig.  14.) 

The  phalanges  have  fourteen  bones.   The  great  toe  has  two  miiges 


FlO.  14. 


FiO.  16. 


Fia.  18. 


v.f  bones ;  the  other  toes  have  three.  Fig.  15  gives  a  view  of  the 
upper  surface  of  the  bones  of  the  foot :  1,  is  the  surface  of  the  as- 
tragalus where  it  unites  with  the  tibia ;  2,  the  body  of  the  astragalus ; 
3,  the  heel-bone  (os  calcis) ;  4,  the  scaphoid  bone  ;  5,  6,  7,  the  cune- 
iform bones ;  8,  the  cuboid ;  9,  9,  9,  the  metatarsal  bones ;  10,  the 
first  bone  of  the  great  toe  ;  11,  the  second  bone ;  12,  13,  14,  three 
ranges  of  bones  forming  the  small  toes. 


liki* 


The  Joints. 

That  bones  may  be  of  any  use,  they  must  be  jointed  together. 
Joints  are  of  the  greatest  importance.  It  is  necessary  they  should  be 
80  constructed  that  then^  shall  be  no  harsh  grating  of  the  bones  upon 
each  other,  and  no  injurious  jars  in  walking,  etc.  To  prevent  these 
things,  a  hard,  smooth,  and  yet  yielding,  cushion-like  substance  is 


*«^l 


■MMM 


a 


i? 


i 


•  ■ 


W  ANATOMY. 

required  between  them  in  joints.     Such  are  tlie  cartilages.     Fig.  16 
ifivcH  a  specimen  oi  these  intervening  cartilaj,'('8.     I),  is  the  body  of 

a    lM)ne,    at   the    end    of 

wliich    is    u    socket ;    C, 

the  cartilage    lining  the 

socket,  tiiin  at  the  sides 

and  thick  in  the  centre ; 

B,  the  body  of  a  bone,  at 

^o.  16.  the  end   of   which   is   a 

round  head  ;    C,  the  investing  cartilage,  thin  at  the  sides  and  thick 

in  the  centre. 

Cartilage  grows  thinner,  harder,  and  less  elastic  in  old  age.  Hence 
old  people  are  not  quite  as  tall  as  in  middle  life,  and  a  little  stiffer 
in  their  joints. 

The  synovial  membrane  is  a  thin  layer  covering  the  cartilage,  and 
being  bent  back  upon  the  inner  surface  of  the  ligaments,  it  forms  a 
closed  sac.  From  its  inner  surface  a  sticky  fluid  oozes  out,  which 
helps  the  joints  to  play  easily. 

There  are  other  smaller  sacs  connected  with  the  joints,  called 
bursa  mucosae.  They  secrete  a  fluid  similar  to  that  from  the  syno- 
vial membrane. 


Fig.  17. 


FlO.  18. 


Fta.  19. 


The  ligaments.  To  retain  the  bones  in  their  places  at  the  joints, 
some  strong,  flexible  straps  are  required  to  stretch  across  from  one 
to  the  other,  and  to  firmly  unite  them.     Such  are  the  ligaments. 

They  are  the  pearl-colored,  lustrous,  shining  parts  about  the  joints, 
in  the  form  of  straps  and  cords.  There  are  a  number  of  them  so 
woven  together  as  to  form  a  complete  covering  of  the  joint,  called  a 
capsular  ligament.  In  Fig.  17  :  1,  2,  are  ligaments  extending  from 
the  hip-bone,  6,  to  the  femur,  4.  In  Fig.  18:  1,  is  the  socket  of  the 
hip-joint;  2,  head  of  the  femur,  lodged  in  the  socket;  3,  the  ligament 
within  the  socket.  In  Fig.  19:  1,  is  the  tendon  of  the  muscle  whicli 
extends  the  leg ;  2,  the  knee-cap  (patella) ;  3,  the  anterior  ligament 


ANATOMY. 


27 


of  the  ])atella;  6,  the  long  external  lateral  ligament;  4,  4,  the  syno- 
vial membrane ;  5,  the  internal  lateral  ligament ;  7,  the  anterior  and 
superior  ligament  that  unites  the  tibia  with  the  tibula. 

Uses  of  the  Bones.    . 

The  bones  are  to  the  body  what  the  frame  is  to  the  house.  They 
hold  up  and  retain  the  other  parts  in  their  proper  places.  They  fur- 
nish points  of  attachment  for  the  muscles,  to  hold  the  body  together 
and  to  give  it  motion.  They  also  furnish  strong,  bony  cavities  for 
the  lodgment  and  protection  of  such  delicate  organs  as  the  eye,  the 
brain,  and  the  heart. 

A  single  bone,  examined  by  itself,  might  not  seem  to  have  much 
beauty  or  design  about  it;  it  might  even  look  clumsy  and  misshapen. 
But  when  all  the  bones  are  inspected  with  reference  to  each  other, 
we  immediately  discover  a  general  plan  upon  which  they  are  made, 
and  are  compelled  to  admire  their  beautiful  harmony,  and  the  sym- 
metrical grace  with  which  they  act.  They  show  us  that  God  can 
command  our  wonder,  even  in  the  bony  frame  of  our  bodies. 


^ts, 
l)ne- 

its, 
so 
a 
lorn 
Ithe 
lent 
tch 
lent 


The  Huscles. . 

That  part  of  the  animal's  body  which  we  call  lean  meat  is  com- 
posed of  muscles.  We  have  already  explained  that  muscles  are  com- 
posed of  threads,  etc.,  put  together  in  great  numbei-s,  forming  bundles. 
So  numerous  are  these  threads  and  bundles  in  some  cases,  that  the 
muscles  which  are  composed  of  them  have  a  strength  truly  wonderful. 

Toward  the  end  of  the  muscle,  the  fibres  cease,  and  the  structure 
is  so  modified  as  to  become  a  white  cord  of  great  density  and  strength. 
This  cordy  substance  is  fastened  to  the  bone  so  strongly,  that  it  is 
impossible,  except  in  some  rare  cases,  to  detach  it.  Generally  the 
bone  will  sooner  break  than  this  attachment  will  give  way.  Some- 
times this  cord  spreads  out  like  a  membrane.  It  is  then  called  fascia 
or  aponeurosis. 

The  fibres  of  a  muscle  have  the  peculiar  property  of  contractiriff 
under  a  nervous  stimulus  sent  to  them  by  the  will.  These  contrac- 
tions cause  them  to  act  as  pulleys,  and  to  move  the  bones,  and  conse- 
quently tlie  limbs  and  body,  in  such  direction  as  the  will  commands. 
This  is  the  special  use  of  the  muscles.  All  our  movements  are  caused 
by  them.  They  pull  us  about,  not .  blindly  and  at  a  nmdom,  but 
under  the  direction  of  an  intelligent  will. 

The  manner  in  which  a  muscle  aista,  with  the  cord  attached,  may 
l)eseen  by  examining  the  leg  or  "  drum-stick  "  of  a  fowl.  If  the  cord 
on  one  side  be  pulled,  the  claws  are  shut ;  if  that  upon  the  other 
side  he  drawn,  they  will  open.  If  both  be  pulled,  they  are  held  fast 
in  one  position,  neither  opening  nor  shutting. 

An  examination   of  a  piece  of  boiled  lean  meat  will  show  the 


i 


! 


! 


n 


28 


ANATOMY. 


FlO.  20. 


threads  of  which  it  is  composed,  With  proper  instruments,  these  may 
be  unravelled,  as  it  were,  until  fibres  will  be  found  not  larger  than  a 
spider's  web.  These,  covered  with  sheaths  of  great  delicacy,  extend 
beyond  the  fleshy  fibre,  and  with  the  cell-sutetance  connecting  the 
fibres,  are  condensed  into  t'    don. 

Millions  of  these  sheathed  fibres  are  gathered  into  a  bundle,  and 
covered  with  a  sheath,  and  thus  form  what  is  called  &  fasciculus.  A 
muscle  is  a  number  of  these  fascicula  made  into  a  bundle,  and  cov- 
ered with  a  sheath  called  n  fascia  (Fig.  1). 

The  arm  is  a  number  of  muscles  bundled  together,  and  covered, 
likewise,  by  a  fascia. 

The  fibres  in  a  fasciculus  being  parallel,  act  together.  But  the 
fasciculous  bundles  which  make  up  a  muscle  act  in  various  ways. 

Shape  of  the  Muscles.  —  Some  muscles  are  fusiform  or  spindle- 
shaped,  so  that  the  attachment  occupies  but  a 
small  space  (Fig.  20). 

Other  muscles  are  radiate  or  fannshaped  (Fip, 
21).     Such  is   the   temioral   muscle,  the  thin 
edge  of  which  is  attache  I  to  the  side  of  the  head, 
without  producing  an  elevation  or  deformity. 

In  some  cases  the  fasciculi  are  arranged  upon 
one  or  both  sides  of  a  tendon.  In  this  way  a 
great  number  may  concentrate  their  action  upon 

a  single  point.     Such  muscles  are  called  penni- 
form,  —  hieing  shaped  like  a  feather  (Fig.  29). 

In  other  instances,  the  fasciculi  form  circular 
muscles,  —  orhiculares,  or  sphincters,  as 
These  surroiuid  certain  openings  iijto  the 
body,  which  thry  are  designed  to  close,  either  in  whole  or 
in  part.  They  surround  the  eyelids,  the  anus,  the  mouth 
of  the  womb,  etc.  (Fig.  23). 

In  still  other  instances  the  fasciculi  are  ranged  side  by  side  in 

rings,   forming  muscular 
tubes.     By  the  successive 
contraction  of  these  rings, 
^^°  24.  any  substance  is  drivt'ii 

through  the  tube,  —  as  food  or  drink  through  the  gullet  of  a  cow. 
Fig.  24  is  a  section  of  the  gullet :  a,  b,  show  the  circular  fibres : 
«?,  the  longitudinal. 

Sometimes  the  fasciculi  curve  around  in  paiuUel  layers  or  intei- 
lace  with  each  other,  forming  a  bag  or  pouch.  By  the  contraction 
of  these  fasciculi,  the  contents  of  the  bag  will  be  turned  from  side 
to  side  as  in  the  case  of  the  stomach,  or  driven  out,  as  in  that  of  tlic 
heart.  Fig.  25  sluiws  the  muscles  of  the  stomach  :  L,  represent*!  the 
fibres  running  in  one  direction  ;  c,  in  another ;  E,  lower  end  of  gullet  : 
( >,  pylorus  ;  i),  beginning  of  duodenum,  or  second  stomach. 


FlO   21 


FlO.  32. 


they  are  called. 


FlO.  23. 


r'Z^r — rr:K^- 


m- 


I 


PI.  8. 


Numbe 

as  tlic  rojK 
iinatoinists 
They  ar 
trunk,  tlios 
tien. 

They  ar« 
this  brief  a 
iiiider  tlie 
while  auotl 
tai  y,  movin 
the  will, 
latter  kind, 
it  to  keep  r 
and  mind  a 

On    the 

layers  of  ini 

other.    Sucl 

**''«ry  to  pel 

movements 

arms,  etc.     ] 

liatc.  hope,  f 

made  expres 

The  diapl 

cavity  of  the 

penetrated  b 

blood-vessels 

•  over  of  a  di: 

the  breath  is 

the  chest  at  1 

out,  the  revei 

Mode  of  Ai 

spoken,  is  sin 


"loved  :  1,  is  , 
'•"lies  below  tl 
attachments  o 


*>.^(irtjii 


MUSCLES  OF  THE  HUMAN  BODY 


m 


ANATOMY. 


29^ 


Number  of  Muscles.  —  The  muscles  of  the  iKidy  arc  nn  numerous 
lis  the  ropes  of  a  ship,  —  there  being  five  hundred  or  more.  Some 
iiiiiitoiniste  reckon  more,  some  less. 

'llii'Y  are  divided  into  those  of  the  head  and  ttenk,  those  of  the 
Inni/c,  those  of  the  upper  extretnitiea,  and  those  of  the  lower  extremi- 
tie». 

They  are  too  numerous  to  be  named  and  indivithially  described  in 
tliis  brief  account  of  them.  A  part  of  them  are  voluntary,  tliat  is, 
under  the  control  of  the  will ; 
while  another  part  are  involun- 
tary, moving  without  reference  to 
tlie  will,  'rhe  heart  is  of  the 
hitter  kind,  it  being  necessary  for 
it  to  keep  moving  when  the  will 
and  mind  are  asleep. 

On  the  back  there  are  six 
layers  of  muscles,  one  above  an- 
other. Such  a  number  are  neces- 
sary to  perform  the  numerous 
movements  of  the  back,  neck. 
anus,  etc.  Every  expression  of  the  human  face,  as  joy,  sorrow,  love, 
liatc.  liope,  fear,  etc.,  is  produced  by  the  gentle  pulling  of  muscles, 
made  expressly  to  indicate  these  emotions. 

The  diaphragm  is  a  large  flat  muscle,  reaching  across  the  great 
cavity  of  the  body,  and  dividing  the  chest  from  the  abdomen.  It  is 
l)i'iietrated  by  the  gullet  going  to  the  stomach,  and  by  the  great 
blood-vessels  leading  to  and  from  the  heart.  It  is  shaped  like  the 
cover  of  a  dinner-dish,  the  convex  surface  being  turned  up.  When 
the  l)reath  is  drawn  in,  it  sinks  down  towards  a  level,  thus  enlarging 
tlie  chest  at  the  expense  of  the  belly.  When  the  breath  is  thrown 
out,  the  reverse  takes  place. 


Fio.  25. 


Mode  of  Action. —  The  cordractibility  of  a  muscle,  of  which  I  have 
spoken,  is  simply  its  power  of  shortening  itself.     The  hand  is  raised 

g  by  the  shortening  of  a  mus- 
cle in  front,  attached  to  the 
bone  above  the  elbow,  and 
to  a  bone  below  the  elbow. 
The  contraction  of  an  an- 
tagonistic muscle  behind, 
also  attached  alwve  and  be- 
low the  elbow,  brings  the 
iK''ud  back  to  its  place.  Fig. 
26  shows  how  all  joints  are 
"lovfd :  1,  is  the  bone  of  the  arm  above  the  elbow ;  2,  one  of  the 
'xjiies  l)elow  the  elbow ;  3,  the  muscle  wliich  Iwnds  the  elbow ;  4,  5, 
iittaeliinents  of   muscles  to  bones ;  6,  the  muscle  that  extends  the 


Fio.  2G. 


i.    : 


I 


30 


ANATOMY. 


eU)ow ;  7,  attachment  to  elbow;  8,  weiglit  in  hand.     The  nuiHcle,  3, 
contiacts  at  the  central  part,  and  hringn  the  hand  up  to  9,  10. 

The  complication,  variety,  and  Hwiftness  of  motion,  executed  by 
muscles,  are  past  conception.  Every  movement  which  a  human  be- 
ing makes,  from  the  heavier  motions  of  the  farmer  in  cultivating  his 
fields,  up  to  the  magic  touches  of  the  painter's  brush,  and  the  metliod- 
ical  frenzy  with  which  the  great  master's  fingers  sweep  the  piano,  are 
all  made  by  muscles  obeying  an  intelligent  will. 

The  Teeth. 

The  teeth  are  not  like  other  bones,  either  in  composition,  method 
of  nutrition,  or  growth.  When  broken  they  do  not  unite,  not  being 
furnished  with  the  necessary  power  of  reproduction  of  lost  parts. 

Both  the  upper  and  lower  teeth  are  set  into  l)ony  sockets,  called 
alveolar  processes.  These,  with  the  fibrous  gums,  give  the  teeth  a 
very  firm  setting. 

Origin. —  The  teeth  have  their  origin  in  little  membranous 
pouches  within  the  bone  of  the  jaw,  which,  in  their  interior,  have  a 
fleshy  bud.  From  the  surface  of  this  the  bone  or  ivory  exudes.  Tiie 
tooth  and  the  Iwny  socket  are  developed  and  rise  up  together,  —  the 
former,  when  sufficiently  long,  pushing  itself  through  the  gum. 

Number. —  The  first  set  of  teeth  are  only  temporary,  and  are  called 
milk-teeth.  There  are  but  twenty  of  them.  lietween  the  age  of  six 
and  fourteen,  these  become  loose,  ard  drop  out,  and  the  permanent 
teeth  appear  in  their  places.  Of  these  there  are  thirty-two,  sixteen 
in  each  jaw. 

Names. —  The  four  front  teeth  in  each  jaw,  a,  h,  Fig.  27,  are  the 
cutting  teeth  (incisors)  ;  the  next  one,  c,  is  an  eye-tooth  (cuspid) ;  the 


Fig.  27. 


next  two,  d,  Cs  are  dmall  grinders  (bicuspids)  ;  the  last  three,  /,  g,  h, 
are  grinders  (molars).  One  appears  late  on  each  side,  from  the  age 
of  twenty  to  twenty-four,  and  is  called  wisdom  tooth. 


Compo 

•  int-ernal  p 
the  surfac 
which  rise 
which  is  c 
root  or  far 
vessels  pat 
into  the  tc 
in  tooth-a( 


The  inc 

solid  parts, 

In  niii8ti( 

aiuklown  r 

motion.     J 

muscles.     ] 

vegetable-ea 

while  man 

a  pretty  clei 

The  teeth 

and  symmet 

kept  in  goot 

their  decay  i 

are  spoken  o 


The  alimei 
the  pharynx, 
chyle  vessels 
oreas). 

The  prepai 
takes  place  in 
cretion  of  the 
on  each  side. 

The  Parotli 

"peniug  into  tl 

i^^y-  This  is 

Hence  the  dise 

TlieSubma 

ot  Its  angle.  ; 
of  the  tongue  ( 
On  each  side 
'''^ne  of  the  ; 
P«««»  its  saliva 


W 


ANATOMY. 


SI 


Composition.— A  tooth  is  composed  of  ivory  and  enamel.     The 

int^.>rnai  part  is  ivory,  which  is  harder  than  bone.  The  coating  upon 
the  surface  is  enamel,  which  is  still  harder  than  ivory.  That  part 
which  rises  above  the  jaw-bone  is  called  the  crotvn  ;  it  is  this  only 
which  is  covered  with  enamel.  The  part  within  the  jaw  is  called  the 
root  or  fang;  this  is  composed  of  bony  matter,  through  which  small 
vessels  pass  in  to  nourish  the  tooth.  Small  white  nerves  also  pass 
into  the  tooth.  — of  the  presence  of  which  we  have  terrible  eviilenoe 
in  tooth-ache. 

Use  of  the  Teeth. 

The  incisors  cut  the  food  asunder;  the  molars  break  down  its 
solid  parts,  and  grind  it  to  a  fineness  which  fits  it  for  the  stomach. 

In  niivsticating  the  food,  the  lower  jaw  has  two  movements,  the  up- 
lUuWown  motion,  like  a  pair  of  sheai-s,  and  the  lateral  or  grinding 
motion.  These  two  movements  are  performed  by  different  sets  of 
iiuuscles.  P'lesh-eating  animals  have  only  the  up-and-down  motion ; 
vegetable-eating  animals  have  only  the  lateral  or  grinding  motion ; 
while  man  has  both  the  up-and-down  and  the  lateral.  This  seems 
a  pretty  clear  intimation  that  he  is  to  eat  both  flesh  and  vegetables. 

The  teeth  aid  us  in  articulating  words,  and  they  give  a  roundness 
and  symmetry  to  the  lower  part  of  the  face.  When  well  formed,  and 
kept  in  good  condition,  they  add  much  to  the  beauty  of  the  face,  and 
their  decay  is  an  irreparable  loss.  Their  proper  care  and  treatment 
are  spoken  of  in  another  place. 


i'] 


The  Digestive  Organs. 

The  alimentary  organs  are  the  mouth,  the  teeth,  the  salivary  glands, 
the  pharynx,  the  gullet  (oesophagus),  stomach,  bowels  (intestines), 
chyle  vessels  (lacteals),  thoracic  duct,  liver  and  sweetbread  (pan- 
creas). 

The  preparatory  process  of  digestion,  the  mastication  of  food, 
takes  place  in  the  mouth,  where  the  food  is  mixed  with  sallAa,  a  se- 
cretion of  the  salivary  glands.  Of  these  glands  there  are  six,  three 
on  each  side. 

The  Parotid  Qiand  lies  in  front  of  the  external  ear.  It  has  a  duct 
opening  into  the  mouth  opposite  the  second  molar  tooth  of  the  upper 
jaw.  This  is  the  gland  that  swells  in  the  disease  called  mumps. 
Hence  the  disease  is  also  called  parotitis. 

The  Submaxillary  Qiand  is  inclosed  withinthe  lower  jaw,  in  front 
of  its  angle.  Its  duct  opens  into  the  mouth  by  the  side  of  the  bridle 
of  the  tongue  (fraenum  linguse). 

On  each  side  of  this  string  or  bridle,  and  under  the  mucous  mem- 
brane of  the  floor  of  the  mouth,  lies  the  mhlingual  gland,  which 
poun  its  saliva  into  the  mouth,  through  seven  or  eight  small  ducts. 


I,:  , 


■■■  > 


l! 


.  I 


I 


n. 


32 


ANATOMY. 


A  disease  called  the  frog  consists 
Fig.  28:  1,  the  parotid  gland;  2, 


in 

its 


Fia.  as. 


the  swelling  of  this  gland, 
duct ;   3,  the  submaxiTlary  ; 
^^vv>K\\wm\^w[i^^^HM^^  *4»  its  duct ;  6,  the  sublin- 

<^^^HM^     gual. 

f/^r^  ^iifiH^^^^I^^       ^^^  Pharynx  con- 

y   4BP^^'^><i^l^EI^^^^^^^^  tiiiuation      the  mouth,  iind 

lis  tlie  cavity  just  below  the 
[soft  palate.  The  two  piw- 
Hiige.H  going  to  the  nose 
(posterior  nares),  the  one 
going  to  the  Htomach 
(oesophagus),  and  the  one 
going  to  the  lungs  (larynx 
and  trachea ;  all  meet  in 
this  cavity.  In  Fig.  29: 
1,  is  the  trachea ;  2,  the 
larynx ;  8,  the  oesof  .lagus ; 
4,  4,  5,  moaflles  of  pharynx ;  5,  muscles  of  the  cheek ;  6,  the  muscle 
which  sui'-ounuB  the  mouth  ;  7,  the  mus- 
cle forming  the  floor  of  tlie  mouth. 

The  Quilet  or  oeaophagus  is  a  long  tube, 
dcHcending  behind  the  windpipe,  the 
lungs,  and  the  heart,  thiough  the  dia- 
phragm into  the  stomach.  It  is  composed 
of  two  membranes  laid  together,  like  two 
pieces  of  cloth.  The  inner  one  is  mucous, 
the  outer  muscular.  The  two  sets  of 
fibres  composing  the  muscular  coat  are 
arranged  circularly  and  longitudinally 
(Fig.  25).. 

The  Stomach  lies  in  the  upper  part  of 
the  belly,  to  the  left,  and  directly  under 
the  diaphragm.  It  has  an  upper  opening, 
where  the  stomach-pipe  enters  it,  called 
the  cardiac  orifice.  This  is  the  larger  end  of  the  stomach,  and  lies 
on  the  left  side ;  the  smaller  end  connecta  with  the  upper  bowel,  at 
which  point  it  has  an  opening  called  the  pyloric  orifice.  In  addition 
to  mucous  and  muscular  coats,  similar  to  those  which  compose  the 
oesophagus,  the  stomach  has  still  another  over  both,  a  serous  coat, 
very  strong  and  tough,  to  give  this  working  organ  additional  en- 
durance.    Within,  it  has  many  glands  to  secrete  l5ie  gastric  juice. 

The  Intestines,  or  alimentary  tube,  or  bowels,  are  divided  into  the 
smaU  and  large  intestines. 

The  small  intestine  has  a  length  of  about  twenty-five  feet,  and  is 
divided  into  three  parts,  —  the  duodenum,  the  jejunum,  and  the  ileum. 

Of  these  three  divisions,  the  duodenum  is  the  largest,  and  is  about 


Fia.  20. 


a  foot  in 
passes  l>a 
down  pel 
the  belly 

The  Je 

The  lie 

angle,  nea 

to  prevent 

the  ileum. 

At  this 

caecum,  a  1 

dix  vermifo 

from  one  U. 

The  Colo 

transverse  c 

The  Ascc 

surface  of  ti 
part  of  the  1 
portion  whi< 
on  the  left  s 
of  the  descei 
which  is  call 

The  Recti! 

ingattheani 

The  Lacte 

mucous  mem 
tween  membn 
glands,  from 
another  coUe 
Passing,  for  a 
glands  to  anc 
progress  increi 
ja  number,  the 
"ito  the  thoraci 
»P  through  tl 
J»lly,  makes  a 
forward,  and  ( 
^.rge  vein  whic 
%  30 :   1,  is 
nie-flenteric  glar 
teals  pass;   6, 
fuaphragnj. 

%  the  help  , 
small  vessels  mi 
«»tofthebowe 


1'. 


AMATOMT. 


83 


a  foot  in  length.  It  begins  at  the  pyloric  oriiice  of  the  stomach,  and 
passes  backward  io  the  under  surface  of  the  liver,  whence  it  drops 
down  perpendicularly  in  front  of  the  right  kidney,  and  i)a8se8  across 
the  belly  behind  the  colon,  and  ends  in  the  jejunum. 

The  Jejunum  continues  the  above,  and  terminates  in  the  ileum. 

The  Ileum  is  a  continuation  of  the  jejunum^  and  opens,  at  an  obtuse 
angle,  near  the  haunch  l)one,  into  the  colon.  A  valve  is  located  here, 
to  prevent  the  backward  passage  of  aubstances  from  the  colon  into 
the  ileum. 

At  this  point  the  large  intestines  begin,  and  here  is  situated  the 
mcum^  a  blind  pouch,  or  cul-de-sac,  attached  to  which  is  the  appen- 
dix vermiformi$,  a  worm-shaped  tube,  of  the  size  of  a  goose-quill,  and 
from  one  to  six  inches  long. 

The  Colon,  or  large  intestine,  is  divided  into  the  ascendinff  colon,  the 
trantvene  colon,  and  the  descending  colon. 

The  Ascending  Colon  rises  from  the  right  haunch-bone  to  the  under 
8urfac«  of  the  liver,  whence  it  bends  inward,  and  crosses  the  upper 
part  of  the  belly,  below  the  liver  and  stomach,  to  the  left  side.  This 
portion  which  crosses  over  is  the  transverse  colon.  From  this  point, 
on  the  left  side,  it  turns  down  to  the  left  haunch,  and  has  the  name 
of  the  descending  colon.  Here  it  makes  a  curve  like  the  letter  S, 
which  is  called  the  sigmoid  flexure. 

The  Rectum  is  the  lower  portion  of  the  large  intestine,  terminat- 
ing at  the  anus. 

The  Lacteals  are  small  vessels  which  begin  in  the  villi,  upon  tlie 
mucous  membrane  of  the  small  bowels.  From  here  they  pass  be> 
tween  membranes  of  the  mesentery  to  small 
glands,  from  which  larger  vessels  run  to 
another  collection  ol  glands;  and  after 
passing,  for  a  space,  from  one  collection  of 
glands  to  another,  at  each  stage  of  their 
progress  increased  in  size  and  diminished 
in  number,  the  lacteals  pour  their  contents  j 
into  the  thoracic  duct.  This  having  passed 
up  through  the  diaphragm,  out  of  the 
belly,  makes  a  sudden  turn  downward  and 
forward,  and  empties  its  burden  into  a 
large  vein  which  ends  in  the  right  heart. 
Fig.  30 :  1,  is  the  bowel  ;  2,  8,  4,  the 
mesenteric  glands  through  which  the  lac- 
teak  pass ;  6,  the  thoracic  duct ;  7,  the  spinal  column ;  8,  the 
diaphragm. 

By  the  help  of  a  magnifying  ^lass,  an  infinite  number  of  these 
smaU  vessels  may  be  seen  starting  from  the  rough,  shaggy  internal 
coat  of  the  bowel. 


Fia.  ao. 


i 


l^ 


84 


ANATOMY. 


The  metentery  ih  a  thick  sheet  of  membrane,  formed  of  several 
folds  of  the  peritoneum,  and  spread  out  from  the  vertebras  like  a  fan. 
The  bowels  are  attached  to  ite  edge,  »ud  are  held  by  it  in  their  place, 
and  at  the  same  time  have  free  motion.  Between  its  layers  are  a 
great  number  of  glands,  which  Hometimes  l)ecome  diseased  and  swol- 
len in  childhood,  and  prevent  the  chyle  from  pasHing  along  to  the 
thoracic  duct.  Thus  affect<Hl,  children  are  not  nourished,  and  waste 
away  with  a  disease  sometimes  called  mesenteric  consumption. 

The  Liver  is  a  large  gland,  lying  under  the  short  ribs  on  the  right 
side,  below  the  diaphragm.     It  is  convex  on  the  upper  surface  and 

concave  on  the  under,  and  is 
composed  of  several  lolies.  Its 
office  is  to  secrete  bile.  It 
weighs  about  four  pouiiik 
Ixjing  the  largest  organ  in  the 
lM)dy.  Fig.  !U  represents  the 
liver:  1,  being  the  right  lol)e; 
2,  leftlolte;  3,4,smailer  lobeH; 
10,  gall-bladder ;  17,  the  notch 
into  which  the  spinal  column 
is  fitted. 

'^'*'  "•  The    Qall-Bladder  lies  on 

the  under  side  of  the  liver,  and  receives,  it  is  supposed,  the  surplus 
bile,  which  is  reserved  for  special  occasions.  It  opens  into  the  gall- 
duct,  which  carries  the  bile  along,  and  pours  it  into  the  duodenum. 

The  Pancreas,  Fig.  32,  is  a  long,  flat  gland,  something  like  the 
salivary  glands.  It  lies  tiansversely  across  the  back  wall  of  the 
domen,  behind  the  stomach. 
It  secretes  a  colorless,  al- 
kaline fluid  called  the  pan- 
creatic juife,  the  office  of 
wliich  is  to  emulsify  the 
different  classes  6f  food, 
so  that  the  lac  teals  can  ab- 
sorb it.  This  fluid  is  car- 
ried by  a  duct,  and  poure(' 
duct  enters. 


al> 


FlO.  32. 


.  duodenum  just  where  the  bile- 


The  Spleen  has  an  oblong,  flattened  form.  It  lies  on  the  left 
side,  just  under  the  diapliragm,  and  close  to  the  stomach  and 
pancreas.  It  is  supposed  to  be  a  reservoir  for  holding  the  surplus 
blood  of  the  liver.  It  was  thought  by  the  ancients  to  be  the  seat  of 
melancholy.  The  blood  in  passing  through  it  loses  a  portion  of  its 
red  globules. 

The  Omentum  or  catd  is  a  doubling  and  «3Xtension  of  the  perito- 
neum.    It  is  a  kind  of  fatty  body,  whicii         upon  the  surface  of  the 


bowels 
(iate  tl 
Hence 


The 
thi!  hlo( 
kidneys. 

The* 

region,  I 

imd  two 

and  weij 

called  tl 

ureter  w 

kidney  is 

01'  cortict 

tlie  bloot 

'i^i^y  the 

TheUi 

and  eight 
men,  behi 
they  empt 

The  Bli 

composed 

and  the  in 

the  interna 

it  secretes 

rosiveness 

means  of  a 

"f  the  orga 

iw  to  give  s 

relaxes  and 

The  blad 

peritoneum, 

the  bladder 

This  orga 

'"thout  it,  A 

dribbling  aw 

The  Uretl 

of  the  bladd( 
tic  fibrous, 
urine  passes 


mt^ 


ANATOMY. 


36 


lus 
lot 


Ihe 


bowels  and  is  iit.taclu'd  to  tlie  stomivch.  Its  use  Heems  to  l)e  to  lubri- 
cate thu  l)owel8,  and  uspecially  to  protect  and  keep  them  warm. 
Hence  it  is  often  called  the  apron. 

The  Urinary  System. 

The  organs  of  this  system  are  devoted  to  separating  the  urine  from 
the  l)loo<i,  and  carrying  it  out  of  the  lM)dy.  These  organs  are  the 
kidneys,  the  ureters,  the  bladder,  and  the  urethra. 

The  Kidneys  lie  one  on  each  side  of  the  Imckbone,  in  the  lumbar 
region,  l)ehind  thu  peritoneum.  They  are  four  or  five  inches  long, 
and  two  and  a  half  broad.  They  are  in  shape  like  the  kidney-bean, 
and  weigh  about  half  a  pound  each.  In  tlie  centre  there  is  a  bag 
called  the  pelvis,  -which  tapers  like  a  funnel,  and  unites  with  the 
ureter  which  convevs  the  urine  to  the  bladder.  The  texture  of  the 
kidney  is  dense,  presenting  in  its  interior  two  structures,  an  external 
or  (;ortical,  and  an  internal  or  medullary.  The  cortical  portion  has 
the  blood-vessels,  the  medullary  is  composed  of  tubes  which  carry 
away  the  urine. 

The  Ureters  are  membranous  tubes  of  the  size  of  a  goose-quill, 
and  eighteen  inches  long,  which  run  down  the  back  wall  of  the  abdo- 
men, behind  the  peritoneum,  to  the  bladder,  into  each  side  of  which 
they  empty  their  contents.  * 

The  Bladder  is  located  in  the  pelvis,  in  front  of  the  rectum.  It  is 
composed  of  three  coats;  the  external  is  serous,  the  middle  muscular, 
and  the  internal  mucous.  The  external  coat  is  strong  and  fibrous ; 
the  internal  is  drawn  into  wrinkles,  which  makes  it  thick  and  shaggy; 
it  secretes  a  mucus  whirh  prevents  it  from  being  injured  by  the  cor- 
rosiveness  of  the  urine.  I'he  urine  is  retained  in  the  bladder  by 
means  of  a  circular  muscle,  called  a  sphincter,  which  draws  the  mouth 
of  the  organ  together.  When  the  quantity  of  urine  is  so  increased 
as  to  give  some  uneasiness  or  pain,  this  miiscle,  by  a  sort  of  instinct, 
relaxes  and  lets  it  out. 

The  bladder  is  attached  to  the  rectum,  to  the  hip-bones,  to  ihe 
peritoneum,  and  to  the  navel,  by  several  ligaments.  In  the  female 
the  bladder  has  the  womb  between  it  and  the  rectum. 

Tliis  organ  is  wisely  provided  as  a  receptacle  for  the  urine ;  v/nich, 
mthout  it,  would  produce  a  great  inconvenience  by  being  constantly 
dribbling  away. 

The  Urethra  is  a  membranous  canal  which  leads  from  the  neck 
of  the  bladder.  It  is  composed  of  two  layers,  a  mucous  and  an  elas- 
tic fibrous.  Through  this  channel,  which  is  curved  in  its  course,  the 
urine  passes  out  of  the  body. 


■^: 


ANATOMY. 


The  Respiratory  Organs. 

These  organs  consist  of  the  windpipe  (trachea)  ;  divinont  and 
mbdiviaiona  of  the  windpipe  (bronchia)  ;  air-cells  ;  and  the  lungs  or 
lights. 

The  Windpipe  (trachea)  extends  from  the  larynx —  the  seat  of  the 
voice — to  the  third  dorsal  vertebra,  where  it  divides  into  two  tubes, 
called  bronchia.  It  runs  down  the  '  <nt  part  of  the  throat,  with  the 
oesophagus  behind  and  between  it  s.",d  .he  spinal  column.  It  is  com- 
posed mainly  of  rings  of  cartilage,  i>.ie  ubove  another. 

The  Bronchial  Tul>es  are,  at  the  div'  n  of  the  windpipe,  two  in 
number,  but  they  divide  and  subdivide  until  they  become  very  nu- 
merous. 

The  Air-Celis  or  Vesicles  are  small,  bladder-like  expansions  at  the 
ends  oi  the  tubes.  They  are  elastic  and  swell  out  when  the  air 
passes  in. 

The  Lungs  All  the  greater  part  of  the  chest,  the  heart  being  the 
only  other  organ  which  occupies  much  space  in  the  cavity.  The 
size  of  these  organs  is  larg^  or  small,  according  to  the  capacity  of  the 
chest.  Ea  ch  lung  —  for  there  are  two  —  is  a  kind  of  cone,  with  its 
base  resting  upon  the  diaphragm,  and  its  apex  behind  the  collar-bone. 
They  are  concave  on  the  bottom,  to  fit  «he  diaphragm,  which  is  con- 
vex on  its  upper  side. 

The  right  and  left  lungs  are  separated  from  each  other  by  a  parti- 
tion called  the  mediastinum,  formed  by  two  portions  of  the  pleura,  a 
smooth  serous  membrane  coming  off  from  the  spine  and  closely  en- 
veloping each  lung ;  the  heart,  covered  by  the  pericardium,  lies 
in  the  centre,  between  them.  The  right  lung  is  divided  into  three 
lobes ;  the  left  into  two. 

Each  lobe  of  the  lungs  is  divided  into  a  great  many  lobules,  which 
are  connected  by  cellular  tissue.  These  lobules  are  again  divided 
into  very  fine  air-cells.  Besides  these,  the  substance  of  the  lungs  is 
compof  t=  i  likewise  of  blood-vessels  and  lymphatics,  and  is  well  su^)- 
plied  with  nerves. 

In  the  foetal  state,  before  the  lungs  have  been  filled  with  air,  tLay 
are  solid  and  heavy,  something  like  other  flesh,  but  after  all  their 
cells  have  been  filled  with  air,  and  breathing  has  been  established, 
they  are  exceedingly  light  and  spongy,  and  float  upon  water. 

In  cases  where  infanticide  is  suspected,  and  where  it  is  desirable 
to  know  whether  the  child  was  still-bom,  or  bom  alive  and  killed 
afterwards,  the  specific  gravity  of  the  lungs,  compared  with  water, 
will  often  settle  ^e  question. 


The  foe 

lacteals,  ca 
tlie  lungs,  i 
if  not  distr 
fecting  thif 
capillaries. 

The  Hea 

side,  and  is 
form  is  som 
ward  in  the 
the  left,  occ 
three  inches 
case  or  sac. 
The  heart 
it  is  endowe( 
sides,  a  right 
cular  partitic 
the  lungs ;  t 
side  is  divide 

The  Auric 

i^servoirs  to  1 
parts. 

The  Ventri 

carnece.  The 
I'ight,  beirg  r 
cavities  will  c 

The  Tricus 

on  the  right 
'uembrane.  ' 
side.  Small  ^ 
pass  from  th 
columnae  earn 
«re  of  the  bl< 
the  auricles. 

'^if  pvlmot 
"ght  ventricle 
"f  the  left  ver 
arteries  are  nn 
valves.  Fig.  3 
^  is  tlie  right  j 
Jght  ventricle 
'll  10,  the  vesse 
the  heart. 


BMi^ 


ANATOMY. 


87 


The  Organs  of  Circulation. 

The  food  having  been  digested,  changed  to  chyle,  absorbed  by  the 
lacteals,  carried  to  the  veins,  poured  into  the  right  heart,  sent  up  to 
the  lungs,  and  prepared  for  nourishing  the  body,  will  still  be  useless, 
if  not  distributed  to  every  part  of  the  system.  The  organs  for  ef- 
fecting this  distribution  are  the  Jieart,  the  arteries,  the  vein*,  and  the 
eapillariea. 

The  Heart  is  placed  obliquely  in  the  chest,  with  one  lung  on  each 
side,  and  is  enclosed  between  the  two  folds  of  the  mediastinum  Its 
form  is  something  like  a  cone.  Its  baae  is  turned  upward  and  back- 
ward in  the  direction  of  the  right  shoulder;  the  apex  forward  and  to 
the  left,  occupying  the  space  between  the  fifth  and  sixth  ribs,  about 
three  inches  from  the  breast-bone.  It  is  surrounded  by  a  membranous 
case  or  sac,  called  the  pericardium. 

The  heart  is  a  muscular  body,  and  has  its  fibres  so  interwoven  that 
it  is  endowed  with  great  strength.  It  is  a  double  organ,  having  two 
sides,  a  right  and  a  left,  which  are  divided  from  each  other  by  a  mus- 
cular partition,  called  a  septum.  The  right  heart  sends  the  blood  to 
the  lungs  ;  the  left  heart  distributes  it  to  the  general  system.  Each 
side  is  divided  into  two  compartments,  an  auricle  and  a  ventricle. 

The  Auricles  have  thinner  walls  than  the  ventricles,  being  only 
reservoirs  to  hold  the  blood  until  the  ventricles  force  it  along  to  other 

parts. 

The  Ventricles  have  within  them  fleshy  columns,  called  columnce 
earnece.  The  walls  of  the  left  ventricle  are  thicker  than  those  of  the 
right,  beirg  required  to  contract  with  more  force.  Each  of  the  four 
cavities  will  contain  from  one  and  a  half  to  two  ounces  of  blood. 

The  Tricuspid  valves  are  situated  between  the  auricle  and  ventricle 
on  the  right  side,  and  consist  of  three  folds  of  a  thin,  triangular 
membrane.  The  mitral  valves  occupy  the  same  position  on  the  left 
side.    Small  white  cords,  called  chordce  tendince,  8^  Lio 

pass  from  the  floating  edge  of  these  to  the 
columnas  earner,  to  prevent  the  backward  press- 
ure of  the  blood  from  carrying  the  valves  into 
the  auricles. 


The  pvlmonary  artery  is  the  outlet  of  the 
right  ventricle ;  the  larger  artery,  called  aorta, 
of  the  left  ventricle.  At  the  opening  of  these 
arteries  are  membranous  folds,  called  semilunar 
valves.  Fig.  33  gives  a  fine  view  of  the  heart : 
1.  is  the  right  auricle  ;  ti,  the  left  auricle ;  8,  the 
right  ventricle  ;  4,  the  left  ventricle;  5,  6,  7,  8, 
9, 10,  the  vessels  which  bring  the  blood  to  and  carry  it  away  from 
the  heart. 


Fia.  8S. 


ANATOMY. 


The  Arteries  are  the  round  tubes  which  carry  the  red  blood  from 
the  left  side  of  the  heart  to  every  part  of  the  body. 

The  sides  of  arteries  are  stiff  and  hard,  and  do  not  fall  together 
when  empty.  They  may  often  be  seen  open  in  a  piece  of  boiled  beef. 

The  arteries  have  tlu-ee  coats, — an  external,  which  is  cellular,  firm 
and  strong ;  a  middle,  which  is  fibrous  and  elastic ;  and  an  internal, 
which  is  serous  and  smooth,  being  a  continuation  of  the  lining  of 
the  heart.  They  are  surrounded  by  a  cell  vestment  called  a  sheath, 
which  separates  them  from  surrounding  organs. 

The  Pulmonary  Artery  starts  from  the  right  ventricle  in  front  of 
the  opening  of  the  aorta,  and  ascends  to  the  under  surface  of  the 
aortic  arch,  where  it  parts  into  two  branches,  sending  one  to  the  right, 
the  other  to  the  left  lung.  Having  divided  and  subdivided  to  a  great 
extent,  they  end  in  the  capillary  vessels,  uniting,  joining  their  mouths, 
and  becoming  continuous  with  the  pulmonary  veins  just  where  they 
pass  around  the  air-cells. 

The  Aorta  is  the  largest  artery  in  the  body.  It  takes  a  slight  turn 
in  the  chest,  called  the  arch  of  the  aorta,  from  which  are  given  off  the 
arteries  which  carry  the  blood  to  the  head,  etc. ;  thence  it  descends 
into  the  belly  along  the  side  of  the  backbone,  and  at  the  bottom  of 
the  abdomen  it  divides  into  two  arteries,  called  the  iliacs  —  one  going 
to  each  of  the  lower  limbs.  The  branches  the  aorta  gives  off  a  supply 
of  red  blood  to  every  part  of  the  body. 


The  Veins  carry  the  dark  or  purple  blood.  Being  made  red  and 
vital  by  meeting  atmospheric  air  in  the  lungs,  and  then  conveyed  to 
every  part  of  the  body  in  the  arteries,  the  blood  loses  its  redness  in 
the  capillaries,  and  comes  back  to  the  heart  in  the  veins,  dark  and 
purple,  and  unfit  to  support  life.  The  veins  are  more  numerous  and 
nearer  the  surface  than  the  arteries.  They  have,  likewise,  thinner 
walls,  and  when  empty,  they  collapse  or  fall  together.  They  begin 
in  the  small  capillaries,  and  running  together,  they  grow  larger  and 
larger,  and  finally  form  the  great  trunks  which  pour  the  dark  blood 
into  the  right  auricle.  The  veins  are  composed  of  three  coats,  simi- 
lar to  those  of  the  arteries,  with  the  exception  of  being  thinner  and 
more  delicate.  These  vessels  have  valves  all  along  their  inner  sur- 
face, to  aid  in  circulating  the  blood. 

The  large  vein  which  receives  all  the  dark  blood  from  above,  and 
pours  it  into  the  right  auricle,  is  called  the  vena  cava  descendens ;  the 
one  which  takes  it  from  below,  tvnd  disposes  of  it  in  the  same  manner, 
is  the  vena  cava  ascendens. 

The  pulmonary  veins  bring  the  red  blood  from  the  lungs  to  the  left 
auricle,  and  thus  are  exceptional  in  their  use,  —  being  the  only  veins 
which  carry  red  blood. 

The  Capillaries  are  the  extremely  fine  network  of  vessels  between 
the  ends  of  the  arteries  on  the  one  side,  and  of  the  veins  on  the  other. 


THE 


W 


mat 


PI.  4. 


THE  ARTERIES  AND  VEINS  OF  THE  HUMAN  BODY 


Tli(>y  inos( 

one  end,  a 

industrioui 

red,  and  i\ 

tliey  take  t 

and  vitaliz 

beginnings 

for  another 

in  the  lun^ 

In  Fig. 

lation.     Fi 

thrown  int 

tery,  3,  ar 

<!arry  it  to 

capilhiry  v( 

conies  in  ( 

and  l)ecom 

Thence  it  i 

auricle  of 

veins,  7,  8. 

into  the  le: 

forcible     C( 

sends  it  foi 

11.     Its  b 

distribute  i 

Iwdy.     The 

in  the  capil] 

the  blood  1( 

goes  back  t 

1,  by  the  ve 

15,  and  tht 

ens,  16.     T 

17,  prevent 

blood  from 

to  the  right 

lunar  valve 

blood  from 

ventricle. 

the  left  ven 

vent  the  bai 

Ky  a  care 
the  reader  n 

The  passa 
and  back  t'> 
its  passii- 0  f: 
to  the  right 


ANATOMY. 


89 


Tlicy  inosculate,  or  join  their  nioutlis  to  tlic  very  small  arteries  at 
one  end,  and  to  the  equally  small  veins  at  the  other.  They  are  the 
industrious  little  builders  of  the  human  frame.  Receiving  the  blood, 
red,  and  full  of  life,  from  the  terminal  extremities  of  the  arteries, 
they  take  the  living  particles  out  of  it,  and  apply  them  to  the  renewing 
and  vitalizing  of  the  body,  and  then  pass  it  along  into  the  hair-like 
beginnings  of  the  veins,  dark  and  Iwreft  of  vitality,  to  he  carried  up 
for  another  freight  of  chyle,  and  to  be  again  vitalized  by  being  touched 
in  the  lungs  by  the  breath  of  heaven. 

in  Fig.  34  we  have  a  good  ideal  illustration  of  the  whole  circu- 
lation.    From  the  right  ventricle  of  the  heart,  2,  the  dark  blood  is 
thrown  into  the  pulmonary  ar- 
tery, !J,  and  its  branches,  4,  4, 
carry  it  to  lx)th  lungs.     In  the 
capillary  vessels,  6,  6,  the  blood 
conies  in  contact  with  the  air, 
and  becomes  red  and  vitalized. 
Thence  it  is  returned  to  the  left 
auricle  of  the  heart,  9,  by  the 
veins,  7,  8.     Thence   it   passes 
into  the  left  ventricle,  10.     A 
forcible     contraction     of     this 
sends  it  forward  into  the  aorta, 
11.     Its  branches,  12,  13,  18, 
distribute  it  to  all  parts  of  the 
l)ody.     The   arteries   terminate 
in  the  capillaries,  14,  14.     Here 
the  blood  loses  its  redness,  and 
goes  back  to  the  right  auricle, 
1,  by  the  vena  cava  descendens, 
15,  and  the  vena  cava  aacend- 
ens,  16.     The  tricuspid  valves, 
17,  prevent  the    reflow  of  the 
blood  from  the  right  ventricle 
to  the  right  auricle.    The  semi- 
lunar valves,  18,  prevent   the 
blood  from  passing  back   from  the  pulmonary  artery  to  the  right 
vcntricrle.     The  mitral  valves,  1 9,  prevent  its  being  forced  back  from 
the  left  ventricle  to  the  left  auricle.     The  semilunar  valves,  20,  pre- 
vent the  backward  flow  from  the  aorta  to  the  left  ventricle. 

By  a  careful  examination  of  this  diagram,  with  these  explanations, 
the  reader  may  understand  the  circulation  very  well. 

The  passage  of  the  blood  from  the  right  heart,  through  the  lungs, 
and  back  t'>  the  left  heart,  is  called  the  lesser,  or  pulmonic  circulation  ; 
its  passu:^3  from  the  left  heart  through  all  parts  of  the  body,  and  back 
to  the  nght  heart,  is  the  greater  or  systematic  circulation. 


FIO.  34. 


.J' 


y 


If 


Vi 


V 


f 


40 


ANATOMY. 


The  Absorbent  Vessels. 


The  vessels  which  absorb  the  chyle  from  the  small  intestines,  and 
convey  it  onward  towards  the  blood,  are  the  lacteaU.  They  have 
been  described.     The  veins  are  also  supposed  to  have  the  power  of 

absorption,  particularly  the  small 
commencements     of     the     veins. 
These     have    likewise    been    de- 
'^°-  «•  scribed. 


The  Lymphatic  vessels  resemble  the  lacteals 
skin,  the  mucous  membranes, 
and  the  lungs.  They  are 
very  small  at  their  origin, 
and,  like  the  veins,  they  in-  • 
crease  in  size,  as  they  dimin- 
ish in  numbers.  Like  the 
veins,    too,   they   travel   to-  • 

wai-ds  the  heart,  and  their 


They  abound  in  the 


Fio.  36, 


FlO.  37. 


contents  are  poured  into  it. 
Their  walls  are  composed  of 
two  coats ;  -S.\e  external  is 
cellular,  and  distensible  ;  the 
internal  is  folded  into  valves, 
like  that  rf  the  veins. 

These  vessels,  on  their 
way  to  the  heart,  pass 
through  soft  bodies,  called 
lymphatic  glands,  which  bear 
to  them  the  relation  that  the 
mesenteric  glands  do  to  the 


lacteals.  T 
lymphatic  g 
arm-pits,  an( 
parts  of  the 
magnified;  '. 
trunks;  Fig 
thi'ough  it. 

Fig.  38  rej 
6,  show  thes( 
the  commenc 
lymphatic  ai 
of  the  stomac 
13, 14,  15,  th 
19,  20,  the  la 
the  heart. 

A  cold  will 
ings  aie  calle( 
from  cold,  an( 
larly  in  scrofi 
and  break,  for 


The  exhalar, 

Hon. 

The  Exhala 

nations  upon  tl 
terminations  uj 
posure. 

The  Follicle 

membranes.  1 
little  bags.     Ve 

QIands  are  s 
ing  many  kinds 
united  in  one  mi 
lias  a  small  d 
main  duct  whic 
shows  a  gland  : 
through  its  bo 
1,  the  large  duct 
substance  is  car 

The  mesente 
werely  modify  tl 
tnem ;  others  se 
fluids  to  be  used 


m^ 


% 


ANATOMY.  4J 

lacteals.     These   glands   are   a   ooUection    ,.f    small    vessels.     The 
lymphatic  glands  are  most  numerous  in  the  neck,  chest,  abdomen 
arm-p,te  and  groins.     They  are  also  found,  to  some  extant,  in  othei^ 
parts  of  the  body      Fig  3o  shows  a  single  lymphatic  vessel,  much 
maguihed;  Fig  36  exhibits  the  valves  along  one  of  the  lymphatic 

though  it^"  ''  '  ^^"'P'^'^^'  ^^'"^  ^''^  '^'  vessels  pLing 

Fig.  38  represents  the  lymphatic  vessels  and  glands.     1,  2,  3  4  5 
b,  show  these  vessels  of  the  lower  limbs ;  7,  the  inguinal  gknds  ;'  8,' 

he  commencement  of  the  thoracic  duct,  into  which  the  contents  of 
lymphatic  are  poured ;  9,  the  lymphatics  of  the  kidneys ;  10,  those 
?q  ir^.T  '  ^M^"«««f  i»'«  liver;  12,  12,  those  of  the  lungs ; 
1Q  Jn'  i '  t  '^  °^-*^^  ^n'"' '  ^^'  ^^'  1^'  *h°««  of  the  face  and  neck  ; 
the  hit  ""^"^  '         *^^  *^°''''''*'  '^"'*'  ^^'  *^^  ly'^Phatics  of 

A  cold  will' often  cause  lymphatic  glands  to  swell.     These  swell- 
mgs  are  called  kernels.     They  often  swell,  also,  without  the  irritation 

cm  cold,  and  become  very  much  and  permanently  enlarged,  particu- 
arlyiu  scrofula.  In  scrofulous  subjects  they  sometimes  suppurate 
and  break,  forming  bad  sores  upon  the  neck. 


The  Organs  of  Secretion. 


^_JHE  exhalants,  the  follicles,  and  the  glands  are  the  organs  of  seere- 

The  Exhalants  are  the  sweat-glands.  These  have  external  termi- 
nations  upon  the  skin,  thus  communicating  with  the  air,  and  internal 
t.™mations  upon  the  surfaces  of  organs  n^ot  having  an'  outwTrd^x- 

membi-anpl,"'''T.  "'"  ''"^"  T'  i^^^^d  V"  ^^e  true  skin  and  mucous  ^ 

iS  iZ     V     ^T  °^  *^'  '^''^  *""  *^«  ^"°"*1^«  "'•  o'^tlete  of  these 
little  bags.     Veins  and  organic  nerves  are  sent  to  these  vessels. 

aiands  are  soft  organs,  having  a  variety  of  structure,  and  perform      • 
ig  many  kinds  of  secretion.     A  gland  is  made  up  of  severallobS 
united  in  one  mass,  and  each  of  these  lobules  ' 

has  a  small  duct,  communicating  with   a  jSl^^.  C? 

main  duct  which  forms  the  outlet.  Fig  39 
shows  a  gland :  2,  the  small  ducts  spread 
hrough  Its  body,  and  running  together; 
i,  the  large  duct,  through  which  the  secreted 
substance  is  carried  away. 

The  mesenteric  and  lymphatic  glands 
merely  modify  the  fluids  which  pass  through 
tnem;  others  secrete  from  the  blood  either 
nuids  to  be  used  in  the  body,  or  such  as  are  to  be  cast  away 


■1^ 


42 


ANATOMY. 


if 


The  Vocal  Organs. 

No  sounds  touch  the  heart  like  those  of  the  human  voice,  for  no 
mechanic,  however  scientific  and  skilful,  has  ever  been  able  to  make 
an  instrument  which  could  produce  sounds  as  beautiful,  tones  its 
varied,  a  timbre  as  melodious,  and  inflexions  as  manifold  and  agree- 
able. It  has  been  compared  to  wind,  reed  and  stringed  instruments. 
In  touching  expression,  it  is  most  resembled  by  the  concert-horn,  tlie 
bassoon,  and  the  hautboy. 

Vocal  sounds,  paat  all  question,  are  produced  in  the  larnyx,  but 
these  sounds  are  grouped,  or  formed  into  articulate  speech,  by  the 
pharynx,  the  nasal  cavities,  the  tongue,  the  teeth,  etc. 

The  Larynx  is  a  kind  of  cavity  or  tube  at  the  top  of  the  windpipe, 
formed  by  the  union  of  five  cartilages,  namely,  the  thyroid,  the  cricoid, 
the  two  arytenoid,  and  the  epiglottis.  Ligaments  bind  these  together, 
and  muscles  move  them. 

The  Thyroid  Cartilage  is  composed  of  two  parts,  and  has  a  con- 
nection with  the  bone  of  the  tongue  above,  and  with  the  cricoid  car- 
tilage below. 

The  Cricoid  Cartilage  is  .shaped  like  a  ring,  and  hence  its  Greek 
name.  It  is  narrowest  in  front,  and  broadest  behind.  It  connectfi 
with  the  thyroid  cartilage 
above,  and  with  the  first  ring ; 
of  the  trachea  below.  Fig.  40 
gives  a  side  view  of  the  car- 
tilages of  the  larynx :  1,  bone 
at  the  base  of  the  tongue  (os 
hyoides)  :  2,  the  ligament  con- 
necting hyoid  bone  and  the 
thyroid  cartilage  ;  .3,  the  front 
of  the  thyroid  cartilage  ;  4,  the 
thyroid  cartilage  ;  6,  the  cri- 
coid cartilage;  7,  the  wind- 
pipe. 
'^*''  **■  Fig.  41  is  a  back  view  of 

the  cartilages  and  ligaments  of  the  larynx :  1,  is  the  back  surface 
of  the  epiglottis ;  3,  3,  the  os  hyoides ;  4,  4,  the  lateral  ligaments 
connecting  the  os  hyoides  and  the  thyroid  cartilage ;  5,  6,  the  back 
face  of  the  thyroid  cartilage;  6,  6,  the  arytenoid  cartilages;  7,  the 
cricoid  cartilage ;    8,  the  first  ring  of  the  windpipe. 

The  Arytenoid  Cartilages  are  upon  the  back  part  of  the  cricoid, 
and  are  connected  with  the  thyroid  cartilage  by  the  vocal  cords. 

The  Epiglottis  is  a  fibro-cartilaginous  lid,  shaped  like  a  leaf,  which 
covers  the  upper  opening  of  the  larynx.      It  is  connected  by  a  carti- 


lage to  the  1 
iage.  Breai 
down  upon  i 
passing  dow 

The  Vocal 

fibres,  enclos 
lines  in  widtl 
antt'iior  pro; 
tilages,  and 
the  anterior 
are  four   ligi 
two  superior 
ter  being  call 
k'tween   ther 
ineiits    thems 
the  lips  of  the 
tween  the  suj 
is  the  ventrich 
Fig.  42  rep 
from  above:  . 
cricoid ;    h,  h, 
verse  ar_ytenoi( 
ligaments. 

The  muscles 
of  pulling  then 
the  laryngeal  c 
and  to  relax  or 
others,  the  soui 
Tightening  the 


The  skin  is 
entire  person. 
is  the  true  skin 
ture  f,nd  uses. 

TheScarf-SI 

"rane.  partially 

blood-vessels  or 
a  simple  coverii 
"gents.  It  is  tl 
The  scarf-skii 
'rom  it  in  the  si 
and  dries  up  int 
of  these  scales, 
new  layen,  are  £ 


ANATOMY. 


48 


uge  to  the  bone  of  the  tongue  (os  hyoides)  and  to  the  thyroid  carti- 
age.     Breathing  opens  and  shuts  it;   and   in  swallowing,  it  closes 

down  upon  the  top  of  the  larynx,  to  prevent  food  and  drink  from 

piissing  down  the  windpipe. 

The  Vocal  Cords  are  two  ligaments,  formed  of  elaatic  and  parallel 
hbres,  enclosed  in  a  fold  of  mucous  membrane.  They  are  about  two 
lines  in  width,  and  inserted  behind  into  the 
aiitt'iior  projection  of  the  arytenoid  car- 
tilages, and  passing  forward,  are  fixed  <o 
the  anterior  angle  of  the  thyroid.  There 
are  four  ligaments  crossing  the  larynx, 
two  superior  and  two  inferior,  —  tlie  lat-  2 
ter  being  called  vocal  cords.  The  interval 
tetween  them  is  the  glottis.  The  ligar 
ineiits  themselveis  are  sometimes  called 
tiie  lips  of  the  glottu.  The  depression  be- 
tween the  superior  and  inferior  liganiciits 

is  the  ventricle  of  the  larynx.  r 

Fig.  42  represents  a  view  of  the  larynx  ''™'  *^- 

from  above  .•    a,  6,  c  the  thyroid  cartilage,  enclosing  the  ring  of  the 
cricoid;   A,  A,  e,  c,  the  arytenoid  cartilages  connected  by  the  trans- 

Z^T  '  '"' ''  *^'  ^"'"*  '"'^  '  "' '''  '^'  crico-aiytenoid 

The  muscles  which  are  attached  to  the  cartilages  have  the  power 
of  pulling  them  about  so  a«  to  change  in  various  ways  the  shape  of 
the  laryngeal  cavity;  to  enlarge  or  diminish  the  size  of  the  riottis 
and  to  relax  or  tighten  the  vocal  cords.     By  these  means,  and  some 
othei.,  the  sounds  of  fhe  voice  receive  theirwious  moScations 
lightemng  the  cords,  for  example,  raises  the  pitch. 

The  Skin. 

The  skin  is  a  membrane  composed  of  two  layers,  coverimr  the 
en  .re  pei.om     The  outer  layer  is  the  scarf-skin  or^^.l-I J  the  fnner 

luiL  r,ud"ust"  ''  '"'"  ''  ""■     ^^'''  ^'^"'^  ^^''  ^"  '^'^  «*^««-. 

The  Scarf-Skin,  called  also  cuticle  and  epidermis,  is  a  thin  mem- 
mne-  P'^rtially  transparent,  like  a  thin  shaving  of  horn.  HavinTS, 
lood-vessels  or  nerves,  and  consequently  no  4ling,  it  appear.  I  be 
a  simple  covering  to  protect  the  true  skin  from  injury  by  external 
agents.  It  is  thickest  on  those  part«  most  exposed  to  friction 
froi-  itrl  ?  ''  *^!  production  of  the  true  skin, -an  exudation 
Z"^J  ■  IT  °^  *  f""'^  ^^^^^  ^«  «P"ad  out  aa  a  thin  layer, 
TiiT  "P/"^  ^f^""^^  '''*^"«-     ^^^  «^<^i«l«  ^  composed  chiefl;  ' 

tl\ZT     \  ^''^'  ''  «T**"*^y  ^^"^  "'^^•^^  off  ^  «curf,  while 
new  layers  are  forming  underneath. 


f 


44 


ANATOMY. 


The  lower,  softer  layer  of  the  scarf-skin,  called  the  malpighian 
layer,  or  rete  mucosum,  is  the  seat  of  ,-:rior.  In  this  part  the  cells 
contain  a  pigment  incorporated  with  the  elementary  granules,  which 
gives  to  the  various  races  their  sevenil  shades  of  color.  The  depth 
of  hue  is  dependent  entirely  on  the  amount  of  tliis  coloring  matter. 

The  True  Skin,  which  is  called  vuiia^derma  or  coriiim,  is  a  kind  of 
wel),  woven  of  small  fil)res  collected  into  strands.  In  the  upper  por- 
tion, the  web  is  line  and  tirm,  but  grows  coarser  below.     Connected 


Fio.  43. 


with  its  under  surface  is  a  fibrous  web  in  which  the  fat  is  deposited. 
Upon  its  upper  surface  is  the  sensitive  or  papillary  layer,  composed 
of  blood-vessels  and  nerves,  doubled  into  loops,  which  give  little 
prominences  called  papillae.  Fig.  43  gives  an  ideal  view  of  these 
elevations,  composed  as  they  are,  of  a  nerve,  an 
artery,  and  a  vein,  lying  side  by  side ;  1,  1, 
represent  the  true  skin ;  2,  2,  the  papillary 
layer;  3,  3,  the  arteries;  4,  4,  the  veins;  and 
6,  5,  the  nerves  of  the  papillse. 

The  arteries,  veins,  and  nerves  are  spread 
over  the  true  skin  in  great  numbers,  —  so  pro- 
fusely, that  it  is  impossible  to  push  the  point  of 
the  finest  needle  into  it,  without  piercing  a 
blood-vessel  and  a  nerve. 

Fig.  44  gives  a  view  of  the  skin :  a,  a,  the 
cuticle ;  b,  6,  the  colored  layer  of  the  cuticle ; 
tf,  c,  d,  c?,  the  true  skin ;  e,  e,  e,  fatKiells ;  /,/,/ 
sweat-tubes. 

The  lymphatics  are  very  numerous  in  the  skin,  besides  which  there 
are  oil-glands  and  tubes,  and  sweat-glands  and  tubes. 

The  Oil-Qiands  are  imbedded  in  the  skin,  and  communicate  with 
the  surface  by  small  tubes.     They  are  most  abundant  on  the  face, 


FlO.  45. 


nose  and  ears 
the  tube,  and 
1 


The  Sweat-i 

through  tlie  tri 
where  it  coils  t 
tory  gland.  Fi 
nified  forty  diai 
two  excretory  d 
tul)e,  which  ope 
fat-cells. 
The  hair  and 


The  Nervous 

nected  with  each 
nerves;  the  spini 

The  Brain  is  t 

wnes.     It  is  mac 

cipal  parts,  — the 
^*'««w,  and  the 
These  are  nicely 
tected  by  three  m 
"wfer,  the  arach^ 
mater. 

^.  %  47  shows  a 
t'on  of  the  brain,  ■ 
»''d  membranes 
^ne  scalp  turned 
rented  by  a,  a  ;  e, 
^''ge  of  the  bonea 
mater,  drawn  up 
">"  convolutions  c 

The  Cerebrum  i 

'■"Kt-'i'  portion  of  i 


MH^ 


ANATOMY. 

noBP  and  eare.     Fig.  4.5  hI.ows  an  oil-glan.l, 
the  tube,  and  c,  ita  mouth. 


46 


—  a,  being  the  gknd,  b. 


W^. 


th4.f rf;ui,T]^r:nVri  n"  *""i  ^^^^'^  p-  ^'-» 

where  it  coils  upon  itself  inSTlTn^  »"  the  -neshes  at  the  bottom, 

mfied  forty  dialtersTT^L  h«  -n  ?  f  i  ''''^'  *''^'  ^^'"»d,  mag- 
two  excretory  duct«  f;om  the  fland  it  *"''"•  *?'"  ^''""^ '  -  2,  the 
tul.,  which  opens  at  4  wh  ch  fs  th^nS'"'  Tf''^  ^''""  «"«  ^P'^*^! 
fat*ells.  '  "  '^  **''  ^'^^"ce  ot  the  cuticle;  3,  are  the 

The  hair  and  the  nails  are  appendages  of  the  skin. 


The  Nervous  System. 


--;  the  spinal  ner^e.  aidlJfe'.X^Srr;:'  '^^ ^  '''  --'«^ 

^n^^  'ftt  iVdf upTfVh^er;^  '"^^^^  '^'^''  -'"^^  *^e  ^^^^H- 
cipal  parts  -the  cer.irwm,  the  cere- 
allium,  and  the  w^rfw/Za  oblor^ata. 
Ihese  are  nicely  covered  and  pro- 

te  ted   y  three  membranes,  the  Zr« 
»'«J^r,  the   aracAno^rf,  and   the  pia 

tilff  ^1  ^t""^^  *  considerable  por- 

ThP^?^"*"^'     being    removed. 
The  scalp   turned    down   is   repre- 

"later,  drawn  up  with  a  hook  •   f 
"'«  convolutions'^  of  the  braTn         ' 

J^^^*';*'"•"™  «  the  upper  and 

'"5>^^  portion  of  the  brain,  and  is  f.o.  47. 


IK 


46 


AM4T0MY. 


(livi(le<l  into  two  hemiflphereB  by  a  fisBure.  A  portion  of  the  dura 
mater  dipu  into  tJuH  (;left,  and  from  its  re8enil>lanc(!  to  a  Hicklu,  in 
called  the  falx  cerebri.  The  dimign  of  tbiH  seems  to  Iw  to  support 
each  half  of  the  brain,  and  to  prevent  it  from  preHsingupon  the  other 
half  when  the  head  reclineH  to  one  side. 

The  undulating  surface  of  the  cerebrum  is  produced  by  what  are 
called  convolutioHH.  The  lower  surface  of  this  organ  is  divided  into 
three  lol)e8,  —  the  anterior,  the  middle,  and  the  posterior. 

The  Burface  of  the  (iereljruni  w  of  a  gray  color,  culled  cortical,  or 
oinerifioug ;  the  central  portion  is  white  and  fibrous,  and  is  called 
medullary. 

The  Cerebellum  is  about  one-sixth  the  size  of  the  cerebnim.  It 
lies  just  under  the  posterior  lobe  of  the  cerebrum,  and  is  separated 
from  it  by  an  extension  of  the  dura  mater,  called  the  tentorium.  It 
is  composed  of  white  and  gray  matter;  when  the  former  is  cut  into, 
there  is  presented  the  appeamnce  of  the  trunk  and  branches  of  a  tree^ 
called  arbor  vita:. 

The  MeduiJa  Oblongata  is  the  top  of  the  spinal  cord;  but  being 
within  the  enclosure  of  the  skull,  it  passes  for  a  portion  of  the  brain. 
It  consists  of  three  pairs  of  bodies,  united  so  as  to  form  a  bulb. 

The  Dura  Mater  is  a  strong,  fibrous  membrane  which  lines  the 
skull  and  spinal  column,  and  sends  processes  inward  to  support  the 
brain,  and  forward,  as  sheaths  for  the  nerves  which  go  out  from  the 
brain  and  spinal  cord. 

The  Arachnoid  is  a  serous  membrane,  and  like  all  other  serous 
membranes,  is  a  closed  sac.  It  is  leilected  upon  the  inner  surface  of 
the  dura  mater. 

The  Pla  Mater  is  a  vascular  membrane,  and  lies  next  to  and  in- 
vests the  whole  surface  of  the 
brain,  —  dipping  into  its  con- 
volutions. It  furnishes  nu- 
triment to  the  brain. 

The  Cranial  Nerves  which 
go  out  from  the  brain  are  in 
twelve  pairs.  In  reading  a 
description  of  them,  let  the 
reader  keep  his  eye  on  Fig.  48. 

The  First  Pair,  olfactory 
(6),  passes  through  several 
small  openings  in  the  ethmoid 
bone,  and  is  distributed  to 
the  mucous  membrane  which 
lines  the  nose.  Destroy  this, 
and  the  sense  of  smell  is  gone. 


FlO.  48. 


The  Secoi 

skull,  and  en 
retina.  It  ii 
of  sight,  call 

The  Third 

iitiid  bone  to 

The  Fourt 

iniiNcle  of  the 

The  Fifth 

loots,  iuid  divi 
iiiid  noNo,  call 
the  teeth  of  tl 
the  third  goin 
jiiw,  and  callei 
the  hranches  o 
affection  callet 

The  Sixth  P 

•arotid  artery  < 
Ntmight  muscle 

The  Seventf 

teniiil  ear. 

The  Eighth  I 

Jt  sends  nervou 

The  Ninth  Pi 

■'^"iiie  opening  w 
lous  membrane 
The  Tenth  P« 

the  pharynx,  lui 
»"a  iKJwels. 

The  Eleventh 

"'"th  and  tenth  j 

The  Twelfth  F 

i"'fl  is  its  motion- 
those  who  talk  m 

The  Spinal  Cor 

'n  connection  wit) 
Ihe  upper  fend  of 
"ft.  Another  s 
^''hich  go  to  the  ui 
toi^,  where  the  ne 

f^'ssures  dip  int. 
'^™  -^teral  parts,  w 

^hese  lateral  col 


ANATOMY. 


47 


The  Second  Pair,  optic  nerve  (7),  paaflea  tliroiigh  the  iweof  the 
skull,  and  enters  the  cavity  of  the  eye  where  i  h  oxpiinded  upon  the 
retina-  It  iH  a  disease  of  this  nerve  which  occtisions  a  gradual  loss 
of  HJpht,  called  amauroHtit. 

The  Third  Pair,  niotoros  oculorum  (9),  passes  through  the  sphe- 
noid lx)ne  to  the  muscles  of  the  eye. 

The  Fourth  Pair,  patheticus  (10),  passes  to  the  superior  oblique 
immclo  of  the  eye. 

The  Fifth  Pair,  trifacial  nerve  (11),  like  the  spinal  nerves,  has  two 
mots,  and  divides  into  three  brandies,  one  going  to  the  eye,  forehead, 
iiiitl  noHe,  called  the  ophthalmio  branch ;  another  going  to  the  eye, 
the  tf t'th  of  the  upper  jaw,  etc.,  called  the  miperior  maxillary  ;  and 
the  third  going  to  the  ear,  the  tongue,  and  the  teeth  of  the  lower 
jaw,  and  called  the  inferior  maxillary.  It  is  a  painful  condition  of 
the  branoheHof  the  fifth  pair  which  constitutes  the  ^'••.libie  neuralgic 
affection  called  tie-douloureux. 

The  Sixth  Pair,  abducentes  (12),  passes  the  opening  by  which  the 
carotid  artery  enters  the  cavity  of  the  skull,  and  goes  to  the  external 
stniiglit  muscle  of  the  eye. 

The  Seventh  Pair,  portio  n<olIiH  (13),  is  distributed  upon  the  in- 
ternal ear. 

The  Eighth  Pair,  facial  nerve  (14),  is  distributed  over  the  face. 
It  sends  nervous  filaments  to  the  muscles. 

The  Ninth  Pair,  glosso-pharyngeal  nerve  (14),  passes  through  the 
same  opening  with  the  jugular  vein,  and  is  distributed  upon  the  mu- 
cous membrane  of  the  tongue  and  throat. 

The  Tenth  Pair,  pneumogastric  nerve  (16),  sends  its  branches  to 
the  pharynx,  larynx,  gullet,  lungs,  spleen,  pancreas,  liver,  stomach, 
and  Iiowels. 

The  Eleventh  Pair,  spinal  accessory  nerve  (16),  connects  with  the 
ninth  and  tenth  pairs,  and  is  distributed  to  the  muscles  of  the  neck. 

The  Twelfth  Pair,  hypo-glossal  nerve  (17),  goes  to  the  tongue, 
and  is  its  motion-producing  nerve.  It  's  a  nerve  of  great  energy  in 
those  who  tivlk  much. 

The  Spinal  Cord  extends  f'om  the  medulla  oblongata,  where  it  is 
in  connection  with  the  brain,  down  to  the  second  lumbar  vertebra. 
The  upper  fend  of  the  cord  presents  a  bulbous  swelling,  or  enlarge- 
ment. Another  swelling  is  found  where  the  nerves  are  given  off 
which  go  to  the  upper  extremities ;  and  a  third  near  the  end  of  the 
cord,  where  the  nerves  l)egin  which  go  to  the  lower  extremities. 

Fissures  dip  into  the  cord  before  and  behind,  and  divide  it  into 
two  lateral  parts,  which  are  united  by  a  thin  layer  of  white  substance. 

These  lateral  colunuis  are  divided  by  furrows  into  anterior^  lateral., 


;  .^K. 


I 


^g.^yjiyi! 


48 


anat6my. 


FIO.  49. 


and  posterior  columns; — the  anterior  being  supposed  to  be  the  motor 
column,  the  posterior  that  of  sensation,  and  the  lateral  divided  iu 
function  between  motion  and  sensation. 

The  5pinal  Nerves,  connecting  with  the  cord,  are  in  pairs,  of 
which  there  are  thirty-one.    Each  pair  has  two  roots,  —  a  motor  root, 

C,  Fig.  49,  arising 
from  the  anterior 
columns  of  the 
cord,  and  a  send- 
tivH  root,  D,  spring- 
ing from  the  pos- 
terior columns.  A, 
is  a  section  of  the 
cord,  surrounded 
by  its  sheath.  B, 
is  the  spinal  nerve, 
formed  by  the 
union  of  the  motor  and  sensitive  roots.  After  the  union,  the  nerve, 
with  its  motor  and  its  sensitive  filaments,  divides  and  subdivides 
as  it  passes  on,  and  is  distributed  to  the  tissues  of  the  several 
organs. 

The  thirty-one  pairs  of  spinal  nerves  are  divided  into  eight  pairs  of 
cervical,  twelve  pairs  of  dorsal,  five  pairs  of  lumbar,  and  six  pairs  of 
sacral  nerves. 

Fig.  50  gives  a  view  of  the  brain  and  spinal  cord,  with  the  nerves 
given  off  by  the  latter:  1,  1,  being  the  two  hemispheres  of  the  brain; 
3,  3,  the  cerebellum  ;  4,  the  olfactory  nerve ;  6,  the  optic ;  7,  the 
third  pair ;  8,  the  pons  varolii,  so  called  ;  9,  the  fourth  pair ;  10,  the 
lower  portion  of  the  medulla  oblongata ;  11,  11,  the  spinal  cord ;  12, 
12,  the  spinal  nerves ;  13,  13,  the  brachial  plexus ;  14,  14,  the  lum- 
bar and  sacral  plexus. 

The  Brachial  Plexus  is  formed  by  the  interlacing  of  the  four  lower 
cervical  and  upper  dorsal  pairs  of  nerves.  It  gives  off  six  nerves, 
which  are  distributed  to  the  muscles  and  skin  of  the  upper  extremi- 
ties. 

The  Lumbar  and  5acral  Plexus  is  formed  by  the  last  aorsal  and 
five  lumbar  nerves,  from  which  nerves  go  to  the  muscles  and  skin  of 
the  lower  extremities,  and  the  last  lumbar  and  four  sacral,  from 
which  nerves  are  sent  to  the  muscles  and  skin  of  the  hips  and  lower 
extremities. 

The  Sympathetic  Nerve  consists  of  a  series  of  knots  (ganglia), 
lying  along  on  each  side  of  the  spinal  column,  and  forming  a  knotted 
chain.  There  is  a  knot  for  each  intervertebral  space,  the  neck  ex- 
cepted. These  knots  are  composed  of  both  cineritious  and  raeduUarv 
matter. 


Each  knot  ] 
downward,  ext 


119. 


PlO.  60. 


•supplied  with  bran 
nerve  of  organic 
preside  over  nutril 
nerves  of  the  brai 
motion  and  sensati 
%  51  is  a  fin 
great  sympathetic, 
nections  with  oth« 
Jne  semilunar  ganj 
'J'"'g  just  under  t 
^fce  in  this  regioi 
Jomach  sometimes 
«"t,  the  external 
''?'; and  left  coror 
'"'fl'Ile,  and  superio 


Tl 


ANATOMY. 


49 


Each  knot  is  a  distinct  centre,  and  gives  off  branches  upward, 
downward,  externally,  and  internally.     All  the  internal  organs  are 


\'¥^' 


FlO.  SO. 


,•/' 


FlO.  61. 

supplied  with  branches  from  the  sjrmpathetic  nerve.     It  is  called  the 
nerve  of  organic  life,  and  is  supposed  to , 
preside  over  nutrition,  secretion,  etc.,  as  the 
nerves  of  the  brain  and  cord  preside  over  1 
motion  and  sensation. 

Fig.  51  is  a  fine  representation  of  the 
great  sympatiietic,  witli  its  knots,  and  con- 1 
nections  with  other  nerves.   A,  A,  A,  is ' 
the  semilunar  ganglion  and  solar  plexus,  ^^  " 

b'ing  just  under  the  diaphragm  and  behind  the  stomach.  Its  pres- 
ence in  this  region  is  the  reason  why  a  blow  upon  the  pit  of  the 
stomach  sometimes  destroys  life.  D,  D,  D,  are  the  thoracic  ganglia ; 
E.  E,  tlie  external  and  internal  branches  of  the  same ;  G.  F,  the 
light  and  left  coronary  plexus  upon  the  heart;  I,  N,  Q,  the  infei..  , 
middle,  and  superior  cervical  ganglia;  1,  the  renal  plexus  around  the 


if 


ANAl'OMY. 


kidneys ;  2,  the  lumbar  ganglion ;  3,  the  internal  branches ;  4,  the 
external  branches  ;  5,  the  aortic  plexus. 

Fig.  52  represents  a  plexus,  showing  how  the  filaments  of  one 
nerve  paas  to  be  enclosed  in  the  sheath  of  another.  In  this  way  they 
change  at  once  the  direction  of  their  journey,  and  their  companions 
upon  the  way. 

The  Organs  of  Sight. 

The  organs  of  vision  are  the  optio  nerve,  the  globe  of  the  eye,  the 
muscles  of  the  eye,  and  the  organs  of  protection. 

The  Optic  Nerve  begins  by  two  roots  at  the  base  of  the  brain,  the 
fibres  from  which  meet,  as  they  come  forward,  and  some  of  them  cross 

each  other.  The  two  nerves  then  sepa- 
.rate,  and  enter  the  back  part  of  the 
'globe  of  the  eyes,  and  then  spread  out 
into  a  kind  of  membrane.  In  Fig.  53 : 
1,  1,  show  the  globe  of  the  eye  ;  2,  the 
crossing  of  the  optic  nerve ;  8,  the 
origin  of  two  pairs  of  cranial  nerves. 

The  Qlobe  of  the  Eye  is  a  better 
constructed  optical  instrument  than 
man  ever  made.  Its  interior  is  filled 
with  what  are  called  refracting  human 
or  mediums,  which  are  surrounded  and 
held  in  their  place  by  membranes,  called  coats. 

The  Coats  are  the  sclerotic  and  cornea  ;  the  choroid,  iris,  and  ciliary 
processes  ;  and  the  retina. 

The  Sclerotic  Coat  is  a  fibrous  membrane,  covering  the  largest 
portion  of  the  globe.  To  this  the  muscles  are  attached.  It  is  the 
part  which  is  called  the  white  of  the  eye.  It  has  a  beveled  edge  in 
front,  into  which  the  cornea  is  fitted. 

The  Cornea  is  a  transparent  layer  which  projects  in  front,  and  forms 
about  one-fifth  of  the  globe.  It  is  shaped  like  a  watch-glass.  Its 
blood-vessels  are  too  small  to  receive  the  red  particles  of  blood. 

The  Choroid  Cpat  is  a  vascular  membrane.  Its  color  is  brown  ex- 
ternally, and  black  within.  It  is  connected  with  the  sclerotic  coat 
externally,  and  internally  with  the  retina.  It  is  composed  of  three 
layers. 

The  Iris  is  named  from  its  having  a  variety  of  colors  in  different 
persons.  It  is  the  partition  between  the  anterior  and  posterior  cham- 
bers of  the  eye,  and  has  a  circular  opening  in  the  centre  called  the 
pupil.  Of  its  two  layers,  the  fibres  of  the  anterior  one  are  radiating, 
and  dilate  the  pupil,  while  those  of  the  other  are  circular,  and  cause 
its  contraction. 


FlO.  63. 


u'ls ; 


"H 


It 


ANATOMY. 


51 


The  Ciliary  Processes  are  a  number  of  folds  formed  from  the  in- 
ternal layer  of  the  choroid  coat. 

The  Retina  has  three  layers.  The  external  is  extremely  thin  ;  the 
middle  is  nervous,  being  an  expansion  of  the  optic  nerve ;  the  in- 
ternal is  vascular,  and  consists  of  a  ramification  of  minute  blood 
vessels. 

The  divided  edge  of  their  coats  may  be  seen  in  Fig.  64,  namely, 
tlie  sclerotic,  the  choroid,  and  the  retina :  2,  is  the  pupil ;  8,  the 
4,  the  ciliary  process ;  .5,  the  scolloped  border  of  the  retina. 


uus 


FlO.  M. 


no.  6S. 


The  Humors  of  the  Eye  are  the  aqueous,  the  cri/stalline,  and  the 

vitreous. 

Th  -  Aqueous  or  watery  humor  is  situated  in  the  chambers  of  the 
eye.  it  is  an  albuminous  fluid,  with  an  alkaline  reaction,  and  a  spe- 
cific gravity  a  little  greater  than  distilled  water. 

The  Crystalline  Humor  is  immediately  behind  the  pupil.  It  is  a 
lens,  and  '^  convex  both  on  the  posterior  and  the  anterior  surface. 

The  Vitreous  Humor  is  also  an  albuminous  fluid  something  like  the 
aqueous  humor,  but  more  dense. 

In  Fig.  55  we  have  in  E  a  good  view  of  the  cornea  fitted  into  the 
sclerotic  coat ;  A,  is  the  choroid ;  B,  the  pigmentum  nigrum ,  C, 
the  retina ;  K,  the  vitreous  humor ;  D,  the  optic  nerve  ;  I,  the  lens ; 
C,  the  Iris,  painted  on  the  backside  with  pigment;  F,  the  aqueous 
humor. 

The  muscles  of  the  eye,  six  in  number,  are  attached  to  the  bones 
of  the  orbit  behind,  and  to  the  cornea  in  front,  by  their  tendons. 
These  tendons  give  the  eye  its  pearly  appearance.  In  Fig.  56, 
five  of  the  muscles  are  indicated  by  o,  5,  c,  d,  e;  f,  is  the  optic 
nerve. 

If  the  internal  muscle  be  too  short,  the  eye  is  drawn  in  towards 
the  nose,  and  the  squinting  called  "  cross^ye  "  is  produced. 


AHATOMY. 

The  Orbits  are  bony  sockets  which  encloue  the  eye.  The  optic 
nerve  passes  through  a  large  hole  at  the  bottom. 

The  Eyebrows  are  the  projecting  arches  above,  covered  with  short 
hair.  They  prevent  the  sweat  from  running  down  into  the  eyes,  and 
also  shade  them  from  strong  light. 

The  Eyelids  are  the  curtains  which  rise  and  fall  in  front.  The 
smooth  membrane  which  lines  them  is  called  the  conjunctiva.  It 
secretes  a  fluid  which  makes  the  eyelids  open  and  shut  easily. 


FlO.  67. 

The  Lachrymal  Qland  is  at  the  upper  and  outer  angle  of  the 
orbit.  Several  small  ducts  open  from  it  upon  the  upper  eyelid, 
through  which  the  tears  run  down  upon  the  conjunctiva. 

The  Lachrymal  Canals  begin  near  the  internal  angle  of  the  eye, 
by  two  small-tear  points,  which  communicate  with  the  sac  at  the 
upper  part  of  the  nasal  duct. 

The  Nasal  Duct  is  a  canal  about  three^uarters  of  an  inch  long, 
which  runs  down  to  the  inferior  channel  of  the  nose. 

Fig.  67  shows  these  organ  :  1,  being  the  lachrymal  gland  ;  2,  the 
ducts  leading  to  the  upper  eyelid;  8,  8,  the  tear-points  (punota 
lachrymalis)  ;  4,  the  nasal  sac  ;  5,  the  termination  of  the  nasal  duct. 


u 


The  Ors^ans  of  Hearing:. 

The  External  Ear  is  composed  of  the  pavilion  of  the  ear  (the  pinna), 
and  the  auditory  canal  (the  meatus  audltorius  externus). 

The  Pinna  surrounds  the  entrance  to  the  auditory  canal.  It  stands 
ou'  .'-om  the  head,  and  is  in  common  language  called  the  ear. 

The  rieatus  Auditorius  in  a  canal  about  an  inch  long,  partly  bony 
and  partly  cartilaginous,  which  goes  from  the  pavilion  of  the  ear  to 
the  drum  of  the  ear. 

The  Drum  of  the  Ear  (membrana  tympani)  is  an  oval-shaped  thin 
membrane,  inserted  into  a  groove  around  the  auditory  canal. 


wim 


2-lS?y-1rifa!-3£tii;^ 


'TSl 


ANATOMY. 

The  Tympanum  is  a  cavity  within  the  temporal  bone. 

The  Eustachian  Tube  is  a 

channel  of  communication  be- 
tween the  tympanum  and  tlie 
upper  part  of  the  pharynx. 
The  object  of  this  is  to  convey 
air  to  the  drum  of  the  ear,  as 
without  air  no  sound  can  be 
produced. 

The  Labyrinth  is  a  seiies  of 
chambers  through  the  petrous 
bone  —  embracing  the  vestibule, 
a  three-cornered  cavity  within 
thv,  tympanum ;  the  semi-circu- 
lar canals,  communicating  with 
the  vestibule,  and  the  cochlea, 
which  makes   two   and  a  half 


53 


PIO.  68. 

the  fenestra  ovalis ;  4,  6,  10,  the 


FlO.  SB. 

turns   around   an  axis,  called  the 
modiolus. 

In  Fig.  68,  a,  is  the  pa- 
vilion of  the  ear;  c,'  the 
auditory  canal ;  g,  the  mem- 
brana  tympani ;  k,  the  t3Tn- 
panum  ;  e,  the  bones  of  the 
ear  ;  b,  the  semicircular  ca- 
nals ;  /,  the  cochlea;  h,  the 
vestibule  ;  i,  the  eustachian 
tube ;  d,  the  auditory  nerve. 
In  Fig.  59,  we  have  a 
view  of  the  labyrinth  laid 
open,  and  highly  magnified : 
1,  1,  being  the  cochlea;  2, 
8,  the  channels  that  wind 
around  the  central  point 
(6)  ;  7,  7,  the  vestibule ;  8, 
the  foramen  rotundum;  9, 

gemicircular  canals, 


PHY8I0I0GICAL   LAWS    OF  LIFE  AND 
HEALTH.— HYGIENE. 


Life,  the  Infancy  of  Being. 

It  may  be  stated  as  a  general  truth  that  man  has  but  just  learned 
to  live  when  he  is  ready  to  die.  We  expend  a  large  portion  of  our 
lives  in  searching  out  our  mistakes,  and  in  striving  to  undo  the  mis- 
chiefs they  have  occasioned.  This  is  true  in  reference  both  to  our 
moral  and  our  physical  life  ;  and  I  draw  from  it  the  conclusion  that 
the  present  must  be  only  the  infancy  of  our  being,  and  that  our  blun- 
ders and  consequent  sufferings  here  will  cause  us,  in  the  great  here- 
after, to  place  a  higher  value  upon  knowledge,  and  to  struggle  with 
new  fortitude  to  rid  oui-selves  of  eveiy  bondage. 

A  life  which  has  just  begun  to  take  shape  and  symraetiy,  cannot 
be  permitted,  I  think,  under  the  rule  of  a  benevolent  Creator,  to  be- 
come extinct.  We  shall  certainly  be  permitted  to  take  up  the  broken 
thread  of  life,  and,  in  the  clearer  light  of  the  future,  with  the  warning 
experience  of  the  past,  and  surrounded  by  better  guards,  to  try  again. 
In  the  meantime,  while  here,  the  sooner  we  become  acquainted  with 
the  laws  of  life,  and  the  better  we  obey  them,  the  more  we  shall  en- 
joy- 

Tlie  Nervous  System. 

Man  is  brought  into  connection  with  the  outward  world  through 
the  senses  of  feeling,  seeing,  hearing,  etc.  These  communicate  with 
the  brain  and  mind  through  the  nerves  of  sensation. 

The  nervous  system  is  divided  into  two  great  central  portions, 
the  brain  and  the  spinal  cord ;  and  these  together  are  called,  by  the 
learned,  the  cerebrospinal  centre.  There  are  numerous  pulpy  white 
cords,  called  nerves,  which  at  one  end  are  connected  with  this  great 
axis  or  centre,  and  from  thence  run  to  all  parts  of  the  system.  A 
portion  of  these  nerves  start  from  the  base  of  the  brain  and  run  to 
the  eye,  the  ear,  the  tongue,  etc.  (Fig.  48)  ;  while  another,  and  a 
larger  part  spring  from  the  cord  which  runs  through  the  backbone, 
and  are  distributed  over  the  body  and  the  lower  extremities  (Figs. 
50  and  60).  One  portion  of  these  cords  produce  feeling ;  another 
part,  motion.  The  former  we  call  sensitive  ;  the  latter,  motor.  Both 
kinds  are  widely  distributed  over  the  body.  Those  which  spring 
from  the  spinal  cord  have  two  roots,  one  uniting  with  the  back,  the 

54 


Copyright,  by  Bradley  &  Woodruff,  1892, 


I 


Copyright,  by  Braolkv  &  WoonRUKK.  1S02 


f   >' 


w 


I 


'^Ir 


\ 


li. 


X 


s\^ 


mm 


"N, 


other  with 
part  to  wl 
mon    lan^ 
comes   nm 
may  move 
before.     C 
root,   whic 
producing, 
to  which  il 
move.       Il 
thougli  it 
acutely.    1 
nerves  tlial 
the  spinal 
pretty  well 
ill  Fig.  60. 
If  the  ci 
of  motion  ' 
the  face  be 
tion  or  pas 
expressed, 
will  all  be 
like  statuar;; 
to  laugh,  t 
give,  expres 
feeling  of 
guish,  or  lo 
impossible, 
breath  of  ai 
face  will  be 
ly  as  before, 
or  palsy,  as 
partial  orge 
result  of  in  ju 
or  many  of  tl 
producing  m 
ralgia,  tic  c 
etc.,   arise    i 
disease,  perh 
nuition,  of  th 
sensation. 

How  the 

of  the  extern! 
communicate 
acted  on  by  e: 
sensations."  ' 
with  the  inte] 


HYGIBNE. 


55 


other  with  the /ron^  part  of  the  cord.     Cut  off  the  back  root,  and  the 

part  to  which  It  18  distributed  loses  its  feeling.     As  wo  say  in  com' 

mon    language,   it   be-  ^ 

comes   numb,  though  it 

may  move    as   well    as 

before.     Cut  the   front 

root,   which   is  motion- 
producing,  and  the  part 

to  which  it  goes  cannot 

move.       It    is  palsied, 

though  it  may  still  feel 

acutely.    The  numerous 

nerves  that  spring  from 

the   spinal   column  are 

pretty  well  represented 

ia  Fig.  60. 

If  the  cranial  nerves 
of  motion  which  go  to 
the  face  be  cut,  no  emo- 
tion or  passion  can   be 
expressed.  The  features 
will  all  be  immovable, 
like  statuary.    To  smile, 
to  laugh,  to  frown,  to 
give,  expression  to  the 
feeliug  of  pity,  or  an- 
guish,  or  love,  is  alike 
impossible.     And  yet  a 
breath  of  air  upon  the 
face  wiWhe  felt  as  readi- 
ly as  before.    Paralysis, 
or  palsy,  as  it  is  called, 
partial  or  general,  is  the 
result  of  injury  upon  few 
or  many  of  these  motion- 
producing  nerves.  Neu- 
ralgia, tic  douloureux, 
etc.,   arise    from    some 
disease,  perhaps  inflam- 
niation,  of  the  nerves  of 
sensation. 

How  the  Mind  get*  Knowledge.  Everything  the  mind  knows 
of  the  external  world,  it  learns  through  the  the  orgLs  of  Teme  wSd! 
communicate  with  it  through  these  nerves.     Thus,  the  nm^es  ail 

ZtZ^'T^:\:'TT''i'''''  ^r^^  ""  the'bmin  anTcaS 

ensatons.     When  the  hand  is  burned  the  nerves  of  sensation  run 

^N.th  the  intelligence  to  the  brain,  which,  quick  as  thought,  through 


FlO.  60. 


KJ 


^iri 


•  WiiTiTW 


HYCTENE. 


the  nerves  of  motion,  despatches  orders  to  the  muscles  to  repel  the 
injury. 

Comparison.  —  The  arrangement  and  operation  of  the  nervous 
system  are  like  thoje  of  the  electric  fire-alarm  system  of  a  city. 
The  brain  is  the  intelligent  centre,  like  the  central  office.  The 
nerves  of  sensation  which  carry  to  the  brain,  with  electric  speed, 
intelligence  of  what  is  going  on  outside,  are  like  the  wires  which  run 
to  the  central  station  from  the  several  boxes.  The  quick  carry- 
ing to  the  brain  of  any  information  of  injury  done  to  some  part  of 
the  body,  is  like  sending  to  the  central  station  from  an  alarm-box 
the  intelligence  of  fire  in  one  of  the  districts.  The  rapid  transmis- 
sion of  orders  from  the  mind  to  the  muscles  is  like  flashing  the  alarm 
over  the  wires  to  every  part  of  the  city.  And,  finally,  the  powerful 
action  of  the  muscles  in  warding  off  danger  is  like  the  dashing  of 
firemen  over  the  pavements  and  the  energetic  playing  of  the 
engines. 

Sensations. 

An  effect  produced  on  the  mind  thi-ough  a  nerve  is  called  a 
sensation.  Hunger  is  a  sensation.  It  is  an  effect  produced  upon  the 
mind  through  ascertain  nerve  by  the  condition  of  the  stomach. 
Thirst,  pain,  heat,  cold,  are  sensations  in  a  similar  sense.  Nausea 
is  a  sensation  produced  by  some  injurious  substance  acting  upon  the 
coats  of  the  stomach. 

Strength  of  Sensation.  —  Some  sensations  are  much  stronger 
than  othei-s ;  some  are  very  intense.  A  very  strong  sensation  is 
called  a  feeling.  It  is  common  to  say,  "  I  feel  cold,"  or,  "  I  feel  hot." 
We  simply  mean  by  this,  that  the  temperature  of  the  weather  makes 
a  very  powerful  impression  upon  us. 

Kinds  of  Sensation. — Sensations  are  either  pleasurable  or  pain- 
ful. Pleasurable  sensations  arise  from  the  proper  exercise  of  some 
healthy  part  of  the  body ;  and  they  are  a  suitable  reward  for  any 
care  the  mind  may  take  of  the  corporeal  organs. 

The  sensations  arising  from  a  proper  amount  of  exercise  are 
pleasurable.  The  muscles  find  a  sort  of  enjoyment  in  action.  He 
who  leads  a  sedentary  life,  either  from  choice  or  necessity,  loses  much 
enjoyment.  Hence,  there  is  pleasure  in  labor ;  and  the  working-man, 
though  often  pitied  by  the  wealthy,  is  generally  the  happiest  of  men.* 
The  eye  and  the  ear,  when  directed  to  agreeable  sights  and  sounds, 
derive  the  most  agreeable  sensations  from  exercise.  The  air  of  a 
beautiful  spring-morning  gives  impressions  which  none  can  describe, 
but  which  all  know  to  be  delightful.  These  impressions  are  well 
fitted  to  reward  us  for  taking  at  that  season,  in  the  open  air,  the  ex- 
ercise we  so  much  need. 

Moral  Uses  of  Sensations.  —  How  little  we  reflect  upon  the 
amount  of  happiness  it  is  in  our  power  to  create  by  making  agreeable 


impression 
impression 
(if  families 
lies  in  the  1 
(hopping  ii 
acts  of  ber 
agreeable  a 
of  life,  —  c 
and  which 
us  like  spri 


In  aiming 

be  governed 

of  happinesi 

stairs, — shi: 

refining  infl 

or  for  recrea 

to  wear  a  fn 

flowers  of  ht 

Every  hui 

ism  of  whicl 

urable  or  pai 

life,  it  shouL 

Wives  may  j 

tion  of  their 

heart  of  the 

the  liusband. 

pressions  upc 

fully.     Most 

the  heads  of 

saying,  or  do 

other.     A  w 

loved  either  I 

who  desires  t 

life,  the  whol 

sions  upon  ot 

Agreeable 

tions  not  onl^ 
to  health.  T 
Travelling  pi 
variety  of  the 

Care  of  the 

portant  that  i 


HYGIENE. 


87 


impressions  upon  others.  A  civil  and  polite  address  makes  a  pleiisant 
iin|)re88ion.  A  kind  word,  fitly  spoken,  makes  the  heart  glad.  Heads 
of  families  might  do  much  to  increase  the  happiness  of  their  domes- 
tics in  the  kitchen  by  meeting  them  with  a  pleasant  countenance,  and 
(hopping  in  their  ear,  now  and  then,  a  word  of  approval.  Such,  little 
nets  of  benevolence  are  easily  performed,  and  they  make  the  most 
agreeable  and  lasting  impressions  upon  persons  in  the  lower  stations 
of  life,  —  creating  attachments,  in  fact,  which  end  only  with  death, 
and  which  in  hours  of  future  sorrow,  which  come  to  all,  may  refresh 
us  like  springs  of  water  in  the  desert. 

"  Full  iiiauy  a  shaft  at  random  sent,  ' 

FindH  luai'ks  the  archer  little  meant; 
Full  many  a  word  at  random  spoken, 
May  heal  a  wounded  heart  that's  broken." 

Sir  Walter  Scott. 

In  aiming  to  make  agreeable  impressions  upon  domestics,  we  should 
be  governed  by  the  simple  desire  to  create  happiness.  Their  sources 
of  happiness  are  comparatively  few.  They  spend  their  days  below 
staira, — shut  out  from  a  portion  of  the  light  of  day,  and  from  the 
refining  influences  of  the  drawing-room,  —  having  little  time  for  rest 
or  for  recreation.  How  unfeeling  to  treat  such  persons  with  harshness, 
to  wear  a  frowning  face  in  their  presence,  and  thus  wither  the  few 
flowers  of  happiness  which  bloom  around  them! 

Every  human  being  is  endowed  with  the  beautiful  nervrsus  organ- 
ism of  which  I  have  spoken,  and  is  daily  receiving  impressions,  pleas- 
urable or  painful,  from  thousands  of  sources.  In  all  the  relations  of 
hfe,  it  should  be  our  aim  to  touch  delicately  this  sensitive  structure. 
Wives  may  add  much  to  the  happiness,  and  I  may  say,  to  the  affec- 
tion of  their  husbands,  by  always  wearing  a  pleasant  face ;  and  the 
heart  of  the  wife  may  be  made  light  and  glad  by  gentle  words  from 
the  husband.  We  cannot  but  love  those  who  make  pleasurable  im- 
pressions upon  us,  and  we  necessarily  dislike  such  as  impress  us  pain- 
fully. Most  of  the  coldness  and  alienations  which  grow  up  between 
the  heads  of  families,  spring  from  the  habit  of  one  of  the  parties,  of 
saying,  or  doing,  or  looking  something  which  painfully  impresses  the 
other.  A  woman  who  habitually  wears  a  "sour"  face  cannot  be 
loved  either  by  her  husband  or  her  children.  The  man  or  the  woman 
who  desires  to  be  loved,  must  cultivate  a  manner,  a  look,  a  speech,  a 
life,  the  whole  scope  of  which  is  fitted  to  make  pleasurable  impres- 
sions upon  others.     It  is  against  nature  to  love  what  gives  us  pain. 

Agreeable  Sensations  a  Source  of  Health.  —  Pleasurable  sensa- 
tions not  only  beget  love,  and  increase  happiness,  but  they  add  much 
to  health.  They  exhilarate  the  spirits  and  drive  away  melancholy. 
Travelling  promotes  health  and  prolongs  life,  by  the  number  and 
variety  of  the  pleasing  impressions  it  makes  upon  the  mind. 

Care  of  the  Sick. —  Tf  the  above  statements  be  correct,  how  im- 
portant that  the  sick  should  be  so  dealt  with  as  to  have  none  but 


I 


HYQIENE. 


aj'p'eeable  sensations  made  upon  them.  Many  a  life  has  been  mcri- 
ficed  to  the  peevish  temper  of  a  nurse.  When  the  nerves  are  weak 
from  disease,  even  slight  causes  make  powerful  impressions  ;  and  if 
these  impressions  are  of  a  painful  kind,  the  results  are  most  deplora- 
ble. To  treat  harshly  the  sick,  especially  those  whose  nervous  system 
is  broken,  implies  either  great  thoughtlessness  or  extreme  cruelty.  A 
single  harsh  word,  which  would  scarcely  move  one  when  well,  may 
send  the  same  person,  when  sick,  almost  to  distraction.  Every  word 
spoken  to  persons  in  sickness  should,  therefore,  l)e  gentle  and  sooth- 
ing. Every  feature  of  the  face  should  express  either  cheerfulness, 
or  tenderness  and  pity. 

As  the  painful  impressions  which  disease  is  making  tends  to  de- 
press the  spirits  and  create  melancholy,  it  is  not  expected  that  peraons 
when  sick  will  exhibit  as  amiable  tempers  as  when  well ;  and  for 
this  all  due  allowance  must  be  made. 

Effect  upon  the  Disposition.  — This  leads  me  to  say  that  pleasur- 
able sensations  improve  the  temper  and  disposition.  This  is  a  fact  of 
very  great  importance,  and  parents  should  never  lose  sight  of  it  in 
dealing  with  their  children.  There  are  few  children  but  would  grow 
up  amiable  and  useful  members  of  society,  were  they  dealt  with  in 
the  gentle  and  tender  manner  which  their  young  and  impressible 
natures  require.  From  the  moment  the  young  mind  wakes  to  intelli- 
gence, it  will  he  occupied  with  something.  Parents  and  guardians 
should  aim,  therefore,  to  turn  it  to  all  those  things  which  will  impress 
it  pleasantly,  and  at  the  same  time  do  it  no  hai-m.  Exercise,  songs, 
playthings,  flowers,  — to  these  and  other  entertainments  it  should  be 
led  by  gentle  hands.  No  thoughtful  parent  will  ever  pain  a  child 
by  harsh  threats  and  denunciations,  or  shock  it  by  an  oath. 

Bad  Effect  of  Unpleasant  Sensations.—  If  pleasurable  sensations 
improve  the  health  and  temper,  unpleasant  ones  do  just  the  opposite. 
They  break  down  the  health  and  spoil  the  disposition. 

They  are  intended  to  give  us  a  warning  of  impending  injury. 
Thus,  we  have  painful  sensations  when  we  have  overworked  the  body 
or  mind.  The  sensation  of  weariness  tells  us  that  the  muscles  have 
worked  as  long  as  their  good  requires,  and  that  they  need  rest.  Were 
this  sensation  unheeded,  exhaustion  and  entire  prostration  would  be 
the  result. 

When  fatigue  begins  to  be  felt,  either  of  body  or  mind,  the  sensa- 
tion may  be  dissipated  by  strong  tea,  or  intoxicating  drink,  or  opium ; 
but  to  drive  it  away  in  this  manner,  for  the  purpose  of  working  longer, 
is  wrong,  and  leads,  in  the  end,  to  disease  or  exhaustion.  It  was  said 
that  one  of  the  most  brilliant  advocates  of  recent  times  was  dependent 
upon  opium  for  the  stimulus  to  carry  him  through  his  extraordinary 
flights  of  eloquence ;  but  his  restless  motion  and  nervous  face  reminded 
one  that  he  had  bent  his  bow  very  nearly  to  the  snapping  point,  and 
that  a  sudden  collapse  of  his  vital  powers,  at  no  distant  day,  might 
be  feared  as  the  result  of  such  tension. 


Persons 

sorrow,  sh( 
jects  and  c 
light,  and 
sliould  visi 
I)res8ions. 

When  w 
to  use  it  a 
our  fault, 
feeble.  T 
which  says 
hungry  for 

Need  of 

ideas  of  the 
the  organs 
mind,  shou 
str laments  i 
and  will  m 
portance,  t 

imprope 

iidierit  dis( 
eased  brain 
the  offsprii 
Among  th( 
Europe,  n( 
arises,  in  a  j 
practice  uni 
The  wisdon 
certain  deg] 
vation  of  p 
who  will  ti 
body,  obser 
relations. 

Need  of 

of  its  duties 
than  any  ot 
to  this  impi 
lessened  or  ( 
loss  of  bloc 
charged  wit 
well,  the  bl 
brain,  and  t 
any  way,  or 
it  is  breathi 
brain,  and  tl 
headache,  fa 


m 


IIYOIENK. 


60 


Persons  in  affliction,  whoso  spirits  are  depressed  and  broken  by 
sorrow,  should  have  their  thoughts  turned  away  from  all  sombre  ob- 
jects and  contemplations.  They  should  be  taken  into  the  open  sun- 
light, and  be  diverted  by  the  beautiful  things  of  nature.  They 
sliould  visit  cheerfu;  society,  and  open  their  hearts  to  pleasurable  im- 
pressions. 

When  we  penmit  any  part  of  the  body  to  remain  idle,  neglecting 
to  use  it  as  much  an  we  ought,  unpleasant  sensations  remind  us  of 
our  fault.  The  muscles,  when  unused,  waste  away  and  become 
feeble.  This  is  sure  to  produce  an  uneasy,  nervous  state  of  feeling, 
vvliich  says  to  us  as  plainly  as  a  sensation  can,  that  the  muscles  are 
hungry  for  exercise,  and  that  it  is  injurious  to  let  them  rest  longer. 

Need  of  a  Healthy  Brain.  —  In  order  that  we  may  get  correct 
ideas  of  the  external  world,  it  is  necessary  that  the  brain,  the  nerves,  and 
the  organs  of  sense  through  wliich  sensations  are  made  upon  the 
mind,  should  be  in  a  healthy  condition.  It  is  evident  that  if  the  in- 
strumenbs  of  sensation  be  diseased,  the  sensation  cannot  be  natural, 
and  will  make  a  false  report  to  the  mind.  It  is  of  the  highest  im- 
portance, therefore,  that  the  brain  should  be  sound. 

Improper  Intermarriages.  —  This  organ,  like  every  other,'may 
inherit  disease  from  parents.  Insanity,  which  springs  from  a  dis- 
eased brain,  is  often  hereditary.  When  both'  parents  are  diseased, 
the  offspring  are  of  course  more  liable  to  partake  of  their  defects. 
Among  the  wealthy,  and  particularly  among  the  royal  families  in 
Europe,  nervous  diseases  and  sterility  are  very  common.  This 
arises,  in  a  great  part,  from  intermarriages  among  blood  relatioJiS,  —  a 
practice  under  which  any  people  will  degenerate,  and  finally  perish. 
The  wisdom  of  the  Old  Testament  prohibition  of  marriage  within 
certain  degrees  of  consanguinity  has  been  established  by  the  obser- 
vation of  philosophers  and  the  experience  of  mankind.  Let  those 
who  will  transmit  to  their  descendants  a  sound  mind  in  a  sound 
body,  observe  the  laws  of  life,  and  avoid  all  marriages  with  blood 
relations. 

Need  of  a  Qood  Supply  of  Blood.  —  B'or  a  proper  performance 
of  its  duties,  the  brain  requires  and  receives  a  larger  supply  of  blood 
than  any  other  part  of  the  system.  One-tenth  of  all  the  blood  goes 
to  this  important  organ.  If  the  quantity  or  quality  be  materially 
lessened  or  changed,  great  disturbance  of  the  brain  follows.  A  large 
loss  of  blood  occasions  dizziness  and  fainting.  If  an  atmosphere 
charged  with  too  much  carbonic  acid  gas  be  breathed,  as  in  a  deep 
well,  the  blood  is  not  vitalized  in  the  lungs,  so  as  to  sustain  the 
brain,  and  unconsciousness  soon  follows.  If  the  air  be  vitiated  in 
any  way,  or  have  its  oxygen  extracted,  as  in  large  assemblies,  where 
it  is  breathed  over  several  times,  it  becomes  unfit  to  support  the 
brain,  and  the  result  is  languid  feelings,  inability  to  apply  the  mind, 
headache,  fainting,  hysterics,  and  other  nervous  manifestations. 


jr- 


HYOIEMK. 

Ventilation.  —  This  hIiowh  the  great  necessity  of  having  dwellings, 
churcheH,  and  school-houMeH  well  ventilated. 

Were  a  good  system  of  ventilation  adopted  in  all  our  churches, 
ministers  would  seldom  preach  to  sleeping  audiences.  A  congregiw 
tion  Hitting  in  one  of  our  places  of  public  worship,  where  the  air  in 
a  single  afternoon  is  as  many  times  used  over  as  the  minister's  ser- 
mons are  in  a  lifetime,  can  neither  hear  with  attention,  nor  compre- 
hend with  clearness. 

In  many  of  our  school-houses,  the  ventilation  is  (juite  as  bad,  and 
the  consequences  worse,  Injcause  they  are  occupied  six  houi-s  of  tlie 
day  instead  of  three,  and  five  days  of  the  week  in  place  of  one.  In 
the  small  s^hool-.'-ouses  which  our  children  filled  to  overflowing  in 
former  yeai-s,  in  wnich  there  was  no  ventilation,  unless  they  happened 
to  be  blessed  with  an  old-fashioned  chimney  and  tire-pjac3,  the  effects 
upon  the  nervous  system  of  the  children  was  deploraWe.  Many  of 
the  diseases  which  afflict  i  j  present  generation  of  men  and  women 
had  their  origin  in  the  bad  air  of  those  crowded  nuraeries  of  edu- 
cation. 

Our  dwellings  were  partly  ventilated  in  olden  time,  when  the 
open  fire-place  received  the  "  back -log,"  the  "  top-stick,"  the  "  fore- 
stick,"  and  other  sticks  to  match ;  but  since  we  have  been  warmed 
by  the  stove  and  the  .furnace  we  have  known  little  of  the  luxury  of 
pure  air  at  the  domestic  hearth. 

Need  of  Exercise  for  the  Brain.  —  Health  requires  that  the 
brain  should  be  properly  occupied  with  vigorous  thought.  The 
same  reasons  may  be  given  for  this  as  for  the  exercise  of  the  muscles. 
It  is  governed  by  the  same  laws  which  apply  to  other  parts  of  the 
system.  Use  improves  its  strength  and  vigor ;  idleness  causes  it  to 
grow  feeble.  Of  course  the  labor  it  is  put  to  should  be  only  reason- 
able in  amount,  and  should  not  be  too  long  continued  at  any  one 
time.  With  the  weakening  of  the  brain,  the  whole  bodily  forces, 
and  indeed  the  whole  mental  and  moral  character,  fall  into  feebleness 
and  decay.  It  is  a  great  mistake  to  suppose  that  the  cultivation  and 
even  vigorous  use  of  the  mind  impairs  health  and  shortens  life. 
Just  the  opposite  is  true.  Many  of  the  most  eminently  intellectual 
men,  who  have  worked  their  brains  hard  all  their  lives,  have  been 
distinguished  for  long  life. 

Bad  Effect  of  Change  in  Circumstances.  —  No  class  of  persons 
suffer  more  from  nervous  diseases  and  general  ill-health  than  those 
who,  having  worked  hard  in  early  life,  with  little  or  no  cultivation 
of  the  mind,  are  suddenly  raised  to  wealth,  and  immediately  drop  all 
exercise,  and  fall  into  habits  of  indolence  and  luxury.  The  condition 
of  such  persons  would  be  much  less  pitiable,  did  they  take  up  books 
when  they  lay  by  the  hoe  or  the  broom.  But  they  seldom  do  this.  Many 
a  woman,  in  early  life,  haa  felt  the  glow  of  health  in  every  limb, 
and  a  thrill  of  pleasure,  too,  while  scrubbing  -the  floor  on  her  hands 


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IMAGE  S:VALUATION 
TEST  TARGET  (MT-S) 


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Photographic 

Sciences 
Corporation 


33  WEST  MAIN  STREET 

WEBSTER,  N.Y.  I4S80 

(716)  873-4503 


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CIHM/ICMH 

Microfiche 

Series. 


CIHM/ICMH 
Collection  de 
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^4 


tmmm 


and  kneei 
her  damaj 
the  health 
ately,  anc 
pleasures 

Discret 

we  must  I 
ply  it  wit 
soon  brin^ 
only  until 
permitted 
a  lighter, 
than  to  en 

Overw* 

used  not  t 
parts  of  tl 
longed  ex( 
early,  and 
from  this 
formerly ; 
years,  a  h 
brain.  Pi 
The  result 
are  depior; 
to  be  culti 
forward  fa 
and  fortif; 
required  t( 
Yet  pan 
verse  this 
startled  eo 
of  their  fo 
softening  < 
the  horrorf 
though  wii 

Old  Pec 

ticularly  ci 
covers  eas 
of  recover 
lapse.  01 
tion.  The 
and  easy  si 

A  Suppl 

work,  nee( 
Without  tl 
to  any  pari 


\/ 


HYGIENE. 


61 


and  knees,  who  has,  in  subsequent  years,  reclined  in  misery  upon 
her  damask-covered  lounge,  and  wondered  that  she  could  not  have 
the  health  of  other  days.  Let  her  cultivate  her  brain,  live  temper- 
ately, and  exercise  in  the  open  air,  and  life  may  again  have  real 
pleasures  for  her. 

Discretion  in  Exercising  the  Brain.  —  In  exercising  the  brain 
we  must  use  discretion.  We  must  not  sit  down  in  the  morning,  and 
ply  it  with  work  during  the  whole  day,  without  rest.  This  would 
soon  bring  upon  it  disease,  or  premature  decay.  It  should  be  worked 
only  until  it  begins  to  show  symptoms  of  fatigue.  Then  it  should  be 
permitted  to  rest ;  or,  what  is  better,  be  turned  to  some  new  subject,  of 
a  lighter,  or  a  different  character.  This  often  rests  the  brain  better 
than  to  entirely  suspend  its  action. 

Overworking  the  Brain  in  Childhood.  —  Great  care  should  be 
used  not  to  exercise  the  brain  too  much  in  early  life.  Like  other 
parts  of  the  system,  it  is  tender  in  childhood,  and  will  not  bear  pro- 
longed exertion.  As  a  general  thing,  children  are  put  to  school  too 
early,  and  made  to  work  their  brains  too  hard.  Great  mischief  arises 
from  this  source.  Children  are  born  with  larger  brains  now  than 
formerly ;  and  it  is  no  uncommon  thing  to  see  upon  a  child  of  ten 
years,  a  head  equal  in  size  to  that  of  an  adult.  Children  run  to 
brain.  Precocity  in  development  of  brain  and  mind  is  common. 
The  results  of  stimulating  and  hastening  the  unfolding  of  such  minds 
are  depiorable.  In  such  children,  the  brain  should  be  the  last  thing 
to  be  cultivated.  We  do  not  need  to  urge  its  growth.  It  will  come 
forward  fast  enough  in  spite  of  us.  Our  chief  aim  should  be  to  harden 
and  fortify  the  general  constitution,  so  that  the  brain  which  it  is 
required  to  bear  up  and  sustain  may  long  be  its  crown  and  glory. 

Yet  parents  are  proud  of  their  precocious  children,  and  often  re- 
verse this  rule.  They  do  it  thoughtlessly,  and  would  be  terribly 
startled  could  they  suddenly  look  into  the  future  and  see  the  results 
of  their  folly.  Could  they  do  so,  they  would  see  inflammation  and 
softening  of  the  brain,  epilepsy,  insanity,  paralysis,  apoplexy,  with  all 
the  horrors  of  uudescribed  and  indescribable  nervous  affections,  which, 
though  without  a  name,  have  a  terrible  reality. 

Old  People's  Brains.  —  Persons  in  advanced  life  should  be  par- 
ticularly careful  not  to  overwork  the  brain.  In  middle  life  it  re- 
covers easily  from  great  fatigue.  In  the  decline  of  life,  its  powers 
of  recovery  are  feeble.  A  single  exhaustion  may  cause  its  fatal  col- 
lupse.  Old  age  should  be  distinguished  for  gentleness  and  modera- 
tion. The  journey  of  the  down-hill  of  life  should  be  made  by  sliort 
and  easy  stages,  through  regions  of  uiversified  beauty. 

A  Supply  of  Blood.  —  EA'iery  part  of  the  system,  when  hard  at 
work,  needs  and  must  have  a  very  large  supply  of  pure  blood. 
Witliout  this,  it  is  torpid  and  inactive.  To  cause  the  blood  to  flow 
to  any  particular  part,  it  must  be  exercised.     The  lumberman,  when 


m 


m 


rm 


s 


62 


HYGIENE. 


in  the  forest  in  extreme  cold  weather,  stamps  his  feet  vinlpnfl, 

the  ground,  or  beat«  them  against  a  log,  anfwhU  hi  Wd«^  "^'"'J 

proportion  that  it  dmws  the  vital  current  to  2Yw7«„;i  ^"'^  '" 

bram  and  all  otiier  working  organs.  ^  ^'  '^'^  "^  *^« 

worrer!:i:ei;lftrsat\im^^^  ^^^  ^'  -^--an 

brain    to   hard   work    i.rTf^dLt^l '     7.  .  'n  '"^P^^Per  to  put  the 

stomach  then  wrt^  the  bio. !.n^  iK^  ^.""  "*""^'  ^«^"««  th« 
the  blood  be  ca  ed  off  fo  h  K  '^'^^^  '^-^^  ^^««*  <^^^^'  ^«od;  and  if 
the    stomach   be     oaded  with  fo^'l  ^'1?"  ""?  ^^P*     ^^'  ^^ould 

.  thinking;  for  the  i:^:^^%ITi;'7:to:'x  i^oii^i  '^•^•' 

own  excitement  has  had  time  to  subside  ^^  ^^'''  ^*" 

Sympathetic  Nervous  System 

need  to  go  on  wh  leTe  Z'ai^-«  .  i  ''  ^'1  ''^*^"''^^  P'""'^^^^^^  ^^^^^^ 
The  nerfous  sy^  e  n  of  .vWch  WtT  "'^•^.^^^"»«t  ^^^^^d  to  them, 
tions  which  areClednvotto/P^'^lf^^f^.^^^^^  -"  those  fuuc- 
will  is  needed  for  their  performanol'  ~s!  '?'^  '^'^"''  "°  ^^*  '^^  the 
and  the  circulation  o  Tebinod  Si  ,^''"f «"'  absorption,  digestion, 
well  as  while  we  ll  e.  wt^  kn  L'^^^^  fj^  M?  "^'^  "^  «^^^P'  ^ 
performance,  as  in  walking  Pntin^  "^'^  necessary  to  their 

have  to  ceas;  thrm^meXe  2^  T'^r""/"^'  '*"•'  '^''^  ^^^^  ^«»W 
the  result.  ^^^  '''^'"  ^^^^  ^^««P'  ^^d  death  would  be 

con^dmoStn;  "TvU'E  ''''\  n.''  ^^«  «^^-  ^^  «- 
flamed,  the  stomach  seemstn^y,  ^   l'-    ^'^^'^  ^^^  ^«ng«  ^re  in- 

becaus;  this  wou  d  a^ivlte  th^T'  "^  '^  T^^"^  ''^^^^^^^"^  f««d' 
Well  would  it  belf  ifS,  n  t         ^^:J  ^^  *^^  neighboring  organs. 

and  abstain  from   bote  ^cte  ^/"ff  "''^'^-f  '''''''''  ^  ^^'  forbeaifnce, 
injure  their  neighboii  ««l%^tification  which  they  know  will 

r  ^^ish  to*add'l*frrwo'Ji??fi!!'  r  ^^/u '"^  ''^^'^^"8^  *h«««  observations, 
diseases  which  chamc^rJ/'u'P'^'^*'"^  ^^'.  ^'^'^^^^  effects  of  nervous 

Thai  tuJ      '^"aractenze  the  present  time. 

That  theya«  far  more  „„i^  ,„„  ,„i„y,^  ^,^„  .„  ^^^^^ 


m.m 


;r'55^^^'~-=*— 


HYGIENE. 


63 


years,  must  be  apparent  to  the  most  careless  observer.  They  are 
nothing  more  nor  less  than  the  price  we  pay  for  a  high  civilization, 
and  especially  for  our  democracy.  Among  us,  every  man  feels  his 
individuality,  and  has  a  motive  for  thinking  and  doing  his  best. 
Thought  and  action  are  here  unfettered ;  and  if  the  race  is  not  to 
the  swift,  nor  the  battle  to  the  strong,  eveiy  man  acts  as  though  he 
thought  it  was.  The  great  excitement  which  the  struggle  for  wealth 
kindles  and  inflames,  deranges  and  shatters  the  nervous  system  to  a 
shocking  degree. 

And  wealth,  when  obtained,  does  its  full  share  to  weaken  the 
nerves.  It  brings  with  it  high  living,  indolence,  loss  of  energy,  dis- 
sipation, and  a  weakening  of  the  whole  moral  and  physical  powers. 
It  need  not  do  this ;  but,  in  most  cases,  it  does. 

Tlie  result  is,  that,  at  least,  every  other  person  has  some  nervous 
disease,  which  makes  life  a  misery  rather  than  a  blessing.  The  brain 
and  nerves  are  too  much  developed  in  comparison  with  the  develop- 
ment of  the  muscles.  Half  our  boys  and  girls  have  heads  as  large 
as  men  and  women.  It  is  common  to  see  a  boy  or  a  girl  at  ten  talk- 
ing and  acting  like  a  man  or  woman.  I  do  not  mean  by  tliis,  that 
they  imperfectly  imitate  the  actions  of  older  persons.  It  seems  to  be 
natural  to  them.  Their  brains  are  prematurely  developed,  and  their 
acts  and  thoughts  have  the  maturity  of  adult  life. 

What  is  Coining  ?  —  What  will  be  the  result  of  this  state  of 
things,  no  man  can  predict.  I  sometimes  think  the  race  will  break 
down ;  that  that  which  was  intended  to  be  its  ornament  and  strength 
will  be  its  destruction.  I  hope  not.  Yet  there  is  danger  of  it. 
Nothing  can  save  us  but  the  wisdom  to  adopt  such  means  as  will 
develop  all  parts  of  the  system  alike.  No  race  of  men  can  stand  for 
many  generations  such  a  strain  upon  the  nervous  system,  unless  bet- 
ter means  are  adopted  to  counterbalance  its  evil  effects  than  are  now 
used  in  the  United  States.  We  have  got  to  pause  in  our  swift 
career,  and  look  after  our  health,  or  we  shall  become  a  nation  of 
maniacs.     No  proof  is  needed  of  what  is  here  said. 

Hopeful  ConsiJe rations It  is  proper  to  say,  the  considerations 

here  presented,  terrible  as  they  are,  are  mitigated  in  some  measure  by 
others  of  a  more  hopeful  character. 

Physiology  and  the  laws  of  life  are  now  better  understood  than  at 
any  former  period.  These  subjects  are  getting  "nto  our  common 
schools,  and  are  engaging  the  attention  of  our  youth.  Declining 
health  has  already  made  us  think  more  of  the  means  of  preserving 
it,  —  such  as  diet,  exercise,  bathing,  travelling,  and  amusement.  To 
encourage  and  intensify  this  hopeful  direction  of  the  public  mind,  I 
propose  to  devote  a  few  pages  to  these  subjects. 


■^I'( 


tmmm 


64 


HYOIENK. 


Pood  and  Digestion. 

F..OM  the  earliest  dawn  of  existence  to  the  last  moment  of  life  our 
bodies  are  constantly  changing.  Old  particles  of  matter,  when  tliev 
are  worn  out,  leave  their  places  and  are  thrown  out  of  the  systeni 
Were  this  the  whole  of  the  matter,  our  bodies  would  soon  wuste 
away,  and  that  would  be  the  end  of  us.  But  as  fast  as  the  old  mate- 
rials are  thiown  away,  new  ones  take  their  places ;  and  it  is  solely 
out  o.t  our  food  that  these  new  materials  are  formed. 

In  order  that  the  food  maybe  well  digested,  it  must  first  be  broken 
into  small  particles  in  the  mouth.  The  act  of  chewing  it  Ls  called 
mastication.  During  this  act,  if  it  be  well  performed,  I  large  quan- 
tity of  spittle,  called  saliva,  flows  out  of  a  number  of  glands,  called 
salivary  giands,  and  mixes  with  the  food,  forming  with  it  a  soft  mass 
m  tlus  conaition,  it  is  thrown  backward  into  the  top  of  the  throat 
called  the  pharynx.  Here,  a  little  cartilage,  called  the  epiglottis 
drops  down  apon  the  opening  into  the  top  of  the  windpipe,  and  pre- 
vents its  entrance  into  the  breath-passage ;  and  it  is  pushed  alonp 
into  the  gullet,  a  tube  which  runs  down  behind  the  windpipe  and 
lungs,  and  which  physicians  call  the  oesophagus.  Here  a  succession 
ot  muscular  bands,  circular  in  shape,  contract  upon  it,  one  after 
another,  and  force  it  down  into  the  stomach. 

It  is  importc^nt  that  two  things  should  be  securfid  while  the  food  is 
m  the  mouth,  namely,  that  it  should  be  reduced  to  a  good  degree  of 
fineness  by  chevying,  and  that  a  proper  amount  of  saliva  should  be 
mixed  with  it.  If  the  chewing  were  not  necessary,  teeth  would  not 
have  been  given  us;  and  the  salivary  glands  would  certainly  not  liave 
been  put  in  the  mouth,  if  the  mixing  of  water  with  our  food  would 
serve  the  purposes  of  digestion  as  well. 

Eating  too  Rapidly., —Americans  have  fallen  into  a  pernicious 
error  in  eating  their  food  too  rapidly.  Time  is  not  given  to  chew  it 
sufficiently  to  excite  a  full  flow  of  saUva;  and  as  it  cannot  be  swal- 
lowed  m  a  dry  state,  it  is  not  uncommon  to  see  persons  taking  a  sip 
of  water  after  every  second  mouthful,  to  enable  them  to  force  it  into 
the  stomach.  It  is  a  habit  we  Americans  have  of  cheating  ourselves 
both  of  the  pleasures  and  the  benefits  of  eating ;  for  the  only  real 
pleasure  of  eating  arises  from  the  flavor  of  food  while  retained  in  the 
mouth,  and  the  only  benefit  we  can  derive  comes  in  consequence  of 
Its  proper  digestion. 

The  food  when  received  into  the  stomach  is  in  the  same  condition 
as  when  taken  into  the  mouth,  except  that  it  is,  or  should  be,  ground 
hne  by  the  teeth,  and  well  mixed  with  saliva. 

The  Gastric  Juice.  — The  stomach,  like  the  mouth,  the  windpipe, 
and  the  gullet,  is  Uned  by  a  mucous  membrane.  The  chief  office  of 
this  membrane  is  to  secrete,  or  take  out  of  the  blood,  a  fluid  which 
we  caU  gastnc  juice,  which  means  stomach  juice,  from  the  Greek 


-iPt^' 


HYGIENE. 


u 


name  of  stomach,  yaorf'p  (gaster).  This  fluid  has  not  much  smell 
or  taste,  and  looks  like  spring  water.  It  has  a  powerful  effect  upon 
food,  which,  when  mixed  with  it,  soon  undergoes  an  important 
change,  which  is  apparent  to  the  taste,  the  smell,  and  the  sight.  The 
natvu-e  of  the  gastric  juice  and  how  it  produces  Its  effect  upon  food 
are  not  certainly  known;  but  it  contsiins  two  active  elements, — a 
tree  acid  and  pepsin,  whose  function  is  to  dissolve  the  nitrogenous 
parts  of  the  food  and  convert  them  into  albuminose  or  peptone.  The 
albnniinose  is  absorbed  by  the  coats  of  the  stomach  and  enters 
directly  into  the  circulation  ;  while  the  sugar  and  fat  pass  on  to  the 
duodenum  to  -be  acted  upon  by  the  bile,  the  i)ancreatic  juice,  and 
other  secretions  of  the  bowels. 

Too  Much  Cold  Water  at  Meals.  —  There  are  some  interesting 
facts  connected  with  the  formation  of  this  fluid,  of  which  it  is  im- 
portant that  every  person  should  be  apprised. 

Its  quantity  and  quality  depend  on  the  amount  and  healthfulness 
of  the  blood  which  flows  to  the  stomach  during  the  first  stage  of 
digestion.  It  is,  therefore,  injurious  to  drink  large  quantities  of  very 
cold  water  with,  or  immediately  after,  our  meals  ;  as  this  will  chill 
the  stomach,  and  repel  the  blood  from  its  vessels,  so  that  but  little 
of  the  juice  can  be  formed.  Digestion,  in  such  case,  must  be  im- 
perfect. 

This  Fluid  not  Secreted  Without  Limit.  — This  fluid  does  not 
flow  into  the  stomach  continuously,  but  only  when  we  swallow  food, 
and  then  not  as  long  as  we  please  to  eat,  but  merely  till  we  have  taken 
what  the  system  requires.  If,  in  the  amount  we  take,  we  go  beyond 
the  wants  of  nature,  there  will  not  be  fluid  enough  formed  to  dissolve 
it,  and  the  whole  will  be  imperfectly  digested,  and  be  a  source  of  in- 
jury rather  than  benefit.  This  should  teach  us  to  be  careful  that  our 
food  be  only  reasonable  in  amount. 

Not  Secreted  in  Sickness.  —  When  we  are  sick,  the  gastric  juice 
is  either  not  formed  at  all,  or  only  in  small  quantities.  Whatever 
may  be  our  feelings  of  lassitude,  and  however  much  we  may  appear 
to  need  food,  at  such  times,  it  is  usjless  to  take  it,  for  it  cannot  be 
digested,  and  will  only  aggravate  our  disease.  If  the  illness  be  only 
slight,  the  fluid  will  be  formed  to  some  extent,  and  food  may  be 
taken  in  proportion. 

Its  Secretion  Favored  by  Cheerfulness.  —  A  cheerful  disposition, 
and  a  happy,  lively  frame  of  mind,  are  highly  favorable  to  the  pro- 
duction of  the  gastric  juice ;  while  melancholy  and  anger  and  grief 
^nd  intense  thought  of  business,  at  the  hour  of  meals,  greatly  hinder 
its  natural  flow. 

This  should  teach  us  to  go  to  our  meals  with  light  hearts,  and  to 
make  the  family  board  a  place  of  cheerful  conversation,  and  of  a  light 
and  joyous  play  upon  the  mirthful  feelings  of  all  present.  Should 
any  of  the  family  circle  be  in  the  habit  of  using  vinegar  as  a  condi- 


6(5 


HYGIBNE. 


ment,  we  should  never  be  guilty  of  compelling  them  to  extract  it 
from  our  faces.  A  vinegar  face  is  not  easily  excused  anywhere ;  at 
the  table  it  is  unpardonable.  A  single  countenance  of  this  description 
will  throw  a  gloom  over  a  tableful  of  naturally  cheerful  peraons  ;  and 
if  habitually  present  at  the  board,  may  finally  spoil  the  digestion  of 
half  a  dozen,  and  entail  dyspepsia  upon  them  for  life. 

The  stomachs  of  the  sick  pour  out  but  very  little  of  this  fluid,  and 
they  can  tiake  but  a  small  amount  of  food.  It  is  cruel  to  deprive 
them  of  the  power  of  digesting  that  little  by  treating  them  harshly, 
and  filling  them  with  gloomy  and  desponding  feelings.  I  therefore 
repeat  the  substance  of  the  advice  given  on  a  previous  page :  Deal 
gently  with  the  sick. 

How  all  this  Is  Known.  —  As  the  stomach  is  wholly  concealed 
from  view,  the  reader  will  very  naturally  ask  how  it  is  known  that 
the  gastiic  juice  is  poured  into  it  in  certsiin  states  of  the  mind,  etc.,  and 
withheld  in  others.  It  certainly  could  not  have  been  so  accurately 
known,  had  it  not  been  for  an  accident  which  opened  the  living  and 
working  stomach  to  the  inspection  of  Dr.  Beaumont,  a  United  States 
Surgeon.  A  young  man  by  the  name  of  Alexis  St.  Martin,  a  Cana- 
dian by  birth,  but  then  in  the  State  of  Michigan,  had  a  large  part  of 
his  side  torn  away,  and  a  hole  of  considerable  size  made  into  his 
stomach,  by  the  accidental  discharge  of  a  gun.  To  the  surprise  ot 
his  surgeon,  St.  Martin  recovered ;  and  the  edges  of  the  wound  in  the 
stomach  refused  to  grow  together,  preferring  rather  to  fasten  them- 
selves to  the  borders  of  the  breach  in  the  side,  thus  leaving  the  pas- 
sage open.  A  kind  of  curtain  grew  down  over  this,  which  prevented 
tlie  food  from  falling  out.  Dr.  Beaumont,  taking  advantage  of  this 
state  of  things,  instituted  a  series  of  valuable  experiments,  by  lifting 
the  curtain,  and  inserting  various  articles  of  food,  and  witnessing  the 
process  of  digestion. 

Movement  of  the  Stomach.  —  The  presence  of  food  in  the  stom- 
ach causes  its  muscular  coat  to  contract  and  throw  it  about  from  side 
to  side,  mixing  it  thoroughly  with  the  gastric  juice,  and  reducing  it 
to  a  pulpy  mass,  called  chyme.  This,  as  fast  as  it  is  properly  pre- 
pared, passes  through  the  pylorus  into  the  upper  bowel,  or  duodenum, 
called  also  the  second  stomach. 

Chyme. — A  certain  witty  professor  of  anatomy  and  physiology 
was  in  the  habit  of  asking  his  class  if  they  ever  saw  any  chyme ;  and 
when  they  answered,  no,  as  they  often  did,  he  called  their  attention 
to  what  is  occasionally  to  be  seen  in  the  morning,  upon  the  sidewalks, 
where  drunken  men  have  held  themselves  up  by  lamp-posts,  and  left 
the  contents  of  their  stomachs. 

The  pylorus,  or  opening  into  the  bowel,  has  a  very  singular  and 
wise  instinct,  which  is  worthy  of  remark.  When  a  piece  of  food, 
which  has  not  been  digested,  attempts  to  pass  into  the  bowel,  the 
moment  it  touches  the  inner  surface  of  this  orifice,  it  is  instantly 


thrown 


'j»»sBP*BBsas 


HYGIENE. 


67 


thrown  back  by  an  energetic  contraction  ;  tliough  a  portion  of  well- 
prepared  chyme,  touching  the  same  opening  immediately  after,  is 
allowed  to  pasa  unchallenged. 

Chyle.  —  The  chyme,  when  it  reaches  the  duodenum,  seems  to 
ciiuse  the  liver  to  S(M;rete  bile,  and 
the  pancreas  to  produce  pancreatic 
juice.  These  two  Huids  aie  con- 
veyed into  the  upper  portion  of  the 
second  stomach,  and  there  are  mixed 
with  the  chyme,  and  cause  it  to 
separate  into  a  delicate,  white  fluid, 
called  chyle^  and  a  residuum,  which, 
being  worthless,  is  pushed  onward, 
and  thrown  out  of  the  body. 

Bile    in    the    Stomach.  —  Most 
persons  suppose  that  the  bile  is  gen- 
erally found   in  the  stomach ;   but 
a  Tani-   H     '^^^  '^  *  mistake.     It  is  thrown  up 
by  vomiting,  because  in  that  act,  the 

action  both  of  the  tii-st  and  the  second  stomach  is  reversed,  and  the 

bile  is  forced  up  from  the  duodenum, 
—  taking  a  direction  the  opposite  of 
its  usual  course. 

Destination   of  the  Chyle.  —  The 

chyle  being  separated  from  the  dregs, 
is  pushed  onward  in  its  course  by  the 
worm-like  motion  of  the  intestine ; 
and  as  it  passes  along,  it  is  gradually 
sucked  up  by  thousands  of  very  small 
vessels,  whose  mouths  open  upon  the 
inner  surface  of  the  bowel.  These 
little  vessels  are  called  lacteals,  froi/i 
the  Latin  word  lac,  which  means  milk, 
because  they  drink  this  white,  milky 
fluid.  Fig.  61  shows  a  section  of  the 
small  bowel,  turned  inside  out,  and 
covered  with  the  villi,  or  root-like  fila- 
ments, closely  set  upon  its  surface,  for 
absorbing  the  chyle,  and  at  the  bottom 
of  which  the  lacteals  take  their  rise. 

In  these  lacteals,  and  in  the  mesen- 
teric glands,  the  chyle  is  gradually 
changed,  so  as  to  approach  nearer  and 
nearer  to  the  nature  of  the  blood  ;  but 
precisely  what  the  change  is,  or  how 
it  is  effected,  is  not  known.     Several 


Fio.  02. 


68 


HYOIENE. 


learned  men  liave  publifllied  their  tlieories  upon  these  points,  and  the 
writer  has  opinions  upon  them;  but  it  is  not  worth  while  to  trouble 
the  reader  with  them.  It  is  B\il1ieient  to  say  that  the  fluid  is  carried 
by  the  lacteals  to  the  thoracic  du(t,tiirough  whi(!h  it  is  conveyed  into 
a  large  vein  at  the  lower  part  of  liie  neck,  wher(i  it  is  jjotired  into 
the  blood,  and  becomes,  after  going  through  the  linigs  and  experi- 
encing another  and  a  vital  change,  the  material  out  of  which  oui' 
bodies  aie  daily  and  hourly  new-created. 

Fig.  62  gives  a  genei-al  idea  of  the  stomach,  bowels,  etc. :  9,  being 
the  stomach ;  10,  10,  the  liver;  1,  the  gall-bladder;  2,  the  duct  which 
conveys  the  bile  to  4,  which  is  the  duodenum ;  3,  is  the  pancreas ;  5. 
the  oesophagus ;  A,  the  duodenum ;  B,  the  bowels ;  C,  the  junction  of 
the  small  intestines  with  the  colon  ;  D,  the  appendix  vermiformis ; 
E,  the  coecum  ;  F,  the  ascending  colon  ;  G,  the  transverse  colon  ;  H. 
the  descending  colon  ;  I,  the  sigmoid  flexure ;  J,  the  rectum. 


Nature  and  Destination  of  Food. 

The  food  which  man  requires  for  his  support  and  development  is 
of  two  kinds,  inorganic  and  organic.  The  firet  of  these  embraces 
certain  mineral  substances,  as  common  salt,  sulphur,  phosphoru.s, 
iron  and  lime,  either  in  combination  or  separate. 

These  are  not  generally  reckoned  as  aliments,  and  yet  no  human 
being  can  live  without  them.  In  their  absence,  the  body  decays,  dis- 
integrates, and  perishes.  Common  salt  is  composed  of  muriatic  acid 
and  soda.  The  first  is  an  important  ingredient  in  the  gastric  juice, 
and  the  latter  promotes  the  secretion  of  bile.  Sulphur  is  found  in 
several  of  the  tissues,  particularly  in  the  muscles.  Phosphorus, 
united  to  fatty  matter,  is  highly  honored  in  forming  a  portion  of 
the  brain  and  nerves,  and  is  also  combined  with  oxygen  and  lime  to 
make  the  earthy  or  hard  part  of  bones. 

Found  in  Food.  —  These  articles  it  is  not  necessary  often  to  intro- 
duce into  the  system  in  a  separate  state.  They  are  contained,  in 
larger  or  smaller  proportions,  in  most  articles  of  food  ;  and  man  al- 
ways suffers,  as  all  animals  do,  from  theit  absence.  Common  salt  is 
found  in  the  flesh  of  animals,  in  milk,  and  in  eggs.  It  is  not  very 
abundant  in  plants ;  and  we  all  know  how  eagerly  domestic  animab 
devour  it  when  it  is  given  to  them,  and  how  constantly  wild  cattle 
resort  to  the  salt  springs,  which,  in  the  grea't  West,  are  called  "  buffalo 
licks."  Lime  exists  in  nearly  all  animal  and  vegetable  substances. 
In  wheat  flour  we  get  it  in  combination  with  phosphcric  acid,  that 
is,  as  phosphate  of  lime.  Lime  exists  too,  in  the  state  of  carbonate 
and  sulphate,  in  all  hard  water.  Iron  is  found  in  the  yolk  of  eggs, 
in  milk,  in  animal  flesh,  in  potatoes,  pears,  cabbages,  mustard  and 
other  articles.  Sulphur  we  get  in  flesh,  eggs  and  milk ;  and,  as 
sulphate  of  lime,  in  spring  and  river  water.  Phosphorus  is  derived 
from  eggs  and  milk;  and  flesh,  bread,  .'ruits,  and  husks  of  grain, 


r-;: 


}''?)!flll 


HYGIENE. 


69 


coniiuonly  called  bran,  contain  even  a  larger  proportion  tlian  we  need 
in  our  diet. 

Organic  Food,  —  The  organic  elements  of  man's  food,  which  in 
bulk  embrace  almost  the  whole  of  it,  remain  to  be  considered.  In  the 
animal  economy  they  serve  two  great  purposes.  A  part  of  the  arti- 
cles which  compose  them  are  blood-formers,  out  of  which  all  the 
tissues  are  made,  —  the  other  part  produces  fat,  which  serves  to  warm 
the  body  by  being  burned  with  oxygen.  These  articles  are  derived 
partly  from  the  vegetable  and  partly  from  the  animal  kingdom. 

Divided  into  Four  Qroups. —  For  convenience,  these  articles  may 

be  divided  into  four  groups.      For   the  

tir.st,  sugar  stands  as  a  type.  We  there- 
fore call  it  tlie  ttaccharine  group.  It  em- 
braces starch,  gum,  and  the  fibre  of  wood. 
These  articles  may  all  be  converted  into 
sugar  by  a  simple  chemical  process. 
Figure  63  gives  a  microscopic  view  of 
the  granules  of  starch. 

The  second  group  we  call  the  oleayinous. 
It  is  composed  of  oily  substances,  from 
whatever  source  derived,  whether  the  an- 
imal or  tht  vegetable  world. 

The  third  group  is  the  albuminous.  A 
good  type  of  it  is  the  white  of  egg. 

The  fourth  is  the  gelatinous,  or  Jelly  group. 

First  and  Second  Groups,  Supporters  of  Respiration. —  The  ar- 
ticles composing  the  first  and  second  groups  are  analogous  in  com- 
position, all  containing  oxygen,  hydrogen,  and  carbon.  They  are  what 
Liebig  calls  supporters  of  respiration ;  the  meaning  of  which  is,  in 
more  comprehensible  terms,  that  they  are  supporters  of  combustion. 
They  are  the  fuel  which  warms  us.  They  keep  the  fires  going,  from 
which  arises  all  the  heat  we  have  in  our  bodies.  But  they  are  desti- 
tute of  nitrogen,  and,  on  this  account,  they  are  not  blood-formers,  and 
cannot  be  worked  into  flesh.     Hence,  man  cannot  live  on  them. 

The  food  articles  embraced  in  the  third  and  fourth  groups  also 
contain  oxygen,  hydrogen,  and  carbon ;  and  to  these  they  add  nitro- 
gen. This  fourth  component  part,  which  forms  only  a  small  portion 
of  them,  gives  them,  for  some  reason  never  explained,  the  peculiar 
quulity  of  producing  blood  and  flesh.  They  are  the  raw  materials, 
out  of  which  our  bodies  are  reconstructed  from  day  to  day. 

Feed  a  man  ever  so  largely  upon  sugar,  starch,  gum,  and  oils,  and 
lie  will  starve  as  certainly  as  if  he  were  allowed  nothing  but  water. 

Names  of  Two  Great  Divisions  of  Food. — The  possession  or  non- 
possession  of  nitrogen,  then,  is  what  distinguishes  from  each  other 
the  two  great  classes  of  food-articles.     Those  which  contain  nitrogen 


»'lO.  «8. 


mmd 


70 


HYOIKKE. 


have  been  called  nitrogenized,  and  thoae  which  are  destitute  of  ii, 
notirnitrogenized  cuni]iound8.  As  nitrogen  is  often  called  azote,  the 
former  class  are  more  frequently  named  azotized ;  the  latter,  no7t- 
azotized. 

Let  the  reader  now  fix  it  in  iiis  mind  that  the  azotized  articles  of 
food  produce  blood  and  flcph ;  the  non-azotized,  heat ;  and  he  will 
have  the  key  to  understand  much  of  what  is  to  be  said,  and  likewise 
to  unlock  many  ot  the  mysteries  of  diet. 

Nutrition  Table. —  Taking  human  milk  as  the  standard,  and  ex- 
pressinp  the  amount  of  nitrogen  it  contains  by  100,  the  following 
tiible  saows  the  relative  amount  of  nitrogen  in  the  principal  flesh- 
producing  articles  of  food,  and  consequently  their  power  of  forming 
the  tissues :  — 


II 


VEGETABLE. 


Rice 81 

Bye l(» 

Com 120 

Buley 12S 

Oati 138 

WhMt 144 


Potatoes 84 

Turnips lOti 

Carrots ISO 

Peas 239 

Be.n8 320 


ANIMAL. 


Human  Miik 100 

Cows'  Milk 237 

Oyster SOB 

Yolk  of  Eggs 305 

Cheese 331-147 

Eel 428 

Pork-Ham 807 

Salmon 610 


White  of  Egg 845 

Herring 910 

Haddock 816 

Pigeon 78(i 

Lamb 8KI 

Mutton ...  882 

Veal 911 

Beef 912 


Other  Standards  of  Value. —  We  must  not  infer  that  t^ose  articles 
which  have  most  nitrogen  are  necessarily  best  adapted  for  human 
diet  because  they  are  the  most  effective  blood-producers.  In  deciding 
the  value  of  an  article  for  food,  other  things  are  to  be  looked  at  be- 
sides its  nutritive  qualities.  Those  which  are  poor  in  nitrogen,  are 
rich  in  carbon  and  hydrogen,  and  are  well  fitted  to  serve  the  double 
purpose  of  nourishing  and  wanning  the  body  at  the  same  time.  The 
fitness  of  n  article  for  diet  depends  veiy  much  upon  the  ease  or 
difficulty  with  which  it  is  digested  and  assimilated.  If  an  article 
having  a  great  deal  of  nitrogen,  and  being  very  nutritive,  is  with 
great  difficulty  reduced  in  the  stomach  by  the  digestive  process,  it 
may  be  much  less  desirable  for  food  than  one  which  is  digested  and 
assimilated  easily,  but  is  much  poorer  in  nutritive  qualities. 

Heat-Keneratins;  Food  Articles.—  The  reader  has  before  him  the 
principal  blood  and  tissue-forming  food  articles.  Those  which  we 
reckon  as  fuel,  or  heat-generators,  are  chiefly  oils,  sugar,  starch,  farina, 
sago,  arrowroot,  tapioca,  gums,  etc.  These  are  less  essential  than  the 
others ;  for  the  blood-forming  articles  have  within  them  the  ele- 
ments out  of  which  fat  is  formed  in  the  process  of  assimilation ;  for 


V 


320 


84S 
910 
816 
7M 
838 
862 
911 
M2 


HYQIKNE. 


71 


inimv  of  them  contiiin  nU\\vh  ;  and  this,  in  tlie  Innnaii  organiam,  is 
(ihan^'od  into  fat.  The  amount  of  starch  in  some  of  these  articles  is 
ii8  follows  :  — 

Wboat  Hour,  good  nunllty,  100,  c.ontaiiiM  lift  to  H<i  partM  in  KJO  tmre  starch. 

Whent     .  108  "  Kl  "  Wt  

Karley  iiioul 119  "  M  •'  «6 

Hurley     .......  130  "  .iT  "  37  

Hyo Ill  "  44  *•  47  

Buckwheat 108  "  43  "  44  

Indian  Corn 138  "  (10  "  «6  

Rice 171  "  88  "  86  

Peas 69  "  ;W  "  .'»9  "        "  " 

Wiiite  BeanH 09  "  37  "  .38  "        " 

In  the  Nutritive  Food  Articles,  there  i.s  a  fixed  relation  existing 
between  the  elements  of  the  tissue-formei-s  and  the  heat-producers 
which  they  contain.  Out  of  a  few  of  them  Baron  Liebig  has  con- 
jtructed  the  following  table :  — 


For  every  ten  parts  of  blood  and  tissue-formers  ther'^'  are,  — 

In  Wheat  flour,  10 46  In  Bwley, 

In  liye  meal,  10 67  In  Rice, 

In  Oatmeal,  10 SO  In  White  potatoes, 

In  Uuolcwheat,  10 130  In  Blue  potatoes, 


10 OT 

10 123 

10 86 

10 130 


Diet  a  Complex  Subject.  —  From  the  facts  and  tables  now  pre- 
sented, it  appears  that  the  question  of  diet  is  one  of  complexity;  and 
that  the  determination  of  its  several  points  requires  that  a  number  of 
things  should  be  taken  into  the  account.  First,  in  deciding  the  use- 
fulness of  any  article,  we  may  i.uquire  respecting  — 

Its  Digestibility. —  If  an  article  be  not  digestible,  it  is  of  little 
coiisequeiice  how  much  or  how  little  albumen,  starch  or  nitrogen  it 
may  contain.  The  first  and  most  important  inquiry  respecting  it  is, 
is  it  digestible  P  If  not,  it  is  to  be  rejected  ;  for,  whatever  ouier  quali- 
ties it  may  have,  it  can  only  injure  the  stomach  and  embaixass  Uie 
whole  system. 

The  following  table  will  be  useful  to  the  reader,  though  I  do  not 
set  it  down  as  reliable  in  all  cases.  There  is  .  ften  a  great  difference 
in  :lie  ease  with  which  different  stomachs  will  digest  the  same  food. 
Many  stomachs  are  afflicted  with  what  is  called  an  idiosyncrasy,  —  a 
liabit,  peculiar  to  itself,  of  rejecting  or  refusing  to  digest  some  one 
or  more  articles  wliich  are  acceptable  to  all  other  stomachs.  This 
tiible  shows  the  length  of  time  required  for  digesting  the  several  ar- 
ticles in  the  stomach  of  St.  Martin,  as  shown  by  the  experiments  of 
Dr.  Beaumont;  — 


■i-    1 


72 


HYGIENE. 


Article*. 

PreparatiODi. 

Time. 

Articles. 

Freparationi. 

Time. 

Rioe 

Boiled 

h.m. 
1  — 

Pork,  recently  salted 

Raw 

h.m. 
3- 

Pig's  feet,  soused 
Tripe,  soused 

Boiled 

1  — 

Soup,  chicken 

Boiled 

3- 

Boiled 

1  — 

Oysters,  fresh 

Roasted 

3  in 

Trout,  salmon,  fresli 

Boiled 

1  ;io 

Pork,  recently  salted 

Broiled 

3  1,') 

«(          11           It 

Fried 

1  30 

Pork  steak 

Broiled 

3  l.T 

Apples,  sweet,  mellow 

Raw 

1  30 

Corn  bread 

Baked 

3  1,5 

Venison,  steak 

Broiled 

1  30 

Mutton,  fresh 

Roasted 

3  15 

Sago 

Boiled 

1  45 

Carrot,  orange 

Boiled 

3  l,-) 

Apples,  sour,  mellow 

Raw 

2  - 

Sau8a.K0,  fresh 
Beef,  fresh,  lean,  dry 

Broiled 

3  20 

Cabbage,  with  vinegar 

Raw 

2  — 

Roasted 

330 

Codfish,  cured,  dry 

Boiled 

2  — 

Bread,  wheat,  fresh 

Baked 

3  30 

Eggs,  fresh 
Liver,  beef's  fresh 

Raw 

2  — 

Butter 

Melted 

330 

Eroi'ed 

2  — 

Cheese,  old,  strong 

Raw 

330 

Milk 

Buiijd 

2  — 

Eggs,  fresh 

Hard  boiled 

330 

Tapioca 

Boiled 

2  — 

Fried 

330 

Milk 

Raw 

2  IB 

Flounder,  fresh 

Fried 

330 

Turkey,  wild 

Roasted 

2  18 

Oysters,  fresh 

Stewed 

3  30 

<i         •< 

Boiled 

2  26 

Potatoes,  Irish 

Boiled 

3  ;«) 

"       domesticated 

Roasted 

2  30 

Soup,  mutton 

Boiled 

330 

Potatoes,  Irish 

Baked 

2  30 

"      oyster 

Boiled 

3  30 

Parsnips 

Boiled 

2  30 

Turnip,  flat 

Boiled 

330 

Pig,  sucking 

'Roasted 

2  30 

Beets 

Boiled 

3  45 

Meat    hashed    with  ) 
vegetables               j 
LamD,  fresh 

Warmed 

230 

Com,  green,  and  beans 
Beef,  fresh,  lean 

Boiled 
Fried 

3  45 
4- 

Broiled 

2  30 

Fowls,  domestic 

Boiled 

4- 

Goose 

Roasted 

2  30 

If            11 

Roasted 

4  - 

Cake,  sponge 

Baked 

2  30 

Veal,  fresh 

Broiled 

4- 

Cabbage-head 

Raw 

2  30 

Soup,  beef,  vegeta^  1 

Boiled 

A   

Beans,  pod 
Custard 

Boiled 

2  30 

bles,  and  bread      ) 

1   ^— 

Baked 

2  4B 

Salmon,  salted 

Boiled 

4  — 

Chicken,  full-grown 
Apples,  sour,  hard 

Fricasseed 

2  46 

Heart,  animal 

Fried 

4- 

Raw 

2  60 

Beef,  old,  hard,  salted 

Boiled 

4  15 

Oysters,  fresh 

Raw 

2  56 

Pork,  recently  salted 

Fried 

4  15 

Bass,  striped,  fresh 
Beef,  fresh,  lean,  rare 

Broiled 

3  — 

Cabbage,  with  vinegar 

Boiled 

4  ;« 

Roasted 

3  — 

Ducks,  wild 

Roasted 

4;!0 

"      steak 

Broiled 

3  - 

Pork,  recently  salted 

Boiled 

4  30 

Com  cake 

Baked 

3  ~ 

Suet,  mutton 

Boiled 

4  30 

Dumpling,  apple 

Boiled 

3  — 

Veal,  fresh 

Fried 

4  30 

Eggs,  fresh 

Boiled  soft 

3    - 

Pork,  fat  and  lean 

Roasted 

6  15 

Mutton,  fresh 

Broiled 

3  — 

Suet,  beef,  fresh 
Tendon 

Boiled 

630 

11          (t 

Boiled 

3  — 

Boiled 

6  30 

This  table  may  be  considered  as  giving  a  general  idea  of  the  rela- 
tive digestibility  of  the  food-articles  contained  in  it.  If  aot  found 
exactly  right  in  each  individual  case,  it  can  be  rectified  by  experience. 
The  experience  of  no  other  individual's  stomach  will  ever  be  found 
precisely  lik  j  that  of  St.  Martin's,  —  though  in  its  general  features, 
it  may  be  sufficiently  similar  to  make  his  valuable.  The  general 
principles  of  conduct  may  be  learned  from  the  experience  of  othei-s. 
The  particular  application  must  come  from  our  own  experience  and 
reason. ' 

Digestibility  Influenced  by  Amount.—  The  rapidity  with  which 
any  article  is  digested  will  vary  with  the  amount  taken.  A  larger 
quantity  than  is  called  for  by  the  wants  of  the  system  will  be  di- 
gested more  slowly  than  the  proper  amount ;  while,  on  the  other 
hand,  an  insufficient  supply  begets  an  inability  to  reduce  in  the 
stomach  even  the  small  quantity  taken.     We  may  err  in  taking  too 


.  Mei™_'_*w--'i.a.i!J^-i^ 


rfa 


Time. 


HYGIENE. 


73 


little  food  as  well  as  in  taking  too  much ;  though  the  former  error  is 
much  less  likely  to  occur  than  the  latter. 

Choosing  Food  in  HI  Health. —  But  in  deciding  the  kirid  and 
amount  of  food  we  must  be  guided  not  only  by  its  digestibility,  but 
by  the  state  of  the  health. 

If  we  find  the  stomach  apparently  in  good  working  condition,  capa- 
ble of  dissolving  properly  whatever  is  submitted  to  its  action,  and 
yet  we  are  for  some  cause  losing  flesh  and  stre:  igth,  we  should  resort 
not  only  to  the  most  nutritious  of  the  albuminous  group  of  the  azo- 
tized  articles,  but  likewise  to  the  oleaginous  group  of  the  non-azo- 
tized.  We  want  a  great  amount  of  nutriment,  and  we  need  oils  to 
make  fat.  This  is  the  kind  of  food  generally  wanted  in  constitu- 
tional consumption. 

In  fevers,  but  little  food  can  be  disposed  of  at  l)est ;  and  that  little 
must  be  chosen  with  reference  to  its  mildness  and  its  unstimulating 
qualities.  Generally  the  ^arinaceous  or  starchy  articles  are  most 
suitable,  because  they  have  no  stimulating  and  irritating  qualities, 
and  especially  because  they  furnish  fuel  to  be  burned  with  oxygen, 
and  thus  take  the  place  of  the  animal  tissues,  which  are  being  rapidly 
consumed  with  this  devouring  element.  In  fever,  oxygen  is  literally 
burning  up  the  body.  In  this  state  of  the  system,  this  element  ac- 
quires, by  some  means,  a  singular  affinity  for  the  tissues ;  and,  unit- 
ing with  them  rapidly,  forms  a  true  combustion.  The  physician  who 
throws  to  this  devouring  agent  some  of  the  mild,  non-azotized  articles 
which  offer  it  stronger  affinities  than  it  finds  in  the  tissues,  is  as  wise 
as  he  who  tosses  his  dog  to  a  hungry  lion  to  avoid  being  devoured 
himself. 

Exercise  to  be  Considered. —  In  deciding  the  diet,  the  amount  of 
exercise  is  not  less  important  to  be  considered  than  the  health.  The 
farmer,  who  works  in  the  open  air,  and  uses  his  muscles  a  great  deal, 
wants  considerably  more  nutritive,  as  well  as  more  combustive,  food 
than  one  who  leads  a  sedentary  life.  Of  course  there  is  a  great  deal 
more  waste  of  the  tissues,  and  he  requires  more  of  the  flesh-forming 
articles  ;  and  as  he  breathes  deeper,  and  takes  in  more  oxygen,  he 
needs  more  of  the  supporters  of  respiration,  —  the  sugars,  oils,  and 
starchy  aliments. 

Beans. —  By  turning  to  the  table  which  shows  the  amount  of  nitro- 
gen in  the  different  food-articles,  the  reader  will  see  that  beans  are 
rich  in  this  element.  They  are,  therefore,  excellent  food  for  working 
men,  who  are  obliged  to  make  great  use  of  their  muscles.  Our 
fathers,  who  broke  and  subdued  the  rocky  soil  of  New  England, 
showed  wisdom  even  in  their  instincts  in  taking  so  large  a  portion 
of  their  aliment  from  the  bean,  —  especially  as  they  oiled  it  with  the 
fat  of  pork.  But  for  the  hard-working  student,  who  daily  makes 
heavy  drafts  upon  his  brain  and  nervous  system,  beans  and  peas  are 
an  improper  diet.     They  contain   no  phosphorus,  in  the  shape  of 


74 


HYGIENE. 


pboHphate  of  lime  ;  and  no  brain  can  work  hard  without  a  due  supply 
of  phosphorus,  which  forms  a  part  of  its  substance. 

Unbolted  Wheat  Flour. —  For  the  man  who  uses  his  brain  a  great 
deal,  there  is  no  other  one  article  of  food  equal  to  bread  made  from 
unbolted  wheat  flour.  Fine  wheat  flour  is  little  better  for  him  than 
beans,  because  the  miller  has  robbed  it  of  much  of  the  phosphorus, 
which  is  found  chiefly  in  the  hull  or  bran. 

I  mention  only  two  or  three  articles  of  food  as  specimens.  By 
looking  over  the  tables  furnished,  and  reasoning  upon  the  whole  in 
the  way  I  have  done  upon  these  few,  the  reader  can  give  every  arti- 
cle something  like  its  proper  value  in  most  circumstances. 

Climate. —  If  health  and  exercise  should  influence  us  in  choosing 
the  kind  and  the  amount  of  food,  climate  must  do  so  quite  as  much. 

In  the  frigid  climate  of  high  latitudes,  it  is  necessary  that  a  great 
deal  of  heat  be  produced  in  the  body,  in  order  to  avoid  perishing 
with  cold.  There  is  no  mystery  now,  as  there  once  was,  about  the 
production  of  this  heat.  It  comes  from  the  burning  of  carbon  and 
other  substances  in  the  body,  where  they  unite  with  oxygen,  and 
make  just  as  real  a  flre  an  that  which  warms  our  houses.  Oils,  sugar, 
starch,  gums,  etc.,  are  largely  composed  of  carbon,  and  readily  unite 
with  oxygen  in  the  body.  This  is  the  reason  they  are  reckoned  as 
fuel,  and  are  called  supporters  of  combustion.  And  for  this  reason, 
they  require  to  be  largely  consumed  in  very  cold  climates.  The  in- 
stincts of  men  seem  to  lead  to  the  same  conclusion,  for  the  dwellers 
in  all  high  latitudes  consume  great  quantities  of  oils  and  fats.  The 
amountof  train-oil,  tallow,  the  fat  of  seals  and  other  animals,  devoured 
by  the  Laplanders,  Kamtschatkans,  and  other  northern  people,  is  truly 
wonderful. 

In  hot  countries,  the  fundamental  rule  for  preserving  the  health  is 
to  keep  the  body  cool.  Without  observing  this  rule,  the  strongest 
will  often  fall  victims  to  the  climate  in  low  latitudes.  But  to  keep 
cool,  of  course  all  the  heat-producing  articles  of  food  should  l)e 
avoided.  Particularly  all  alcoholic  drinks,  which  are  powerful  sup- 
portera  of  combustion,  should  be  rejected.  Rice  and  the  various  fruits 
form  the  most  suitable  articles  of  diet. 

The  great  sacrifice  of  life  witnessed  among  the  early  emigrants  to 
California,  was  the  result  chiefly  of  using  ardent  spirits  and  heat- 
producing  food  while  crossing  the  Isthmus,  which,  to  a  northern 
constitution,  is  much  like  a  vast  oven,  heated  to  a  temperature  suit- 
able for  baking  bread.  There  are  few  persons,  with  tolerable  health 
and  strength,  but  could  safely  endure  the  hottest  climate  if  they 
would  avoid  alcoholic  liquors  and  confine  themselves  to  an  abstem- 
ious vegetable  and  fruit  diet. 

Bayard  Taylor's  Opinion. —  The  distinguished  traveller,  Bayard 
Taylor,  reports  that  while  spending  a  few  days  in  a  heated  part  of 
Africa,  he  lived  as  the  inhabitants  did,  pretty  much  e.itirely  upon  the 


HYGIENE. 


76 


supply 


flesh  of  well-fatted  sheep  ;  and  that  he  enjoyed,  meantime,  excellent 
health  and  strength.  From  this  he  concludes  that  animal  food  is  as 
suitable  in  hot  climates  as  in  cold. 

It  is  a  pity  a  man  of  such  excellent  parts  as  Mr.  Taylor  should 
have  allowed  himself  to  rear  so  tall  a  structure  upon  so  narrow  a 
foundation.  That  he  could  live  on  flesh  in  eo  hot  a  region,  and  not 
be  made  sick,  only  proved  that  he  had  a  fine  constitution,  and  that 
liis  health  was  not  easily  disturbed ;  and  when  he  attempted,  from 
Iiis  limited  experience  of  a  few  days,  to  reason  against  the  established 
facts  of  science,  and  against  the  well-attested  laws  of  life,  he  did  it 
evidently  without  reflecting  that  he  was  in  a  field  of  thought  which 
he  never  had  occasion  to  cultivate. 

The  great  Jewish  Lawgiver  doubtless  had  a  reason  for  prohibiting 
pork  to  the  Jews.  Whatever  that  reason  was,  the  prohibition  had  a 
wise  bearing  upon  the  health  of  the  people.  Palestine  has  a  hot 
climate,  in  which  pork-fat  is  an  improper  diet. 

More  Fat  in  Winter, —  It  follows  from  what  has  been  said,  that  a 
more  fatty  as  well  as  stimulating  diet  is  needed  in  winter  than  in 
summer.  But  the  change  should  be  made  gradually.  When  cold 
weather  approaches,  the  food  should  become  more  nutritious  and 
warming  by  little  and  little.  The  exercise  should  likewise  be  in- 
creased. 

Even  the  lower  animals  act  upon  this  plan.  In  the  fall,  squirrels 
eat  nuts,  which  are  full  of  oil,  and  grow  fat  upon  them. 

The  instincts  of  men  move  in  the  same  direction.  It  is  in  the  fall 
that  the  hog,  the  ox,  and  the  poultry  are  killed  ;  and  in  the  winter 
that  they  are  largely  feasted  upon  and  enjoyed.  Upon  such  food, 
combined  with  various  sorts  of  starch,  man  fattens  ;  and  a  good  sup- 
ply of  fat,  deposited  in  the  cells,  is  equal,  in  keeping  out  cold,  to  a 
layer  of  cotton  batting,  —  to  say  nothing  of  the  fire  kept  up  within 
the  body  by  the  burning  of  such  fuel.  As  hot  weather  comes  on,  we 
gradually  lay  aside  these  fattening  articles  (or  ought  to),  and  return 
to  the  watery  vegetables  and  fruits,  such  as  squash,  string-beans, 
strawberries,  currants,  etc. 

Few  of  us,  I  apprehend,  would  suffer  from  heat  in  summ'er,  if  we 
could  persuade  ourselves  to  abandon  stimulating  and  firo-producing 
food,  and  confine  ourselves  pretty  much  to  a  cooling  and  succulent 
diet.  Diarrhoeas  in  summer  are  not  induced  by  eating  wholesome 
vegetables,  but  by  combining  them  with  large  quantities  of  animal 
food 

The  State  of  the  Mind. —  This  should  by  no  means  be  over- 
looked in  choosing  the  kind  and  the  amount  of  food.  If  we  have 
lost  friends,  or  heard  desponding  news,  or  experienced  calamities  of 
itny  kind,  we  must,  during  the  first  hours  of  the  shock,  or  even  during 
the  first  days,  if  the  affliction  be  heavy,  partake  very  sparingly  of  food. 
The  stomach  is  in  no  condition  to  receive  it.     The  brain  lies  pros- 


tmmm 


d 


76 


HYGIKNE. 


trate  under  the  stroke,  and  the  stomach,  in  sympathy  with  il,  u«ks 
for  a  day  of  sorrow  and  fasting.     Disturb  it  not. 

Heat-producing  Food   Incompatible  with   Excitement. — It  is 

folly  to  take  heat-producing  aliment  when  laboring  for  days  under 
high  excitements.  During  political  campaigns,  when  the  blood  of 
politicians  is  at  the  boiling  point,  the  diet  should  be  unstimulating, 
—  containing  very  little  animal  flesh,  and  not  much  combustive  food. 
Many  a  man  has  died  of  apoplexy,  or  of  heart-disease,  by  putting  on 
the  steam  when  his  blood  was  up.  Whenever  we  have  a  day  of  un- 
common excitement  to  pass  through,  we  should  always  begin  and 
end  it  with  an  unusual  degree  of  al»tinence  as  to  the  amount  of  food 
taken,  and  with  special  care  that  the  articles  be  of  the  highest  kind. 

Anger  Demaad«  Abstinence. —  Anger  is  a  passion  which  espe- 
cially unfitii  the  stomach  for  doing  much  work.  If  it  occur  often,  or 
be  protracted,  but  little  food  should  be  taken.  Those  who  indulge  it 
have  a  double  cause  for  abstinence.  Both  their  folly  and  their  stom- 
achs call  for  a  fast. 

Food  Adapted  to  Different  Periods  of  Life —  Food  must  vary  in 
different  periods  of  life.  The  infant  needs  a  fattening  diet ;  and  this 
has  been  supplied  in  the  milk  of  tlie  mother,  which  contains  more 
hitter  (the  fattening  portion)  than  the  milk  of  any  other  animal. 
But  as  the  infant  has  much  less  exercise  than  the  young  of  animals, 
its  flesh  is  not  wasted,  and  it  does  not  require  so  much  azotized  food, 
that  is,  the  reader  will  remember,  foorl  witli  nitrogen  in  it.  Accord- 
ingly, it  will  be  seen  by  looking  at  tli  table  on  page  70,  that  human 
milk  has  much  less  of  this  element  'an  that  of  the  cow.  As  the 
child  grows  up,  and  begins  to  take  acti\  'xercise,  indoors  and  out, 
it  wants  more  solid  food,  and  teeth  make  their  appearance  to  masti- 
cate or  chew  it. 

In  Youth  and  Jlanhood,  the  great  amount  of  exercise  usually 
taken  calls  for  larger  supplies  of  azotized  aliment,  —  beef,  mutton, 
pork,  fowl,  fish,  wheat-flour,  corn-meal,  rye-meal,  potatoes,  turnips, 
peas,  betlns,  etc.  This  is  the  working  part  of  life,  when  the  tissues 
are  rapidly  wasted  by  action,  and  the  flesh-forming  aliments  are 
wanted  to  keep  them  good. 

In  Old  Age,  the  exercise  is  diminished,  the  blood  circulates  more 
slowly,  and  the  body  grows  cold.  Now  is  the  time  to  resort  to  non- 
azotized  food,  —  oils,  fats,  the  various  kinds  of  starch,  sugar,  and  the 
like.  These  will  furnish  fuel  to  warm  the  sluggish  blood,  and  will 
invest  the  body  with  fat,  which  will  serve  the  purpose  both  of  a  cush- 
ion and  a  garment.  Wine,  beer,  porter,  and  distilled  spirits  are  never 
needed  by  young  peraons  in  health  ;  but  the  aged  are  frequently  bene- 
fited by  them,  if  taken  in  small  quantities.  They  are  chiefly  com- 
posed of  oxygen,  hydrogen  and  carbon,  and  are  properly  ranked  with 


HYGIENE 


77 


the  supportera  of  combustion.  They  are  like^vi8e  stirauiant,  and  add 
to  the  comfort  of  the  old  by  quickening  their  circulation.  Like  tea 
and  coffee,  they  diminish  the  waste  of  the  body,  and  thereby  lessen 
the  demand  for  food. 

The  smallest  amount  of  aliment  upon  which  a  healthy  adult  person 
ever  lived  for  any  length  of  time,  v.as  twelve  ounces  a  day.  Upon 
this  small  daily  allowance,  Lewis  Cornaro,  a  noble  Venetian,  sub- 
sisted in  perfect  health,  during  the  protracted  period  of  fifty-eight 
years.  This  he  was  able  to  do  only  by  adding  daily  to  his  food 
about  twelve  ounces  of  light  wines.  I  shall  have  occasion  to  refer 
to  this  case  again.  ' 

Cost  of  Pood. 

Onk  other  consideration  must  ever  influence  the  great  majority  of 
•  men  in  selecting  their  food.  I  mean  its  cost.  It  is  a  matter  of  great 
importance  to  the  poor,  to  know  what  kinds  of  food  they  can  subsist 
upon  with  least  expense.  Sometimes  provisions  are  so  high  that 
persons  in  poor  circumstances  greatly  need  advice  in  this  matter. 
Let  me  endeavor  to  furnish  some  information  which  shall  be  of  ser- 
vice to  the  reader. 

Milk  is  supplied  by  nature  to  be  our  first  food,  and  is  a  good  type 
of  all  alimentary  substances.     It  contains 
(turd,  which  has  nitrogen,  and  is  equivalent 
to  albumen  and  fibrin,  and  represents  the 
hlood-formers.     It   has   butter   and   sugar. 
These  represent  the   heat-formers.     It  has 
salts,  which  contain  potash,  soda,  phospho-j 
rus,  etc.     Fig.  64  is  a  microscopic  view  of  I 
good  milk ;  Fig.  65,  of  poor  milk ;  and  Fig. 
66,  of  milk  adulterated  with  calf's  brains. 

Food  will  be  valuable  in  proportion  as 
it  combines,  in  due  proportion,  the  articles 
contained  in  the  four  groups,  represented 
by  albumen.,  fat.,  sugar.,  and  salts. 

Albuminous  Group. —  Albumen,  fibrin,  casein,  and  gluten,  all  en- 
ter into  the  substance  of  animal  and  vegetable  bodies,  and  are  all 
composed  of  the  same  elements,  namely,  48  parts  carbon ;  36  of 
hydrogen ;  14  of  oxygen  ;  and  6  of  nitrogen.  In  containing  nitrogen 
they  all  differ  from  the  other  three  groups.  Albumen  being  a  good 
type  of  them,  they  are  called  albuminous  compounds.  Albumen 
forms  a  large  portion  of  the  serum,  or  colorless  part  of  the  blood. 
It  is  the  leading  principle  in  alimentation.  It  is  worked  up  into  the 
tissues  of  our  bodies.  It  forms  our  muscles,  our  membranes,  a  por- 
tion of  our  nerves,  etc.  It  is  the  bricks  of  which  the  house  we  live 
in  is  made.  AH  the  articles,  therefore,  which  are  chemically  consti- 
tuted like  it,  may  well  be  termed  albuminous. 


FlO.  64. 


V 


|r 


78 


HYGIENE. 


These  bodies,  consisting  of  the  four  organic  elements  named  above, 
have  been  called  quaternary  compounds.  Besides  these  elements,  they 
have  a  minute  portion  of  sulphur  and  phosphorus.  They  are  also 
called  protein  or  proteinaceous  compounds. 

Albumen  is  a  very  unsUible  compound, —  tending  strongly  to  de- 
composition.    This  is  owing  to  the  complexity  of  its  cor'position. 


Fio.  65. 


FlO.  6G. 


and  to  its  union  with  the  fickle  element,  nitrogen,  which  forms  chemi- 
cal compacts  reluctantly,  and  breaks  tliem  without  remorse.  Sub- 
stances which  coagulate  or  fix  albumen  in  an  insoluble  compound, 
or  preserve  the  tissues  of  the  body,  which  are  made  from  it,  from 
decomposition  or  putrefaction,  are  called  antiseptics. 

Fatty  Oroup. —  The  next  group,  represented  by  fat,  performs  very 
important  offices  in  the  system,  —  the  most  injportant  of  which  is  a 
union  with  albumen  in  the  formation  of  cells.  All  animal  and  vege- 
table life  begins  with  the  cell, —  the  tiny  cup,  with  which  nature  dips 
all  the  streams  of  life  out  of  the  great  fountain  of  inorganic  matter. 
No  cell  is  formed  without  a  minute  ]jarticle  of  oil.  Tiie  portion  not 
used  in  forming  cells,  is  either  burned  as  fuel  to  keep  us  warm,  by 
uniting  with  oxygen,  or  it  is  stored  away  in  the  cellular  tissues,  add- 
ing to  the  bulk  of  the  person.  If,  then,  the  very  beginnings  of  life 
are  dependent  upon  fat,  it  is  of  great  importance  as  an  article  of  diet. 
So  necessary  is  it  in  the  economy  of  life,  that  when  not  taken  in  the 
food,  it  is  formed  out  of  albumen  in  the  processes  of  assimilation. 

The  Starch  and  Sugar  Group,  composed  of  several  kinds  of  sugar, 
gum,  etc.,  is  never  used  in  forming  the  tissues,  but  they  perform  im- 
portant offices  in  the  changes  going  on  within  the  human  organism. 
Thus,  sugar  of  milk  is  decomposed,  and  forms  lactic  acid,  so  called 
from  being  found  in  sour  milk.  This  acid  plays  a  veiy  important 
part  in  the  process  of  nutrition. 

Pure  starch  is  a  snow-white  powder,  having  a  glistening  aspect. 
It  is  composed  of  grains  from  .gj^  to  ^^^  of  an  inch  in  diameter  in 
the  different  grains ;  being  largest  in  the  potato  and  smallest  in 
wheat.  When  examined  with  the  microscope,  they  appear  as  in  Fig. 
68. 


^ 


HYGIENE. 


79 


The  Salts  Qroup  are  sufficiently  spoken  of  in  another  place. 

A  wise  philosopher  in  ancient  time  said,  "  I  do  not  live  to  eat  and 
drink;  I  eat  and  drink  to  live."  If  we  intend  to  eat  to  live,  we  must 
combine,  in  our  food,  the  four  groups  above  explained;  and  if  we 
would  live  at  as  small  expense  as  possible,  we  must  take  those  arti- 
cles which  are  low  in  price  and  rich  in  nutritive  matter.  The  fol- 
lowing table  will  help  the  reader  make  his  selections :  — 

Tabk  of  the  relative  value  of  articles  of  food  arranged  according  to  their  proportions  of 
nutrimt  matter  in  each  of  the  four  groups  of  elements  concerned  in  vital  changes. 


In  100  pound!  of 


I 


Gbains  : 

Wheat 

Barley 

Oats 

Rye 

Indian  Com     .    .    ,     . 

Buckwheat       .    .    .     . 

Rice 

Pod  Plants: 

Beans  

Peas 

Roots  : 

Potato 

Turnip 

Carrot 

Beet  (manKold  wurzel) 

Long  red 

Sliort  red 

Sugar  beet    .... 

Parsnip 

Leaf; 

Cabbage  

Mkal; 

Wheat  flour     .    .    .    . 

Ryemeal 

Barleymeal 

Oatmeal 

Wheat  bran      .... 


I 


.-I 

r 


15 
16 
16 
12 
14 
15 
13 

14 
14 

76 
88 
86 
86 
86 
85 
86 
80 


16 
16 
16 
15 
l.S.l 


15 

16 

20 

10  to  20 

0 
26 

:i 

8  to  11 
9 

4 

2 

3 

2 
3.03 
3.31 

2 
1.6 


4.63 

55 


la© 

E  3  "I 


10  to  19 
12  to  16 
14  to  19 
10  to  15 
11 

8 

7 

24  to  28 
24 

2.1 
1.6 
1.5 
•     2 
0.48 
0.26 

2.5 

30  to  36 

10.8 

8 

6.3 
12.6 
19.3 


So 

H 


2to4 
2  to  3 
6to7 
3to4 

8.1 

0.4 

0.7 

2to3 
2.1 

0.«l 
0.3 
0.4 


0.36 


9 


r£ 


'J 


it 


2 

2 

2.4 

6.6 

4.7 


6S 
60 
60 
60 
74 
60 
79 

40 

50 

18 
9 

10 

11 

10.36 
12.46 

13 

16 


70.6 
73 
74 
64 
.6 


2 
3 
4 

2 

Oi 

3 
3 

;toii 

Sto4^ 

lito2 

tol 

.s 

i 


2 

2 
3 
7.3 


The  following  tables  have  an  admirably  practical  bearing  upon 
economy  in  food  :  — 


100  lbs. 


Parley 

Beans 

Beets 

Buckwheat      .    .    . 

Carrots 

Corn 

Oats 

Peas 

Potatoes 

Turnips  (field)  .  . 
Do.  (Swedish)  .  . 
Wheat  Flour  .  .  . 
Wheat  Bran  .  .  . 
Cheese  (whole  milk) 
Cheese  (skim-milk) 


Muscle- 

forminc 

Elemenn, 

in  lbs. 


14 
26 

2 

8 

li 

12 

17 

24 

2 

2i 
11 
18 
28.4 
49.8 


Fat-forminp; 

Blcmenta, 

Inlbt. 


64 
42 
12 
64 
10 
77 

62 
19 

9 
12 
79 

6 
51.1 

6.3 


Relatire  Propor- 
tion of  each, 
In  lbs. 


ItoA 
Itofj 


Husky,  or 

Woody  fibre, 

in  lbs. 


16 
10 

(?) 
26 
3 
6 
20 
8 
4 
2 
2 

56 


lAlil'iUi 


iHri 


80 


▲rtlelM. 


Barley    .    .    .    : 

Beans 

Corn 

Outs 

Peas 

PotaiiOeB.  .  .  . 
Turalpg  .... 
Flour  ^flne)  .  . 
Flour  (unbolted) 


HYGIENE. 

Cost, 

Mtuole-prodnolng 

Coatof  Muacle-pro 

Eleuent*. 

ducing  Klemanti. 

$1.00  per  bu. 

M  lbs. 

12c.  per  lb. 

1.80      " 

16.6   " 

lie.      " 

0J50      " 

6.7   " 

7*0.    " 

OM      " 

8.2  " 

7a      " 

1.00      " 

14.3  " 

7a     " 

0.(15      " 

1.6  " 

Ks,.     " 

OJ50       " 

1.2  " 

41a      " 

n.OO  per  bbl. 

22.0  " 

23c.      " 

4J0      " 

24.8  " 

18c.      " 

These  tables  will  well  repay  study,  for  their  practical  use  will  s.ave 
many  dollars  to  the  poor.  Let  it  be  remembered  that  producing 
muscle  is  the  same  thing  as  producing  strength,  or  labor-power. 
Bearing  this  in  mind,  the  following  table  will  be  very  interesting:  — 

One  pound  of  labor-power  from  Potatoes  costs  6Sc.  per  lb. 

"      Fine  Flour,     2;k;. 

"     Unbolted  do.,  18c.        " 


Turnips, 

Barley, 

Corn, 

Beans, 

Peas, 

Oats, 


41c. 
12c. 

7ic. 
lie. 

7c. 

7c. 


\ 


Meats  are  omitted  in  the  table.  So  far  as  their  nutritive  qualities 
are  concerned,  it  is  of  little  consequence  which  are  taken.  Some  are 
more  digestible  than  others,  and  this  consideration  should  influence 
those  with  weak  stomachs  in  selecting.  Every  person,  of  coui-se, 
knows  their  relative  cheapness. 

Among  the  vegetables  given  in  the  table,  there  is  a  wider  range 
for  choice.     Let  us  consider  them  in  course. 

Wheat. —  In  this,  the  four  groups  are  represented  in  excellent 
proportion.  When  not  deprived  of  the  bran,  it  is  perhaps  the  very 
best  supporter  of  animal  life.  So  high  have  been  the  regards  of  men 
for  it,  and  so  generously  have  they  awarded  to  it  their  acknowledg- 
ments, that  its  product,  bread,  has  been  everywhere  called  "  the  staff 
of  life."  The  settlement  and  cultivation  of  the  immense  prairies  of 
the  West  have  within  recent  years  so  increased  the  production  of 
wheat,  that  its  cost  is  now  less  than  half  what  it  was  fifty  years  ago, 
and  it  is  indeed  within  the  means  of  all  in  America. 

Barley.— This  has  the  four  groups  represented  in  nearly  the  same 
proportions  as  wheat.  It  is,  therefore,  nearly  as  valuable  an  alimen- 
tary grain.  Unfortunately  it  is  not  so  toothsome  as  wheat,  ai)d  can 
never  be  so  popular  an  article  of  diet.  The  Scotch,  however,  feed 
upon  it  with  apparent  relish,  and  doubtless  think  it  strange  that  for- 
eign palates  are  not  better  pleased  with  it. 

Oats.—  This  grain,  strange  to  say,  has  more  albuminous,  or  nutri- 
tive matter,  more  fat,  more  starch,  and  more  salts  than  wheat.  In 
uniting  a  large  quantity  of  the  four  alimentary  groups,  it  surpasses 


^ 


HYOIKNE. 


81 


liutri- 
In 
basses 


every  other  vegetable  substance.  In  albumen,  it  is  not  quite  as  rich 
as  peas  and  beans,  and  in  starch  it  falls  a  trille  below  fine  wiieat 
rtoiir ;  but  in  fat  it  is  exceeded  only  by  Indian  corn.  This  grain  is 
likewise  cousiuned  largely  by  the  Scotch, —  a  people  whose  claims  to 
sliiMwd  common  sense  are  well  supported  by,  iw  their  liardy  coustitu- 
tioiis  vindicate,  tiie  choice.  This  grain  might  well  be  permitted  to 
tike  tiie  j)lace  of  rice.  It  affords  several  times  as  much  nutriment, 
u  liile  it  costs  only  about  one-fifth  as  much.  There  is  good  reason 
why  the  hoi-se  should  thrive  upon  oats.  Most  stidjle-keepei-s  think 
their  horses  will  do  more  work  upon  corn-meal,  but  this  must  Ihj  a 
mistake.  In  using  oats  for  horse-feeding,  a  large  portion  of  the  nu- 
triment is  lost  by  not  (jrinding  them. 

Rye. —  This  is  also  a  grain  of  considerable  nutritive  value.  It  is 
much  cheaper  than  wheat ;  and  r3-e  meal  has  long  been  a  standard 
article  of  diet  in  New  England,  —  particularly  in  connection  with 
Indian  meal,  as  "brown  bread."  It  is  useful  for  relieving  costive- 
ness,  in  th«  form  of  "  hasty-pudding,"  with  molasses. 

Indian  Corn. —  This  stiiple  article  of  American  produce  needs  no 
praise  from  me.  It  is  comparatively  cheap,  nutritive,  and  wholesome. 
It  abounds  in  fat  and  starch,  and  has  a  fair  amount  of  albumen, 
though  not  as  much  as  the  oat,  the  barley,  or  the  wheat.  In  salts,  it 
is  rather  deficient.  Indian  corn  is  strictly  an  American  plant,  and  is 
perhaps  the  most  popular  grain  in  the  country.  It  has  emphatically 
a  national  reputation,  and  is  perhaps  worked  up  into  more  savory 
dishes  than  any  otlier.  At  the  South  it  is  an  institution.  It  is  there 
made  into  hoe-cake,  corn-cake,  batter-cakes,  batter-bread,  muffins,  corn- 
pone,  etc.  At  the  North,  we  have  johnny-cake,  Indian  and  pumpkin- 
cake,  baked  Indian  pudding,  boiled  Indian  pudding,  beside  the  well- 
known  rye  and  Indian  bread,  and  other  preparations.  Give  an  in- 
genious Southern  or  Northern  housewife  a  few  simple  adjuncts,  such 
as  lard,  milk,  sugar,  eggs,  cream  of  tartar,  and  soda,  and  she  will 
make  a  pretty  respectable  larder  from  this  single  grain.  If  molasses 
be  substituted  for  sugar,  and  a  little  stewed  pumpkin  be  thrown  in 
by  way  of  garniture,  we  may  have  several  preparations  which  are 
very  nourishing  as  well  as  cheap. 

Buckwheat. —  Poor  in  nutritive  matter,  fat,  starch,  and  sugar,  but 
tolerably  well  supplied  with  salts.  Jt  will  do  very  well  for  batter- 
cakes  in  winter.  When  brought  smoking  upon  the  table,  and  served 
with  sugar  or  molasses  and  butter,  these  cakes  are  a  luxury,  in  which 
the  rich  may  indulge  if  they  clioose ;  but  for  the  poor,  the  amount  of 
nourishment  they  afford  is  too  small  for  their  cost. 

Rice. —  Much  like  buckwheat,  except  that  it  has  more  fat,  sugar, 
and  starch,  and  less  salts.  As  an  article  of  diet,  it  has  had  too  high 
a  reputation.  Those  who  would  live  on  small  means  cannot  afford 
it.  Boiled  in  plain  water,  it  is  excellent  for  a  relaxed  state  oi  tlie 
bowels;  and  this  about  all  the  conunendation  to  which  it  is  entitled. 


82 


HYOIKMB. 


Beans.—  The  rlclicHt  in  nutritive  mutter  of  all  vegetable  substances, 
except  cabbage  and  oats.  They  have  more  albumen  than  wiieat,  or 
corn,  or  barley,  or  oats ;  but  in  fat  and  starch  they  are  lower  in  Ihe 
scale.  Add  to  them  salt  pork,  and  the  highoet  of  all  nutrient  com- 
pounds is  obtiiined.  During  not  less  than  four  generations,  pork 
and  beans,  as  the  principal  diet,  nourished  an  iron-sided  race  of  men 
in  New  England.  Hcan-porridge  was  like  honey  upon  tlie  tongue  of 
the  foundem  of  New  England  institutions.  They  ate  it  morning, 
noon,  and  night ;  and  thanked  God  for  it  every  time.  And  well  they 
might  thank  Him ;  for,  with  Indian  corn,  it  furnished  them  with  a 
diet  better  adapted  to  their  condition  than  any  other. 

Peas. —  Not  quite  as  rich  as  Iwans  in  albumen,  but  more  rich  in 
starch,  is  of  about  the  same  value  on  the  whole.  The  Canadian  French, 
in  Lower  Canada,  feed  on  pciis  to  about  the  same  extent  that  the 
New  Englanders  did  on  l)eans.  Pea-soup,  as  prepared  by  the  best 
cooks  among  them,  is  a  dish  of  great  nutritive  excellence ;  and,  in 
my  judgment,  more  palatable  than  bean-soup. 

The  Potato. —  Three-quarters  of  this  root  is  water,  and  it  is  poor 
in  all  the  elements  of  nutrition.  It  is  a  palatable  article,  and  most 
persons  are  much  attached  to  it.  As  bulk  is  of  some  consequence  in 
food,  the  potato  is  not  without  value.  Men  do  not  often  live  entirply 
upon  potatoes, —  not  even  in  Ireland.  Milk,  butter-milk,  and  cop.> 
cially  cabbage,  are  united  with  them. 

Turnips,  Carrots,  Beets,  Parsnips. —  These  are  much  alike, — 
being  all  poor  in  nutritive  qualities.  They  serve  to  please  the  pal- 
ate by  furnishing  a  variety  ;  but  in  our  city  markets  they  are  expen- 
sive, and  do  not  furnish  an  economical  diet. 

Cabbage. —  It  is  interesting  to  observe  how  the  instincts  of  men 
have  in  all  tages  led  them  to  select  those  articles  of  diet  which  their 
circumstances  have  demanded.  The  poverty  of  the  Irish  has  led 
them  to  subsist  hugely  upon  the  potato,  —  a  root  which  the  soil  of 
their  country  yields  profusely.  But  as  this  root  has  but  little  nutri- 
tive matter,  necessity  required  that  it  should  be  united  with  some 
other  vegetable.  The  natural  instinct  selected  the  cabbage ;  and 
when  chemical  science  came,  at  length,  to  pass  judgment  upon  the 
correctness  of  this  instinct,  it  turns  out  that  the  cabbage  is  the  richest 
in  albumen  of  any  known  vegetable.  The  cabbage,  then,  is  the  nat- 
ural complement  of  the  potato  ;  and  the  Irish  had  the  sagacity,  with- 
out science,  to  bring  the  two  together.  It  is  said  the  Irish  have  a  dish 
named  "  kohl-cannon,"  consisting  of  boiled  and  mashed  potatoes  and 
cabbage,  seasoned  with  pork  fat,  pepper,  and  salt,  and  that  it  is  a 
truly  savory  dish.  It  certainly  is  a  nourishing  and  a  cheap  one.  The 
ambassador  who  was  sent  to  tamper  with  the  patriotism  of  a  Roman 
who  liad  dined  on  beans,  wiis  asked  if  he  was  silly  enough  to  think 
gold  anti  silver  could  bribe  a  man  who  was  satisfied  with  so  plain  a 


HYQISNE. 


9» 


expen- 

of  men 
ch  the  li- 
as led 
le  soil  of 
iiutrl- 
th  some 
^e  ;  and 
)on  the 
richest 
the  nut- 
ty, with- 
Ive  a  clisli 
toes  and 
it  is  a 
ne.   The 
Roman 
)  think 
ph'in  a 


fare,  and  dcsirod  no  other.  We  come  to  the  fonrhision  then,  that 
l)ean-|i()rridgo,  pcii-noin),  «iU!t-piulding  swecflened  with  nioliisHeH,  tuit- 
iiieal,  iiiid  buioy-hreiid,  with  "  kohl-ciiniion  "  for  those  who  can  digest 
it,  will  t'urniBh,  for  hard-workinjj  men,  tlm  most  Knhstiintial  diet,  at 
the  smallest  possible  G"i)en8e.  To  ren(U'r  these  dishes  savory,  and 
to  make  the  bible  on  which  they  are  spread  an  inviting  lx)ard,  the 
deft  housewife  must  emph)y  her  best  skill  in  servinjj  them.  With 
the  thouspud  "  fixings,  with  whi<h  a  New  England  matron  knows 
how  to  garnish  them  (or  would  know  how  if  they  came  within  her 
culinary  operations),  they  are  well  fitted  to  leave  savory  impressions 
upon  tongues  which  would  praise  them  to  the  end  of  life.  I  speak 
of  these  articles  as  furnishing  a  cheap  diet  for  working  men.  The 
indolent,  the  sedentary,  and  the  effeniimite  from  various  causes,  uould 
not  digest  them. 

The  Amount  of  Food  Taken. 

We  have  already  exj)lained  that  this  should  be  governed,  in  part, 
by  the  amount  of  exercise  taken,  by  the  condition  of  the  health,  by 
the  state  of  the  mind,  by  the  climate,  by  the  seiuson,  etc.  It  remains 
to  add  a  few  words  in  a  general  way,  respecting  the  rtl)eolute  amount 
required  by  an  adult  man. 

It  is  plain  enough  that  most  men  eat  too  much.  We  come  veiy 
near,  in  this  country,  being  a  nation  of  gormands.  A  principal  rea- 
son of  our  over-eating  is,  that  we  eat  so  fast.  When  the  food  is  well 
and  slowly  masticated  and  swallowed,  the  gastric  juice  has  time  to 
mix  with  it ;  and  at  the  proper  moment  the  appetite  ceases.  But 
when  our  food  is  bolted  rapidly,  nature,  finding  her  laws  disregarded, 
and  all  her  purposes  frustrated,  stands  back,  and  lets  mh  learn  to  stop, 
too  late,  alas !  from  a  sense  of  fullness  in  a  stretched  and  abused 
stomach. 

It  has  already  been  stated  that  Lewis  Cornaro  lived  fifty-eight 
yeai-s,  namely,  from  the  age  of  forty-two  to  one  hundred,  on  twelve 
ounces  of  solid  food  a  day,  with  about  the  same  amount  of  light 
wines.  At  the  age  of  eighty-four  he  wrote  a  book,  in  which  he 
praises  "  divine  temperance  "  in  terms  which  are  sometimes  eloquent 
and  often  enthusiastic.  Indeed  it  is  very  rare  that  a  man  at  tliat 
age  retains  such  clearness  of  intellect,  and  especially  such  freshness 
of  feeling  as  he  evinces  in  his  book.  Probably  but  few  could  live  on 
tlie  amount  of  food  which  he  found  sufficient.  Yet  it  is  said  tlie 
distinguished  John  Wesley  lived  on  sixteen  ounces  a  day,  which,  as 
he  took  no  wine,  and  had  to  derive  the  combustive  materials  for 
warming  the  body  from  the  food,  was  quite  as  scanty  a  fare  as  that 
of  Cornaro.  Considering  that  he  led  a  most  extraordinarily  active 
life,  both  of  body  and  mind,  being  half  his  waking  hours  in  the  sad- 
dle and  preaching  almost  daily,  this  is  probably  the  most  remarkable 
case  of  absteminousness  on  record.  Jonathan  Edwards  did  not,  I 
think,  exceed  the  same  amount  of  food,  but  he  was  not  so  active  a 
man. 


M 


HYfilKNE. 


Putting  asido  such  oxcoptiotml  civhpr  ns  (Ih'hc,  w«'  nmyHay  in  round 
iiun)bei*H,  tliat  ii  ltilN)riii^  iiiiiii  r(M]iiiri!H,  ti>  k(!(i()  him  in  luniltli,  aluiiii 
two  or  two  and  a  half  pnumlB  of  Holid  food  per  day.  For  miniHtvi'x, 
lawyerH,  doctoix,  aiillioix,  and  niun-lianUi,  ono  pound  and  a  lialf  is 
amply  Huniciunt.  TUv  amount  hIiouUI  Ik;  inciraHod  a  littlu  iiy  a  se- 
lection from  Honut  of  tlu;  fnul-fonnurM,  if  no  ft>rmonte<l  or  alc()lit)li(' 
drinks  Ixt  taken,  and  Hlightly  diminished  if  they  are  UHed.  Tlii'  ivii- 
Hon  is  that  thuNi'  drinkH  furnish  fuel  to  l>c  lmrni>d  in  hreatliin^', 
which  haw  to  l)e  drawn  from  the  food  when  they  are  not  employi'il, 
This  furnisheH  no  motive  for  usin//  ardent  spiritM ;  for  there  is  fuel 
enough  tu  be  had  in  the  oJs,  starcheH,  and  sugani. 

Dyspeptics.  —  U  is  said  that  dyHi>eptic8  eat  more  than  {Mirsons  in 
health  ;  and,  in  many  caHes,  the  remark  may  he  true.  The  appetite 
of  a  person  suffering  from  this  disease  is  almost  always  morbid,  and 
the  information  it  gives  respecting  the  real  want«  of  the  systenj  van 
seldom  be  trusted.  If  we  allow  a  disetuied  sk)math  to  dictate  to  us 
when  and  what  and  how  much  we  shall  eat  and  drink,  our  misery 
for  life  is  a  foregone  (juestion.  A  sick  stomach  is  like  a  spoiletl  eliild, 
—  it  cries  for  what  it  should  not  have.  If  the  dyspeptic  will  live, 
and  enjoy  any  amount  of  peace  and  eonifort,  lie  must  follow  tiiis 
simple  rule  :  I'o  eat  no  more  than  can  be  diiiegted,  even  though  the 
amount  be  only  an  ounce  a  day. 


Animal  and  Vegetable  Food. 

It  has  generally  been  supposed  that  it  was  intended  man  should 
subsist  on  a  mixed  diet,  consisting  of  both  animal  and  vegetjii)le 
substances.  Within  the  last  fifty  years,  however,  a  school  of  physi- 
ologists have  appeared,  who  affirm  that  a  vegetable  diet  is  alone 
consistent  with  the  laws  of  health.  They  declare  tiiat  animal  food  is 
not  adapted  to  man's  organization,  —  that  it  unduly  stimulates  the 
blood,  predisposes  tf)  fevers,  consumptions,  diarrhoeas,  choleras,  apo- 
plexy, and  numerous  other  diseases,  and  of  course  shortens  life. 
That  such  a  school  should  have  come  into  existence  in  this  countiy, 
where  animal  food  is  more  largely  consumed  than  in  any  other  part 
of  the  world,  in  proportion  to  the  number  of  people,  is  not  surprising. 
We  do,  undoubtedly,  eat  too  much  flesh.  So  enormous  is  the  consunip 
tion,  that  notwithstanding  the  vast  herds  of  cattle  raised  in  all  our 
agricultural  states,  and  especially  on  the  western  plains,  the  deniund 
keeps  up  with  the  supply  so  well  that  beef  brings,  on  an  average, 
about  twenty  centa  per  pound,  —  at  least  twice  its  full  value  as  a 
blood-former. 

Facts  show  that  man  may  live  upon  flesh  alone,  upon  vegetables 
alone,  or  upon  flesh  and  vegetables  combined.  Is  it  be»t  he  should 
subsist  upon  vegetables  only,  or  upon  a  mixed  diet  ?  A  mere  affirm- 
ation upon  these  points  is  of  little  consequence.  To  cite  facts  avails 
nothing.     Men  have  a  way  of  making  their  own  affirmations,  and  of 


HYaiENE. 


86 


lortkiiig  lit  factH  with  oyes  which  uometimcs  see  clearly  enough  on 
lK)th  HidcH  of  them,  hut  totally  ignore  their  existence. 

Man's  Structure  Settles  the  Question. — To  settle  thJH  matter,  we 
must  a[)]>eal  to  man's  organization.  His  structure  will  tell  uh  some- 
thiiiji;  we  need  not  mistake.  All  the  works  of  God  show  design. 
Kvi'iything  he  has  made  has  a  use,  and  is  so  contrived  as  to  he 
iidiipted  to  that  use.  Lions,  tigers,  and  other  animals,  for  example, 
whicli  feed  on  flesh  alone,  have  a  tshort  second  stomach,  —  it  heing 
(inly  ahout  three  times  tiie  length  of  the  animal's  l)ody.  Aninials 
witicli  eat  no  flesh  have  a  long  second  stomach,  —  that  of  the  sheep 
lieiiijr  from  thirty  to  thirty-five  times  the  length  of  its  body.  A  very 
iviiiarkablo  difference  of  anatomical  structure  I 

This  is  the  meaning  Oi  .he  difference  :  Vegetable  foqd  has  a  great 
(leal  of  waste  matter  in  i  Woody  fibre  makes  quite  an  item  in  it« 
cDiiiposition.  This  wiuste  portion  must  be  carefully  separated  from 
the  nutritive  part,  and  tiiis  must  all  be  done  in  the  second  stomr.  h. 
It  takes  time  to  do  it.  It  must  not  l)e  done  in  a  hurry.  The  nutri- 
tive materials  are  destined  to  build  a  living  structure,  whose  dura- 
tion, like  that  of  all  other  fabrics,  will  depend  on  the  care  with 
which  the  materials  are  selected  and  put  together.  The  second 
stomach  of  the  sheep  is  long,  that  there  may  be  ample  time  for  the 
mixed  mass  of  chyme,  when  it  pisses  out  of  the  first  stomach,  to  Xte 
(iiaiiged  to  chyle,  and  then  to  lie  carerfully  separated  into  the  two 
parts,  the  useful  and  the  useless.  Animal  food  is  in  iXn  composition 
just  like  our  own  flesh,  —  the  «  is  little  waste  matter,  and  not  much 
time  is  required  for  it«  separation ;  ^  ^nce,  the  second  stomach  of 
flesh-eating  animals  is  short.  Nearly  the  whole  alimentary  mass  is 
([uiekly  taken  up  by  the  lacteals,  and  there  is  no  occasion  fOr  itf 
travelling  through  a  long  second  stomach. 

Mans  second  stomach  is  in  length  midway  between  that  of  the 
fle8h-<^ating  and  the  vegetable-eating  animals.  If  there  be  design  in 
the  works  of  the  Creator,  and  if  that  design  in  the  structure* of  the 
flesh  and  vegetable-consuming  animals  has  now  been  correctly  inter- 
preted, it  is  plain  that  man  is  best  nourished  when  he  eats  both  kinds 
of  food.  The  structure  of  his  teeth  and  the  motions  of  his  jaws 
(see  p.  80),  confirm  the  same  conclusion. 

Americans  Eat  too  Much  Meat. —  Yet,  as  I  have  said,  there  is  no 
doubt  the  Americans  eat  too  much  meat.  Sedentary  persons  require 
but  very  little.  Less  is  wanted  in  summer  than  in  winter, —  in  warm 
chiiiat€s  than  in  cold.  People  of  wealth,  whose  circumstances  im- 
pose no  bodily  hardships,  need  less  than  the  poor,  who  are  much 
exposed,  and  work  hard;  whereas,  they  consume  more.  Those  who 
<lo  not  labor  with  their  hands,  should  never  taste  meat  more  than 
oncfc  a  day. 

It  ife  painfuUy-amusing  (if  such  a  compound  word  is  admissible) 
to  hear  a  nervous  female,  whose  sole  exercise  consists  in  going  from 


I 


m.. 


H 


86 


HYQIEME. 


the  parlor  to  the  kitchen  once  or  twice  a  day,  and  in  making  a  brief 
shopr'ug  excursion  once  a  week,  complain  that  she  cannot  maintuin 
her  strength  unless  she  eats  freely  twice  a  day  of  moat,  vnd  takes  her 
free  potations  of  strong  coffee  and  wine. 

A  like  opinion  prevails  generally  among  the  feeble  who  are  not 
obliged  to  labor.  Tiie  child  in  its  nurse's  arms  must  daily,  it  is 
thought,  suck  a  piece  of  chicken  or  beefsteak  in  order  to  thrive. 
Children  thus  fed  have  their  blood  constantly  inflamed,  and  stand  a 
poor  chance  when  attacked  by  scarlet  fever.  The  little  master  or 
miss  who  attends  school  complains  of  headache,  and  grows  pale, 
feeble,  and  nervous.  The  booki  are  blamed  and  thrown  aside  for 
what  the  dishes  have  done.  The  doctor  is  called  in  and  assured 
that  the  dear  child  can  eat  nothing  but  a  little  fat  broth,  a  custard, 
or  cake ;  and  if  he  prescribe  a  diet  of  plain  bread  and  milk,  he  is 
believed  to  be  heartless,  and  his  prescription  is  not  followed. 

The  Majority  of  Mankind  Eat  no  Flesli.  —  All  such  misguided 
persons  should  be  apprized  that  the  great  majority  of  mankind  eat 
no  flesh,  because  they  cannot  afford  it.  And  they  do  not  appear  to 
suffer  from  its  loss.  Millions  of  7rish  do  not  taste  of  flesh  or  fish 
from  one  month's  end  to  another.  Potatoes,  oatmeal,  and  cabbage 
constitute  their  chief  diet.  Rice,  poor  aa  it  is  in  nourishment, 
sustains,  when  combined  with  vegetable  oil,  millions  of  people  in 
Asia.  The  Lazaroni  of  Naples,  with  active  and  finely  moulded 
forms,  live  on  bread  and  potatoes.  These  facts  do  not  afford  ground 
for  altogether  rejecting  animal  food,  any  more  than  Bayard  Taylor's 
statement  respecting  whole  tribes  in  Africa  who  live  upon  flesh 
furnishes  a  reason  for  excluding  vegetable  aliment.  Man  may  live 
and  enjoy  health  upon  either,  but  his  organization  implies  the  use 
of  both. 

Proportions  of  Animal  and  Vegetable  Food. 

Upon  this  subject,  it  is  impossible  to  fix  any  absolute  rules.  This 
is  a  point  which  must  be  determined  by  the  temperament,  the  state 
of  the  health,  the  constitution,  etc.  Persons  of  a  scrofulous  habit 
should  eat  freelj'^  of  animal  food.  But  an  inflamed  stomach  should 
never  be  tormented  with  flesh.  Meat  is  stimulating,  and  will  i)C 
almost  sure  to  do  nc'schief  v  hen  there  is  heat  and  tenderness  at  the 
pit  of  the  stomach.  There  are  cases  of  inflammation  of  this  organ, 
in  which  it  may  be  necessary  to  live  on  bread  and  milk,  with  articles 
of  the  starch  group,  for  months,  and  even  for  years. 

On  the  other  hand,  when  the  system  has  run  low  from  some 
exhausting  disease,  which  excites  no  feverish  action,  it  may  be 
necessary  at  times  to  take  a  diet  almost  exclusively  animal. 

It  is  absurd  to  talk  of  the  same  diet  as  adaptea  to  all  persons,  even 
when  in  health.  As  well  might  we  expect  one  shoe  to  fit  every 
foot,  or  one  coat  every  back,  or  one  color  every  eye,  or  one  doctrine 
every  mind. 


nummm 


HYGIENE. 


87 


Temperance  the  Main  Thing.  —  After  all,  the  great  thing  to  hv> 
aimed  at  is  tempenince.  It  is  not  so  necessary  to  reject  one  article 
and  use  another,  as  to  partake  of  all  with  moderation,  "  I  do  not 
live  to  eat  and  drink  ;  I  eat  and  drink  to  live,"  said  a  wise  philoso- 
pher of  the  olden  time.  One  would  think  the  moderns  have 
reversed  this  rule.  A  modern  table  has  the  appearance  of  being 
s[iread  for  the  purpose  of  inducing  men  to  eat  all  their  stomachs  will 
hold.  A  man  who  can  dine  daily,  for  half  a  dozen  years,  at  one 
of  our  first-class  hotels,  and  then  find  himself  free  of  dyspepsia  and 
all  other  diseases,  must  have  a  fine  constitution,  as  well  as  most 
admirable  control  over  his  appetite.  Mr.  Addison  said,  "  When  I 
behold  a  full  table  ^et  out  in  all  its  magnificence,  I  fanr^  .  see 
gout,  cholic,  fevei-8,  )d  lethargies  lying  in  ambuscade  among  the 
dishes " ;  to  which  he  adds,  with  much  truth,  in  another  place, 
"  Abstinence  starves  a  growing  dist3mper." 

Qood  Results  of  Temperance. — A  temperate  diet  has  always 
been  attended  with  excellent  results,  and  always  will  be.  There  are 
times  of  great  anxiety,  when  abstinence  should  be  pushed  to  the 
extreme  verge  of  endurance.  During  the  siege  of  Gilbraltar,  Lord 
Heathfield,  its  gallant  defender,  lived  eight  days  on  four  ounces 
of  rice  per  day.  Dr.  Franklin,  when  a  journeyman  printer,  lived 
two  weeks  on  bread  and  water,  at  the  rate  of  ten  pounds  of  bread  a 
week,  and  was  stout  and  hearty.  Dr.  Jackson,  an  eminent  physician 
in  the  British  army,  says,  "  I  have  wandered  a  good  deal  about  the 
world,  and  never  followed  any  prescribed  rule  in  anything;  my 
iiealth  has  been  tried  in  all  ways ;  and,  by  the  aid  of  temperance  and 
liard  work,  I  have  worn  out  two  armies,  in  two  wars,  and  probably 
could  wear  out  another  before  my  period  of  old  age  arrives." 

Lord  Bacon  was  right  in  tlie  opinion  that  intemperance  of  some 
kind  or  othtjr  destroys  the  bulk  of  mankind,  and  that  life  may  be 
sustained  by  a  very  scanty  portion  of  nourishment.  Cornaro,  whom 
I  have  before  mentioned  as  having  lived  fifty-eight  years  on  twelve 
ounces  of  solid  food  a  day,  wrote  as  follow  respecting  himself  in 
his  eighty-fifth  year :  "  I  now  enjoy  a  vigorc"8  state  of  body  and 
of  mind.  I  mount  my  horse  from  the  level  ground ;  I  climp  steep 
ascents  with  ease  ;  and  have  written  a  comedy  full  of  innocent  mirth 
and  raillery.  When  I  return  home,  either  from  private  business  or 
from  the  senate,  I  have  eleven  grand-children,  with  whose  education, 
amusement  and  songs  I  am  greatly  delighted;  and  I  frequently 
sing  with  them,  for  my  voice  is  clearer  and  stronger  now  than  ever 
it  was  in  my  youth.  In  short,  I  am  in  all  respects  happy,  and  quite 
a  stranger  to  the  doleful,  morose,  dying  life  of  lame,  deaf  and 
blind  old  age,  worn  out  with  intempei-ance."  Howard,  the  philan- 
thropist, fasted  one  day  in  the  week ;  and  Napoleon,  when  he  felt  his 
system  unstmng,  suspended  his  meals,  and  took  exercise  on  horse- 
l»ck. 

Nothing  can  be  plainer  than  the  duty  of  fasting,  when  the 
stomach,  having   been   overworked,    is   disinclined  to  receive  food. 


88 


HYGIENE. 


Brutes  invanably  follow  this  suggestion  of  nature ;  they  never  eat 
when  sick,  —  probably  because  they  have  no  silly  nurses  to  coax 
them  to  swallow  stimulating  aliments.  The  habit  of  putting  high- 
seasoned  food  into  the  stomach  when  it  is  inflamed  and  feverish  is 
about  as  wise  as  directing  streams  of  blue,  violet,  or  red  light  into 
the  eye  when  it  is  red  and  swollen  with  inflammation. 


Tea  and  Coffee. 

It  is  proper,  before  closing  this  chapter  upon  diet,  that  something 
should  be  said  respecting  the  beverages  of  tea  and  coffee. 

Some  years  ago,  a  meeting  was  held  by  the  leading  physicians 
of  a  city  in  the  old  world,  in  which  the  merits  of  tea  and  coffee  were 
discussed.  In  this  discussion  each  man  first  stated  his  experience 
in  the  use  of  these  articles,  and  then  consti  acted  his  argument 
according  to  that  experience.  The  amount  of  what  the  reader  could 
learn  from  the  discussion  was  that  Dr.  A.  had  used  tea  all  his  life, 
and  been  benefited  by  it,  while  coffee  had  uniformly  injured  him ;  and 
that  he  thought  tea  should  be  used,  while  coffee  should  be  rejected ; 
that  Dr.  B.  had  taken  coffee  at  breakfast,  and  found  it  an  excellent 
support  to  the  stomach  and  nervous  system,  while  tea  had  disturbed 
his  digestion  and  his  mind ;  and  that  the  former  was  a  beverage 
of  excellent  qualities,  wnlle  the  latter  was  detestable ;  that  Dr.  C. 
had  always  drank  both  tea  and  coffee,  and  recommended  them  to 
everybody ;  and  that  Dr.  D.  had  hi^iself  never  been  able  to  indulge 
either  tea  or  coffee,  and  would  have  them  both  expelled  from  every 
household. 

The  discussion  was  not  creditable  to  the  learned  and  really  able 
men  who  participated  in  it.  The  arguments  were  all  based  upon  the 
miserably  narrow  basis  of  single  individual  experiences.  They  were 
no  more  valid  than  that  of  the  man  who  should  hold  up  a  shoe,  de- 
claring it  fitted  his  foot  the  best  of  any  he  ever  had,  and  recommend- 
ing all  men  to  have  their  shoes  made  upon  the  same  last. 

The  truth  is,  there  is  but  one  thing  which  can  be  afiirmed  univer- 
sally of  the  effect  of  tea  and  coffee.  They  both,  when  taken,  tend  to 
prevent  waste  in  the  body,  and,  consequently,  less  food  is  required 
when  they  are  used.  This  may  be  afiirmed  of  tLem  in  their  applica- 
bility to  all  persons,  but  nothing  further.  The  truth  is,  some  can 
drink  tea  but  not  coffee,  and  some  coffee  but  not  tea ;  some  can  use 
both,  and  some  neither.  Every  man's  susceptibility  to  the  effects  of 
these  beverages  is  his  own,  as  much  as  liis  susceptibility  to  the  effects 
of  light,  or  heat,  or  atmospheric  changes ;  and  these  effects,  each  per- 
son must  learn  from  experience.  Coffee  often  produces,  and  gener- 
ally aggravates,  a  bilious  habit,  —  an  effect  which  cannot,  I  believe, 
be  traced  to  the  use  of  tea.  I  have  no  doubt  but  that  many  cases  of 
confirmed  dyspepsia  are  traceable  to  the  use  of  coffee  alone. 


HYGIENE. 


89 


Water. 

There  is  one  universal  beverage  ;  it  is  water.  All  men  are  fond 
of  it.  In  sickness  and  in  health,  in  joy  and  sorrow,  in  summer  and 
winter,  in  cold  climates  and  in  hot,  man  loves  and  drinks  water.  The 
stomach,  abused  and  made  sick  by  stimulating  food  and  drinks,  and 
repelling  everything  else,  still  gratefully  opens  itself  to  water.  Wher- 
ever man  exists,  therefore,  or  wherever  he  should  exist,  water  is 
found,  either  in  the  form  of  springs,  or  running  brooks,  or  rivers,  or 
ponds,  or  lakes ;  and  even  where  it  is  not  found  in  some  of  these 
forms,  it  is  periodically  dropped  down  from  the  clouds.  As  there  is 
110  element  in  nature  more  necessary  for  '  j  *s  existence  than  water, 
80  there  is  none  more  universally  diffuse' 

Pure  Water  Essential  to  Health But  water  varies  very  mate- 
rially, both  in  its  pliysical  qualities,  and  in  its  adaptation  to  its  pur- 
poses. Pure  water  is  as  essential  to  health  as  pure  air.  When  either 
of  these  fluids  is  rendered  impure  by  mixture  with  foreign  matters, 
disease  will  be  a  frequent  result.  The  ancients  must  have  been  in- 
fluenced by  this  fact,  or  they  would  not  have  incurred  such  heavy 
expenses  in  procuring  pure  water  from  great  distances.  The  strong 
aqueducts  through  which,  for  many  miles,  large  streams  of  water  are 
even  at  this  day  poured  into  Rome,  attost  the  freeness  of  the  expendi- 
tures she  mad^  for  this  purpose  in  the  day  of  her  greatest  renown. 
We  may  pity  the  ancient  Romans  for  being  governed  in  their  military 
operations  by  the  opinions  of  augurs  and  soothsayers,  and  certainly 
these  things  were  silly  enough ;  but  in  other  things,  at  first  view 
equally  superstitious,  they  showed  practical  wisdom.  Vetruvius  re- 
ports that  in  selecting  the  sites  of  theii:  cities,  they  inspected  the 
livers  and  spleens  of  animals  to  learn  the  salubrity  of  the  waters  and 
the  alimentary  productions  of  the  region.  The  size  and  condition  of 
these  organs  do  in  fact  indicate  the  nature  of  the  pasturage  and  the 
qualities  of  the  water  with  which  animals  are  supplied.  No  people 
can  enjoy  good  health  when  subjected  to  the  double  influence  of  bad 
water  and  impure  air. 

Division  of  Water. —  The  simplest  division  of  water  is  into  two 
kinds,  soft  and  hard.  Rain,  river,  pond,  and  snow  water  is  soft: 
well  and  spring  water  is  generally  hard.  Soft  water  contains  but 
little  impurities,  and  when  used  for  washing,  forms  a  good  lather 
with  soap.  Hard  water  contains  at  least  one  of  the  salts  of  lime, 
often  more ;  mixed  with  soap,  it  curdles  and  turns  white.  Tte  reason 
of  this  is,  that  the  oily  acids  of  the  soap  unite  with  the  lime,  and 
form  a  compound  which  the  water  will  not  dissolve.  Such  water  is 
not  suitable  for  domestic  purposes. 

Chemical  Nature  of  Water. —  Water  contains,  reckoning  the  ele- 
ments of  which  it  is  composed  in  volumes,  two  volumes  of  hydrogen, 
and  one  volume  of  oxygen.     These  two  gases,  the  unlearned  reader 


90 


HYGIENB. 


will  please  remember,  &.re  highly  subtle  bodies,  not  visible  to  the  eife ; 
and  yet,  when  chemically  united,  they  form  a  liquid  which  covei-s 
two-thirds  the  entire  surface  of  the  globe,  —  floating  upon  its  lx)S(im 
the  navies  and  merchant  ships  of  all  nations,  and  by  its  unmeasured 
depths  and  vast  breadths  and  sublime  movements,  fills  the  thoughtful 
mind  with  conceptions  of  creative  Power,  which  words  never  attempt 
to  express.  Should  the  two  gases  which  compose  this  vast  body  of 
water  cease  to  love  each  other,  and  fall  asunder,  the  first  lighted  taper 
would  set  the  world  on  fire,  and  not  a  living  being  upon  its  surface 
could  escape  destruction. 

Impurities  in  Water. —  It  is  not  surprising  that  a  fluid  with  as 
great  a  solvent  power  as  water,  should  often  dissolve  and  hold  in 
solution  a  great  many  impuritiss.  In  passing  along  through  the 
earth,  before  it  comes  up  in  springs  and  wells,  it  is  filtered  through 
various  mineral  earths,  and  becomes  contaminated  accordingly.  In 
running  through  beds  of  limestone,  it  takes  up  a  little  carbonate  of 
lime.  Salt-beds  impart  to  it  common  salt  (muriate  of  soda),  while 
sulphur  and  other  ores  tinge  it  with  salts  of  various  kinds. 

Warer-Supply. —  At  the  present  time  all  large  cities  and  most  of 
the  towns  in  this  country  are  supplied  with  water  for  domestic  pur- 
poses, either  from  ponds  or  lakes,  or  from  artesian  wells,  of  greater 
or  less  purity,  but  in  almost  all  cases  superior  to  the  common  well- 
water,  so  liable  to  contamination  by  cesspools  and  sewage.  The  re- 
sult is  that  the  health  of  the  people  has  been  materially  improved, 
and  fevers,  particularly  those  of  a  typhoid  type,  have  diminished  both 
in  prevalence  and  fatality.  The  decaying  vegetable  and  animal  mat- 
ter, which  formerly  was  washed  into  the  soil,  and  percolated  into  and 
poisoned  the  wells,  is  now  washed  away  by  copious  supplies  of  pure, 
fresh  water. 

Lead  Pipes. —  In  cities,  water  is  usually  conveyed  through  the 
dwellings  in  leaden  pipes,  —  a  practice  fraught  with  a  danger,  to 
avoid  which  various  expedients  have  been  devised.  That  lead  does 
often  become  oxidized  and  impart  its  poisonous  properties  to  water 
when  long  in  contact  with  it,  is  a  well-known  fact.  Let  a  number  of 
persons  drink  every  morning  from  the  the  first  water  drawn  from  tiie 
pipes,  and  a  portion  of  them  will  be  attacked  with  some  form  of  lead 
disease.  The  pipes  should  be  emptied  every  morning  before  using 
the  water  for  domestic  purposes,  and  then  there  is  little  danger.  Tin- 
lined  pipes  have  been  found  to  be  almost  entirely  free  from  danger 
of  lead-poisoning. 

Physical  and  Otlier  Properties  of  Water.—  Good  water  is  with- 
out smeil,  is  perfectly  clear,  and  in  the  mouth  has  a  soft  and  lively 
feel.  Whan  poured  from  one  vessel  to  another,  it  should  give  out 
aiivbubbljb.  Boiled  and  distilled  waters  have  a  vapid,  flat  taste. 
This  is  ovdng  to  their  containing  no  carbonic  acid  gas  or  atmospheric 


acid 


we 


MVJ 


Wff« 


HYGIENE. 


91 


air, —  these  being  driven  off  in  the  act  of  boiling  and  distilling.  A 
hundred  cubic  inches  of  good  river  water  contain  about  2^  of  carbonic 
acid,  and  1^  of  common  air. 

Carbonic  acid  is  what  gives  to  mineral,  or  soda  water,  its  brisk, 
and  even  pungent  taste.  Without  a  portion  of  this  acid  and  atmos- 
pheric air,  water  is  perfectly  insipid,  and  not  fit  to  be  used  as  a  bev- 
erage. Hence,  if  it  be  boiled  or  distilled  to  clear  it  of  earthy  matters, 
we  must  expose  a  large  surface  of  it  to  the  air,  and  shake  it,  that  it 
may  re-absorb  from  the  atmosphere  what  it  has  lost,  and  thus  recover 
its  taste.  .         . 

Rain  Water  is  the  Result  of  Distillation  on  a  large  scale,  and 
would  be  insipid,  like  other  distilled  water,  only  that,  after  being 
distilled  off  from  the  waters  upon  the  surface  of  the  earth,  it  recovers, 
while  ascending  as  vapor,  the  carbonic  acid  and  atmospheric  air. 

Fishes  breathe  air  as  well  as  land-animals,  and  hence,  lakes  upon 
the  tops  of  high  mountains,  where  but  little  oxygen  can  be  absorbed 
into  the  water  from  the  air,  are  not  inhabited  by  the  finny  tribes. 

The  Saltness  of  the  Ocean  is  simply  the  accumulation  of  the  saline 
substances  washed  out  of  the  bowels  of  the  earth. 

The  water  which  for  thousands  of  years  has  been  distilling  off  as 
vapor  from  the  surface  of  the  ocean  is  nearly  pure.  Reing  carried 
by  the  winds  to  the  continents,  it  falls  as  rain,  sinks  iulci  the  earth, 
is  filtered  through  mineral  substances,  comes  to  the  surfaces  in  springs, 
is  collected  into  rivers,  and,  with  all  its  freight  of  mineral  salts,  is 
borne  back  to  the  ocean.  Everything  that  water  can  dissolve,  and 
carry  down  from  the  continents,  finds  a  great  depository  in  the  ocean; 
and  as  this  has  no  outlet,  the  accumulation  must  go  on  without  limit. 
Rivers  which  flow  into  the  ocean  contain  from  ten  to  fifty  grains  of 
salts  to  the  gallon, —  composed  chiefly  of  common  salt,  sulphate  and 
carbonate  of  lime,  magnesia,  soda,  potash  and  iron ;  and  these  are 
the  constituents  of  sea-water. 

Cleansing  of  Impure  Water. —  Impure  waters  should  be  cleansed 
before  being  used  for  domestic  purposes.  Distillation  is  the  most 
perfect  method  of  purification.  Filtration  through  sand  is  a  good 
method.  It  removes  all  suspended  vegetable  or  animal  matter,  and 
all  living  animals.  Boiling  likewise  kills  all  animals,  and  throws  to 
the  bottom  carbonate  of  lime.  It  is  this  which  constitutes  the  crust 
which  lines  tea-kettles  in  all  regions  where  limestone  exists. 

'Settlers  in  a  new  country  should  make  it  a  prime  object  to  find 
good  water.  This  is  of  great  moment.  Their  own  health  and  the 
health  of  their  posterity  is  dependent  upon  it.  Any  soil,  good  or 
bad,  is  not  worth  half  price,  if  it  yield  impure  water. 

Reasons  for  Prizing  Water. —  Finally,  we  ought  all  to  prize  water 
very  highly,  for  it  composes  nearly  eight-tenthn  of  our  entire  bodies,  in- 
cluding our  flesh,  blood,  and  other  fluids.    Nay,  we  owe  to  it  the  very 


m 


mM 


92 


HYGIENE. 


softness,  delicacy,  and  smoothness  of  our  persons.  Our  musclfs. 
nerves,  blood  vessels,  glands,  cartilages,  etc.,  all  play  smoothly  upon 
each  other  in  consequence  of  water.  Take  all  the  water  out  of  us, 
and  we  should  be  dry  sticks  indeed.  All  our  comeliness  would  W 
gone.  Nobody  would  or  could  love  us.  We  should  be  walking 
reeds,  sh  '  -n  and  sported  with  by  every  wind.  Let  us  never  forget 
how  mu  ire  indebted  to  water. 


Exercise. 

Animal  life  is  conditioned  upon  exercise.  Without  it  health  can- 
not exist,  or  life  -itself  be  continued  for  any  great  length  of  time. 

Proper  exercise  communicates  motion  to  every  part  susceptible  of 
it.  It  expands  the  chest,  contracts  and  relaxes  the  muscles,  quickens 
the  motion  of  the  blood,  moves  afresh  all  the  other  fluids,  and  stirs  to 
the  centre  of  the  whole  frame.  More  easy  and  perfect  digestion,  the 
nutrition  of  every  part,  and  the  proper  performance  of  all  the  secre- 
tions and  excretions,  are  the  results  of  such  exercise. 

A  distinguished  physician  said :  "  I  know  not  which  is  most  neces- 
sary to  the  support  of  the  human  frame,  food  or  motion."  Some  of 
the  finest  talents  in  the  world  are  probably  lost  for  the  want  of 
exercise ;  for  without  it  the  mind  loses  its  keen  perception  and  its 
bounding  energy,  ita  power  of  application  and  its  general  scope.  If 
men  of  great  talents  would  give  attention  to  exercise,  the  world 
would  reap  a  larger  harvest  from  their  written  thoughts. 

The  arrangements  of  modern  society  have  very  much  abridged  the 
facilities  for  taking  exercise ;  but  if  Trenck  in  his  damp  prison, 
with  fetters  of  seventy  pounds  weight  upon  him,  could  preserve  his 
health  by  leaping  about  like  a  lion,  most  persons  could  do  as  much 
with  the  fetters  of  modern  society  upon  their  limbs. 

Must  be  Regular. —  Exercise,  to  be  of  much  service,  must  be  regu- 
lar, —  not  taken  by  fits  and  starts,  —  a  good  deal  to-day  and  none  to- 
morrow ;  but  in  reasonable  measure  every  day.  Occasional  efforts, 
with  intervening  inactivity,  only  does  mischief. 

Must  be  Pleasurable. —  It  should  be  connected,  too,  if  possible, 
with  some  pleasing  occupation  or  pursuit.  The  movement  of  the 
limbs  should  carry  us  towards  some  place  or  end  in  which  the  mind 
feels  an  interest ;  exercise  will  then  do  us  most  good.  Hence  botan- 
ical pursuits,  the  cultivation  of  a  garden,  and  the  like,  are  often  pre- 
ferable to  a  solitary  and  aimless  walk.  , 

Must  not  be  Excessive Exercise  should  never  be  carried  so  far 

as  to  produce  great  fatigue.  Extremes  are  injurious  ;  and  too  much 
exercise,  especially  by  a  sick  or  feeble  person,  may  he  as  injurious  as 
too  little. 

No  clothing  should  be  thrown  off  after  exercise,  nor  should  one 
cool  off  by  sitting  in  a  draft  of  air.  Very  serious  consequences  often 
follow  this  practice. 


HYGIENE. 


w 


Not  to  be  Taken  After  Meals. —  It  is  not  best  to  take  exercise  im- 
mediately after  meals.  The  reasons  for  this  caution  have  been  ex- 
plained. It  is  true  many  laboring  men  go  at  once  to  their  work  after 
eating,  without  apparent  injury.  Yet  they  are  strong,  and  can  en- 
dure what  those  who  use  their  brains  chiefly  could  not.  And  even 
they  do  not  labor  as  easily  and  cheerfully  immediately  after  dinner. 

Active  and  Passive. —  Exercise  is  properly  divided  into  active  and 
passive.  Walking,  running,  leaping,  dancing,  gardening,  various 
sports,  etc.,  are  active.  While  sailing,  swinging,  and  riding  in  car- 
riages are  passive.  Riding  on  horse-back  is  of  a  mixed  nature, — 
being  both  active  and  passive. 

A  few  remarks  upon  these  several  kinds  of  exercise  will  have  a 
practical  value  to  some  of  the  readers  of  these  pages. 

Walking  is  one  of  the  most  gentle,  easy,  and  generally  one  of  the 
most  useful  of  the  active  exercises.  It  is  within  the  reach  of  all  who 
have  the  use  of  their  limbs,  and  is  indulged  at  the  expense  only  of  a 
little  shoe-leather.  To  make  it  agreeable,  the  face  is  only  to  be 
turned  to  some  favorite  locality,  and  the  mind  put  in  communion 
with  the  voices  of  nature. 

To  walk  with  the  best  advantage,  the  body  should  be  kept  upright, 
the  shoulders  thrown  back,  the  breast  projected  a  little  forward,  so  as 
to  give  the  lungs  full  play,  and  the  air  an  opportunity  to  descend  to 
the  bottom  of  them.  This  attitude  places  all  the  organs  of  the  body 
ill  the  most  natural  position,  and  relieves  them  from  all  restraint. 
Walking  then  becomes  a  source  of  pleasure.  The  artist  who  bends 
over  his  pallet,  and  gets  into  a  cmmped  position,  is  by  this  kind  of 
walking  relieved,  and  his  body  kept  upright.  Females,  particularly 
of  the  wealthier  class,  are  much  more  apt  to  neglect  this  species  of 
exercise  than  males. 

It  is  not  so  in  England.  There  it  is  no  uncommon  thing  for  ladies 
of  high  rank  to  walk  ten  miles  a  day ;  and  they  do  it  in  shoes  of  suf- 
ficient thickness  to  protect  their  feet  from  all  dampness,  and  in 
clothes  large  enough  to  give  their  muscles  full  play.  As  a  conse- 
quence, they  enjoy  excellent  health,  and  in  many  cases  even  retain 
their  freshness  and  beauty  to  old  age. 

A  master  of  one  of  the  vessels  of  our  navy  who  spent  some  time, 
lately,  in  the  British  Channel,  was  several  times  invited  to  spend  the 
evening  at  Lord  Hardwick's,  where  he  made  the  acquaintance  of  two 
•laughters  of  his  lordship,  who,  in  the  drawing-room,  he  thought  the 
most  accomplished  ladies  he  ever  saw.  Yet  those  young  women,  on 
two  occasions,  in  company  with  other  friends,  walked  miles  to  visit 
his  vessel,  once  on  a  rainy  day,  clad  in  thick,  coarse  cloth  cloaks  which 
no  rain  could  penetrate,  and  caring  as  little  for  wet  weather  as  a 
couple  of  ducks. 

Good  for  the  Studious. — For  the  studious,  walking  is  a  most  capi- 
tal exercise.     It  varies  the  scenes  so  constantly,  and  brings  the  mind 


■•BiiiiTirann/Tir' 


^■''■■■"  ■  ■  I 


94 


HYGIKNE. 


in  contact  with  so  many  objects,  that  the  monotony  of  in-door  Hfe  is 
admirably  broken.  It  was  a  maxim  of  Plato,  that  "  he  is  truly  a  crip- 
ple, who,  cultivating  his  mind  alone,  suffers  his  body  to  languish." 

Good  in  Cold  Weather. —  Walking  is  valuable  in  cold  weather, 
because  it  exposes  one  to  the  cold  atmosphere,  and  hardens  the  person 
against  frosty  weather,  —  a  consideration  of  great  consequence  in 
countries  which  are  subject  to  extremes  of  cold. 

Running  and  Leaping  are  forms  of  exercise  which  should  be  in- 
dulged with  prudence  even  by  the  young  and  healthy.  For  the  feeble 
and  the  aged,  they  are  entirely  inadmissible.  Used  cautiously,  in  a 
system  of  regular  training,  they  may  help  raise  the  bodily  powers  to 
a  high  degree  of  agility  and  endurance.  The  North  American  Indian, 
who  was  bred  to  the  chase,  ran  with  surprising  swiftness,  and  for  en- 
durance was  scarcely  excelled  by  his  faithful  dog.  What  training 
has  done  for  the  Indian,  it  may  do  for  the  white  man,  who  may 
chance  to  inherit  as  good  a  constitution. 

Tlie  Qame  of  Base-Ball  requires  very  active  running,  and  for  the 
young,  it  is  an  exceedingly  healthful  amusement.  It  fills  the  whole 
frame  with  a  bounding  spirit,  and  sets  the  currents  of  life  running 
like  swollen  brooks  after  heavy  rains. 

QymnasticA. —  The  more  active  species  of  exercise  have  generally 
been  included  under  the  term  gymnastics.  Among  the  (ireeks  aiul 
Romans,  feats  of  strength  and  endurance  were  supposed  to  confer 
honor.  For  this  reason,  and  because  war  was  a  laborious  calling,  re- 
quiring bodily  endurance  and  strength,  their  youth  were  trained  in 
the  most  active  exercises.  Gymnastic  games  were  with  them  at  once 
the  school  of  health,  and  the  military  academy. 

In  England,  during  the  middle  ages,  acts  of  Parliament  and  royal 
proclamations  were  'employed  to  regulate  and  foster  those  manly 
sports  and  exercises,  which  fitted  the  people  for  the  activity  required 
on  the  field  of  battle. 

Those  preparations  for  brutal  wars  would  be  unsuited  to  the  pres- 
ent state  of  the  world ;  but  the  capacity  for  endurance  which  these 
trainings  produced,  could  be  most  usefully  employed  in  the  laborious 
and  scientific  researches  which  modern  advancement  requires.  Very 
few  of  our  scientific  men  have  sufficient  hardness  of  fi-ame  to  sustain 
them  in  their  laborious  studies. 

The  heart-diseases  which  prevail  so  extensively  are  the  result, 
many  of  them,  of  violent  exercise,  taken,  perhaps,  from  necessity,  and 
proving  injurious  because  not  a  matter  of  every-day  practice.  Violent 
exercise,  more  than  any  other  kind,  must  be  regular  in  order  to  be 
borne. 

Needed  by  Young  Women. —  Gymnastic  exercises  and  calisthenics 
are  particularly  needed  by  our  young  women,  to  give  them  something 
of  the  robustness  of  our  mothei-s,  a  few  genemtions  back.     For  the 


HYGIENE. 


M 


loor  life  is 
uly  a  crip- 
tiguish." 

I  weatlier, 
the  pei-soii 
qnence  in 

uld  be  in- 

the  feeble 

ously,  in  a 

powers  to 

an  Indian, 

Hid  for  en- 

it  training 

who  may 

nd  for  the 
the  whole 
'e  running 

!  generally 
treeks  and 
to  confer 
calling,  re- 
trained in 
3in  at  once 

;  and  royal 
)8e  manly 
;y  required 

0  the  pres- 
hich  these 
3  laborious 
res.  Very 
to  sustain 

the  result, 
lessity,  and 
5.  Violent 
rder  to  be 

alisthenics 
something 
,     For  the 


want  of  them,  they  are  dwindling  away,  and  becoming  almost  worth- 
less for  all  the  purposes  for  which  they  were  made. 

In  view  of  this  want  of  exercise  the  introduction  of  the  lucycle 
offers  an  excellent  means  of  development  for  ladies,  and  it  is  very 
gratifying  to  note  its  increasing  use.  It  brings  into  play  many  of 
the  nniscles  of  the  body,  while  affording  an  exhilarating  enjoyment 
of  fresh  air  and  changing  scenery.  But  caution  must  be  used,  not  to 
overdo  one's  self.  Short  rides  only  should  be  taken  at  first,  increas- 
ing the  distance  as  the  muscles  l)ecome  hardened. 

Moderns  Physically  Inferior  to  the  Ancients.      Reason  for  it. — 

It  is  evident  that  the  moderns  are  inferior  in  bodily  strength  to  the 
ancient  Greeks  and  Romans.  Before  the  introduction  of  Christianity, 
men  knew  very  little  about  the  future,  and  therefore  strove  to  make 
the  most  of  the  present.  Hence,  they  took  measures  to  ensure  health 
and  long  life.  It  is  true  that  a  due  regard  to  the  welfare  of  the  fu- 
ture need  not,  and  should  not,  prevent  a  care  for  the  present ;  but 
from  various  causes,  to  be  referred  to  on  a  subsequent  page,  such  has 
been  the  practice,  to  the  manifest  physical  injury  of  the  race. 

Dancing:,  when  hedged  about  with  proper  restrictions  and  limita- 
tions, has  great  advantages  as  a  physical  training  for  the  young. 
There  are  very  few  forms  of  exercise  which  give  so  free  a  play  to  all 
the  muscles,  and  at  the  same  time  so  agreeably  interest  the  mind. 
Begun  in  early  life,  and  pursued  systematicaHy,  dancing  imparts  a 
grace  and  ease  of  motion  which  nothing  else  can  give.  For  this  rea- 
son alone,  it  should  be  cultivated  as  an  art. 

Every  man  and  woman  is  often  placed  in  circumstances  in  life 
where  the  possession  of  an  easy  carriage  of  body,  and  an  unembar- 
rassed manner,  would  be  prized  above  gold.  One's  personal  influence 
in  tlie  world  is  greatly  increased  by  an  easy,  graceful  manner.  We 
all  know  how  a  polite  manner  wins,  while  a  rough  and  vmcouth  one 
rejjels  us. 

Warning  against  Excess. —  While  dancing  has  many  things  to 
recommend  it,  there  are  also  several  considerations  which  should  warn 
us  against  using  it  to  excess,  particularly  in  the  ball-rooms  of  fashion- 
able life.  So  many  muscles  are  called  into  play,  the  breathing  is  so 
much  quickened,  and  the  air  breathed  is  often  so  impure,  that  the 
circulation  of  the  blood  is  hastened  almost  to  fever  excitement.  And 
when  to  this  we  add  the  use  of  wines  and  cordials,  alternated  with 
ices  and  iced  drinks,  and  the  exposure,  on  returning  home  from  balls, 
to  the  chilly  night  air,  under  the  insufficient  protection  of  light  cloth- 
ing, we  have  drawbacks  enough  to  abridge,  if  not  to  annihilate  the 
benefits  derived  from  this  otherwise  healthful  and  elegant  exercise. 

But  then  it  will  be  said,  and  truly  enough,  that  these  are  the  abuses, 
not  the  uses  of  dancing.  To  these  abuses,  no  parent  should  permit 
the  health  of  a  child  to  be  exposed.  In  the  parlor  at  home,  with  a  few 
young  friends  gathered  in  to  spend  an  evening ;    or,  in  a  well-venti- 


r 


XIIMI 


96 


IIYGIRNR. 


lated  hall,  under  the  instruction  of  a  master  of  known  character  and 
refinement,  dancing  is  of  high  utility,  and  much  may  be  said  in  its 
favor.  An  amusement  for  which  there  is  so  general  a  fondnoss,  one 
may  say,  passion,  must  be  fitted  to  meet  some  want  of  the  animal 
economy,  and  perhaps  of  man's  higher  nature. 

Grace  of  motion  gratifies  our  sense  of  the  beautiful,  and  in  its  na- 
ture is  allied  to  poetry.  Turning  away  from  the  abuses  of  dancing, 
let  the  reader  thankfully  use  it  as  one  of  the  very  best  physical,  so- 
cial, and  rosthetical  educatora  of  youth. 

But  if  dancing  is  salutary,  it  is  only  when  every  limb  and  muscle 
is  allowed  to  participate  naturally  and  without  restraint  in  the  general 
motion.  When  performed  in  a  dress  so  tight  as  to  restrain  all  free- 
dom, not  only  is  every  grace  destroyed,  but  injury  of  a  serious  char- 
acter may  be  the  result. 

The  Cultivation  of  a  Qarden  is  also  a  species  of  exercise  highly 
conducive  to  health.  To  the  poor  it  should  have  a  double  attraction. 
It  is  not  only  a  healthful  exercise,  but  it  yields,  in  its  season,  many 
wholesome  vegetables,  the  price  of  which,  when  they  have  to  be  pur- 
chased, frequently  puts  them  beyond  their  reach.  It  is  pleasant  to 
know  that  in  many  of  our  manufacturing  towns  the  workmen  own 
small  pieces  of  ground  which  they  cultivate  as  gardens, —  deriving 
health  both  from  the  labor,  and  from  the  vegetables  raised.  This  is 
one  of  the  kinds  of  exercise  which  are  more  beneficial  from  having 
an  end  in  view.  The  man  who  works  in  his  garden  derives  pleasure 
from  the  improvement  he  is  making  upon  his  ground,  and  from  the 
prospect  of  advantage  to  himself  and  family. 

Otiier  Active  Exercises. — To  the  exercises  already  spoken  of  may 
be  added  those  which  are  mostly  taken  indoors,  —  the  dumb-bells, 
jumping  the  rope,  battledore,  etc.  They  may  be  resorted  to  when 
the  weather  is  stormy,  or  when  any  other  cause  may  prevent  one 
from  going  into  the  open  air.  Nevertheless,  as  promoters  of  health, 
they  are  inferior  to  those  exercises  which  take  one  out  under  the 
open  sky.  They  are  too  mechanical  in  their  nature,  and  have  too 
little  aim,  to  be  allowed  to  take  the  place  of  the  preceding. 

Passive  Exercises. 

Sailing. —  This,  to  many  persons,  is  among  the  most  pleasurable 
and  exciting  of  the  passive  exercises.  But  the  excitement  arising 
from  the  motions  of  a  boat,  sometimes,  in  case  of  timid  persons,  de- 
g  lerates  into /ear,  which  is  injurious.  Young  gentlemen  who  man- 
age the  boat  upon  sail:.ig  excursions,  should  never  put  on  too  much 
sail  in  a  brisk  wind,  and  torment  the  ladies  by  exciting  their  fears,  as 
their  own  amusement  may  be  in  this  way  purchased  at  the  cost  of 
others'  health,  — a  result  far  enough  from  their  thoughts  or  inten- 
tions, but  not  the  less  real. 


jaw5-iMwTOiifwiiiiHinMrii<iBiiMwww».«. 


'"nrnfWlifMWii 


'-^A'^iiiiaAi 


■f<ritii     ^ 


HYOIRNE. 


97 


ractcr  and 
said  in  itn 
(liicHs,  one 
;he  animal 

1  in  its  na- 
f  (lancing, 
lynical,  so- 

nd  muscle 
he  general 
u  all  free- 
rious  char- 


ise  highly 
attraction, 
^on,  many 
to  be  pur- 
tieasant  to 
imen  own 
—  deriving 
I.  This  is 
)m  having 
98  pleasure 
i  from  the 


ken  of  may 
lumb-bells, 
i  to  when 
revent  one 
I  of  health, 
under  the 
1  liave  too 


pleasurable 
ent  arising 
)er8ons,  de- 
I  who  man- 
too  much 
}ir  fears,  as 
;he  cost  of 
s  or  inten- 


Swinging. —  The  sick  may  sometimes  indulge  in  this  exercise,  w^ion 
capable  of  enduring  no  other.  To  swing  gently  has  a  soothing  eflfect, 
and  often  allays  nervous  irritability  in  a  way  which  nothing  else  can. 
It  is  like  the  lullaby  motion  of  the  cradle.     It  calms  and  soothes. 

Nervous  children  and  grown  persons  in  feeble  health  are  some- 
times, by  roguish  boys,  swung  too  high,  and  very  much  excited  and 
alarmed.  This  is  wrong.  It  may  do  great  injury.  Very  few  boys 
would  do  it  if  they  knew  the  evil  consequences.  Boys  and  girls  are 
generally  kind-hearted ;  and  though  they  may  like  to  hector  others, 
they  will  seldom  knowingly  iin'ure  them  for  their  own  amusement. 

Carriage-Riding. —  The  advantages  to  l)e  derived  from  this  species 
of  exercise  are  probably  rated  too  high.  For  feeble  persons,  just  re- 
covering from  illness,  who  cannot  endure  walking  or  riding  on  horse- 
back, it  is  valuable,  particularlj'  if  taken  in  an  open  carriage.  But  for 
those  who  have  more  strength,  it  is  less  desirable  than  many  other 
exercises.  True,  it  is  generally  an  agreeable  mode  of  locomotion,  and 
for  this  reason,  it  is  more  serviceable  than  the  small  amount  of  exer- 
cise afforded  by  it  would  lead  one  to  suppose. 

Carriages  are  luxuries,  and  like  all  other  luxuries,  they  are  apt  to 
bring  on  debility,  and  perhaps  shorten  life.  A  man  is  apt  to  order 
his  carriage  to  the  door  at  the  time  when  increasing  wealth  enables 
him  to  retire  from  the  active  pursuits  of  life, —  the  very  moment  when 
he  is  most  in  need  of  some  exertion  to  take  the  place  of  that  to  which 
he  has  l)een  accustomed.  Yet  so  it  is,  luxury  comes  to  enfeeble,  at 
the  time  when  we  need  something  to  harden  us. 

Could  rich  men  be  persuaded  to  let  their  luxuries  consist,  in  part, 
in  doing  good,  and,  like  Howard,  find  pleasure  in  travelling  on  foot 
to  visit  those  who  are  sick  and  in  prison,  they  would  be  surprised  to 
see  how  their  happiness  would  be  increased. 

Close  carriages  are  generally  used  by  the  wealthy.  They  at  best 
contain  but  little  air,  which  is  breathed  over  and  over,  and  becomes 
unfit  for  respiration.  The  windows  of  such  carriages  should  always 
be  open,  except  in  rainy  weather,  when  the  latticed  windows  only 
shou'd  be  used. 

Riding  in  Sleighs  furnishes  an  agreer'ole  excitement,  and  may  be 
indulged  in  to  some  extent  with  advantage.  Yet  it  can  be  had  only 
in  cold  weather,  and  persons  who  partake  of  its  pleasures  should  be 
careful  to  wear  clothing  enough  to  protect  themselves  against  the 
frost.  This  is  the  more  necessary,  as  very  little  motion  is  communi- 
cated to  their  bodies  by  the  sleigh. 

Horseback  Riding.—  This  form  of  exercise  may  fairly  rank  next 
to  walking  ;  in  some  states  of  the  system  it  is  preferable.  It  justly 
holds  a  high  rank  as  an  exercise  for  consumptive  persons.  Many  a 
man,  and  woman  too,  has  been  benefited  by  it  when  suffering  from 
lung  disease.  For  those  who  have  hernia,  or  falling  of  the  bowel,  it 
is  not  proper,  as  the  most  serious  consequences  may  result  from  its 
use. 


lilfi 


•i  nvniKNE. 

The  Horse  should  be  Owned, —  A  feeble  man  \/ho  rides  on  horse- 
back, should,  if  possible,  own  his  hoi"se ;  for,  beconiinjr  attached  to 
him,  as  ho  generally  does,  he  will  be  able  to  ride  farther  than  ii|)ou 
an  animal  in  which  he  feels  less  interest.  A  honse  is  p.  noble  cmou- 
turo,  and  a  man  who  loves  him  will  sometimes  acquire  a  passiciji, 
almost,  for  beingupou  his  back,  and  witnessing  his  splendid  purfoiin- 
ances. 

Pleasurable  Exercises  most  Beneficial. —  Finally,  those  exorcises 
are  most  beneticial,  and  can  l>e  longest  endured,  in  which  we  feel  the 
greatest  interest.  Place  before  eveii  a  feeble  man  some  desirable  (»l>- 
ject,  and  he  will  endure  a  great  deal  to  reach  it;  or  engage  the  iiiiiid 
of  a  very  tired  peraon  in  something  which  greatly  interests  it,  and 
considembly  more  exertion  will  be  easily  borne;.  This  is  well  illus- 
trated by  the  story  told  by  Miss  Edgeworth  of  a  certain  father,  who 
had  taken  a  long  walk  with  his  little  son,  and  founil  the  boy  appar- 
ently unable  to  walk  further,  some  time  before  reaching  home. 
"  Here,"  said  the  shrewd-minded  father,  "  ride  on  my  gold-headed 
cane."  Immediately  the  little  fellow  was  astride  the  cane,  which 
carried  him  as  safely  home  as  the  freshest  horse. 

Mentc'  Co-operation  is  of  the  highest  importance  in  all  exercise. 
Men  who  are  paid  by  the  job,  work  with  far  more  spirit  than  those 
who  are  paid  by  the  day.  One  would  dig  in  the  earth  with  \ery 
little  spirit,  if  he  had  no  motive  for  doing  it ;  but  if  expected  with 
every  shovelful  of  earth  to  bring  u[)  gold-dust,  he  would  not  only 
work  with  a  will,  but  would  endure  a  great  deal  more  labor.  From 
these  considerations  we  may  infer  that  those  farmers  and  manufac- 
turers who  pay  their  men  the  highest  wages,  make  the  most  money 
on  their  work. 

The  best  time  for  taking  exercise  is  that  in  which  it  does  us  most 
good.  For  most  pei-sons  the  morning  hours  may  be  considered  most 
favorable.  But  there  are  many  who  cannot  take  exercise  in  the  early 
morning,  without  suffering  from  it  through  the  whole  day.  Some 
are  able  to  walk  miles  in  the  afternoon,  who  would  be  made  sick  by 
similar  exertions  immediately  after  rising. 

Persons  often  injure  friends  who  have  this  peculiarity  of  constitu- 
tion by  urging  them  out  in  the  morning.  They  do  it  from  good  mo- 
tives, but  are,  nevertheless,  blameworthy  for  attempting  to  advise  iu 
matters  which  they  do  not  understand. 


Rest  and  Sleep. 

Oim  bodies  are  like  clocks ;  they  run  down  and  are  wound  up  once 
every  twenty-four  hours.  Were  they  obliged  to  work  on  uninter- 
ruptedly, they  would  wear  out  in  a  few  days.  It  is  a  merciful  pro- 
vision that  periods  of  repose  are  allotted  to  us.     Eveiything  has  its 


-"®^;.?*flAi'.T;-VAt,~ i!K55rei3r«.i'a*a 


HYOIENE. 


M 


oil  liorse- 
tiU'lmil  to 
Imu  iijioii 
•  >l)lo  creii- 
a  passion, 
1  pt'ifoiiu- 


1  exorcis's 

0  feel  ilic 

siraltlc  dlh 

ttu!  niiiid 

tH  it,  and 

veil  illiiH- 

itlier,  will) 

lK)y  a|)[)ar- 

njj   iioiiie. 

)l(l-ht>adcd 

me,  which 


1  exercise. 

han  those 

with  \^ry 

ectcd  witli 

not  only 

or.     From 

.  manufac- 

ost  money 


les  us  most 
lered  most 
1  the  early 
ly.  Some 
de  sick  hy 

I  constitu- 
:  good  mo- 
advise  in 


id  up  once 
Q  uninter- 
rciful  pro- 
ing  has  its 


proper  place.  Rest  is  not  less  a  luxury  after  oxercisc,  than  exercise 
is  after  rest.  They  botli  confer  happiness  at  the  same  time  thai  they 
promote  our  well-l/oing. 

Sleeping  Rooms. —  The  largest  part  of  our  rest  is  taken  in  sleep. 
Of  course  the  kind  of  room  in  which  we  sleep  is  worthy  of  considera- 
tion. Hufeland  says:  "It  must  not  Ikj  forgotten  that  wo  spend  a 
considerable  portion  of  our  lives  in  the  l)ed-chamber,  and  consecpiently 
that  its  healthiness  or  iinhealthinuss  cannot  fail  to  have  a  very  ini 
portant  influence  upon  our  physical  well-being."  It  should  at  lea«t 
1)0  huge.  That  is  of  prime  importance,  Iwcause,  during  the  several 
iiours  tliat  wo  are  in  bed,  we  need  to  breathe  a  great  deal  of  air,  and 
our  health  is  injured  when  we  are  obliged  to  breathe  it  several  times 
over.  We  should  at  least  pay  as  much  attention  to  the  size,  situa- 
tion, temperature,  and  cleanliness  of  the  room  we  occupy  during  the 
horn's  of  repose,  as  to  the  parlors,  or  drawing-room,  or  any  other 
apartment.  And  yet  how  different  from  this  is  tho  general  practice 
of  families.  The  smallest  room  in  the  hoi^ise  is  commonly  set  apart 
for  the  bed  and  ita  nightly  occupants. 

The  sleeping-room  should  have  a  good  location,  so  as  to  be  dry. 
It  should  be  kept  clean,  and  neither  be  too  hot  nor  too  cold.  And, 
more  important  still,  it  should  be  well  ventilated. 

One  bed,  occupied  by  two  persons,  is  as  mucli  as  should  ever  be 
allowed  in  a  single  room ;  though,  of  course,  two  beds  in  a  large  room 
are  no  more  than  one  in  a  small  one.     Both  are  objectionable. 

Fire  in  Sleeping  Rooms. —  As  to  having  fire  in  a  sleeping  room, 
that  is  a  matter  to  be  determine:'  by  the  health  of  the  occupant. 
Persons  who  have  poor  circulation,  and  are  feeble,  had  better  have  a 
little  fire  in  the  bed-chamber  in  cold  weather.  For  those  in  good 
health  a  cold  room  is  preferable. 

Open  Windows  in  Sleeping  Rooms. —  In  the  hot  weather  of  sum- 
mer, it  is  better  to  keep  the  windows  open  to  some  extent,  through 
the  night,  but  not  on  opposite  sides  of  the  room  so  as  to  make  a  draft 
across  the  bed. 

There  is  a  difference  of  opinion  as  to  the  safety  of  this  practice, 
but  the  experience  of  those  who  have  used  it  prudently  and  persever- 
ingly  has  generally  sanctioned  its  employment.  It  is  presumed  that 
night-ail  is  made  to  be  breathed;  and  if  we  breathe  it  habitually, 
there  is  no  good  reason  why  it  should  be  considered  hurtful.  At  all 
events  we  have  got  to  do  one  of  three  things,  —  either  breathe  it,  or 
be  poisoned  by  air  which  is  breathed  several  times  over,  or  use  very 
large  sleeping-rooms,  and  thus  lay  in  a  stock  to  last  over  night. 

An  Open  Fireplace  in  a  bed-chamber  will  do  much  towards  its 
purification.  It  carries  off  foul  air.  But  many  persons  board  up  this 
outlet  as  if  bad  air  were  a  friend  with  whom  they  could  not  think  of 
parting.  At  the  same  time  they  will  carefully  close  all  windows  and 
doors,  as  if  fresh  air  were  an  enemy  not  to  be  let  in. 


100 


HYGIENE. 


Beds. —  It  is  a  pleasant  thought  that  while  so  many  things  which 
injure  health  are  coming  into  fashion,  some  which  have  a  like  effect 
are  going  out.  Among  the  injurious  things  which  are  silently  witli- 
drawing  are  feather-beds. 

In  earlier  times,  a  bed  made  of  eider-down  was  thought  to  be  a 
great  luxury^  to  be  carefully  preserved,  and  handed  down  from  mother 
to  daughter.  Beds  made  of  hen's  feathers,  and  other  coarser  kinds, 
were  thought  to  be  only  fit  for  children.  With  due  deference  to 
these  earlier  judgments,  it  must  be  said  that  feather  beds,  whether 
downy  or  coarae,  are  not  even  fit  for  children.  They  are  composed 
of  animal  matter,  and  by  a  slow  process  of  decay,  are  always,  when 
stirred,  sending  up  an  exhalation  which  it  is  not  healthful  to  breathe. 

By  their  softness,  too,  they  increase  the  general  tendency  to  effemi- 
nacy. In  warm  weather  they  are  too  heating.  To  sink  down  into 
thera,  and  lie  nearly  buried  all  night,  is  to  insure  a  feeling  of  lassi- 
tude and  debility  in  the  morning.  Only  the  strongest  persons  can 
endure  it  without  being  made  conscious  of  the  evil  effects. 

Beds  must  not  be  too  Hard. —  On  the  other  hand,  it  is  almost 
equally  unwise  to  choose  a  bed  of  absolutely  unyielding  hardness. 
When  very  tired,  we  may  rest  even  upon  a  board ;  but  sleep  will 
generally  be  moro  sound  as  well  as  refreshing,  if  the  bed  be  some- 
what yielding.  The  hair  mattress  is  the  very  best  bed  yet  used.  It 
is  healthful  and  easy.  No  person  once  accustomed  to  it  will  ever 
return  to  feathera  In  summer,  it  is  a  luxury ;  in  winter,  it  is  suffi- 
ciently warm,  though  a  little  more  covering  is  needed  than  with 
feathers. 

Bedding. —  In  hot  weather,  linen  sheets  are  preferable  to  cotton, 
and  of  course  will  be  used  by  those  who  have  ample  means.  But 
cotton  ones  are  good  enough,  and  in  winter  are  decidedly  the  more 
desirable  of  th<3  two.  Cotton  is  best,  too,  for  those  who  suffer  with 
rheumatic  affections.  For  external  covering,  comforts  are  objection- 
able, because  they  do  not  let  the  insensible  pe  spiration  pass  off  as 
freely  as  it  should.  They  are  light,  however,  and  so  are  rose  blankets, 
which  have  the  additional  good  quality  of  being  porous.  We  should 
sleep  under  as  few  clothes  as  possible,  consistently  with  con.  fort. 

Night- Dress.  —  The  flannel,  cotton,  linen,  or  silk,  worn  next  the 
skin  through  the  day,  should  always  be  replaced,  on  retiring,  by  a 
suitable  night-dress.  The  undershirt  should  be  cf  the  same  ma- 
terial with  that  which  is  taken  off,  but  thinner.  If  we  wear  flannel 
through  the  day,  we  need  it  quite  as  much  at  night. 

Do  not  Cover  tlie  Face.  —  The  practice  of  sleeping  with  the  face 
entirely  covered  with  the  bed-clothes  is  very  injurious.  It  compels 
one  to  breathe  the  air  over  several  times. 

Natural  Position  for  Sleep.  — The  most  natural  position  in  which 
to  sleep  is  upon  the  right  side.     This  affords  the  easiest  play  to  the 


"■T^aafe'iWa^^^reaBtiBy'gaawiiiiia^^  ATg 


HTOIEKI. 


101 


internal  organs.  It  is  best,  however,  to  learn  to  sleep  in  different 
positions,  and  to  change  occasionally  from  side  to  side.  Upon  the 
bacic  is  not  so  easy  a  position.  To  lie  in  this  way  obstructs  the  cir- 
culation of  the  blood,  by  the  pressure  of  the  stomach,  bowels,  etc., 
upon  the  large  blood-vessels  which  pass  down  and  up  in  front  of  the 
backbone.  It  u  very  tiresome  and  inJHrious  to  lie  with  the  hands 
above  the  head. 

Amount  of  Sleep.  —  The  average  auiount  of  sleep  required  by 
persons  in  health  is  from  seven  to  eight  hours.  Occasionally  we  find 
persons  who  get  along  very  well  with  six,  or  even  five  hours ;  while 
some,  even  in  health,  require  nine.  There  is  no  ^vbsolute  standard 
for  all  persons,  in  the  amount  of  sleep,  any  more  than  in  that  of 
food.  It  depends  on  the  temperament,  the  constitution,  the  amount 
of  exercise,  and  the  exhausting  nature  of  the  mental  application. 

The  object  of  sleep  is  to  repair  the  energies,  the  extent  to  which 
they  are  wasted,  and  the  recuperative  power  possessed,  will  measure 
the  amount  required. 

Late  Suppers.  —  These  are  a  bar  to  all  sound  and  healthful  sleep. 
The  last  meal  should  always  be  taken  at  least  three  hours  before  re- 
tiring and  should  be  light.  During  sleep  the  stomach  should  have  a 
chance  to  rest.  It  will  work  the  better  on  the  morrow.  ^  Some  per- 
,8ons  boast  that  they  can  sleep  perfectly  well  after  a  heavy  supper. 
Perhaps  they  can,  but,  as  Franklin  lias  wisely  suggested,  they  may 
by  and  by  "  have  a  fit  of  apoplexy,  and  sleep  till  doomsday."  This 
will  be  sleeping  too  well! 

Preparation  for  Sleep. —  Dr.  Franklin  left  behind  the  record  of 
a  wise  life,  as  well  as  many  excellent  moral  and  philusophical  direc- 
tions. A  good  conscience  was  his  prescription  for  quiet  sleep  and 
pleasant  dreams,  —  a  most  excellent  direction.  Sleep  is  promoted, 
too,  by  withdrawing  the  mind,  a  short  time  before  retiring,  from  all 
hard  study  and  exciting  themes  of  conversation,  and  turning  it  to 
calmer  subjects  of  reflection,  such  as  the  moral  attributes  of  God,  and 
particularly  his  love  and  paternal  character 


Objects  oii  Clothing. 

The  clothes  we  wear  are  intended,  or  should  be  intended,  to  secure 
three  objects, —  warmth  in  winter,  coolness  in  summer,  and  health  at  all 
times. 

It  has  already  been  shown  that  our  bodies  are  warmed  by  their 
own  internal  fires.  In  the  lungs,  in  the  skin,  and  indeed  in  all  parts 
of  the  body,  oxygen  unites  vath  carbon  ,  :  d  other  combustible  mat- 
ters, producing  heat  in  the  same  way  that  it  is  produced  in  a  grate 
where  coal  is  burned ;  and  as  our  temperature  always  needs  to  be  kept 
to  about  98°  Farenheit,  it  follows  that  this  combustion  must  always 
be  going  on. 


102 


HYOIENE. 


Now,  the  atmosphere  which  surrounds  us  is  alwajrs  receiving  into 
itself  the  heat  which  comes  to  the  surface  of  our  bodies,  and  thus 
robbing  us  of  our  warmth.  In  summer,  the  atmosphere,  full  of  the 
rays  of  a  burning  sun,  may  impart  heat,  instead  of  taking  it  away ; 
while  in  winter  it  takes  more  than  it  gives,  and  would  cause  us  to 
parish  with  the  cold,  were  it  not  for  the  protection  afforded  by  our 
clothing. 

Clothes,  of  course,  have  no  power  to  manufacture  or  impart  heat. 
They  only  retain,  and  keep  in  contact  with  our  bodies,  that  which  is 
generated  within  us.  If  we  have  on  a  single  garment  which  is  made 
tight  at  the  bottom  and  top,  so  that  no  current  can  pass  up  or  down, 
there  will  be  a  layer  of  air  between  it  and  the  body,  which,  becoming 
immediately  heated,  and  being  retained  there,  helps  keep  us  warm,  or 
rather,  prevents  us  from  being  cold.  With  every  additional  garment 
put  over  this,  there  is  another  layer  of  heated  air,  adding  still  more 
impenetrable  guards  against  either  the  intrusion  of  cold,  or  the  escape 
of  internal  heat. 

Bad  Conductors  of  Heat. —  But,  that  our  clothes  may  thus  retain 
our  warmth,  and  prevent  its  dispersion,  they  must  be  had  conductors 
of  heat, —  that  is,  they  must  not  readily  take  up  the  heat  and  convey 
it  away  from  the  body.  They  must  slowly  absorb  the  caloric  into 
their  own  substance,  and  then  retain  it  tenaciously. 

Linen,  which  is  so  universally  popular  in  temperate  climates,  as 
an  article  to  be  woi-n  next  the  skin,  is  unfortunately  a  good  conduc- 
tor of  heat.  It  does  not  afford  a  warm  garment.  It  conducts  heat 
rapidly  away  from  the  body.  Hence  it  always 
feels  cool  to  the  touch.  It  is  really  no  colder  in 
itself  than  other  kinds  of  cloth,  but  it  is  solely 
the  rapidity  Avith  which  it  conducts  heat  away 
from  the  body,  that  gives  it  the  feeling  of  cold- 
ness. It  has  other  qualities  which  compensate, 
in  some  measure,  for  this  defect.  The  fibres  of  which  it  is  composed 
are  round  and  pliable,  which  makes  linen  cloth  smooth  and  soft,  and 
the  sensations  produced  by  it  on  the  skin  altogether  agreeable.  Fig. 
67  represents  a  fibre  of  linen,  as  it  appears  under  a  microscope  which 
magnifies  it  155  times. 

Cotton  is  warmer  than  linen,  because  it  is  a  worse  conductor  of 
heat.  The  perfection  to  which  its  manufacture  has  been  carried, 
makes  it  almost  a  rival  of  linen  in  softness  and  pliability.  It  does 
not  al)sorb  as  much  moisture  as  linen,  and  there- 
fore better  retains  its  powers  as  a  non-conductor. 
But  then  the  fibres  of  cotton  are  not  round  and 
smooth,  like  those  of  linen,  but  flat  and  spiral, 
with  sharp  edges.  Fig.  68  represents  two  of  its 
fibres,  magnified  155  times.  This  renders  cotton 
irritable  to  some  very  delicate  skins.     This  is  the  reason  why  linen 


Fio.  er. 


FlO.  68. 


HYGIKNE. 


103 


Biving  into 
i,  and  thus 
full  of  tlu. 
J  it  away; 
iiuse  us  to 
led  by  our 

npart  heat, 
it  which  is 
ch  is  made 
p  or  down, 
,  becoming 
8  warm,  or 
\\  garment 
still  more 
the  escape 

hus  retain 
conductors 
nd  convey 
iloric  into 


limates,  as 
id  conduc- 
iucts  heat 

it  always 
3  colder  in 
it  is  solely 
heat  away 
g  of  cold- 
jmpensate, 

composed 
I  soft,  and 
,ble.  Fig. 
ope  which 

nductor  of 
sn  carried, 
.  It  does 
and  there- 
conductor, 
round  and 
and  spiral, 
two  of  its 
lers  cotton 
why  linen 


FlO.  69. 


is  better  than  cotton  for  binding  up  wounds,  where  there  is  tender- 
ness of  the  surface. 

Silk  has  a  round  fibre,  like  linen,  which  is  even  softer  and  smaller. 
It  absorbs  less  moisture  than  cotton,  and  in  its  power  of  retaining 
warmth,  it  is  superior  to  both  the  preceding.  It  forniR  the  most  de- 
sirable fabric  for  clothing  that  we  have  ;  but  its  cost  makes  it  inacces- 
sible to  the  great  body  of  the  people,  except  as  a  holiday  dress  for 
the  ladies.  Its  culture  in  our  country,  if  extensively  established, 
would  be  a  source  of  national  wealth. 

The  Fibre  of  Wool  is  quite  rough,  almost  scaly,  and  highly  irrita- 
tive to  delicate  skins.  Fig.  69  shows  fibres  magnified  310  times.  It 
is  not  possible  for  some  persons  to  wear  it  next 
the  skin.  But  where  this  cannot  be  done  it  may 
be  worn  outside  the  linen  or  cotton ;  and  being  a 
good  nortrconduetor,  it  will  in  this  way  preseive 
the  warmth  of  the  body,  without  either  irritating 
the  skin,  or  disturbing  its  electricity. 

Wool,  in  cold  climates,  is  one  of  the  very  best 
materials  of  which  clothes  can  be  made.  In  New 
England,  and,  indeed,  in  all  cold  and  temperate 
regions,  it  should  be  worn  by  delicate  persons,  in 
the  form  of  thick  or  thin  garments,  all  the  year  round.  It  does  not 
readily  absorb  moisture,  and  is  a  dry,  warm,  and  wholesome  material 
for  clothing. 

Hair. —  Though  not  precisely  in  the  line  of  these  remarks,  hair 
may  as  well  be  introduced  here.  Wool  is  in  fact  hair.  Every  part 
of  the  skin,  with  the  exception  of  that  upon  the  soles  of  the  feet,  and 
the  palms  of  the  hands,  is  intended  to  produce  hairs.  On  most  parts 
of  the  body,  they  are  short  and  fine,  hardly  ri-'ing  above  the  surface. 
Upon  the  head  and  the  face,  they  grow  to  coii,.iderable  length. 

Hair,  like  wool,  is  a  bad  conductor  of  heat ;  and,  as  growing  upon 
the  head  and  face,  is  doubtless  intended  for  some  useful  purpose. 
That  it  was  designed  as  a  warm  covering,  can  hardly  be  doubted. 
The  beard,  when  permitted  to  grow,  is  a  natural  respirator,  guarding 
the  lungs  against  cold  and  dust.  It  has  been  noticed  that  black- 
smiths who  have  allowed  their  beards  to  grow,  had  their  mustache 
discolored  by  iron-dust,  which  lodged  among  the  hairs,  and  very 
justly  inferred  that  the  dust  must  have  found  its  way  into  the  lungs, 
and  done  mischief,  had  it  not  been  arrested  by  this  natural  respirator. 

That  the  beard,  when  long,  does  Avard  off  a  grcsat  many  colds  and 
throat  troubles,  is  too  well  known  to  be  denied.  It  has  required  moral 
courage  on  the  part  of  those  who  have  broken  away 
from  the  universal  practice  of  shaving,  foe  which  they 
should  be  honored  rather  than  ridiculed.  For  those 
who  do  not  suffer  from  throat  or  lung  complaints,  espe- 1 
cially  if  they  are  getting  advanced  in  life,  it  may  not  be 
thought  worth  while  to  abandon  the  razor.     Yet  the  change  would 


M 


*!! 


FlO.  70. 


■P&asvw" 


■^^smmmm^ii&m&^^^i<iiiM^> 


104 


.lYOIENE. 


not  be  regretted.      Fig.  70  is  a  human  hair,  magnified  250  timts, 
showing  its  scaly  surface. 

The  Color  of  our  Clothing  is  a  matter  of  some  moment.  The  dark 
colors  absorb  the  light,  the  sun's  rays,  and  heat,  much  more  than  the 
lighter  ones  ;  and  as  those  bodies  which  absorb  heat  well  are  likewise 
good  radiators,  the  dark  colors  have  the  highest  radiating  power.  White 
reflect  heat  and  rays  of  light,  and  is  a  bad  absorber  and  bad  radiator. 
In  su.amer  it  prevents  the  sun's  rays  from  passing  inward  to  heat  the 
body,  and  in  winter,  intermpts  the  heat  of  the  body  in  its  passage 
out.  In  summer,  it  makes  the  coolest  garment ;  in  winter  the  warmest 
one.  These  facts  can  be  very  simply  illustrated,  by  laying,  side  bj 
side,  upon  the  snow,  when  the  sun  shines,  two  pieces  of  cloth,  the 
one  black,  the  other  white.  Lifting  them  up,  after  a  time,  the  snow 
will  be  found  considerably  melted  under  the  black  cloth,  but  not  under 
the  white. 

It  is  now  seen  that  the  object  of'  clothing  is  not  to  impart  heat  to 
the  body,  but  to  prevent  its  loss ;  that  it  is  not  to  create  it,  but  to 
furnish  the  occasion  for  increasing  its  degree.  It  appears  further, 
that  clothing  protects  the  body  against  the  evil  effects  of  changes  of 
temperature,  and  that  white  garments,  by  reflecting,  instead  of  ab- 
sorbing heat,  guard  it  against  the  heat  of  summer. 

Clothing  should  be  Porous. — All  articles  used  for  garments  should 
be  porous,  and  permit  the  free  passage  of  insensible  perspiration.  The 
skin  receives  oxygen  through  its  pores,  and  gives  back  carbonic  acid. 
It  performs  a  sort  of  subordinate  respiration.  India-rubber  garments, 
worn  next  to  it,  interrupt  this,  and  must  do  mischief.  Shoes  made 
of  this  material  soon  cause  the  feet  to  become  damp  and  cold.  The 
dampness  is  occasioned  by  the  insensible  perspimtion,  which  cannot 
escape  through  the  rubber.  Such  shoes  worn  in  the  open  air,  should 
be  immediately  taken  off  on  entering  the  house. 

Thin  Shoes. —  The  defective  way  in  which  American  females  pro- 
tect their  feet  from  cold  and  wet,  is  a  sore  evil;  and  he  who  persuades 
them  to  adopt  a  wiser  fashion,  and  cover  their  feet  with  better  guard? 
against  colds  and  consumption,  will  deserve  the  gratitude  of  the  na- 
tion. We  are  in  many  things  too  fond  of  copying  foreign  fashions: 
but  if  our  ladies  would,  in  this  matter,  follow  the  excellent  example 
of  English  women,  they  would  live  longer,  and  leave  a  hardier  pos- 
terity behind  them. 

The  shoes  worn  by  our  females,  high  and  low,  rich  and  poor,  are 
not  thick  enough  to  walk  with  safety  upon  a  painted  floor,  hardly 
upon  a  carpet  in  an  unwarmed  room ;  and  yet  they  walk  with  them 
upon  cold  brick  sidewalks,  upon  damp  and  frozen  ground,  and  even 
in  mud. 

The  result  is,  that  they  suffer  from  colds,  sore  throats,  pleurisies, 
lung-fevers,  suppressions,  inflammations  of  the  womb,  and  many  other 
ailments,  which  in  early  life  rob  them  of  their  freshness  and  beauty, 


'•i»^^\ 


;k«w«iesii;;;^«i^S£uu^^^ 


HYGIENE. 


106 


passage 


of  tlioir  health  aftfl  comfort,  of  their  usefulness  to  their  linusehold 
1111(1  the  world,  and  leave  them  helpless  in  the  arms  of  their  friends, 
with  a  patrimony  of  suffering  for  themselves  while  they  live  and  a 
legacy  of  disease  to  hand  down  to  their  children.  Would  that  they 
were  wise  in  season '    Some,  to  their  honor  be  it  said,  have  already 


adopted  a  safer  coui-se. 
rected. 


It  is  hoped  the  evil  will  be  gradually  cor- 


Never  attempt  to  mould  the  Form  by  Dress. — Parents  commit  a 
great  error  when  they  attempt  to  mould  the  forms  of  their  children, 
particularly  their  daughters,  by  their  dress.  This  cannot  be  done. 
It  is  the  work  of  nature,  and  she  wants  no  assistance  in  it.  The 
great  object  of  dress  in  childhood,  as  well  as  in  adult  life,  is  to  pro- 
mote health.  With  this,  there  is  not  much  difficulty  in  preserving 
the  symmetry ;  without  it,  deformity  is  almost  a  matter  of  course. 

The  fact  cannot  be  too  often  repeated,  nor  too  seriously  urged  upon 
parents,  that  while  the  foundation  of  all  graceful  and  just  proportion 
of  the  different  parts  of  the  body  must  be  laid  in  infancy,  it  cannot 
be  done  by  tight  bands,  and  ligatures  upon  the  chest,  and  loins,  and 
legs,  and  arms.  Upon  all  these  points,  the  garments  of  children 
should  set  easy,  leaving  the  muscles  at  liberty  to  assume  the  fine 
swell  and  development  which  nothing  short  of  unconstrained  exercise 
can  give.  Could  infants  tell  all  the  hon'ors  they  suffer  from  the  re- 
straints put  upon  them  by  tight  dresses,  it  would  make  many  a 
mother's  heart  bleed. 

In  these  brief  remarks,  the  principles  are  given  which  should  guide 
us  in  the  selection  of  our  clothing.  The  intelligent  reader  will  be 
able  very  easily  to  fill  up  the  outline. 


Bathing  and  Cleanliness. 

Aristotle  calls  cleanliness  one  of  the  half  virtues ;  and  Addison, 
ill  the  Spectator,  recommends  it  as  a  mark  of  politeness,  and  as  analo- 
gous to  purity  of  mind.  Both  in  the  Jewish  and  Mohammedan  law, 
it  is  enforced  as  a  part  of  religious  duty.  Its  requirement  as  a  pre- 
requisite to  cliristian  communion  would  be  wiser  than  the  demands 
sometimes  made.  A  dirty  Christian  may  perhaps  be  found,  but  not 
among  those  who  mean  to  be  intelligent. 

The  importance  of  keeping  the  skin  clean  is  not  generally  appreci- 
ated. The  motive  for  cleanliness  is  often  a  lower  and  meaner  one 
than  should  be  allowed  to  have  place  in  the  mind.  Many  persons 
would  be  mortified  to  have  their  hands,  or  face,  or  neck  dirty,  who 
ilo  not  wash  their  whole  body  once  a  year.  That  they  may  appear 
well  in  the  eyes  of  others,  is  the  only  motive  with  such  for  keeping 
clean. 

Offices  of  the  Skin. —  If  we  look  a  little  at  the  offices  of  the  skin, 
we  shall  better  understand  the  need  of  keeping  it  clean. 


■■■■ 


106 


HYGIENE. 


The  skin  is  not  merely  a  covering  to  protect  us  trom  the  weather. 
It  is  a  living  structure,  curiously  wrought,  with  a  large  extent  of  sur- 
face, and  having  important  duties  to  perform  in  the  animal  economy. 
Its  structure  is  more  particularly  explained  under  the  liead  of  "  Anat- 
omy "  and  "  Skin  Diseases."  It  has  been  aheady  said,  that  it  helps 
the  lungs  in  breathing.  It  does  many  other  things  on  Wi.ich  the  health 
is  dependent. 

Number  of  Perspiratory  Tubes.  —  The  skin  performs  several 
kinds  of  secretion,  —  that  is,  it  separates  several  things  from  tlie 
blood, —  one  of  which  is  the  persjnratfbn,  or  sweat.  The  sweat  is 
formed  in  small  glands,  situated  just  under  the  skin,  and  is  brought 
to  the  surface  in  small  ducts,  or  tubes,  like  the  hose  tlirough  which 
firemen  throw  water.  These  little  tubes  are  spiral,  as  seen  in  cut  44. 
and  run  up  through  the  two  skins. 

These  spiral  canals  are  very  numerous,  covering  every  part  of  the 
human  frame,  -  there  being  about  2800  of  them  upon  every  square 
inch  throughout  the  body  ;  and  as  a  man  of  ordinary  size  has  about 
2500  square  inches  of  surface,  the  number  of  tubes  in  the  skin  of  one 
man  is  seven  millions. 

The  mouths  of  these  tubes  are  called  tlie  pores  of  the  skin.  Each 
one  of  these  tubes  is  extended  just  below  the  skin  ;  and  there,  among 
the  cells  where  the  fat  is  deposited  it,  or  rather  the  two  bi-anches  into 
which  it  is  divided,  is  wound  into  a  coil,  called  the  sudoriferous  or 
sweat  gland.  These  ducts  are  each  about  a  quarter  of  an  inch  in 
length,  which  make  an  aggregate  length  of  tubing  in  the  human  skin 
of  about  twenty-eight  miles. 

Insensible  Perspiration. —  Through  each  of  these  seven  million  of 
quarter-inch  hose,  there  is  poxired  out,  day  and  night,  as  long  as  a 
man  lives,  a  stream  of  sweat  in  the  form  of  vapor.  When  this  is 
thrown  off  very  rapidly,  as  happens  when  active  exercise  is  taken,  it 
accumulates  in  drops,  and  is  called  sweat.  Ordinarily  it  does  not 
thus  accumulate ;  it  is  then  called  insensible  perspiration,  —  not 
being  recognized  by  the  senses. 

This  transpiration  may  be  proved  very  beautifully  by  inserting  the 
naked  arm  into  a  long  glass  jar,  and  closing  up  the  space  around  it 
at  the  month  so  that  no  air  can  get  in.  The  inside  of  the  glass  will 
soon  be  covered  with  a  vapor,  which  will  grow  more  and  more  den.se 
until  it  is  converted  into  drops.  Boerhaave  says  :  "  If  the  piercing 
chill  of  winter  could  be  introduced  into  a  summer  assembly,  the  in- 
sensible perspiration  being  suddenly  condensed,  would  give  to  each 
person  the  appearance  of  a  heathen  deity,  wrapped  in  his  own  sepa- 
rate cloud." 

Now,  this  continual  exudation  of  sweat  through  these  millions  of 
tubes  is  for  a  wise  and  necessary  purpose.  It  is  to  take  out  of  the 
blood  and  other  fluids  various  salts,  which  would  do  mischief  if 
allowed  to  remain  longer,  and  particularly  carbonic  acid,  which  is 


ESfissBEKeanHH 


HTGIENB. 


107 


the  weather, 
ffentof  sur- 
iil  economy. 
'1  of  "  Anat- 
that  it  helps 
h  the  health 

rms  several 
fs  from  the 
he  sweat  is 
is  brought 
ough  which 
11  in  cut  44. 

part  of  the 

very  square 

;e  has  al)out 

skin  of  one 

skin.  Each 
lere,  among 
unches  into 
oriferous  or 
an  inch  in 
luman  skin 

n  million  of 
s  long  as  a 
/^hen  this  is 
is  taken,  it 
it  does  not 
tion,  —  not 

iserting  the 
!  around  it 
B  glass  will 
more  den.se 
16  piercing 
bly,  the  in- 
ve  to  each 
own  sepa- 

millions  of 
out  of  the 
nischief  if 
,  which  is 


poisonous,  —  the  same  matters,  in  fact,  which  are  thrown  out  by  the 
lungs.  The  skin,  in  truth,  is  a  kind  of  helper  of  the  lungs ;  and  a 
lady,  by  covering  herself  with  garments  which  have  no  pores,  and 
will  neither  admit  air  nor  let  off  insensible  perspiration,  may  be 
strangled  almost  as  certainly  as  by  putting  a  cord  around  her  neck, 
and  closing  her  windpipe.  Almost  twice  as  much  fluid  passes  off 
through  the  skin  as  through  the  lungs. 

Keep  the  Pores  Open.  —  It  is  obvious  from  what  has  now  been 
said,  that  the  pores  of  the  skin  should  be  kept  open  to  preserve 
health.  When  bathing  is  neglected,  and  the  undergannents  are  not 
changed  sufficiently  often,  the  insensible  perspiration  accumulates 
and  dries  up  upon  the  skin,  mingling  with  the  oily  matter  secreted 
by  the  oil-glands,  and  with  tha  slireds  of  the  scarf-skin,  and  form- 
ing a  tenacious  gluey  matter,  which  closes  up  the  pores.  By  this 
misfortune,  that  large  quantity  of  worn-out  matter  which  usually 
goes  off  with  the  fluid  througVi  the  pores  is  retained  to  poison  and 
embarnvss  the  living  current  of  blood,  or  seek  an  outlet  through  lungs 
or  kidneys,  which  are  already  burdened  with  quite  as  much  as  they 
are  able  to  do.  How  important,  then,  that  these  channels  through 
which  the  body  is  purified  should  be  kept  open  I  that  the  skin  shoiUd 
be  kept  healthy  and  in  working  order  ! 

The  Bath,  the  Great  Purifier.  —  But  this  can  only  be  done  by . 
daily  washing.     The  bath  is  the  great  purifier  of  the  human  skin. 

The  antiquity  of  bathing  is  very  great.  The  practice  is  supposed 
to  reach  back  to  the  infancy  of  the  race,  or  certainly  to  a  very  early 
period.  The  inhabitants  of  Middle  Asia  are  said  to  have  been  the 
firet  to  use  the  bath  for  the  specific  purposes  of  purification  and 
health.  Domestic  baths  are  represented  as  having  been  used  by 
Dioraed  and  Ulysses.  Andromache  prepared  warm  water  for  Hector 
on  his  return  from  battle.  Penelope  banished  sorrow  by  unguents 
and  baths. 

The  Baths  of  the  Medes,  the  Persians,  and  the  Assyrians  were 
much  celebrated.  Alexander,  though  familiar  with  the  voluptuous 
baths  of  Greece  and  Macedon,  was  astonished  at  the  magnificence  of 
those  of  Darius. 

Roman  Baths.  —  As  luxury  and  refinement  advanced,  the  means 
of  luxurious  bathing  were  multiplied,  until  establishments  were 
built  by  the  Romans,  the  very  remains  of  which  excite  wonder  at 
this  day.  Among  these  are  the  Thermae  of  Agrippa,  of  Nero,  of 
Vespasian,  of  Titus,  etc.  One  of  the  halls  of  the  building  con- 
structed for  baths  by  Diocletian,  forms  at  this  day  the  church  of  the 
Carthusians,  one  of  the  most  magnificent  temples  in  Rome. 

Number  and  Character.  —  According  to  Pliny,  baths  were  intro- 
duced into  Rcme  about  the  time  of  Pompey ;  their  first  erection 
Dion  attributes  to  Maecenas.     Agrippa  increased  their  number  to 


108 


HYGIENK. 


one  hundred  and  seventy ;  and  within  two  hundred  years  they  were 
multiplied  to  about  eight  hundred.  These  establishments  were  sn 
vast  that  one  writer  compares  them  to  provinces.  They  were  paved 
either  with  crystal,  or  mosaic,  or  plaster,  and  were  adorned  by  Hcidj)- 
ture  and  painting  to  the  very  highest  degree.  They  added  not 
merely  to  the  health  and  luxury  of  the  people,  but  contributed  to 
their  culture  in  the  highest  departments  of  art  and  taste. 

Names  of  Baths.  —  To  the  apartment  of  their  dwelling  in  wliich 
they  washed  their  bodies  in  warm  or  hot  water,  the  Romans  gave 
the  name  of  balneum,  or  bath ;  to  the  public  establishments,  that  of 
balnea,  or  baths.  The  apartment  which  held  the  vessels  was  called 
vasarium.  In  this  were  the  three  immense  vessels  which  conttuned 
the  cold,  warm,  and  hot  water.  There  were  instruments  of  lx)ne, 
ivory,  and  metal,  for  scraping  the  skin,  with  a  groove  in  the  edge, 
through  which  the  impurities  of  the  skin  might  run  oif. 

On  the  north  front  of  the  thermae  was  a  reservoir  of  cold  water 
large  enough  for  swimming,  called  by  Pliny  the  younger,  baptuterinm. 
In  the  centre  was  a  spacious  vestibule,  and  on  each  side,  warm,  cold. 
and  vapor  biths,  with  apartments  for  cooling,  dressing,  and  refresli- 
ments.  There  was  the  frigidarium,  a  vaulted  room,  a  cooling  room 
midway  between  the  warmer  and  the  open  air ;  the  tepidarium,  with 
a  temperature  midway  between  the  above  and  the  hot  bath ;  and  the 
calidanum,  or  the  vapor  bath. 

Then  there  was  the  room  where  the  body  was  rubbed  over  with  a 
great  number  of  ointments  and  essences  of  the  most  precious  kinds ; 
and  another  in  which  it  was  sprinkled  over  with  powder ;  and  also  a 
room  which  held  the  clothes,  in  which  the  bathera  undressed  and 
dressed  at  pleasure. 

All  these  upartments  were  double,  the  two  wings  being  appropri- 
ated to  the  sexes. 

Open  to  all.  —  These  baths,  thus  numerous  and  magnificent,  were 
open  to  all  classes  of  the  people,  and  contributed  largely  to  the  gen- 
eral health  and  physical  endurance  for  which  the  Romans  were  con- 
spicuous. 

The  Bath  Neglected  under  the  Christian  System.  —When  Jesus 
of  Nazareth  came  into  the  world,  he  found  man's  nature  cultivated 
in  a  most  defective  way.  The  moral  element  had  sunk  down  to  the 
lowest  place,  while  the  physical  had  risen  to  the  highest,  — just  the 
reverse  of  the  true  order  of  things.  This  Divine  Teacher  came,  not 
to  recomm  i  a  neglect  of  the  body,  but  a  new  cure  for  the  imper- 
ishable pa.  -.  Mankind  were  for  the  first  time  systematically  taught 
to  forgive  injuries.  Prostrate  liberty  and  degraded  woman  became 
the  wards  of  Christianity. 

Unfortunately,  under  the  new  order  of  things,  the  lower  element 
of  man,  which  had  been  exalted  and  worshipped,  was  cast  down  and 
abused.     What  the  Pagan  had  pampered,  the  Chiistian  pei-secuted. 


*»-  ----  ^ 


HYGIENK. 


109 


i  they  were 
nte  were  ho 
were  jHivcd 
hI  hy  Hculj)- 
added  not 
tribntcd  (o 

ig  in  wliicli 
)mans  gave 
intH,  that  of 
was  calh'd 
1  contained 
t«  of  lx)ne, 
1  the  edge, 

coUl  water 
aptisterinm. 
warm,  cold, 
nd  refresh- 
loling  room 
%rium,  with 
h ;  and  the 

over  with  a 

iouu  kinds ; 

and  also  a 

ressed  and 


appropri- 


icent,  were 
to  the  gen- 
were  con- 

^hen  Jesus 

cultivated 

own  to  the 

-just  the 

came,  not 

the  imper- 

illy  taught 

an  became 

element 
down  and 
teraecuted. 


The  Imdy,  which  had  been  bathed,  and  scrubbed,  and  anointed,  and 
perfumed,  waa  thenceforward,  in  consequence  of  the  improper  inter- 
pretation of  certain  texts,  scourged,  and  fasted,  and  clothed  in  rags. 
Thousands  believed,  and  thousands  do  to  this  day,  that  to  torment 
the  body  is  to  please  God.  Under  this  feeling,  the  public  and  pri- 
vate baths  were  neglected ;  and  to  this  day  no  Christian  nation  has 
fully  appreciated  the  necessity  of  cleanliness,  and  of  sanitary  meas- 
ures for  the  maintenance  of  the  public  health.  To  a  considerable 
extent,  the  body  is  still  under  disabilities ;  still  the  subject  of  perse- 
cution ;  and  where  this  is  not  the  case,  it  is  too  often  regarded  only 
as  a  loose  outside  garment,  to  be  thrown  over  the  traveller  to  the 
celestial  city,  and  is  expected  to  be  well  soiled  with  mud  and  dust. 
The  teachings  of  the  Great  Master  will  by  and  by  cease  to  be  per- 
verted, and  will  be  applied  to  raise  up  man's  body,  as  they  have 
raised  his  mental  and  moral  nature,  and  will  make  a  well-developed 
and  harmonious  being. 

In  the  meantime,  it  is  the  duty  and  the  privilege  of  the  physician 
to  urge  a  return,  not  to  the  magnificence  of  the  ancient  regimen  for 
training  the  body,  but  to  its  real  efficiency  in  a  simpler  form. 

Cold  Bathing. — Water  applied  to  the  skin  at  a  temperature  below 
75°  of  Farenheit,  is  called  a  cold  bath.  If  applied  to  a  person  with 
sufficient  constitutional  energy  to  bear  it,  it  is  a  decided  and  very 
powerful  tonic.  By  this  is  meant  that  it  promotes  the  solidity,  com- 
pactness, and  strength  of  the  body. 

The  first  effect  of  the  application  of  cold  water  to  the  skin,  is  the 
sudden  contraction  of  all  its  vessels,  and  the  retreat  of  the  blood 
towards  the  internal  organs.  The  nervous  system,  feeling  the  shock, 
causes  the  heart  to  contract  with  more  energy,  and  throw  the  blood 
back  with  new  force  to  the  surface. 

This  rushing  of  the  blood  back  to  the  skin,  is  called  a  reaction ; 
and  when  it  occurs  with  some  energy,  it  is  an  evidence  that  the  sys- 
tem is  in  a  condition  to  be  much  benefited  by  the  cold  bath.  When 
this  does  not  take  place,  but  the  skin  looks  shrunken,  and  covered 
with  "  goose  flesh,"  and  a  chilliness  is  felt  for  a  longer  or  shorter  time 
after  bathing,  then  the  inference  should  be,  either  that  the  water  has 
been  used  too  profusely,  or  that  the  bather  has  too  little  reactionary 
power  for  this  form  of  the  bath.  The  latter  conclusion  must  not  be 
accepted  until  cold  water  has  been  tried  with  all  possible  guards,  — 
such  as  beginning  with  tepid  water,  and  gfradually  lowering  the  tem- 
perature ;  bathing  for  a  time,  at  least,  in  a  warm  room ;  beginning 
the  practice  in  warm  weather ;  and  applying  the  water  at  first  with  a 
sponge  out  of  which  most  of  it  has  been  pressed  by  the  hand.  With 
some  or  all  of  these  precautions,  mosf  persons  may  learn  to  use  the 
cold  bath.  It  is  always  to  be  followed  by  brisk  rubbing  with  a  coarse 
towel  or  flesh-brush. 

The  Sponge  Bath. —  \.  wet  sponge  is  the  simplest,  as  well  as  the 
best  mode  of  applying  water  to  the  surface  of  the  body.     With  per- 


fiU 


tli> 


Jl 


no 


HYGIENE. 


sons  who  are  feeble,  a  [nirl  only  of  the  hody  should  bo  exposed  at  a 
time,  —  which  part,  having  been  quickly  sponged  and  wiped  dry, 
should  Ihj  covered,  and  another  part  exposed,  and  treated  in  a  likt; 
manner.  In  this  way,  all  parts  of  the  body  may  successively  be  kiiI)- 
jected  to  the  bnvcing  influence  of  water  and  friction,  with  little  risk, 
even  to  the  most  delicate,  of  an  injurious  shock.  The  only  furniture 
required  for  carrying  out  this  simple  plan  of  bathing,  is  a  sponge,  a 
basin,  anrl  a  towel.  There  is  no  form  of  iNithing  so  universally  appli- 
cable as  this,  or  so  generally  conducive  to  health. 

The  Shower  Bath  requires  a  brief  notice.  The  shock  to  the  ner- 
vous system  produced  by  itKs  much  greater  than  that  from  sponging. 
Beside  the  sudden  application  of  coldness,  there  is  a  concussion  of 
the  skin  by  the  fall  of  the  water.  This  form  of  the  bath  is  excellent 
for  those  who  are  strong  and  full  of  vitality,  but  is  fraught  with  some 
danger  for  the  feeble  and  delicate.  This,  however,  depends  on  the 
judgment  with  which  it  is  used.  In  the  form  of  a  delicate  shower, 
and  with  tepid  water,  the  frailest  body  might  bear  its  shock. 

The  Warm  Bath. —  A  temperate  bath  ranges  from  75°  to  85° ;  a 
tepid  bath,  from  86°  to  95° ;  a  warm  bath,  from  95°  to  98° ;  a  hot 
bath  from  98°  to  105°.  A  warm  bath  is  of  the  same  temperature 
with  the  surface  of  the  body.  Of  course  it  produces  no  shock.  To 
those  who  are  past  the  meridian  of  life,  and  have  dry  skins,  and  l)egin 
to  be  emaciated,  the  warm  bath,  for  half  an  hour,  twice  a  week,  is 
eminently  serviceable  in  retarding  the  advances  of  age. 

It  is  a  mistake  to  suppose  the  wann  bath  is  enfeebling.  It  has  a 
soothing  and  tranquillizing  effect.  It  renders  the  pulse  a  little 
slower,  and  the  breathing  more  even.  If  the  bath  be  above  98°,  it 
becomes  a  hot  one,  and  the  pulse  is  quickened. 

The  temperature  of  the  warm  bath,  as  of  the  cold,  should  be  made 
to  range  up  and  down  according  to  the  vigor  of  the  frame,  and  the 
circulation  of  the  individual.  The  aged  and  the  infirm,  whose  hands 
and  feet  are  habitually  cold,  require  it  to  be  well  up  towards  the 
point  of  blood  heat.  The  pulse  should  not  be  made  to  beat  faster  by 
it,  nor  should  sensations  of  heat  or  fullness  be  induced  about  the 
temples  and  face. 

The  Vapor  Bath. —  This  differs  from  the  warm  bath  in  being  ap- 
plied to  the  interior  as  well  as  to  the  exterior  of  the  body.  The 
warmth  is  inhaled  into  the  air-tubes  at  the  same  time  that  it  envelops 
the  external  person.  The  first  sensation  of  the  vapor  bath  is  oppres- 
sion, and  causes  some  difficulty  of  breathing ;  but  this  passes  off  as 
soon  as  the  perspiration  begins  to  flow.  From'  the  steam-chamber, 
the  bather  should  step  into  a  tepid  bath,  and  after  remaining  a  short 
time  in  this,  wipe  himself  thoroughly  with  diy  towels. 

Cold  Affusion  immediately  after  either  the  warm  or  the  vapor  bath, 
i(i  excellent.     In  Russia  it  is  common,  after  the  vapor  bath,  to  pour 


m^ 


posed  at  a 

npud  dry, 

in  a  like 

ily  IX!  Hlll)- 

Uttli'  risk, 

'  furniture 

sponge,  a 

ally  appli- 


to  tlio  ner- 
Hpoiiging. 
cu88ion  of 
)  excellent 
with  some 
ids  on  tlie 
te  shower, 
k. 

to  85° ;  a 
'8°;  a  hot 
mperature 
bock.  To 
and  l)egin 
■I  week,  is 

It  has  a 
se  a  little 
»ve  98°,  it 

d  be  made 
,  and  the 

1086  hands 

wards  the 
fiister  by 

about  the 

being  aj*- 
dy.  The 
envelops 
IS  oppres- 
ses off  as 
-chamber, 
y  a  short 

ipor  bath, 
1,  to  pour 


HYUIENK. 


lU 


upon  the  head  of  the  bather  a  bucket  of  warm  water,  then  one  of 
tepid,  and  hwtly  one  of  cold ;  and  to  finish  with  giving  hira  a  good 
towelling.  It  is  even  said  that  the  natives  leave  the  uteaiu  and  the 
hot  bath,  and  roll  themselves  in  the  snow. 

No  danger  need  Ik;  feared  from  cold  affuwion  when  the  skin  is  red 
and  excited  by  tlie  warm  bath,  provided  the  nervous  frame  is  not  in 
a  depressed  condition.  If  the  body  is  chilled,  and  the  nerves  pros- 
trated by  disease  or  fatigue,  the  appli(!ation  of  cold  water  to  the  skin 
may  do  great  mischief,  and  should  in  no  case  bo  hazarded.  Cold 
water  applied  to  a  hot  skin  cannot  do  harm  ;  to  a  cold  skin,  it  can  do 
nothing  but  harm.  Hence,  the  cold  bath  may  In;  used  with  advan- 
tage on  rising  in  the  morning,  while  the  lK)dy  is  warn>.  Another  good 
time  is  at  ten  or  eleven  o'clock  in  the  forenoon,  when  the  nervous 
power  is  advancing  towards  its  height  for  the  day. 

Reaction  Necessary. —  iVs  a  means  for  promoting  cleanliness,  the 
importance  of  the  bath  can  liardly  be  overstated.  For  the  support 
and  improvement  of  health,  it  is  equally  important.  But  for  the  pro- 
motion of  the  latter,  one  prerequisite  is  essential,  —  the  reaction  of 
the  skin. 

Various  means  are  resorted  to,  to  secure  this.  The  Hindoos  secure 
it  by  a  kind  of  shampooing,  thus  described  by  a  writer:  " One  of  the 
attendants  on  the  bath  extends  you  upon  a  bench,  sprinkles  you  with 
warm  water,  and  presses  the  whole  body  in  an  admirable  nianner.- 
He  cracks  the  joints  of  the  fingers,  and  of  all  the  extremities.  He 
then  places  you  upon  the  stomach,  pinches  you  over  the  kidneys, 
seizes  you  by  the  shoulders,  and  cracks  the  spine  by  agitating  all  the 
vertebrae,  strikes  some  powerful  blows  over  the  fleshy  and  muscular 
parts,  then  rubs  the  body  with  a  hair-glove  until  he  perspires,"  etc. 
"  This  process,"  siiys  the  wiiter,  "  continues  for  three-quartera  of  an 
hour,  after  which  a  man  scarcely  knows  himself;  he  feels  like  a  new 
l)ei.ig."  Sir  John  Sinclair  speaks  thus  of  the  luxury  of  the  process : 
"  Tf  life  be  nothing  but  a  brief  succession  of  our  ideas,  the  rapidity 
with  which  they  now  pass  over  the  mind  would  induce  one  to  believe 
that  in  the  few  short  minutes  he  has  spent  in  the  bath,  he  has  lived  a 
number  of  years." 

The  Coarse  Towel,  the  horsehair  glove,  and  the  flesh-brush  are  the 
appliances  commonly  used  for  stimulating  the  skin,  and  causing  re- 
action. For  tender  skins,  the  towel  is  sufficiently  rough.  With  this 
the  bather  should  rub  himself,  unless  he  is  weak  and  the  exertion 
produces  palpitation.  The  muscular  exertion  necessary  for  this  will 
help  the  reaction. 

Restoration  oi  the.  Bath  deslrabie. —  It  is  greatly  to  be  wished 
that  the  bath  miglit  be  restored  to  .something  like  the  importance  it 
held  among  ancient  nations.  It  is  a  luxury,  a  means  of  health,  and 
iv  source  of  purity  both  of  body  and  of  mind  ;  for  the  morals  of  any 
people  will  rise  when"}  the  use  of  the  bath  is  regular  and  habitual. 


h 


112 


HYUIENR. 


The  attempt  to  cure  all  diseases  by  what  in  called  the  "  water-cure," 
h:tH  a  hit  of  fanaticlHm  about  it,  which  will  cure  ituelf  in  time.  But 
that  water,  used  judiciously  in  the  form  of  baths,  is  a  potent  moral 
and  physical  renovator  of  the  nice,  is  not  to  be  doubted ;  and  this 
should  commend  it  to  all  sensible  peo[)le,  even  though  it  should  some- 
times be  abused  by  excess,  at*  all  good  things  art>. 

A  people  with  clean  hands,  anU  clean  bodies,  and  clean  health,  will 
very  natunilly  come  to  like  clean  streets  and  clean  cities,  and  finally, 
dean  consciences.  A  fondness  for  cleanliness  in  one  form,  almost  ne- 
cessarily runs  into  a  like  fondness  for  it  in  other  forms,  until  the  pu- 
rifying desire  pei-vades  the  whole  nature,  moral  as  well  as  physical. 


Air  and  Ventilation. 

Water  and  air  are  fluids.  Water  covers  two-thirds  the  surface  of 
the  globe,  having  a  depth,  in  some  places,  of  five  miles  or  more.  Air 
covers  not  merely  the  remaining  third  of  the  earth,  but  the  water  as 
well.  It  embraces  the  entire  globe,  pressing  alike  upon  land  and 
water,  and  having  a  depth  of  about  forty-five  miles.  This  is  a  sea  of 
such  magnitude,  tliat  the  Atlantic  or  Pacific  shrinks  to  a  very  small 
lake  in  the  comparison. 

Man  has  his  residence,  and  walks  about  fo  the  bottom  of  this  ocean. 
He  has  no  means  of  navigating  it,  and,  therefore,  never  rises  to  its 
surface  ;  but,  with  his  natural  eyes,  and  with  telescopes,  he  discovei's 
objects  which  lie  millions  and  billions  of  miles  beyond  it,  and  even 
acquires  much  exact  and  useful  information  respecting  them. 

This  vast  ocean  of  air  we  call  an  atmosphere,  from  two  Greek  words 
signifying  vapor,  and  a  sphere, —  it  being  an  immense  fiuid-sphere,  or 
globe. 

Pressure  of  the  Atmosphere. — This  atmosphere  presses  upon  man 
and  upon  every  object  on  the  surface  of  the  earth,  with  a  force  equal 
to  fifteen  pounds  to  every  square  inch ;  and  as  a  man  of  average  size 
has  a  surface  of  about  2500  square  inches,  the  air  in  which  he  lives, 
presses  upon  him  with  a  weight  of  eighteen  tons.  This  would  of 
course  crush  every  bone  in  his  body,  but  for  the  fluids  within  him 
which  establish  an  equilibrium,  and  leave  him  unoppressed. 

The  Phllc^ophy  of  Breathing  cannot  be  fully  explained  in  the 
brief  space  p  'to  this  subject;   it  is  enough  to  say,  that,  upon 

the  attem'  made  to  draw  in  the  breath,  the  muscles  of  the 

breast  ne  ribs,  the  diaphragm  or  midriff  at  the  same  time 

conti  —  the  whole  movement  being  such  as  to  create  a  vacuum 

in  tht  xgs.  The  air,  pressing  upon  every  part  of  the  surface,  as 
mentioned  above,  rushes  in  and  fills  the  vacuum.  The  limgs  being 
filled,  the  contraction  of  the  muscles  of  the  belly  causes  the  dia- 
phragm, which  has  sunk  down  towards  a  plane,  to  rise  up  into  the 
form  of  an  umbrella,  aud  squeeze  the  aii-  out  of  the  lungs. 


HYGIENE. 


113 


This  is  about  all  that  need  to  Ix)  said  of  the  method  of  getting  the 
air  into  and  out  of  the  lungs.  The  whole  process  is  under  the  con- 
trol of  that  part  of  the  nervous  system  called  the  medulla  oblongata, 
or  the  top  of  the  sjjinal  cord. 

Objects  of  Breathing. —  There  are  at  least  three  objects  to  be  ac- 
complished by  breathing ;  the  renewal  of  the  blood  and  the  taking  of 
impurities  out  of  it ;  the  warming  of  the  body  ;  and  the  finishing  uj) 
of  the  process  of  digestion,  and  the  change  of  chyle  into  nutritive 
blood. 

There  is  no  good  reason  for  attempting  here  to  explain  the  last  of 
these  objects.  To  give  any  idea  of  the  first  two,  it  is  necessary  to 
funiish  a  very  brief  explanation  of  the  circulation  of  the  blood. 

The  heart  is  double.  There  are  in  fact  two  hearts,  a  right  and  a 
left,  joined  together.  The  right  heart  receives  the  blood  from  the 
veins,  and  forces  it  up  into  the  lungs,  whence  it  is  brought  back  to 
the  left  heart,  and  by  this  is  driven  through  the  arteries  into  e  v^ery 
part  of  the  body.  When  received  into  the  lungs,  the  blood  is  cf  a 
dark  purple  color,  and  is  loaded  with  carl)onic  acid  and  some  other 
impurities.  It  has  also  l)een  deprived,  during  its  circulation  through 
the  l)ody,  of  most  of  its  oxygen.  The  small,  delicate  vessels  which 
convey  this  dark  and  impure  blood  through  the  lungs,  pass  directly 
over  the  air-cells ;  and  at  this  moment  the  carbonic  acid  and  water 
pass  through  the  blood-vessels  and  air-cells,  and  are  borne  from  the 

body  on  the  outgoing  breath ;  while  the  oxy- 
gen enters  the  blood  through  the  walls  of  the 
same  vessels ;  and  this  exchange,  which  takes 
place  with  every  breath,  alters  the  blood  from 
a  dark  purple  to  a  scarlet  red.  Fig.  71 
shows  at  1,  a  bronchial  tube  divided  into  three 
branches ;  2,  2,  2,  are  air-cells ;  3,  branches  of 
the  pulmonary  artery  winding  around  the  air- 
cells  with  the  dark  blood  to  be  reddened. 

That  carbonic  acid  and  water  are  borne  out  of  the  lungs  with  every 
breath,  may  be  esisily  proved.  If  we  breathe  into  limo-water,  it  will 
become  white.  This  is  owing  to  the  carbonic  acid  in  the  breath  unit- 
ing with  the  lime,  and  producing  carbonate  of  lime.  Then,  if  we 
breathe  upon  a  piece  of  glass,  it  becomes  wet,  showing  that  there  is 
watery  vapor  in  the  breath.  That  the  blood  receives  oxygen  from 
the  air  we  breathe  is  proved  by  the  fact  that  the  ingoing  breath  has 
one-fourth  more  oxygen  in  it  than  the  outgoing. 

The  lungs,  then,  take  out  of  all  the  air  we  breathe,  one-fourth  of 
its  oxygen.  If  we  breathe  it  over  a  second,  a  third,  and  a  fourth 
time,  it  not  only  has  less  oxygen  each  time,  and  is  less  useful  for  the 
purposes  of  respiration,  but  it  becomes  positively  hurtful  by  rea- 
son of  the  poisonous  carbonic  acid  which,  at  every  outgoing  breath, 
it  carries  with  it  from  the  lungs. 

Effect  of  Sleeping  in  a  Small  Room. —  Now,  consider  the  effect  of 


Fro.  71. 


114 


HTOIBNE. 


sleeping  in  a  small  room,  seven  feet  by  nine,  not  furnished  with  the 
means  of  ventilation.  A  pair  of  lungs,  of  ordinary  size,  take  in,  at 
each  breath,  about  a  pint  of  air.  Out  of  this  air  one-fourth  of  its 
oxygen  is  extracted ;  and  when  it  is  returned  from  the  lungs,  there 
comes  along  with  it  about  eight  or  nine  per  cent  of  carbonic  acid. 
As  it  is  not  safe  to  breathe  air  containing  more  than  three  or  four 
per  cent  of  this  gas,  the  pint  which  the  lungs  take  in  and  throw  out 
at  each  breath  is  not  only  spoiled,  but  it  spoils  something  more  than 
another  pint  with  which  it  mingles ;  and  as  the  breatli  is  drawn  in 
and  thrown  out  about  eighteen  times  per  minute,  not  less  than  four 
culjic  feet  of  air  is  spoiled  in  that  time  by  one  pair  of  Ivmgs.  This  is 
two  hundred  '••■id  forty  feet  an  hour  ;  and  in  eight  hours,  the  usual 
time  spent  iU  L  .e  sleeping  room,  it  amounts  to  one  thousand  nine 
hundred  and  twenty  cubic  feet.  During  the  hours  of  sleep,  therefore, 
one  pair  of  luags  «o  %poil  one  thousand  nine  hundred  and  twenty 
cubic  feet  of  air        ;  it  is  positively  dangerous  to  breathe  it. 

In  a  room  seven  feet  by  ten,  and  eight  feet  liigh,  there  are  five 
hundred  and  sixty  cubic  feet  of  air,  a  little  more  than  one-quarter 
the  amount  spoiled  by  one  pair  of  lungs  during  sleeping  hours.  In 
a  room  of  this  size,  there  is  not  air  enough  to  last  one  person  three 
yhours  ;  and  yet  two  persons  often  remain  in  such  rooms  eight  or  nine 
hours. 

Why  then  do  they  not  perish  ?  Simply  because  no  room  is  entirely 
air-tight.  Fortunately,  all  our  rooms  are  ;^o  made  that  some  foul  air 
will  get  out,  and  a  little  that  is  pure  will  find  its  way  in.  Were  it 
not  80,  no  man  who  closed  the  door  behind  hir.i,  for  the  night,  in  a  small 
bed-^oom,  would  ever  see  a  return  of  day 

Suppose  fifty  children  are  confined  in  an  urventilated  school-room, 
twenty  feet  by  thirty,  and  ten  feet  high.  These  children  will  spoil 
about  one  hundred  and  fifty  feet  of  air  in  one  minute,  or  nine  thou- 
sand feet  per  hour,  or  ttventy-seven  thousand  feet  in  three  hours,  —  a 
usual  half -day's  session.  But  the  room  holds  only  six  thousand  o-uhic 
feet  of  air, —  the  whole  of  which  these  children  would  spoil  in  forty 
minutes. 

These  simple  facts  show  the  absolute  necessity  of  ventUation.  Yet 
ho\v  poorly  it  is  provided  for  in  our  sleeping  rooms,  our  sitting  rooms, 
our  school  houses,  our  churches,  our  court  houses,  our  halls  of  legis- 
lation, and  even  in  our  anatomical  and  medical  lecture-rooms ! 

In  sick-rooms,  ventilation  sfiould  receive  special  attention.— 

Every  disease  is  aggravated  by  the  breathing  of  bad  air.  Yet  it  is 
common  to  close  all  the  doors  and  windows  of  rooms  where  sick  per- 
sons are  confined,  lest  the  patients  should  take  cold.  This  is  a  bad 
practice.  The  sick  should  have  plenty  of  fresh  air.  Their  comfort 
is  promoted  by  it,  and  their  recovery  hastened. 

It  is  strange  that  human  beings  sliould  be  afraid  of  pure  air.  It 
is  their  friend  and  not  their  enemy.  Impure  air  only  should  be 
shunned. 


.:X' 


■-  aUai.T-*-- 


HYGIENE. 


115 


The  supply  of  good  air  ample. —  There  is  no  necessity  for  breath- 
ing air  which  has  lost  a  part  of  its  oxygen,  and  acquired  a  portion  of 
carbonic  acid.  The  supply  of  good  air  is  ample.  An  ocean  of  it 
forty-five  miles  deep,  covering  the  whole  glote,  seems  a  pretty  plain 
intimation  that  it  is  not  to  Ix)  sparingly  used.  When  men  retire 
within  their  dwellings,  and  attempt  to  shut  out  this  great  sea  of  air, 
they  show  about  as  much  wisdom  as  would  be  exhibited  by  fishes 
which  should  build  water-tight  huts  around  themselves  at  the  bottom 
of  the  ocean,  and  swim  about  continually  in  the  unchanged  water 
within.  Fishes  can  ordy  live  in  glass  globes  when  the  water  is 
changed  every  day ;  and  if  the  water  be  changed  half  a  dozen  times 
a  day,  they  cannot  be  as  healthy  as  when  swimming  in  the  great 
ocean. 

Cultivating;  Trees. —  In  most  of  our  cities  there  is  almost  a  crimi- 
nal neglect  of  the  cultivation  of  trees ;  yet  they  add  greatly  to  the 
health,  and  prolong  the  lives  of  the  citizens. 

The  leaves  of  a  tree  are  the  lungs  with  which  it  breathes  ;  but  in- 
stead of  extracting  oxygen  from  the  air,  and  giving  back  carbonic 
acid,  like  man,  it  takes  only  the  poisonous  carboni-j  acid,  and  gives 
back  oxygen. 

Were  there  no  animals  on  the  globe,  the  vegetables  would  con- 
sume all  the  carbonic  acid,  and  die  for  v  ant  of  breathing  material ; 
on  the  other  hand,  were  there  no  trees  or  other  vegetables,  the  ani- 
mals would  in  time  so  far  exhaust  the  oxygen  as  to  perish  for  lack 
of  it.     The  two  together  keep  the  air  healthy  for  each. 

The  relation  of  plants  and  animals,  in  all  that  relates  to  their 
peculiar  actions  and  effects,  is  a  complete  antagonism.  Their  move- 
ments are  in  contrary  directions,  and  by  hostile  forces.  Their  oppos- 
ing actions  may  be  illustrated  thus  :  — 

The  ATTiMAii  ooNSTmBS  the  non-nl- 
trogenized  substances,  sugar,  starch, 
and  gum. 

The  animal  peoditcbs  carbonic  acid. 


The  vegetable  produces  the  non- 
nitrogenized  substances,  sugar,  starch, 
and  gum. 

The  vegetable  decomposes  carbonic 
acid,  water,  and  ammoniacal  saits. 

The  yeqbtable  disengages  oxygen. 

The  vegetable  absorbs  heat  and 
electricity. 

The  vegetable  is  a  de-oxidizer. 

The  vegetable  is  stationary. 


water,  and  ammoniacal  salts. 

The  animal  absorbs  oxygen. 

The  animal   produces  heat 
electricity. 

The  animal  is  an  oxidizer. 

The  animal  is  locomotive. 


and 


We  learn  from  the  facts  of  Geology  that  the  time  was  in  the  his- 
tory of  our  globe,  when  lunged  animals  could  not  breathe  its  atmos- 
phere ;  it  was  too  much  loaded  with  carbonic  acid.  The  trees  then 
grew  with  a  rapidity  almost  incoTiceivable,  decomposing  the  poison- 
ous gas,  taking  to  themselves  the  carbon  and  setting  the  oxygen 
free,  and  lifting  up  their  brawny  ar*  s  to  heaven  in  acts  of  thankful- 
ness for  the  great  feast. 

At  length  the  noxious  gas  was  exhausted  \  and  then,  pale  and 
sickly,  they  feebly  held  up  their  hands  for  help ,  and  God  sent  num- 
berless tribes  of  warm-blooded  uaimals,  full  of  life  and  energy,  that 


116 


HYGIENE. 


tl 


1 


I 


and  carefully 
Ever}'^  narrow 
absence,  thou- 


sported  in  the  exhilarating  air,  anu  destroyed  vast  forests,  thereby 
reproducing  carbonic  acid. 

These  simple  facts  should  teach  man  the  sanitary  importance  of 
trees  and  bushes ;  and  wherever  he  has  a  rod,  I  had  almost  said  a 
foot  of  ground  to  spare,  a  tree  should  be  planted 
nursed.  This  is  particularly  necessary  in  large  cities, 
street  in  a  city  should  be  lined  with  trees.  For  their 
sands  of  men,  women,  and  children  have  died  sooner  than  they 
otherwise  would.  We  want  them  stretching  up  their  arms  to  all 
our  windows  to  give  us  oxygen,  and  to  take  to  themselves  the  car- 
bonic acid  we  exhale. 

Tight  Dresses.  —  The  health  may  be  injured  by  not  breathing  air 
enough,  as  well  as  by  inhaling  that  which  is  impure.  It  is  therefore 
improper  to  compress  the  lungs  by  wearing  tight  dresses.  If  the 
ribs  are  held  down  by  the  dress,  but  little  air  can  get  into  the  lungs, 
and  only  a  small  amount  of  carbonic  acid  can  be  carried  out.  In 
this  event,  the  health  is  injured  in  two  ways :  the  blood  is  not  vital- 
ized by  oxygen  received,  and  it  is  poisoned  by  carbonic  acid  retained. 

Tight  lacing  has  in  a  measure  gone  out  of  fashion  ;  yet  too  much 
of  it  for  the  best  development  of  female  health  is  yet  retained.  As 
a  knowledge  of  physiology  and  the  laws  of  life,  and  a  better  judg- 
ment of  the  true  symmetry  of  the  female  form  prevail,  this  barbar- 
ous custom  will  pass  out  of  use,  and  the  substantial  health  and 
real  beauty  of  the  American  woman  will  together  rise  to  a  higher 
standard. 

Fill  the  Lungs  well.  —  Persons  who  take  but  little  exercise  are 
apt  to  acquire  the  habit  of  drawing  the  air  very  little  into  the  lower 
part  of  the  lungs.  This'  should  be  counteracted  by  taking  long  and 
full  inspirations  for  a  short  time,  every  day,  while  in  the  open  air. 
This  practice  would  get  the  lungs  in  the  habit  of  opening  to  the  air 
quite  down  to  their  base,  and  would  make  the  breathing  much  more 
natural  as  well  as  effectual  at  all  times.  In  the  case  of  young  per- 
sons, it  would  enlarge  the  capacity  of  the  chest,  and  add  to  the  brief 
years  of  life.  Parents  should  see  to  it  that  their  children  spend 
from  ten  to  twenty-five  minutes  every  morning  inflating  their  lungs 
with  pure  air. 

Travelling. 

It  is  true  that  many  persons  who  dwell  in  one  spot,  and  hardly 
move  from  it  all  their  lives,  live  to  old  age.  Yet  change  of  location 
for  a  short  time,  or  permanently,  does  promote  health,  and  protract 
life.  The  mind  tires  of  contemplating  one  set  of  objects  for  a  great 
length  of  time ;  and  in  the  absence  of  all  stimulation,  it  sinks  into 
apathy,  and  imparts  no  energy  to  the  body.  The  physical  frame, 
partaking  of  the  ennui  of  the  mind,  droops.  This  is  doubly  true 
when  one  is  suffering  from  illness. 


HYGIENE. 


117 


Travelling  is  eminently  fitted  to  chaw  the  thoughts  of  the  nervous 
and  feeble  from  themselves,  and  to  turn  them  with  interest  to  out- 
ward objects.  This  is  of  great  importance.  It  is  better  than  stimu- 
lants and  tonics. 

The  nervous  system  has  great  power  over  the  health;  and  the 
pleasurable  sensations,  excited  by  visiting  new  places  and  scenes, 
and  conveyed  to  the  mind  through  the  nerves,  often  awaken  in  the 
constitution  energies  which  are  essential  to  recovery. 

Travelling  places  a  man  in  entirely  new  circumstances.  It  sur- 
rounds him  with  novelties,  every  one  of  which  makes  a  demand  upon 
his  attention.  It  breaks  up  his  old  trains  of  thought,  which  have 
been  monotonous  so  long  that  they  have  grown  oppressive.  It 
3au8e8  the  world  to  touch  him  at  a  thousand  new  points,  and  sur- 
prises him  every  day,  perhaps  every  hour,  with  a  view  of  the  false 
relations  he  has  sustained  to  it.  It  opens  to  him  new  depths  in  his 
own  nature,  and  causes  him  to  wonder  that  they  never  attracted  his 
attepoion  before.  It  opens  to  him  one  door  after  another,  leading 
him  into  new  apartments  of  knowledge ;  and  as  the  world  grows,  he 
finds  himself  growing  with  it,  until  his  whole  nature  dilates  and 
beats  with  new  life. 

Means  of  Travelling  Increased.  —  The  last  twenty-five  years 
have  greatly  increased  the  facilities  for  travelling.  Many  of  the 
sick  may  now  seek  health  in  distant  lands,  who,  had  their  circum- 
stances been  similar  twedty  years  ago,  would  have  been  compelled 
to  pine  at  home.  The  railroads  give  an  easy  journey  to  thousands 
with  the  comforts  of  the  parlor  cars. 

One  thing  more  wanted.  —  But  one  thing  is  wanted  to  bring  the 
means  of  travelling,  for  the  sick,  very  nearly  to  perfection ;  it  is  a 
method  of  propelling  carriages  upon  common  roads,  by  some  cheap 
power,  which  can  never  be  exhausted,  and  which  shall  be  easily  man- 
aged by  the  traveller  or  his  companion.  This  is  a  prominent  want 
of  the  present  hour ;  a  giant  discovery,  which,  at  a  single  stride, 
would  cany  the  world  forward  a  hundred  years,  and  which,  we  may 
hope,  is  in  the  womb  of  the  near  future.  The  power,  it  is  believed, 
will  be  electro-magnetism.  The  mode  of  applying  it,  when  discovered, 
will  be  simple,  yet  wonderful ;  and  the  results  to  the  sick,  beneficent 
beyond  expression.  The  human  mind  cannot  conceive  the  advan- 
tages which  invalids  would  derive  from  such  a  mode  of  conveyance. 
Journeys  might  be  long  or  short ;  might  be  made  with  any  rate  of 
speed  which  the  strength  permitted.  The  morning  or  afternoon 
stages  might  be  discontinued  when  fatigue  demanded,  and  resumed 
at  pleasure.  Over  uninviting  regions  the  traveller  might  gli'de 
swiftly,  and  linger  where  Nature  spreads  her  feasts  for  the  mind. 

The  best  Seasonsfor  Travelling  are  spring  and  autumn.  Win- 
ter is  too  cold.  A  pleasurable  excursion  may  sometimes  be  made  in 
summer,  but  in  general  the  season  is  too  hot  for  comfort.     In  chang- 


iHri 


118 


HYGIRNE. 


ing  climate,  food,  water,  etc.,  in  the  stiltry  seaHon,  there  is  danger  of 
contracting  very  troublesome  bowel  complaints. 

Means  of  Travelling  for  the  Poor.  —  There  is  one  painful  thought 
connected  with  travelling  as  a  means  of  health,  —  it  cannot  be  en- 
j'»yed  by  the  poor.  When  sick  they  generally  have  the  careful 
attention  of  humane  physicians ;  they  receive  from  kind  neighbors 
little  delicacies  of  food  and  drink ;  they  are  watched  witli  by  night, 
and  visited  by  day  ;  but  though  suffering  from  the  hard  routine  of 
a  laborious  life,  and  needing  diversion  and  recreation  more  than  all 
else,  they  cannot  travel.  They  have  not  the  means,  and  nobody 
thinks  of  supplying  them  for  such  a  purpose. 

This  is  a  channel  into  which  charity  ought  to  pour  some  of  its 
benevolent  streams.  In  large  cities  there  is  a  class  of  poor  females 
who  sit  in  their  small  rooms  and  ply  the  needle  diligently  through 
the  whole  year,  and  who  run  down  every  summer  very  near  to  con- 
finement in  bed.  Two  or  tlu-ee  weeks,  in  the  hot  season,  spent  in 
travelling  in  the  mountains  and  elsewhere,  would  bring  back  the 
color  to  the  pale  cheeks  of  such  persons,  and  save  them  many  years 
both  from  the  grave  and  from  the  almshouse.  No  millionaire  could 
make  a  better  use  of  property  than  to  set  it  apart,  at  his  death,  for 
the  specific  purpose  of  enabling  the  poor  to  travel.  And  if  this 
suggestion  should  induce  one  rich  man  to  consecrate  his  wealth  to 
the  Godlike  work  of  bestowing  health,  happiness,  and  intelligence 
upon  the  poor,  the  great  labor  of  preparing'  this  book  will  not  have 
been  endured  in  vain. 

Amusements. 

That  which  engages  the  mind,  and  at  the  same  time  impresses  it 
with  pleasurable  sensations,  is  a  sufficiently  accurate  definition  of 
amusement.  Whatever  occupies  the  thoughts  and  senses  in  an 
agreeable  way,  and  employs  them  with  some  degree  of  intensity, 
comes  under  the  same  head. 

This  broad  and  general  definition  allovra  us  to  disregard  our  daily 
employments  as  amusements  when  they  engage  our  deep  attention 
and  at  the  same  time  give  us  pleasure. 

The  term  "  amusements,"  however,  in  the  more  popular  sense,  is 
restricted  to  those  sports,  games,  plays,  exhibitions,  entertaimaents, 
etc.,  which  involve  a  mspension  of  our  daily  labors,  and  are  properly 
called  diversions. 

When  nature  is  tired  and  worn  with  those  severe  and  exhausting 
toils  by  which  we  earn  our  bread,  amusements  turn  us  aside,  divert 
us,  engage  other  powers,  and  allow  our  tired  faculties  to  rest.  They 
are,  therefore,  of  very  great  importance.  Even  the  most  trifling 
amusements  may  have  the  highest  value.  Their  very  nature  and 
object  imply  that  they  will  be  valuable  just  in  proportion  as  they 
divert  and  rest  us.  And  just  in  proportion  as  they  do  these  thinori^, 
they  give  us  health. 


HYCIENR. 


119 


One  other  thing  amusements  do  for  us,  which  must  not  be  forgot- 
ten ;  they  preserve  in  us,  in  middle  life,  and  even  in  old  age,  the 
warm  simplicity  of  childhood.  They  keep  us  young  in  our  disposi- 
tions and  feelings.  They  keep  us  in  harmony  with  nature,  and  con- 
sequently artless  and  truthful.  They  prevent  the  formalities  of  con- 
ventional life  from  stiffening  us  into  cold  and  repulsive  hypocrites. 

Selection  of  Amusements.  —  Of  course  the  same  amusements  are 
not  adapted  to  all  persons.  The  farmer  who  has  worked  his  muscles 
all  day,  would  not  be  benefited  by  a  game  of  ball  in  the  evening ; 
yet  there  are  few  games  more  suitable  for  the  student  who  has  bent 
for  many  hours  over  his  books.  Care  should  always  be  taken,  there- 
fore, that  amusements  or  sports  do  not  bear  upon  those  limbs  or 
faculties  which  are  wearied  by  work. 

Amusements  improve  various  faculties.  —  To  one  who  haa  a 

taste  for  art,  who  is  fond  of  works  of  genius  and  poetry,  theatrical 
entertainments  will  always  be  agreeable,  and  a  source  of  gratification 
and  health.  I  know  these  exhibitions  are  objected  to  by  many  as 
immoral  and  hurtful,  but  more,  I  think,  from  habit  and  fashion,  than 
upon  any  solid  grounds  of  reason  or  religion.  They  certainly  appeal 
to  a  high  order  of  faculties  in  the  human  mind ;  and  to  those  who 
are  fitted  to  receive  them,  teach  lessons  of  great  moment.  Even  the 
lower  exhibitions  of  comedy,  though  not  particularly  improving  to 
the  mind,  are  yet,  from  their  power  to  provoke  laughter^  among  the 
most  powerful  up-builders  of  health. 

Tlie  Games  of  Wtiist,  Euchre,  etc.,  engage  the  minds  of  the  play- 
ers in  a  sort  of  mental  contest,  which  is  exciting,  agreeable,  and 
health-imparting.  These  games  make  us  skilful  in  calculating 
chances,  and  judging  how  men  ought  to  act  under  certain  contin- 
gencies. They  make  us  sharp  to  detect  and  turn  aside  the  unseen 
forces,  which  tend  to  oppose  and  destroy  our  success  in  life. 

I  hardly  need  to  say  that  money  or  rather  property  should  never 
be  staked  upon  a  game  of  cards,  or  upon  any  other  game.  Gambling 
is  one  of  the  meanest  as  well  as  most  destructive  things  in  which  men 
can  engage.  It  raises  the  healthful  excitement  of  these  innocent 
amusements,  —  innocent  when  prope  'v  pursued,  —  into  raging  pas- 
sions, which,  when  defeat  comes,  as  curae  it  will,  sink  into  remorse 
and  bitterness  as  terrible  as  the  mind  can  conceive.  I  warn  young 
men,  as  they  would  escape  the  pangs  of  a  hell  on  earth,  and  the  loss 
of  character,  happiness,  and  probably  health  for  life,  to  avoid  any 
such  abuse  of  cards. 

Chess,  Chequers,  etc.,  appeal  likewise  to  the  fondness  of  competi- 
tion, which  is  common  to  all  men.  But  they  cultivate  in  us  a  little 
more  of  the  mathematical  element.  As  they  require  very  close  appli- 
cation of  the  mind,  they  are  not  suitable  for  persons  of  sedentary  em- 
ployments, or  whose  daily  avocations  require  a  constant  use  of  the 


120 


Hy«)IKNK. 


II 

ij 


mind.     Such  persniiH  hIioiiM  cliooHe  lighter  and  more  active  amuse- 
raente. 

Lighter  Amusements. —  Beside  these  higher  amusements,  there 
are  a  great  number  of  lighter  and  more  childish  ones,  which  should 
not  be  overlooked. 

Some  of  these  are  merely  physical,  involving  a  trial  of  strength, 
fleetness,  action,  etc.,  as  the  games  of  ball,  cricket,  etc.  Othera  are 
domestic  in  their  nature,  involving  mirth,  and  various  other  of  the 
lighter  excitements,  as  blind-man's  buff,  puss  in  the  corner,  hole  in  the 
wall,  fox  and  geese,  hunt  the  slipper,  hurly-burly,  roll  the  platter,  etc. 

In  fashionable  American  households,  these  simple  domestic  plays 
have  in  a  great  measure  gone  out  of  use, —  being  deemed  vulgar,  and 
below  the  dignity  of  ladies  and  gentlemen.  I  am  sorry  to  say  this; 
for  the  vulgarity,  in  my  judgment,  is  in  those  \.  ho  reject  them,  and 
not  in  the  play. 

The  oflBcer  of  our  navy,  whose  visit  to  the  mansion  of  Lord  Hard- 
wick  I  have  spoken  of  on  page  93,  reports  that  on  the  evening  of  one 
of  his  visits,  the  ])lay  of  blind-man's  buff  was  engaged  in  by  the  whole 
party ;  and  that  his  Lordship  in  attempting  to  make  a  short,  tfrn  dur- 
ing the  play  fell  upon  his  back,  when  one  of  his  daughters,  who  was 
blinded,  caught  him  by  the  heels,  and  being  assisted  by  others,  drew 
him  feet-foremost  half  the  length  of  the  hall,  amid  the  shouts  of  the 
whole  party.  This  would  have  been  deemed  very  vulgar  by  fashion- 
able people  in  this  country.  But  to  me,  who  am  no  believer  in  any 
nobility  which  Lord  Hardwick  can  receive  from  kingp  or  queens,  this 
simple  naiTative  raised  him  at  once  to  a  peerage  in  nature's  realm. 
Without  doubt,  he  is  one  of  nature's  noblemen.  A  man  in  his  sta- 
tion, and  with  his  wealth  and  temptations  to  snobbery,  who  can  pre- 
serve such  simplicity  of  character,  must  have  a  warm  as  well  as  a 
noble  heart  in  his  breast. 

Value  of  Domestic  Amusements. —  I  remark  here  that,  in  all  our 
amusements,  we  should,  as  far  as  possible,  seek  those  of  a  domestic 
character.  They  are  more  simple  and  childlike  in  their  nature,  and 
preserve  in  us,  even  to  old  age,  the  freshness  of  feeling,  and  truthful 
simplicity,  which  spread  so  beautiful  a  greenness  over  the  autumn  of 
life. 

Simple  domestic  amusements,  too,  are  always  gotten  up  on  a  cheap 
scale;  they  do  not  encourage  costly  extravagance,  and  can  be  in- 
dulged in  by  the  poor  as  well  as  the  rich. 

But  more,  and  better  than  all,  they  keep  young  men  and  old  men, 
and  young  women  and  old  women,  at  home,  by  making  the  domestic 
circle  the  centre  of  attraction.  They  draw  the  seekers  of  pleasure 
around  the  hearth-stone,  instead  of  outward  in  the  world.  They  in- 
cline young  and  old  to  look  to  the  family  circle  as  the  centre  of  the 
most  pure,  because  the  most  simple  and  natural,  enjoyments.  They 
teach  us  to  look  to  home  as  the  centre  of  life,  and  to  all  outside  as 
onlj  its  appendages. 


-'Hif-i'-:-vMujjeiri, 


mmmsi^^^i^^ 


HYGIKNK. 


121 


It.  has  been  said  that  homeg  are  found  only  in  England;  that  in 
(itlier  countries,  life  wanders,  houseless  and  shelterless,  abroad,  seek- 
ing happiness,  it  knows  not  where,  while  in  England  it  nestles  warmly 
in  the  bosom  of  home.  To  whatever  extent  this  is  true, —  and  I  be- 
lieve there  is  truth  in  it, —  it  is  owing  to  the  simple  household  amuse- 
ments of  England. 

An  American  Want. —  One  of  the  great  wants  of  this  country  is  a 
more  liberal  provision  for  amusements.  We  attach  here  too  much 
value  to  wealth ;  and  we  pursue  it  with  an  intensity  altogether  in- 
compatible with  health.  We  cannot  take  time  for  recreation  because 
we  are  in  so  great  a  hurry  to  be  rich. 

If  we  would  save  ourselves  from  a  total  wreck  of  health,  we  must 
tako  broader  and  better  views  of  life.  We  must  value  it  for  its  solid 
comforts,  rather  than  for  its  glitter  and  show. 

Contrary  to  the  general  belief,  insanity  is  very  prevalent  among 
seamen  and  farmers.  The  former  lead  a  life  of  dreary  solitude  upon 
the  ocean ;  the  latter,  one,  if  not  of  equal,  certainly  of  very  objection- 
able solitude  upon  the  land.  The  sailor  who  does  business  upon  the 
great  sea  should  provide  himself  with  great  numbers  of  games  to 
amuse  hira  in  his  wanderings.  The  farmers  of  our  land  should  cul- 
tivate more  of  the  sociabilities  of  life.  Let  them  meet  together  in 
the  fine  summer  evenings,  like  the  peasants  of  France,  and  dance 
upon  the  green  lawns  before  their  cottages.  They  will  till  their  lands 
more  cheerfully  for  it ;  enjoy  better-  spirita  and  health ;  and  live  to 
greater  age. 

Completeness  of  Life.  —  Amusements  are  necessary  in  order  to 
give  a  completeness  to  life.  The  faculties  of  the  human  mind  are 
numerous.  It  is  only  when  they  are  all  exercised,  in  their  due  pro- 
portion, that  there  is  a  harmonious  beauty  in  our  lives.  The  cus- 
toms of  society  twist  us  all  out  of  shape,  —  perverting  us  mentally, 
morally,  and  physically,  and  robbing  us  of  every  maidy  and  health- 
ful quality.  Getting  out  of  the  ruts  of  fashionable  life,  we  must 
come  back  to  the  simple  paths  of  nature. 

I  would  strongly  impress  upon  parents,  teachers,  and  guardians, 
the  importance  of  studying  well  the  various  temperaments,  physical 
and  mental  peculiarities  of  their  children,  in  order  to  judge  wisely 
of  the  kind  and  amount  of  recreation  required  by  them. 

Instance  :  a  pale,  delicate  child  of  ten  to  twelve  or  fourteen  years, 
with  clear  complexion,  flaxen  hair,  blue  eyes,  slender  frame,  and'  a 
nervous,  sensitive  organization,  with  strong  mental  cast,  requires 
much  more  recreation  and  out-door  exercise  than  a  full-blooded, 
robust  child  of  that  age ;  a  fact  not  at  present  duly  considered,  as  a 
general  thing. 


fl3E7tSS?^SS^?? 


>U^.'>*^i«»^KiS^*l»*«'*' 


TEMPEBAMENT8,  CONSTITUTION,  AND 

SYMPTOMS. 


Man  has  thinking^  wanning,  nourishing^  and  moving  powers.  For 
the  performance  of  each  of  these  great  functions,  he  has  organs  of 
the  best  possible  construction. 

For  Thinking,  he  has  a  brain.  If  this  be  large  in  proportion  to  his 
other  organs,  it  gives  a  character,  a  cast,  a  peculiarity  to  his  whole 
organization.  Everything  about  him  is  subordinate  to  his  brain. 
We  recognize  him,  at  once,  as  a  thinking  and  feeling  being.  He 
has  an  intellectual  look.  There  is  a  delicacy,  a  refinement,  a  sensi- 
tiveness, a  studious  habit,  an  air  of  thoughtfulness  about  him,  which 
determine  his  traits,  his  tone,  his  temper,  his  whole  character.  Hence 
it  is  proper  to  say  he  has  a  cephalic  or  thinking  temperament. 

The  Lungs  and  Heart,  devoted  to  renewing  and  circulating  the 
blood,  are  placed  in  the  chest  or  thorax.  If  these  be  large  in  man  in 
proportion  to  other  organs,  he  is  characterized  by  great  activity  of  cir- 
culation, by  a  large  supply  of  red  blood,  and  by  the  general  indica- 
tions of  a  full,  warm,  and  bounding  life.  This  activity  gives  him 
his  tone  and  temper,  and  shows  that  his  is  the  thoracic  or  calorific 
temperament. 

In  the  Great  Cavity  of  the  Abdomen  is  done  the  work  of  receiv- 
ing, digesting,  and  disposing  of  the  materials  which  nourish  the  body. 
If  the  organs  which  do  this  work  be  large  in  proportion  to  others,  the 
body  is  fed  to  repletion,  and  the  whole  organization  speaks  of  the 
table.  The  habit,  the  look,  the  temper,  are  ell  sluggish.  This  is  the 
abdominal  or  alimentary  temperament. 

The  Bones  and  Muscles  are  instruments  by  which  the  movements 
of  the  body  are  performed.  If  these  be  the  largest,  in  proportion,  of 
any  in  the  body,  then  the  locomotive  powers  are  in  higher  perfection 
than  any  others.  There  is  largeness  'of  person,  energy  of  movement, 
and  greatness  of  endurance.  The  whole  cast  of  the  person  partakes 
of  the  strength  and  coarseness  of  bone  and  muscle.  This  is  the 
muscular  or  locomotive  temperament. 

This  gives  us  four  temperaments,  as  follows :  — 

I.  The  Cephalic  Temperament,  denoted  by  large  brain,  activity  of 
mind,  and  general  delicacy  of  organization. 

122 


-T 


TEMPERAMENTS,  CONSTITUTION,  AND  SYMPTOMS. 


123 


,  AND 


•wers.    For 
1  organs  of 

jrtion  to  his 
)  his  whole 
his  brain, 
being.  He 
snt,  a  sensi- 
him,  which 
iT.  Hence 
It. 

ilating  the 
in  man  in 
vity  of  cir- 
iral  indica- 
gives  him 
or  calorific 

of  receiv- 
L  the  body. 
others,  the 
iks  of  the 
Fhi^  is  the 


movements 
portion,  of 
perfection 
novenient, 
n  partakes 
his  is  the 


ictivity  of 


II.  The  Thoracic  Temperament,  indicated  by  a  large  chest,  force 
of  circulation,  redness  of  skin,  great  activity,  warmth  of  temper, 
and  fulness  of  life. 

III.  The  Abdominal  Temperament,  denoted  by  a  large  develop- 
ment of  the  stomach,  liver,  bowels,  and  lymphatics;  by  a  fulness  of 
l)elly,  fondness  of  high  living,  and  a  disposition  to  float  sluggishly 
upon  the  current  of  the  world,  rather  than  to  struggle  against  it. 

IV.  The  Muscular  Temperament,  indicated  by  largeness  of  frame 
and  limbs,  coarseness  of  structure,  and  great  power  of  locomotion 
and  endurance. 

There  are  some  reasons  for  reckoning  but  three  temperaments  in- 
stead of  four,  by  reducing  the  thoracic  and  abdox  mal  to  one,  after 
the  manner  of  the  phrenological  Fowlers,  —  especially  as  the  organs 
in  the  chest,  and  their  appendages,  take  an  important  part  in  the 
process  of  nutrition.  But  as  the  heart  and  lungs  are  placed  in  one 
cavity,  and  the  stomach,  liver,  etc.,  in  another,  and  as  one  set  of 
these  organs  may  be  largely  developed,  and  the  other  defectively,  I 
have  thought  it  most  convenient,  on  the  whole,  and  quite  as  philo- 
sophical, to  letain  the  four  temperaments. 

These  temperaments  seldo.a  or  never  appear  single  and  pure. 
They  mix  and  cross  with  each  other  in  all  possible  ways. 

Medication  and  Temperaments. 

The  object  of  speaking  of  temperaments  in  this  work  is  to  make 
the  reader  acquainted  wit£  the  principles  upon  which  remedies  are 
to  be  adapted  to  their  development.  The  philosophical-minded  phy- 
sician will,  in  prescribing,  always  keep  the  temperament  in  view. 

Persons  of  a  Cephalic  Temperament  cannot  bear  powerful  medi- 
cines, —  particularly  drastic  purges.  Their  fine,  delicate  and  sensi- 
tive organizations  would  be  torn  all  to  pieces  by  doses  which  would 
hardly  be  sufficient  in  a  fully-developed  muscular  temperament. 
This  should  always  be  borne  in  mind  in  prescribing  for  persons  of  a 
large  brain  and  delicate  organization. 

In  this  temperament,  too,  fevers,  instead  of  running  a  high  and 
fiery  course,  take  the  low  typhoid  type,  the  patient  becoming  pale, 
and  showing  a  constant  tendency  to  sink.  Such  patients  would  be 
killed  by  purging,  leeching,  cupping,  sweating,  and  starving.  They 
want  tonics,  stimulants,  and  every  kind  of  support  ich  the  case 
will  possibly  permit. 

Persons  of  a  Thoracic  Temperament,  having  a  rapid  circulation, 
and  a  fulnesp  of  blood,  are  most  liable  to  inflammatory  diseases. 
When  fever  attacks  them,  they  have  what  is  called  a  "  high  fever." 
If  rheumatism  comes,  it  is  acute  rheumatism.  Disease  takes  hold  of 
them  smaHly.     As  they  do  everything  with  emphasis  and  energy 


124 


TEM'iiRAMENTS,  CONSTITUTION,   AND  SYMPTOMS. 


1.1' 


when  well,  ao,  when  ill,  they  make  a  businefls  of  it,  and  are  sick  with 
all  their  might. 

Stimulants  and  tonics  generally  make  such  persons  worse.  They 
want  sedatives,  and  diaphoretics,  and  Hweato,  and  purgatives,  and 
leeches,  and  cups,  and  low  diet,  and  cold  bathing,  and  whatever  else 
will  slacken  the  ferocious  swiftness  of  their  circulation. 

Those  of  the  Abdominal  Temperament  are  not  particularly  sub- 
ject either  to  veiy  high  fevers,  or  to  those  typhoid  forms  which 
produce  sinking.  As  in  the  two  temperaments  noticed  above,  their 
complaints  chiefly  attack  the  organs  most  largely  developed.  Their 
diseases  affect  the  stomach,  the  liver,  the  spleen,  and  the  Ixiwels. 
These  are  the  largest  organs  in  their  bodies,  and  are  most  used ;  and, 
being  overworked,  they  fall  into  disease. 

As  these  persons  are  slothful  in  all  their  habits,  so  their  diseases 
run  a  sluggish  course.  They  are  not  so  liable  to  sudden  death  as 
persons  of  either  of  the  preceding  temperaments.  They  have  all 
sorts  of  chronic  diseases  which  linger  a  great  while,  and  are  cured 
with  much  difficulty. 

These  persons  will  bear  larger  doses  of  medicine  than  either  of 
the  preceding.  Neither  do  their  constitutions  respond  as  readily  to 
medicine.  A  physician  will  be  disappointed  if  he  expects  to  see 
them  recovering  as  fast  under  its  use. 

Those  of  a  Muscular  Temperament,  having  little  fondness  for 
any  wiing  but  a  hardy,  active  life,  are  much  exposed  to  the  elements. 
Though  strong  and  long-enduring,  the  hardship  of  their  lives  often 
breaks  them  down,  and  when  felled  by  disease,  they  are  oftentimes 
shockingly  racked  and  torn  by  it. 

These  persons  bear  large  doses  of  medicine,  and  when  sick,  need 
to  be  treated  with  an  energy  proportioned  to  the  strength  of  their 
constitution.  Rheumatism,  which  affects  the  joints,  the  ligaments, 
and  the  tendons,  is  an  affection  from  which  they  suffer  severely. 


The  Constitution. 

In  prescribing  for  disease,  it  is  of  very  great  importance  to  take 
notice  of  the  constitution.  This  is  a  different  matter  from  the  tem- 
peraments. Persons  of  the  same  temperament  are  often  quite  unlike 
in  the  strength  of  their  constitution.  And  those  having  good  natural 
constitutions,  frequently  abuse  them  by  improper  habits  and  indul- 
gences, and  at  length  come  to  have  broken  and  very  feeble  consti- 
tuiidns. 

Some  persons'  muscles  and  other  tissues  are  put  together  as  if 
they  were  never  intended  to  come  apart.  Like  some  of  the  woods 
of  the  forest,  —  the  lignum  vitse  for  example, — they  are  fine-grained 
and  tough.  A  real  smart  boy  will  wear  out  an  iron  rocking-horse 
sooner  than  one  of  these  persons  can  exliaust  their  constitution  by 


TIMPKBAMBNT8,  CONSTITUTION,   AND  SYMPTOMi 


125 


e  sick  with 

rae.  They 
atives,  and 
utever  else 

iilarly  sulh 
rnis  which 
bove,  their 
3d.  Their 
!ie  lx)wel8. 
wed;  and, 

ir  diseases 
»  death  as 
f  have  all 
are  cuied 

either  of 
readily  to 
:ts  to  see 


dness  for 
elements, 
ves  often 
iftentimes 

jick,  need 
I  of  their 
igaments, 
3rely. 


e  to  take 
the  tem- 
te  unlike 
d  natural 
id  indul- 
e  consti- 

her  as  if 
le  woods 
3-grained 
ng-horse 
ution  by 


hard  work.  Otliera,  to  outward  appearance  equally  well  made,  have 
very  little  endurance,  break  dov/n  easily  under  hard  work,  and  lose 
their  flesh  from  trifling  causes. 

The  state  of  the  constitution,  therefore,  should  always  be  learned 
before  much  medicine  is  given ;  for  what  a  person  of  a  strong  con- 
stitution will  need,  may  greatly  injure  a  feeble  person,  even  of  the 
same  temperament. 

Habits.— These  must  likewise  be  attended  to.  Persons  using 
stimulants  require  larger  doses  of  medicine  to  affect  them  than  other 
persons. 

Climate.—  Medicines  act  differently  on  the  same  persons  in  sum- 
mer and  winter.  Narcotics  act  more  powerfully  in  hot  weather  and 
climates  than  in  cold,  and  must  be  given  in  smaller  doses. 

IdioAyncraAy.—  Medicines  of  only  ordinary  activity,  act  very  pow- 
erfully, and  even  violen  My  on  some  persons.  This  is  owing  to  a  pecu- 
liarity of  stomach,  or  constitution,  called  idiosyncrasy.  It  makes  the 
person,  in  this  particular,  an  exception  to  the  general  rule.  And  no 
physician  can  knv)w  beforehand  in  what  imrticulars  this  exceptional 
disposition  will  show  itself.  Persons,  however,  learn  their  own  idio- 
syncrasies, and  should  make  them  known  to  those  who  prescribe  for 
them  for  the  first  time. 

Thi  Sex.— The  peculiarities  of  each  sex  should  never  be  forgotten 
in  prescribing  for  the  sick. 

Males  are  not  so  sensitive  as  females.  They  will  bear  more  medi- 
cine, and  their  nervous  system  is  not  so  readily  excited  by  it. 

Influence  of  Age.—  Human  life  is  divided  into  infancy,  childhood, 
youth,  manhood,  and  old  age.  Each  of  these  periods  has  peculiarities 
which  modify  disease. 

The  First  Period,  extending  from  birth  to  the  age  of  seven  years, 
is  marked  by  tenderness  and  excitability,  and  is  alive  to  every  "irrita- 
tion. Teething  and  other  disturbances  occur  at  this  period,  and  need 
careful  management. 

The  Second  Period  extends  from  seven  to  fourteen,  and  is  quite 
subject  to  disease,  including  the  second  dentition.  During  these  two 
periods  there  is  no  great  difference  between  the  sexes ;  both  are  ten- 
der, and  need  careful  watching. 

During  the  Third  Period,  the  changes  occur  which  mark  and  sepa- 
rate the  sexes.  This  is  a  developing  period,  when  the  functions  be- 
come established,  and  the  frame  acquires  form,  proportion,  and 
strength. 

At  this  time,  hereditary  tendencies  to  disease,  latent  till  now,  begin 
to  show  themselves,  and  call  for  every  possible  endeavor  to  break 
them  up,  and  fortify  the  constitution. 


.  -.rr^aicSBTpcfWy .31 


126 


TKMPKRAMENTS,   CONSTITUTION,   AND   HYMPTOMH. 


The  Fourth  Period  vinbroces  tliu  vigorouH  maturity  nf  life,  wlion 
the  powera  of  body  and  mind,  in  both  sexes,  are  at  the  Hutninit  of 
their  excuUunce.  The  functions  are  now  well  established.  It  Ih  dur- 
ing this  periwl  that  the  female  is  siibjeut  to  most  of  the  ImniNNin^ 
ailments  peculiar  to  her  sex.  So  numerous  are  these  complaints,  luiil 
so  large  and  valued  the  class  of  persons  uff;icted  by  them,  that  ho  who 
treats  thenj  with  the  greatest  skill,  and  with  the  delicacy  which  their 
nature  demanils,  may  be  said  to  be  ut  the  head  of  his  profession. 

The  Fifth  Period  is  that  of  old  iige,  wlien  the  functions  are  detain- 
ing, and  the  frame  is  bending  u  .der  the  weight  of  yeara.  ()ld  age 
l)egin8  earlie'"  with  females  than  with  males.  Many  ailmelits  are  com- 
mon to  this  period,  which  require  peculiar  management,  both  medi- 
cinal and  hygienic. 

Proper  Frequency  of  Dose. —  Kach  suciceeding  dose  should  Ixi 
given  before  the  effect  of  the  preceding  is  gone.  If  this  rule  is  not 
attended  to,  the  cure  does  not  advance.  What  is  gained  by  each 
dose  is  lost  by  the  rallying  of  the  disease  in  the  interval.  Care  must 
he  taken,  however,  not  to  apply  this  rule  too  strictly  with  very  active 

medicines. 

« 

How  to  Examine  a  Patient. 

When  a  patient  is  presented  for  examination,  having  observed  the 
tempemment,  constitution,  sex,  and  age, 

1.  Learn  the  causes  of  the  disease,  whether  local,  specific,  or  gen- 
eral, and  also  its  history. 

2.  Search  out  its  nature  and  character,  whether  febrile  or  other- 
wise. 

8.  Take  notice  of  the  whole  train  of  symptoms,  -^  embracing  the 
pulse,  the  condition  of  the  mouth,  tongue,  and  digestive  organs,  the 
breathing,  the  urine,  the  fecal  discharges,  the  condition  of  the  brain 
and  nervous  system,  the  state  of  the  skin,  etc. 


Brief  Table  Explanatory  of  Symptoms. 

GENERAL  APPEARANCE  OF  PATIENT. 


1.  Tonic  spaHtn  of  the  trunk 

2.  Distorted  features,  altered  pooltion, 

and  impaired  motion  of  limbs 
'■\.  Irregular  and  perpetual  motion 
4.  Entire  and  absolute  immobility 
.').  Qreat  and  unnatural  Iroldneas 
(i.  Great  and  unusual  languor 

7.  Ability  to  lie  only  upon  the  back 


8.  Lying  upon  the  face 

9.  Lying  upon  one  side 


indicates    Locked  jaws. 

"  Paralysis  of  one  side.   * 

"  St.  Vitus's  dance. 

"  Catalepsy. 

"  Insanity  or  delirium. 

"  The  beginning  of  an  acute  disease,  or 

the  progress  of  a  chronic  one. 

"  Apoplexy.  Organic  disease  of  the  brain 

or  spinal  marrow.  Acute  inflamma- 
tion of  the  lining  of  the  abdomen. 
Rheumatism  of  the  joints. 

"  Several  kinds  of  colics. 

"  Pleurisy,  or  inflammation  of  the  lungs. 

When  one  lung  only  is  affected  in 
consumption,  the  pai'.ont  generally 
lies  on  the  diseased  side. 


t^aifkoA 


TEMPERAMENTS,  C0N8TITUTI0N,   AND   HYMPT0M8. 


127 


in.  MnlnUlninK    tli«    NittlnR    poaturn  indioaton 

only 
11.  The  lieail  tlirown  bock  " 

Vi.  KflNtlflmnnm  Hiid  totMinipt  •• 

13.  Uen«nl  «nlargem     (  of  the  body  " 


DUnafin  of  tlio  lionrt  or  InnRM,  wlilrh 

interfnroH  with  br«athln|{. 
Hevere  diiieaiieMof  the  larynx  and  wlnd- 

pljMS. 

Th«  beKlnnlnp  of  acute  Indammatlon. 

Fevers.   Dellniini,  uiid  acute  inanlu. 
CelUlroimy.        Eui|ihy»enia    from    a 

wound  of  the  clinNt. 


Head,  Face,  and  Neck. 


1.  TToad  bent  to  one  Hide 


2.  Head  increasetl  in  ilze 

3.  Hwollon  Hcali) 

4.  Dull  exprexNion  of  face 

5.  Full,  red  face,  with  blood-veaaeU 

of  eyed  injected 

6.  Pinched,  contracted  countenance 

7.  I'iiiched  nose,  Hunken  even,  hollow 

tonipleH,  Hkin  of  forehead  tense 
and  dry,  complexion  livid 
H,  Wrinklefi  hvtdm  tho  forehead 
0.  Wrinkles  from  forehead,  vertically 
to  root  of  nose 

10.  A  white  line  from  inner  angle  of 

the  eye  to  just  below  the  cheek- 
liono 

11.  White  line  from  the  upper  border 

of  the  wing  of  the  nose  (ala  nasi ) , 
curved  to  the  outer  margin  of  the 
orb  of  the  oye 


12.  The  white  line  In  children  from 

angle  of  mouth  to  lower  part  of 
face 

13.  A  white  line  external  to  the  last 

two,  in  a  semicircular  direction 
towards  the  chin 

14.  Swelling  of  tlie  face  and  eyelids 

15.  Transient  redness  or  flushing  of 

face 

16.  Hectic  flush 

17.  Paleness  of  face 


18.  Dingy,  white,  or  greenish  face 

19.  Yellow  tint 

20.  A  citron  tint 

21.  A  bluish  tint 

22.  Pc-petual  motion  of  eyelids 

23.  Forcible  closure  of  eyelids 

24.  Byelidti  remaining  open 

25.  PMsy  of  the  upper  lid 

20.  Plowing  of  tears  over  the  cheek 

27.  Nostrils,  dilating  forcibly  and  rap- 

idly 

28.  ItohiQg  of  nostrils  in  oldldren 


Indicates    ConvuLiions.    Paralysis  of  oiie-half  the 

bo*ly.     Dislocation  of  hones  of  neck. 

Swelling  of  glands  of  neck. 
"  Chronic  hydropholus.  Knlarged  brain. 

"  Erysipolas.    Hmall-pox. 

"  Typhoid  fever. 

Hwolling   of    heart.       Congestion    of 

brain. 
"  Acute   Inflammation   of   peritoneum. 

Exposure  to  severe  cold. 
"  Chronic  disease  just  before  death. 

"  ExcesfllTe  pain  arising  externally. 

"  Distress,  anxiety,  and  severe  internal 

pain. 
In  children,  a  brain  or  nervous  affec- 
tion ;  in  adults,  abuse  of  the  genera- 
tive organs. 

"  In  consumption  and  wasting  -f  flesh. 

The  lower  part  of  the  line  indicates 
disease  of  stomach  ;  the  upper  part, 
some  afTection  of  upper  part  of  bowel. 
When  united  with  the  white  line 
named  above,  and  with  a  drawing  in 
of  the  cheek,  fixed  eyes,  and  a  wan 
complexion.  It  implies  worms. 

'  An  afrection  of  the  chest,  with  diffl- 

culty  of  breathing. 

"  Chronic  and  obstinate  disease  in  the 

chest  or  belly. 

"  Albumen  in  the  urine. 

"  Suffering  from  the  monthly  irregular- 

"  Consumption.    Chronic  aflfections. 

Cold  stage  of  fever.    Acute  inflamma- 
tion.     Chronic   diseases,  especially 
Bright's  disease,  during  recovery. 
A  low  and  deficient  state  of  blood. 
Jaundice. 
"  Cancerous  disease. 

"  Poor  circulation  in  the  veins.  Cholera. 

Typhus  fever.     Blue  disease. 
Mania  and  idiocy. 
"  Intolerance  or  dread  of  light. 

"  Orbicularis  palpebrarum.   Paralysis  of 

the  muscle  which  closes  the  eye. 
Injury  of  the  tliird  pair  of  nerves. 
'  Obstruction  of  the  lachrymal  duct. 

Difficulty  of  breathing. 


Worms  in  the  bowels. 


The  Tongue. 


Surface  of  tongne  covered  with  a 
layer  of  whitish,  soft,  mucous 
substance,  which  may  partially 
be  taken  off  with  a  scraper, — 
also,  clammy  mouth 


indicates    Derangement  of  stomach ,  or  bowels,  or 
both. 


128 


TBMPEBAMSNTS,  CONSTITUTION,  AND  SYMPTOMS. 

icdloates    Acute  dyspepsia.    Asthma. 
"  Severe  oases  of  acute  dyspepsia. 


3.  State  of  tongue  as  above,  with 

clammy  mouth,  bitter  taste,  and 
fetid  breath. 
8.  Oreat  load  on   tongue  as  above, 
which    pwU    off,   leaving    the 
tongue  smooth,  red  and  tender 

4.  TonKue  slightly  white  from  small 

white  pomts,  and  sometimes  cov- 
ered with  for,  like  the  fibres  of 
coarae  velvet 
6.  Tongue  pale,  tumid,  cloan  and  very 
smooth 

6.  Tongue /urred  and  dry 

7.  Tongue  white    and  loaded,  with 

much  thirst 

8.  As    above    at   first,  —  afterwards 

c/ean,  red,  and  dry 

9.  Tongue  white  and  loaded,  with  dry- 

ness 

10.  Tongue  dry,  parched,  tender,  and 

dark  brown  or  black.  Pushed  out 
with  great  difficulty  and  tremb- 
ling 

11.  Tongue  loaded  with  white,  through 

which  numerous  elongated,  very 
,  red  papillae  protrude  their  points 


Chronic  djrspepsia.    Some  affection  of 
the  liver,  if  the  fur  be  yellow. 


Chlorosis  or  green  sickness. 

Violent  local  inflammation.  Irritation 

in  bowels. 
Inflammatory  fever. 

Protracted  inflammatory  fever. 

Mild  tjrphus  fever. 

Severer  forau  of  typhus  fever. 


Scarlet  fever. 


The  Throat. 


1.  Throat  enlarged 

2.  Violent  pulsation  of  carotid  arteries 


8.  Pulsation  of  the  nameless  artery 
(arteria  innominata)  above  the 
breast  b  me,  and  to  the  right  of 
the  windpipe. 

4.  Circumscribed  swelling  about  throat 


indicates    The  approach  of  puberty  in  females. 
"  Acute  mania.   Inflammation  of  brain. 

Enlargement  of  heart,  and  dilation 
of  right  ventricle.    Anemia. 
"  Regur^tation  from  aorta. 


Enlivgement  of  glands. 


The  Chest 

1.  General  enlargement  of  one  side  of    indicates    Large  effusion  of  water  from  pleurisy, 
chest 

"  Water  from  pleurisy  settling  to  the 

bottom. 
"  Emphysema. 

"  Enlargement  of  liver. 

"  Water  in  heart-case.    Enlargement  of 

heart. 
"  Aneurism  of  the  ascending  aorta. 


2.  Bulging  at  the  base  of  a  lung 

3.  Bulging  at  front  upper  part  of  chest 

4.  BuIgingrighthypochondrium(See 

5.  Bul^iig  m  region  of  heart 

6.  Tumor  where  the  third  rib  joins  the 

breast-bone 

7.  Tumor  between  the  base  of  the 

shoulder  blade  and  the  spine 

8.  Depression  or  retraction  of  one  tide 

of  chest 

9.  Breathins  increased  in  rapidity. 

Oenerally,    in     health,     about 
twenty  breaths  aro  taken  in  a 
minute 
10.  Breathing  diminished  in  rapidity 


11.  Jerking  respiration 

12.  Breathing  with  muscles  of  ribs  only 


Aneurism  of  the  descending  aorta. 

Constmiption.      Absorption  of  fluid, 

effusea  by  pleurisy. 
Spasmodic  asthma. 


Pleurisy.  Paralysis  of  respiratory  mus- 
cles, inflammation  of  lungs.  Emphy- 
sema. Pneumothorax.  Consumption. 

Spasmodic  asthma.  Obstruc)Jon  in 
larynx  and  windpipe. 

Abdominal  inflammation.  Inflamma- 
tion of  diaphragm. 


1.  Increased  size  of  belly 


The  Belly. 

indicates  Dropsv.  Wind  in  bowels.  Inflam- 
mation of  peritoneum.  Obstruction 
in  bowels.    Hysteria. 


TEMPERAMINTS,  CONSTITUTION,   AND   SYMPTOMS. 


129 


2.  Enlargement  In  epigastrium  (FUr.  93)  indicates  Hysteria.    Cancer  of  stomach. 

3.  Enlargement  In  hypogastrium  (Pig.  96)  "  Distension  of  bladder.     Ovarian  tu- 

mors.     Accumulation  of    feces  in 
bowels 

4.  Belly  diminished  In  dze  "  Chronic  dysentery.    Lead  ooUc.    Also 

in  most  chronic  diseases, 


1.  Enlarged  penis  in  children 

2.  Drawing  up  of  testicles 

3.  Enlargement  of  scrotum 


1.  The  limbs  immovable 

2.  Limbs  contracted  and  rigid 

3.  General  swelling  of  limbs 

4.  Swelling  of  joints 

5.  Limbs  diminished  in  size 


Private  Organs. 

indicates    Stone  In  bladder.    Masturbation. 
"  Stone  In  kidneys. 

"  Hydrocele.    Hematocele.    Sarocele. 

The  Limbs. 

Indicates    Paralysis. 

"  Softening  of  the  brain. 

"  Defective  circulation  of  blood. 

"  Bhenmatism.     Water  In  the  joints. 

White  swelling. 
"  Faralysiii.  * 


The  Nervous  System. 


/' 


1.  Morbidly  increased  sensation 

2.  Tensive  pain 

3.  Dull,  heavy  pain 


4.  Smarting  pain 

5.  Shooting,  tearing  pains 

6.  Boring  pains 

7.  Contualve  pains. 

8.  Itching.    Sensation  as  of  ants  creep- 

ing over  the  skin 

9.  Exaltation  of  vision 

10.  Black  flecks  floating   before  the 

eyes 

11.  Painfully  acute  hearing 

12.  Dull  hearing 

13.  Increase  of  strength 

14.  Debility 
16.  TrembUng 

16.  Rigidity  of  upper  extremities 

17.  Cramp 

18.  Temporary  spasm 

19.  Pain  at  extremity  of  penis 

20.  Pain  in  right  shoulder 

21.  Pain  in  left  shoulder 

22.  Exaltation  of  affections 

23.  Loss  of  moral  sensibility 

24.  Ezaltat  m  of  Intellect 


Indicates    Acute    Inflammation   of    brain   and 
spinal  marrow.    Fevers.    Hysteria. 

"  Phlegmonous  inflammation. 

Enlarged  internal  organs.  Internal 
tumor.  Effusion  of  water  into  cavi- 
ties lined  with  serous  membranes. 
Felt  In  the  loins  previous  to  dis- 
charge from  menstruation,  and  from 
piles. 

"  Scarf -ekln  removed. 

'  "  Neuralgia.    Cancer. 

"  Constitutional  syphilis.  Rheumatism. 

Oout.    Inflammation  of  periosteum. 

"  Bruises.    Acute  diseases. 

"  Several  diseases  of  the  skin. 

"  Ophthalmia.    Inflammation  of  brain. 

Some  nervous  diseases. 
"  Affections   of    the    brain    and   optic 

nerve.    Dyspepsia. 
"  Inflammation  of  brain.    Hysteria. 

"  Typhus  fever. 

"  Delirium.      Inflammation    of   brain. 

Mania. 
"  Most  diseases. 

"  Cold  stage  of  fever.    Nervous  affec- 

tions.   Old  age.    Action  on  the  sys- 
,  tern  of  lead,  mercury,  strong  coffee, 

alcoholic  drink,  tobacco,  opium. 
"  Softening  of  the  brain.     Infiltration 

of  blood  into  the  brain.    Hysteria. 
"  Pregnancy.  Hysteria.  Painters' colic. 

In  convulsions  of    children.     Some 

affections  of  the  brain. 
"  Stone  in  bladder. 

"  Congestion  of  liver. 

"  Disordered  stomach. 

"  Hypochondriasis. 

"  Mania.    Typhus  fever.    Masturbation. 

Melancholy.      Sometimes     indicates 

close  of  Ufe. 


1.  Stiffness  of  chest 

2.  Pressure  upon  parta 


The  Breathing. 

indicates    Cartilages    turned  to   bone.      Pleura 
hardened.    Distortion  from  rickets. 
Tumors.    Dropsy  of  belly. 


180 


TEMPERAMENTS,   CONSTITUTION,  AND   SYMPTOMS. 


3.  Obstruction  of  air-tubes 


4.  Compression  of  lungs 

5.  Pain  in  parts  moved  in  breathing 

6!  Paralysis  of  muscles  of  chest 

7.  Spasm  of  muscles  of  chest 

8.  Deficiency  of  red  blood 


indicates  Spasm  of  glottis.  Spasm  near  the 
small  ends  of  bronchial  tubus. 
Mucus,  etc.,  thrown  out  upon  the 
inner  surface. 

"  Effusions    in    pleurisy.      Water    in 

chest.  Air  in  substance  of  lungs. 
Aneurism  and  other  tumors. 

"  Pleurisy.       InflAmmation    ol  perito- 

neum. 

"  Injury  of  spinal  marrow. 

"  Locked  jaw.    Spasmodic  asthma. 

"  Angemia.    Chlorosis  or  green  sickness. 


1 .  Hollow  and  barking  cough 

2.  Sharp,  ringing  cough 

3.  Hoarse  cough 


4.  Wheezing  cough 

5.  Belching  cough 
H.  Cough  in  paroxysms 

7.  Cough  sounding  harsh  and  concen- 

trated when  listening  with  the 
stethoscope. 

8.  Cough  sounding  hollow,  when  lis- 

tening with  the  stethpscope,  as 
thougli  it  came  from  a  cavern. 

9.  Cough  having  a  metallic  or  ringing 

sound  when  listening  with  the 
stethoscope. 


The  Cough. 

indicates  Last  8i.age  of  consumption.  Clironic 
bronchitis.  Some  nervous  affections. 

"  Croup. 

"  Beginning  of   cold.     Chronic  laryn- 

gitis. 

"  Asthma. 

"  Some  diseases  of  larynx. 

"  Hooping  cough.    Hysteria. 

"  Consumption.      Inflamination  of  thn 

lungs.  Pleurisy.  Enlargement  of 
bronchial  tubes. 

"  Tuberculous  cavity.     Enlarged  bron- 

chial tubes. 


Large  tuberculous  cavity. 


1.  Scanty  expectoration 

2.  Copious  expectoration 

3.  Watery  expectoration 

4.  Mucous  expectoration 
6.  Expectoration  of  pus 


6.  Expectorated  matter  shaped  like 

coin  (nummular) 

7.  Muco-purulent,  iloculent  expecto- 

ration 

8.  Tubular  expectoration 

9.  Whitish  or  greenish  expectoration, 

that  clings  to  the  vessel 

10.  Yellow  expectoration 

11.  Rusty  expectoration 

12.  Putrid  smell  of  expectoration 

13.  Faint  and  sweetish  smell  of  expec- 

toration. 

14.  Expectoration  smelling  like  garlic 


The  Expectoration. 


indicates  First  stage  of  acnte  diseases  of  the 
lungs. 

"  Decline  of  acute  diseases  of  air-passages 

and  lungs. 

"  Beginning  of  bronchitis.     Congestion 

of  lungs.     Vesicular  emphysema. 

"  Bronchitis.    Inliammation  of  lungs. 

"  Consumption.    Third  stage  of  inflam- 

mation of  lungs. 

"  Tubercular  consumption.    Bronchitis 

of  measles. 

"  Consumption  far  advanced. 


Plastic  bronchitis.    Pneumonia. 

Acute  affections  of  lungs,  particularly 
bronchitis 

Chronic  bronchitis.  Other  chronic  af- 
fections of  the  lungs  and  throat. 

Inflammation  of  tL  '  lungs. 

Gangrene  of  the  lungs. 

Bronchitis.  First  sta^o  of  consumpti  jn. 

Broncho-pleuial  fistria. 


1.  Dull,  heavy,  aching  pain   at  the 

base  of  the  chest 

2.  Soreness  about  the  breast  bone,  and 

between  the  shoulders 

3.  Sharp,  sudden,  tearing  pain  below 

the  nipple 

4.  Pain  darting  from  front  part  of 

chest  to  between  shoulder  blades 

5.  Constant  paiu  between  the  shoulders 


Pain. 

indicates 

Acute  bronchitis- 

'■ 

j-V,".!  J  b/onci'.itis. 

If 

Pleurisy. 

It 

Consumption. 

Consumption.    Green  sickness.    Other 
chronic  diseases. 


TEMPERAMENTS.    CONSTITUTION,    AND   SYMPTOMS. 


131 


«m  near  the 
Oiial  tubus. 
iUt  upon  the 

Water    in 
ice  of  lungs. 
nors. 
n    of   perito- 


;  asthma. 
:een  sickness. 


on.    Clironic 
lUH  affections. 

tironic  luryii- 


ia. 

lation  of  the 

largenient  uf 

ilarged  bron- 


leases  of  the 

if  air-passages 

Congestion 
iphysema. 
jn  of  lungs, 
ige  of  innani- 


iimonia. 

,  particularly 

er  chronic  af- 
d  throat. 

consuuipti  ju. 


The  Pulse. 

^'  ^W.rfi^lfir^''"'"'  compression  indicates  Intiammatory  affectionH.  osi.ecially  of 
Dy  tiie  linger  the  substance  of  large  organs,  as  the 

liver,  etc. 

I'rostration  from  disease.  Nervous  and 
clironic  affections.  Fear.  Diseases 
of  women  and  children,  and  old  per- 
sons. 

Congestion  of  brain.  Apoplexy.  Dis- 
ease of  heart. 

Inflammation  of  stomach,  bowels, 
bladder,  etc.  Hysteria,  and  other 
nervous  affections. 

Inflammation  of  membranes.  Active 
bleedings.    Lead  colic,  et«. 

Affections  cliaracterized  by  debility. 

Inflammatory  diseases.  Hemorrhages. 
Apoplexy.      Sometimes  in  disease  of 
heart. 


Weak  pulse,  easily  pressed  down 


."?,  Full  pulse,  as  if  the  artery  were  in- 
creased in  size 

4.  Small  pulse,  opposite  of  full 

5.  Hard,  sharp,  contracted  pulse,-     ,. 
brating  like  a  cord  under  the  finger 


-  vi- 


«.  Soft  pulse,  yielding  readily  to  pres- 
sure 

7.  Frequent  pulse 

8.  Slow  pulse 


Relating  to  Digestion. 


1.  Tongue  trembling  and  dry,  and  di- 

minished in  size 

2.  Voracious  appetite 

3.  Diminished  appetite 

4.  Ii-.creased  thirst 

5.  Thirst  gone 
(i.  Vomiting 


7.  Pain  increased  by  pressure 

8.  Pain  relieved  by  pressure 

9.  Urgent  desire  to  go  to  stool 

10.  Watery  stools 

11.  Mucous  stools,  like  white  of  egg 

12.  Hard  and  lumpy  stools 

13.  Clay-colored  stools 

14.  Yellow  or  dark-brown  stools 

15.  Dark-green  stools 

16.  Stools  red,  and  streaked  with  blood 

17.  Pitchy  black  stools 

18.  Stools  pure  blood,  with  no  colic 

19.  Stools  like  rice-water 

20.  Black  stools 

21.  Shreds  of  false  membrane  in  stools 

22.  Fat  with  stools 

23.  Fetid  stools 


indicates    Typhoid  and  other  low  fevers. 

Pregnancy.  Hysteria.  Insanity.  Some- 
times in  dyspepsia. 
"  In  most  acute  diseases. 

Acute  affections  of  stomach  and  bowels. 
Cerebral  disease,  with  coma. 
"  Early  pregnancy.    Colic.     Disease  of 

brain.     Inflammation  of    stomach. 
Hernia. 
"  Inflammation  of  internal  organs. 

Over-distension  of  bowels.   Neuralgia. 
Colic. 
'■  Dysentery.    Sometimes  in  diarrhoea. 

Diarrh&a,    Cholera. 
''  Chronic  inflammation  of  colon. 

Constipation.    Colic.    Cancer  of  stom- 
ach. 
"  Deficiency  of  bile. 

"  Too  much  bile. 

Bile  from  children  after  taking  cal- 
omel. 
■'  Dysentery. 

"  Meltena. 

"  Bleeding  piles. 

"        -  Asiatic  cholera. 
"  Iron  taken  in  medicine. 

"  Dysentery.    Diarrha>a.    Worms. 

Diabetes.    ConsmniJtion. 
"  Diseases  attended  by  debility. 


The  Urine. 


kuess.    Other 


1.  Diminished  secretion  of  urine 

2.  Retention  of  urine  in  the  bladder 

3.  Urine  increased  in  amount 

4.  Red  or  yellow  sand  deposits  in  urine 

(uric  acid) 

5.  White  sediment  in  urine  (earthy 

phosphates) 
B-  Oxalate  of  lime  deposits  in  urine 

7.  Blood  in  urine 

8.  Albumen  in  urine 

9.  Mucus  in  urine 

10.  Sugar  in  urine 


indicates    Dropsy.     Inflammatory   and    febrile 
diseases. 

"  Paralysis.    Typhoid  fever.    Hysteria. 

"  Diabetes.    Cold  stage  of  fevers.    Hy- 

steria. Various  passions  of  the  mind. 

"  Fevers.     Acute   Rheumatism.     Con- 

sumption.   Dyspepsia.    Great  indul- 
gence in  animal  food. 

"  Depressed  state  of  the  nervous  system, 

of  serious  import. 

"  Derangement  of  digestion. 

"  Bleeding  of  kidneys,  etc.  - 

"  Bright's  disease. 

"  Inflamed  mucous  membrane  of  ure- 

"  thra,  bladder,  etc. 

Diabetes. 


132 


TEMPERAMENTS,  CONSTITUTION,  AND   SYMPTOMS. 


The  Perspiration. 


!■  Profum  {Mnpiratlon 

2.  Diminished  perspiration 

3.  Night  sweats 

4.  Sour-smelling  sweat 
6.  Fetid  smelling  sweat 

6.  Sweat  with  mouldy  odor 

7.  Smalling  like  ammonia 

8.  Sweat  having  the  odor  of  mice 

9.  Sweat  smelling  like  rottenstoue 


indicates    Acute  rheumatism.    Decline  of  acuto 
"  inflammations    and     fevers,    beine 

sometimes  critical. 

"  ^n/'il****  **'  **"***  disease.    Dropsy. 

"  Consumption.  , 

"  Rheumatism.    Oout. 

"  Some  debilitating  fevers. 

"  Measles.    Scarlet  fever. 

"  Typhoid  fever  sometimes. 

"  Insanity. 
Miliary. 


The  Temperature. 


1.  (General  heat  of  surface 

2.  External  local  heat 

3.  Hot  forehead 

4.  Hot  scalp 

fS.  Skin  of  chest  hot 
1 6.  Hands  and  feet  hot. 

7.  Acrid  heat,  burning  the  hand  when 

applied 

8.  Chflfs 

9.  Low  temperature 
10.  Cold  hands  and  feet 


indicates    Fevers. 

Inflammation. 
Headache. 
Disease  of  brain. 
Inflammation  in  chest. 
Consumption. 
Typhus  fever. 

Beginning  of  fever. 
Poor  circulation. 

Nervous  diseases.   Dyspepsia.  Impure 
state  of  the  blood. 


The  Temperature  of  the  Body. 

The  use  of  the  thermometer  is  an  important  addition  to  the  means 
of  making  physical  examination,  and  is  one  of  the  improvements  in 
modern  medicine. 

It  is  intended  to  measure  the  heat  of  the  oody. 

The  best  kind  now  in  use  is  the  self-registering. 

The  bulb  of  the  instrument  is  to  be  placed  in  the  warmest  part  of 
the  body,  and  should  be  allowed  to  remain  there  for  eight  to  ten 
minutes. 

Some  place  it  under  the  tongue  ;  some  in  the  axilla. 

Sometimes  it  is  necessary  to  introduce  it  into  the  rectum  or  vagina. 
In  these  parts  the  temperature  is  a  degree  higher  than  in  other  parts. 

The  normal  temperature  of  the  body  is  from  98°  to  99°  Fahrenheit, 
in  the  great  majority  of  persons. 

Exceptionally  it  may  be  half  or  a  whole  degree  either  above  or  be- 
low this  range. 

The  normal  fluctuations  are  inconsiderable  in  comparison  with  the 
variations  of  disease. 

The  natural  variations  in  health  are  as  follows :  The  temperature 
is  at  its  minimum  at  five  o'clock  A.  M. ;  the  maximum  is  reached  in 
the  latter  part  of  the  afternoon,  and  then  decreases  till  five  o'clock 

A.  M. 

By  means  of  the  thermometer  we  are  able  to  determine  all  differ- 
ences with  precision. 


TEMPBRAMBNT8,   CONSTITUTION,   AND   SYMPTOMS. 


188 


The  increase  of  heat  in  different  febrile  diseases  rarely  exceeds 
110°  Fahrenheit,  ant*  as  a  rule  the  amount  of  increase  is  a  criterion 
of  its  severity. 

An  increase  to  lOO^  Fahrenheit  or  101°  is  evidence  of  mildness  of 
the  disease. 

If  the  thermometer  indicates  steadily  106°  Fahrenheit,  it  is  certain 
tliat  the  disease  is  severe. 

A  persisting  temperature  above  106°  Fahrenheit  denotes  that  there 
is  great  danger,  and  an  increase  to  108°  to  110°  Fahrenheit  is  usually 
a  fatal  sign. 

The  abnormal  changes  of  temperature  consist  of  more  or  less  in- 
crease. 

Diminution  below  the  normal  standard  is  comparatively  rare ;  yet 
it  sometimes  occurs  and  is  of  some  importance. 

In  the  course  of  typhoid  fever,  a  sudden  decrease  may  indicate  in- 
testinal hemorrhage.  Sometimes  the  temperature  falls  without  im- 
provement in  the  other  symptoms.    This  is  an  unfavorable  symptom. 

The  value  of  thermometric  changes  depends  in  no  small  measure 
upon  the  symptoms  with  which  they  are  associated. 


:.,iw;j?.i^fe'teH.''.'->^.     '-''>- '■'~'^' ''-'-"''  •-•• 


Iff 


ULl 


^ 


SKIN  DISEASES. 


The  skin  is  the  soft  and  pliant  membrane  which  covers  the  entire 
surface  of  the  body.  The  interior,  like  the  exterior  is  likewise  covered 
by  a  skin,  which,  from  its  always  being  moist,  is  called  a  mucous 
membrane.  At  the  various  openings  of  the  body,  the  outer  and  the 
inner  skins  are  united,  —  forming  one  continuous  skin,  —  like  the 
same  piece  of  silk  turned  over  the  border,  and  covering  both  the  out- 
side and  inside  of  a  bonnet. 

From  this  continuity  or  oneness  of  the  skin  and  mucous  membran  ; 
springs  an  important  medical  law,  namely,  that  a  disesise  of  the  skin 
may  spread  to  the  mucous  membrane,  and  a  disease  of  the  mucous 
membrane  may  spread  to  the  skin.  We  see  this  illustrated  by  the 
breaking  out  around  the  lips  v/hich  follow  colds,  and  the  itching  of 
the  nose  of  children  when  the  mucous  membrane  of  the  bowel  is  irri- 
tated by  womwj. 

The  Skin  is  Composed  of  Two  Layers. —  These  are  separated  from 
each  other  by  the  action  of  a  blister.  The  thin  portion  which  is  raised 
up  by  the  fluid  of  a  blister  is  called  the  scarf  skiti,  the  cuticle,  or  the 
epidermis;  that  which  remains  in  connection  with  the  body  is  the 
sensitive  skin,  the  cutis,  the  derma,  or  the  true  skin.  The  two  skins 
have  very  different  offices  to  perform.  The  scarf-skin  is  horny  and 
insensible,  and  serves  as  a  sheath  to  protect  the  more  sensitive  skin 
under  it.  Were  the  scarf-skin  taken  off,  we  could  not  bear  to  have 
anything  touch  us. 

The  derma,  or  true  skin,  and  its  glands,  etc.,  are  the  seat  of  all  the 
cutaneous  diseases.  These  may  be  separated  into  four  great  divisions, 
—  namely,  diseases  of  the  true  skin,  diseases  of  the  sweat  glands  and 
tubes,  diseases  of  the  oil  glands  and  tubes,  and  diseases  of  the  hairs 
and  hair  glands. 

Then  the  diseases  of  the  true  skin  are  divided  into 

Inflammation  of  the  true  skin  ; 

Enlargement  of  the  papilloe  of  the  true  skin  ; 

Disorders  of  the  vessels  of  the  true  skint- 
Disorders  of  the  sensibility  of  the  true  skin ; 

Disorders  of  the  color-producing  function  of  the.  true  skin. 

The  inflammation  of  the  true  skin  is  conveniently  divided  into  two 
groups,  —  namely, 

Such  as  are  marked  by  inflammation  of  the  derma  and  mucous 
membranes,  with  constitutional  symptoms  of  a  specific  kind,  and 

134 


3  the  entire 
k'ise  covered 
I  a  mucous 
ter  and  the 
—  like  the 
Jth  the  out- 

i  membran  j 
of  the  skin 
ihe  mucous 
ited  by  the 
itching  of 
3wel  is  irri- 

irated  from 
ih  is  raised 
'icle,  or  the 
)ody  is  the 
!  two  skins 
horny  and 
sitive  skin 
ir  to  have 

;  of  all  the 

;  divisions, 

jlands  and 

the  hairs 


rf 


m 


SKIN  DISEASES. 


135 


Surli  aH  arc  (liHtin^nnslu'd  by  iiiflaniniiitioii  of  the  derma,  withnut 
consfitutional  symptoms  of  a  specij'u;  kind. 

Congestive  Inflammation  of  tlie  True  Sl<in. 

The  First  of  these  Qroups. —  those  characterized  by  inflammation 

of  the  cutis,  with  constitntional  symptoms  of  a  specific  kind, embraces 

measles,  scarlet  fever,  varioloid,  and  cow-pox. 

Measles.  —  Rubeola. 

Measles  is  an  acute  inflammation  of  the  entire  skin,  both  external 
and  internal,  associated  with  an  infectious  and  contsigious  fever. 

Symptoms —  The  disease  sets  in  with  chills,  succeeded  by  burning 
heat,  listlessnesH,  languor,  drowsiness ;  pains  in  the  head,  back,  and 
limbs ;  frequent  pulse  ;  soreness  of  the  throat ;  thiret,  nausea,  vomit- 
ing, frequent  dry  cough  and  high-colored  urine.  These  symptoms 
hicrease  in  violence  for  four  days.  On  the  third  day  the  eyes  become 
inflamed,  cannot  bear  the  liglit,  and  pour  fourth  a  profusion  of  teai-s. 
This  last  symptom  is  called  coryza.  The  nose  likewise  discharges  a 
large  quantity  of  watery  secretion,  and  sneezing  is  frequent.  The 
larynx,  windpipe,  and  bronchial  tubes  become  inflamed,  and  hoarae- 
iiess,  soreness  of  the  breast,  etc.,  are  the  result. 

The  redness  of  the  skin  and  breaking  out  appear  about  the  fourth 
day,  and  produce  heat  and  itching.  This  breaking  cut  is  character- 
ized by  a  patchy  redness,  which,  on  close  inspection,  is  found  to  con- 
sist of  numberless  minute  red  points  and  pimples,  collected  into 
patches  in  the  shape  of  a  half  or  quarter  moon.  They  appear  first  on 
the  forehead  and  front  of  the  neck,  then  upon  the  cheeks  and  around 
the  nose  and  mouth.  On  the  fifth  day  they  reach  their  height  in  this 
region,  and  then  appear  upon  the  body  and  arms,  and  on  the  sixth 
day,  upon  the  legs.  The  color  of  the  skin,  when  the  inflammation  is 
at  Its  height,  is  of  a  bright  raspberry  red.  The  decline  of  the  rash 
takes  place  in  the  same  order  in  which  it  comes  out.  The  redness 
fades  on  the  sixth  day  upon  the  face ;  on  the  seventh,  upon  the  body 
and  hmbs ;  on  the  eighth,  upon  the  back  of  the  hands.  The  coiyza, 
the  hoarseness,  and  the  cough,  decline  about  the  seventh  day,  while 
a  diarrhoea  comes  on  about  the  eighth  or  tenth,  —  showing  that  the  in- 
flammation of  the  mucous  membrane  is  subsiding.  When  the  inflam- 
mation disappears,  the  whole  scarf-skin  peels  off  in  the  form  of  a 
scaly  scurf.  The  artist  has  given  a  good  picture  of  the  disease  in  the 
beautifully  colored  lithograpli,  Plate  I,  Fig.  1. 

Treatment —  When  the  disease  is  mild  and  regular  in  its  course, 
scarcely  anything  will  be  required,  except  mild  diet,  slightly  acid 
dnuks,  with  flax-seed  tea,  slippery  elm,  or  some  equivalent,  to  quiet 
the  cough.  Sponging  with  tepid  water,  if  done  with  frequency,  mod- 
erates the  fever,  and  adds  to  the  comfort  of  the  patient.    If  the  fever 


—t^a^asKB?- 


186 


HKIN    DISEASES. 


runs  high,  take  half  an  ounce  of  i-ochelle  salt,  and  uae  recipe  125. 
Should  the  eruption  "strike  in,"  apply  leeches  or  cups  over  the  in- 
ternal organ  affected,  if  any,  and  recall  the  rash  by  sweating. 

Those  who  have  been  exposed  to  the  contagion,  and  are  liable  to 
have  the  disease,  should  avoid  all  unnecessary  exposure  to  wet  or 
cold,  —  keeping  the  feet  warm  and  dry,  and  the  whole  body  well  clad. 
With  these  precautions,  and  a  mild,  unstimulating  diet,  much  of  the 
force  of  the  disease  may  be  broken. 

During  the  first  stages  of  the  disease,  bathing  the  feet  once  or  twice 
a  day  with  hot  water,  and  freely  using  warm,  sweating  drinks,  as 
saffron,  summer-savory,  pennyroyal,  bilm,  and  mullein  tea,  and  put- 
ting mustard  drafts  to  the  feet,  will  hasten  the  coming  out  of  the 
eruption. 

Should  the  breaking  out  be  delayed  by  excessive  fever,  give  full 
doses  of  tincture  of  veratrum  viride,  or  nauseating  doses  of  ipecac, 
antimony,  lobelia,  or  hive-syrup,  and  teaspoonful  doses  of  compound 
tincture  of  Virginia  snake-root. 

Besides  the  milder  forms  of  the  disease,  cases  occur,  chiefly  in 
broken-down  constitutions,  in  which  the  rash  delays  its  coming  out 
till  the  seventh  day,  and  is  then  mingled  with  dark  and  livid  spots, 
which  remain,  ofteii,  for  ten  or  twelve  days.  The  fever  is  of  a  low, 
typhoid  kind,  and  the  patient  is  extremely  weak  and  languid. 

In  this  condition  of  things,  the  patient  must  be  supported  by  tonics 
(77  and  59),  and  whisky,  and  expectoration  promoted  by  some  appro- 
priate remedy,  if  required. 

If  at  any  stage  of  the  disease  there  should  be  fixed  pain  in  any 
part  of  the  chest,  which  is  made  worse  by  coughing,  or  by  taking  a 
full  breath,  we  may  conclude  there  is  some  inflammation  of  the 
chest ;  and  it  must  be  treated  as  directed  for  pneumonia. 


Scarlet  Fever.  —  Scarlatina. 

This  is  likewise  an  acute  inflammation  of  the  entire  covering  of 
the  body,  both  external  and  internal,  connected  with  fever  which  is 
infectious  and  contagious. 

Symptoms. —  The  fever  comes  on  somewhere  between  the  second 
and  tenth  day  after  exposure.  On  the  second  day  of  the  fever,  the 
eruption  comes  out  in  the  form  of  very  small  points  and  pimples, 
which  appear  either  in  patches,  or  constitute  a  general  redness,  of  a 
bright  scarlet  color.  In  Platk  I,  Fig.  2,  the  artist  has  given  a  fine 
picture  of  the  disease. 

The  disease  begins  with  languor,  pains  in  the  head,  I  ack,  and  limbs, 
with  drowsiness,  n&Uf»ea,  and  chills  ;  and  these  are  followed  by  heat, 
thirst,  etc.  When  the  redness  appears,  the  pulse  is  quick,  and  the 
patient  is  anxious,  restless,  and  sometimes  delirious.  The  eyes  are 
red,  the  face  swollen,  the  tongue  covered  in  the  middle  with  white 
mucus,  and  is  studded  with  elevated  points  of  extreme  redness.    The 


SKIN   0IBKA8B8. 


137 


3cipe  126. 

'er  the  in- 

ag. 

3  liable  to 
to  wot  or 
well  clad. 

auh  of  the 

36  or  twice 
drinks,  as 
.,  and  put- 
3Ut  of  the 

',  give  full 
of  ipecac, 
compound 

chiefly  in 
oming  out 
ivid  spots, 
I  of  a  low, 
lid. 

:l  by  tonics 
)me  appro- 

lin  in  any 
y  taking  a 
3n  of  the 


jvering  of 
r  which  is 


he  second 
fever,  the 
1  pimples, 
[ness,  of  a 
fQn  a  fine 

md  limbs, 
d  by  heat, 
,  and  the 
eyes  are 
irith  white 
less.    The 


tonsils  are  Rwclled,  and  the  throat  red.  Tbn  grciitrst  dngren  of  led- 
iiusH  is  reaclied  on  the  evening  of  the  third  or  fourtli  day  from  it«  l)e- 
ginning,  when  a  gentle  moisture  appearH,  tlio  diHease  I>egi)i8  to  decline, 
with  itching,  and  the  scai-f-Hkin  falls  off  in  branny  scaU^s. 

A  swelling  or  putliness  of  ti>e  tlesli,  which  spreads  out  tin*  tingers 
in  a  singular  manner,  seems  to  be  peculiar  to  scarlet  fever. 

In  the  first  stage  of  the  complaint,  the  tongue,  as  stated  al)Ove,  is 
covered  with  a  fur ;  but  as  it  advances,  the  tongue  often  Ixicomes 
suddenly  clean,  and  presents  a  glossy,  fiery-red  surface,  which  is 
sometimes,  with  the  whole  lining  of  the  mouth,  raw  and  tender. 

It  is  peculiar  in  this  complaint,  that  the  inflammation  of  the 
throat  alwayp  runs  into  a  stiite  of  ulceration.  As  far  us  can  be 
seen,  on  pressing  down  the  tongue,  the  throat  is  swollen  and  of  a 
deep,  florid  I'jid ;  and  on  the  tonsils  may  be  seen  white  or  gray 
ulcers.  This  makes  swallowing  very  ditiicult,  and  aggravates  the 
sufferings  of  the  patient.  The  great  amount  of  mucus  in  these 
parts  causes  also  a  continual  rattling  in  the  throat. 

The  eustachian  tube,  which  extentls  up  to  the  ear,  is  apt  to  get 
involved  in  the  inflammation,  and  cause  swelling  and  pain  in  that 

region.  The  glands  under  the  ear  and  jaw 
sometimes  inflame,  and  after  a  time  they  oc- 
Ciisionally  break.  Abscesses  formed  in  the 
ear  frequently  produce  some  deafness  which 
is  not  easily  cured. 

In  the  cell-dropsy,  which  sometimes  appears 
after  scarlet  fever,  the  crystals  of  urate  of 
ammonia  may  often  be  found  in  the  urine 
with  the  microscope  (Fig.  72). 

This   disease   resembes  measles,  but  may 

*■'<*•  "•  be  distinguished  from  it  by  the  absence  of 

cough ;  by  the  eruption  being  finer^  and  of  a  more  scarlet  color  (see 

plate) ;  by  the  rash  coming  out  on  the  second  day  instead  of   the 

fourth ;  and  by  the  ulceration  in  the  throat. 

Treatment.  —  In  ordinary  cases,  the  treatment  should  be  very 
simple.  The  apartment  should  be  kept  cool,  and  the  bed-covering 
light.  The  whole  body  should  be  sponged  with  cool  water  as  often  as 
it  is  hot  and  dry,  and  the  patient  be  permitted  to  take  cooling  drinks. 
Besides  this,  in  many  cases,  very  little  is  needed,  except  to  give  a 
few  drops  of  the  tincture  of  belladonna,  night  and  morning. 

In  some  cases  where  there  is  a  good  deal  of  fever  and  soreness  of 
throat,  give  tincture  of  veratrura  (125)  often  enough  to  keep  down 
the  pulse.  Give  every  half  hour  (an  adult)  till  pulse  reaches  sixty. 
Aconite  in  drop  doses  to  children  every  fifteen  minutes.  In  addi- 
tion to  this,  the  feet  and  hands  should  be  soaked  in  hot  water,  with 
a  little  ground  mustard,  or  pulverized  ca3'^enne,  stirred  in.  This 
bath  should  be  continued  twenty  minutes,  twice  a  day,  for  two  or 
three  days. 


rSMSS&K' 


.aiii.l<wJlilMiilliiiiii'iiii»inriiiiw'i*'iiii>iniiiiiiriHl»iT  ' in 'i     "i "  '    ' 


SKIN   niHRAHRn. 


The  cold  8tajr«  having  piwHcd,  and  the  fovor  Hot  in,  wiinn  water 
may  Iw  ubjhI  without  the  miiHtard,  eU-.  If  tiic  head  Ik;  iifTecU-d,  um 
nuiHtui'd  (IniftH  upon  the  feet.  Shouhl  the  JK)welH  lie  coHtivo,  they 
may  \x'  gently  o[)(auHl  hy  Honie  very  miUi  physic. 

No  Holid  food  Hhould  bo  aUowed ;  but  after  the  fiixt  shock  of  the 

di8eit«e  iH  pusHed,  dnnka,  in  reiwonablc  (juantiticH,  will  Iw  advisable, 

Buch  au  cold  wattu',  lemonade,  barlMtrry  and  tamarind  water,  rice 
water,  balm  or  tlax-Heed  tea,  and  Home  thin  wat<*r-gruel. 

To  promote  the  action  of  the  skin,  the  HpiriUi  of  nitre,  with  other 
articles  (125),  adapting  the  dose  to  a  child,  will  be  found  useful. 
The  nitrate  of  poUwh  iw  UHeful,  given  in  on»>  to  three-grain  doses, 
dissolved  in  water,  every  three  or  four  houm. 

Muriatic  acid,  foity-tive  drops  in  a  tumbler  filled  with  wattu-,  and 
sweetened,  and  given  to  a  child  in  teiuspoonful  doses,  is  a  good  remedy. 

In  very  violent  attacks,  the  system  sometimes  inclines  to  sink  im- 
mediately ;  typhoid  symptoms  show  themselves  ;  there  is  great  pros- 
tration ;  the  eruption  strikes  in;  the  skin  changes  to  a  purple  or 
mahogany  color;  the  tongue  is  of  a  deep  red,  nr  has  a  dark-brown 
fur  upon  it,  and  the  ulcers  in  the  throat  become  putrid.  This  is 
called  scarlatiua  maligna ;  but  it  is  only  a  severer  form  of  the  same 
disease. 

The  treatment  of  this  form  must  be  different  from  that  recom- 
mended above.  It  must  Iw  tonic.  Quinia  (66)  must  be  freely  given. 
Wine  whey,  mixed  with  toast-water,  will  be  useful.  Tincture  of 
cayenne,  in  sweetened  water,  may  be  given  often  in  small  doses. 
Ammonia  (135)  may  likewise  be  given  as  a  stimulus.  Gargles  (245) 
(244)  (243)  are  also  required. 

A  dropsical  affection  is  one  of  the  most  frequent  results  of  scarlet 
fever.  It  is  believed  that  this  seldom  occurs,  if  the  warm  bath  is 
daily  used,  as  soon  as  the  skin  begins  to  peel  off.  After  the  dropsy 
has  set  in,  give  the  warm  bath  twice  a  week,  and  encourage  perspi- 
ration by  the  compound  tincture  of  Virginia  snake-root,  and  similar 
articles.  The  child  should  have  a  generous  diet,  at  the  same  time, 
to  bring  up  its  strength. 

Anointing  the  skin  with  vaseline  at  night  and  washing  off  in  the 
morning  with  suds  removes  the  poisonous  scales,  and  lessens  the 
danger  of  contagion,  as  well  as  improves  the  activity  of  the  skin. 
Nasal  and  aural  catarrhal  diseases  are  commonly  observed  to  follow 
scarlet  fever  and  need  attention  of  a  physician.  Rheumatism  like- 
wise is  a  frequent  sequela,  wliile  nephritis  or  inflammation  of  the 
kidneys  is  often  a  sad  reminder  of  the  disease.  These  two  compli- 
cations are  to  be  treated  as  directed  elsewhere. 


TABLE  EXHIBITING  THE  DIFFERENCE  BETWEEN  SMALL  T  OX,  VARIO- 
LOID, SCARLET  FEVER  AND  MEASLES. 


SMALL-POX. 


VABIOLOID. 


first.  Period  between  expocure  and  when  dU- 
ea«e  flnt  abowa  Itaelf  li  from  five  to  twenty  daya  — 
oaokUy  abowa  itaelf  in  ten  or  twelve  daya. 


First.  Period  of  InoubRtfn*.  more  Irregnlar 
than  Buiall- Pox  — from  five  u  <  wty  daya— av- 
eragea  twelve  daya. 


tm^ 


•iirm  wdttT 
rented,  put 
Htivo,  they 

Jck  of  the 
IviHiiblu, — 
water,  rice 


with  other 
nd  UNefiil. 
ail)  doHes, 

watt(r,  and 
)d  remedy, 
o  sink  im- 
jreat  pros- 
pur  j)le  or 
ark-brown 
1.  This  is 
the  same 


*^ 


lat  recom- 
Jely  given, 
incture  of 
lall  doses, 
jles  (246) 

of  scarlet 
11  batli  is 
he  dropsy 
ge  perspi- 
ud  simihir 
iime  time, 

off  in  the 
jssens  the 

the  skin. 

to  follow 
itism  like- 
on  of  the 
ro '  compli- 

)X.  VARIO- 


nore  irregnUr 
)Pty  (Uyi  — «T- 


m 


I 


SMALL  POX 


■*■■'" 


dfeo 


o-^ 


Q-  O*^ 


9^ 


*  ..'  e 


^o^ 


'f 


0r^O 


*j..-,ai;-.ii    «'l*tf*,    /S'jfefAVS 


■p^;. .  .^v^;*p<- " 


Proof  ress  of        M,  ^ 

SnuxU  Pox.  *^' 


l?f<iajj.2'}il4»y.3'iday.5'^dMf.       S^day.        Hf'kUui. 


M.-»r^      (.4!«;fffii 


Progivssof 
Varioloid. 


m 


0    #    0    i     # 


/?.*«%.    ?'^rfay.  ^.'^<%.       -^.'^^fcty.  5/^<%.  7/??V«y. 


Progress  of 
Vaccination, 


4^hday.         e^^oLay. 


a^hihxy. 


llf'^day. 


SKIN   DISEASES. 


139 


;^^ 


Secnnit.  The  fever  and  temperature  U  high,  bat 
ia  less  after  rash  appears. 

Third.  The  rash  appears  on  third  or  fourth  day 
and  is  seen  on  the  forelieail  or  Kouie  part  of  face. 

Fourth.  The  eruption  first  consists  of  pimples, 
then  watery  blisters  wbioh  become  white  and  sink 
in  the  center. 

Fi/th.    The  tor.^e  is  coated  and  swollen . 

Sixth.  The  eyes  do  not  run,  and  broncbitia  does 
not  appear. 

fieventh.  Sore  throat  is  often  present  but  not  to 
as  great  an  extent  as  in  Scarlet  Fever.  Delirium 
and  convulsions  may  occur. 

Eighth.  Beoondary  fever  appears  after  several 
days. 

Ninth.  There  are  apt  to  be  pocks  and  the  eye- 
sight be  weakened,  but  by  modem  treatment  it 
can  usually  be  avoided. 


8CABLET  FETEB. 

Firtt.  Period  between  contagion  and  when  dis- 
ease first  shows  itself  is  usually  from  three  to  six 
days,  but  may  be  much  longer. 

Second.  Fever  greatly  increased  and  continues 
without  abatement  after  eruption  appears. 

Third.  Eruption  makes  its  appearance  on  sec- 
ond AV  on  the  chest  and  neck  and  spreads  over 
the  l)ody  during  tl'«  next  twelve  hours. 

Fourth,  The  eruption  extends  over  the  entire 
skin. 

Fifth-  Eruption  lasts  from  six  to  seven  days 
when  it  begins  to  come  off  in  larpe  scales. 

Sixth.    Tongue  is  covered  with  little  red  points. 

Seventh.  There  is  little  trouble  with  bronchitis 
or  running  of  eyes. 

Eighth.    Sore  throat. 

Ninth.  The  mind  is  apt  to  be  affected  and  there 
may  be  delirium. 

Tenth.    Usually  no  seoondary  fever. 

Eleventh.  In  Scarlet  Fever  there  is  great  .dan. 
ger  of  the  patient  being  left  with  kidney  trouble, 
or  the  eyes,  ears,  or  throat  may  be  affected. 


Second.  Fever  high  till  rash  is  well  developed 
and  then  a  greater  &provei.ient  than  in  Small- 
Pox. 

Third.  Eruption  appears  on  third  or  fourth 
day. 

Fourth.  Rash  consists  of  pimples,  may  ^o  on 
to  pustules  and  blisters,  but  usually  subi'ide  be- 
fore advancing  so  far. 

Fifth.    Tongue  coated  and  swollen. 

Sixth.    No  nose  or  eye  symptoms  as  a  rule. 

Seventh.  Bore  throat  mild.  Delirium  and  sev- 
erity of  diseiwe  often  marked  at  Iwginning  but 
quickly  subside. 

Eighth.  Secondary  fever  less  marked  than  In 
Small- Fox. 

Ninth.  Instead  of  rapidly  convalescing,  the 
patient  often  shows  an  amount  of  weakness  and 
anemia  all  out  of  proportion  to  preceding  symp- 
toms. 

MEASLES. 

Firtt.  Period  between  exposure  and  when  dis- 
ease first  shows  Itself  is  from  seven  to  fifteen 
days. 

Second.  There  Is  a  moderate  fever.  It  does 
not  decrease  but  increases  alter  eruption. 

Third.  Eruption  appears  on  fourth  day  on 
face  and  spreads  over  rest  of  body  in  about  two 
days. 

Fourth.  Eruption  is  orescent-shaped,  rest  of 
skin  healthy. 

Fifth.  Eruption  lasts  about  five  days,  then 
peels  off  in  scales. 

Sixth.    Tongue  has  red  edges  and  is  coated. 

Seventh.  The  nose  and  eyes  run  and  bronchitis 
is  usually  apparent. 

Eighth.    Usually  throat  is  not  sore. 

Ninth.    The  mind  is  not  affected. 

Tenth.  The  fever  subsides  after  the  third  day 
and  there  is  no  secondary  fever. 

Eleventh.  The  patient's  eyes  may  be  inflamed 
and  consumption  or  bronchitis  follow. 


Small-Pox.  —  Variola. 

This  is  another  disease  characterized  by  acute  inflammation  of 
the  entire  skin,  both  external  and  internal,  connected  with  infectious 
and  contagious  fever.  The  eruption  has  the  form  of  red  points, 
which  soon  becom^  pimples,  then  vesicles,  then  flattened  and  scooped- 
out  vesicles,  then  pustules,  and  finally  hard  brown  scabs.  These  last 
fall  off  from  the  eleventh  to  the  twenty-fifth  day,  and  leave  behind 
them  small  pits  and  scars.  The  fever  is  remittent,  and  precedes  the 
eruption  some  three  or  four  days,  —  ceasing  when  the  eruption  is 
developed,  and  returning  when  it  has  reached  its  height.  The 
period  between  exposure  and  the  attack  of  the  disease,  called  incu- 
bation,  is  from  five  or  six  to  twenty  days,  — being  short  in  the  severe 
cases,  and  longer  in  the  milder  ones. 

Symptoms.  —  The  'disease  begins  with  languor  and  lassitude,  with 
shivering,  and  pains  in  the  head  and  loins  ;  with  hot  skin,  and  quick- 
ened pulse  and  breathinpf-  -yi^h  thirst,  loss  of  appetite,  and  furred 
tongue ;  with  nausea,  vo.  iting,  constipation,  restlessness,  and  uni- 
vei-sal  prostration.  To  these  symptoms  sometimes  succeed  <lifBcult 
breathing,  cough,  drowsiness,  and  even  insensibility.  The  tongue, 
white  at  firet.  soon  becomes  red  at  the  point,  and  over  the  whole 


Jf 


140 


SKIN  DISEASES. 


surface.  The  fever  is  highest  during  the  night.  The  constitutional 
symptoms  are  more  violent  just  before  the  eruption,  but  immediately 
subside,  and  soon  disappear,  when  the  breaking  out  is  established. 
The  eruption  is  at  first  in  the  shape  of  small  red  points,  which  are 
1ia'>d  to  the  touch,  and  shaped  like  a  cone,  and  are  proportionate  in 
number  to  the  subsequent  pustules.  In  Plate  II  the  artist  has 
well  exhibited  the  developed  disease,  as  well  as  the  progress  of  the 
eruption  from  day  to  day. 

Treatment.  —  Like  the  two  preceding  disease..,  the  ordinary,  un- 
complicated form  of  this  requires  only  the  most  simple  treatment. 
Not  much  is  wanted,  except  confinement  in  bed,  cooling  drinks,  cool 
and  even  temperature,  frequent  change  of  linen,  and  sponging  the 
body  with  cool  water.  But  when  what  is  called  the  fever  of  inva- 
sion is  past,  and  the  eruption  is  fvlly  developed,  and  has  brought 
along  with  it  the  secondary  fever,  then  some  recipe,  as  (131),  (355), 
(126)  will  be  in  place,  and  some  gentle  laxative  to  keep  the  bowels 
open  (8),  —  also  gentle  injections  (249),  and  opiates  to  relieve 
sleeplessness  and  nervous  symptoms ;  (366)  (367)  may  be  used  if 
very  sleepless. 

Should  the  system,  at  this  period,  appear  to  be  sinking,  a  more 
generous  diet,  and  a  little  wine  may  be  allowed.  If  the  brain 
suffers,  apply  cold  ice-cloths  to  head,  or  an  ice-bag  behind  the  ears, 
and  put  the  feet  in  a  mustard  bath  (242).  If  the  breaking  out 
appears  with  difficulty,  put  the  patient  into  a  warm  bath,  and  give 
extract  of  jaborandi  (368).  Gargles  will  frequently  be  needed  for 
the  inflammation,  and  dryness  of  the  mouth  and  throat  (243). 
Cold  sponging  may  be  considered  as  highly  beneficial,  in  both  the 
primary  and  secondary  *ever.  The  belladonna  likewise  is  a  useful 
remedy,  used  in  the  same  way  as  in  scarlet  fever.  The  plaster  (288), 
applied  to  the  face,  will,  it  is  said,  arrest  the  formation  of  matter, 
and  prevent  the  unsightly  scars  which  so  often  cover  the  face  of 
persons  who  have  suffered  from  small-pox.  Paint  the  face  once  or 
twice  a  day  vnth  glycerine,  which  will  effectually  prevent  pitting. 
The  use  of  collodion  is  still  better. 

To  avoid  Pittins:,  and  the  occurrence  of  unsightly  scars  of  the 
face,  several  methods  of  dressing  have  been  used.  The  simplest 
consists  in  covering  in  the  vesicle  with  iodof orm-collodior ,  say, 
twenty  grains  of  the  former  to  one  ounce  of  the  latter.  Having 
pricked  the  vesicle  with  an  absolutely  clean  needle,  one,  for  instance, 
that  has  been  boiled  in  sodarwater  for  five  minutes,  a  layer  of  this 
collodion  should  be  applied  a..d  allowed  to  dry  on  at  once.  Should 
pus  form  under  this  coating  it  must  be  released  by  washing  off  the 
collodion  with  alcohol.  The  wound  is  then  to  be  thoroughly  disin- 
fected with  carbolic  acid  water  (one  teaspoonful  to  pint  of  water) 
and  the  collodion  again  applied. 

This  process  will  avoid  most  of  the  pitting. 


m^rr 


SKIN  DISEASES. 


141 


Varioloid.  —  Varicella. 

Varioloid,  or  modified  small-pox,  begins  with  symptoms  similar 
to  those  of  small-pox,  but  much  milder  in  degree.  These  symptoms 
are  feverishness,  nausea,  vomiting,  pains  in  the  loins  and  head,  and 
a  quickened  pulse.  The  eruption  comes  out  on  the  third  or  fourth 
day,  and  looks  like  that  of  small-pox.  It  reaches  its  height  the 
fourth  or  fifth  day,  and  then  declines  without  any  secondary  feve'-. 
The  pustules  dry  up  and  form  brown  scabs  which  fall  off  in  a  few 
days,  and  leave  slight  pits,  and  a  few  red  or  purple  spots. 

Varicella  appears  under  a  variety  of  forms,  called  "  hives,"  "  swine- 
pox," "  chicken-pox,"  "  horn-pox,"  etc.  But  they  all  have  a  family 
likeness,  and  need  not  be  described.  The  treatment  of  all  these 
forms  must  be  conducted  on  the  same  principles  with  small-pox. 
Sponging  the  skin  in  all  these  inflamhaatory  conditions  has  the  hap- 
piest effect,  and  should  seldom  be  omitted. 

Cow-Pox.  —  Vaccina. 

This  disease  exists  to  some  extent  among  lower  animals,  and  is 
identical  with  small-pox  in  man.  The  immortal  Jenner  taught  the 
world  that  the  pus  taken  from  the  cow  having  this  disease,  and  in- 
troduced under  the  skin  of  man,  would  produce  an  eruption  similar 
to  that  of  small-pox,  and  that  this  would  protect  the  system  from 
the  latter  disease.  This  was  an  immensely  important  discovery,  and 
will  render  the  name  of  Jenner  famous  through  all  time. 

It  is  a  question  of  great  importance  how  far  vaccination,  or  inocu- 
lation with  the  matter  of  cow-pox,  does,  in  fact,  protect  tlxe  system 
from  small-pox.  That  it  is  a  protection,  to  a  certain  extent,  is 
doubted  by  none.  That  in  some  instances  it  protects  through  life, 
is  likewise  generally  admitted.  Is  it  a  protection  in  all  cases,  and 
through  the  whole  life?  Perhaps  not,  though  this  is  a  disputed 
point.  Probably  the  mild  form  of  the  vaccine  disease  does  not  im- 
press the  system  powerfully  enough  to  last  more  than  a  certain  num- 
ber of  years.  Most  thinking  physicians  now  believe  it  is  wise  to 
revaccinate  occasionally,  to  make  sure  of  the  protection.  It  is  done 
with  little  trouble,  and  may  save  a  terrible  infliction.  Plate  II, 
^^S-  4,  gives  a  good  idea  of  the  appearance  and  progress  of  the 
eruption. 

The  Second  Group  of  diseases,  characterized  by  inflammation  of 
the  true  skin,  without  constitutional  symptoms  of  a  specific  kind,  are 
Erysipelas,  Nettie-Rash,  False-Measles,  and  Inflammatory  Blush. 

Erysipelas.  —  St.  Anthony's  Fire. 

Erysipelas  is  a  diffused  inflammation  of  the  skin,  affecting  only 
a  part  of  the  surface  of  the  body,  and  is  accompanied  by  a  fever, 
which  is  generally  thought  to  be  infectious  and  contagious.     The 


!   f 


>«*MHMMM<iMMiai 


mknim 


wmM 


142 


SKIN  DISEASES. 


local  inflammation  is  disposed  to  spread ;  it  extends  deep,  and  is 
attended  by  swelling,  a  tingling,  burning,  and  pungent  heat,  and  ])y 
a  redness,  which  disappears  when  the  skin  is  pressed  by  the  fiuger 
and  returns  on  remitting  the  pressure. 

Symptoms.  —  The  constitutional  symptoms  are  chilliness  aiul 
shaking,  succeeded  by  heat ;  lowness  of  spirits,  lassitude,  pains  in 
the  back  and  limbs,  pains  in  the  head,  quick  and  hard  pulse,  thirst, 
loss  of  appetite,  white .  and  coated  tongue,  bitterness  of  moutli, 
nausea,  vomiting,  pain  in  stomach,  and  costivencss. 

These  symptoms  go  before  the  local  inflammation  several  days; 
they  increase  with  the  redness  of  the  skin,  and  disappear  upon  its 
decline.  The  nervous  system  is  sometimes  severely  affected,  and 
indicated  by  low,  muttering  delirium.  At  the  close  of  the  inflam- 
mation there  is  generally  a  relaxation  of  the  bowels,  and  the  scarf- 
skin  peels  off.  Sometimes  matter  forms  under  the  skin,  and  occa- 
sionally mortification  occurs.  The  face  is  the  most  frequent  seat  of 
the  disease.  It  commonly  begins  on  one  side  of  the  nose,  and  soon 
spreads  over  one  side  of  the  face,  closing  up  the  eye,  and  changing 
the  features  in  a  shocking  manner.     See  Plate  III,  Fig.  1. 

Somewhere  about  the  third,  fourth,  or  fifth  day,  very  minute  blis- 
ters appear  on  the  inflamed  parts,  filled  with  water,  which  increases 
until  the  blisters  break  and  let  it  out.  The  disease  comes  to  a  head 
on  the  eighth  or  ninth  day,  when  the  blistered  parts  dry,  and  the 
skin  begins  to  peel  off. 

Treatment.  —  In  the  treatment  two  things  are  to  be  done,  —  to 
subdue  the  fever,  and  the  local  inflammation.  The  fever  is  assuaged 
by  rest,  mild  diet,  gentle  laxatives  (26),  (21),  (125) ;  and  by  the 
use  of  tincture  of  veratrum.  For  the  local  inflammation,  various 
things  have  been  advised,  but  nitrate  of  silver,  on  the  whole,  has  the 
preference.  First  wash  the  inflamed  part  with  soap  and  water  to 
remove  any  oily  substance,  and  wipe  the  skin  dry.  Then  moisten 
the  inflamed  and  surrounding  skin,  and  pass  over  it  a  stick  of  nitrate 
of  silver,  touching  not  only  the  inflamed  part,  but  going  even  an 
inch  beyond  it  on  all  sides.  Or,  a  solution  of  nitrate  of  silver  and 
nitric  acid  (214)  will  in  many  cases,  according  to  Dr.  Higginbottom, 
do  even  better.  A  solution  of  copperas  (215)  is  a  good  application. 
So  is  (303). 

In  mild  cases,  flour  may  be  dusted  on  the  inflamed  part  from  the 
dredging-box.  Warm  fomentations  are  also  useful,  and  cloths  wet 
with  water,  and  laid  on.  A  solution  of  perchloride  of  iron,  applied 
to  the  inflamed  skin,  is  much  used  now,  or  water  as  hot  as  can  he 
borne. 

In  erysipelas  the  powers  of  the  system  are  generally  reduced,  and 
tonics,  such  as  quinine,  wine,  etc.,  are  genemlly  required.  Dr. 
Robert  Williams,  —  high  authority  in  these  matter's,  —  says  he  puts 
his  patients  upon  milk  diet,  gently  opens  the  bowels,  and  gives  them, 
daily,  from  four  to  six  ounces  of  port  wine,  together  with  sago,  and 
that  he  seldom  has  to  change  this  coui-se,  whatever  the  symptoms. 


I 


ERYSIPELAS 


3ep,  and  is 
eat,  and  by 
the  finger, 

liness  and 

e,  pains  in 

ilse,  thirst, 

of  mouth, 

eral  days; 

r  upon  its 

fected,  and 

:;he  inflani- 

the  scarf- 

and  occa- 

int  seat  of 

,  and  soon 

changing 

inute  blis- 
increases 
to  a  liead 

y,  and  the 

lone,  —  to 
!  assuaged 
nd  by  the 
1,  various 
ie,  has  the 
water  to 
1  moisten 
of  nitrate 
[  even  an 
nlver  and 
inbottom, 
iplication. 

from  the 
loths  wet 
1,  applied 
8  can  be 

iced,  and 
ed.  Dr. 
be  puts 
/es  them, 
3ago,  and 
ptoms. 


PI.  3. 


INFLAMMATORY   BLUSH 


Fig.l 


■iiiT  idirn'ii 


iii>T8iirr[im« 


■ii^l<ilir»Oiilii 


Ki  i 


i 


1 1 


'^sm^^m_ 


^rn 


mt^ 


^iU^' 


SKIN   DISEASES. 


143 


For  the  inflamed  skin,  a  tea  made  of  buckwheat  meal  is  a  good 
wash.  Alcohol  and  water,  or  new  rum,  may  be  used  for  the  same 
purpose.  » 

Nettie-Rash. --  Urticaria. 

Nettle-rash  begins  with  fever,  which  lasts  two  or  three  days, 
when  wheals  of  various  shapes,  round,  oval,  and  oblong,  appear  in 
the  midst  of  red,  slightly  elevated  patches,  attended  by  great  itching 
and  tingling,  as  if  the  common  nettle  had  been  applied  to  the  skin. 
The  wheals  go  ofif  during  the  day,  and  come  again  at  night.  The 
eruption  is  often  a  symptom  of  other  diseases,  or  of  mental  anxiety. 
Sometimes  it  is  the  effect  of  articles  of  diet.  Children  have  it  occa- 
sionally while  cutting  teeth.  A  lighter  form  of  the  disease  exists,  in 
which  the  wheals  appear  and  disappear  at  short  intervals,  according 
to  the  heat  of  the  weather,  the  exercise,  diet,  etc. 

Treatment. —  The  treatment  varies  according  to  the  cause  of  the 
disease.  If  tliis  be  anything  offending  the  stomach,  especially  if  it  be 
putrid  fish,  an  emetic  (2),  (4)  will  be  required,  followed  by  brisk 
physic  (359).  After  which  take  a  few  doses  of  quinine  (75).  For 
external  application,  the  lotion  (216)  or  common  vinegar  and  water 
(215)  will  be  useful.  Dr.  "Wilson  recommends  corrosive  sublimate, 
etc.  (217),  as  the  best  lotion  to  apply  outwal-dly.     Soda  bath  better. 

The  diet  should  be  simple  and  cooling,  ail  stimulating  food  and 
condiments  being  avoided.       Fruit,  candies,  and  berries  often  the 


cause. 


Rose-Rash.—  Roseola.  —  False  Measles. 

Symptoms —  The  summer  rose-rash  appears  first  on  the  arms,  face, 
and  neck,  thence  it  spreads  over  the  whole  body,  producing  tingling 
and  Itching.  It  is  usually  preceded  by  the  symptoms  of  fever-chills, 
succeeded  by  flushes  of  heat,  languor,  pains  in  the  head,  back,  and 
hmbs,  restlessness,  quick  pulse,  and  thirst.  The  rash  appear  in 
small  irregular  patches,  paler  than  those  of  measles,  and  of  a  more 
roseate  hue.  There  is  some  hoarseness  from  inflammation  of  the 
throat.  The  rash  never  continues  more  than  five  days,  unless  it  be 
merely  partial,  in  which  case  it  sometimes  comes  and  goes  at  inter- 
vals for  weeks.  If  it  "strike  in,"  it  generally  produces  disturbance 
of  the  stomach,  headache,  and  faintness,  which  are  relieved  by  its  re- 
appearance. 

The  autumnal  rose  rash  is  in  more  distinct  patches  than  the  former, 
of  a^  circular  figure,  slightly  elevated,  and  of  a  dark  damask-rose  hue. 
seldom  any  fever,  or  itching  and  tingling. 

Treatment.—  For  the  firs^described  form  of  the  disease,  light  diet, 
acid  drinks,  and  gentle  laxatives;  for  the  second,  recipe  59  or  51,  ac- 
cording to  convenience. 


m 


iHri 


144 


8KIN   DISEASES. 


Inflammatory  Blush.  —  Erythema. 


Whvt  is  called  marginated  inflammatory  blush,  is  a  mottled,  red, 
smooth  fullness  of  the  skin,  occurring  on  the  extremities  and  loins,  in 
irregular  patches,  bounded  on  one  side  by  a  hard,  elevated,  red  border. 
This  species  of  disease  attacks  old  people,  and  indicates  some  inter- 
nal disorder,  which  is  dangerous. 

Another  form  of  the  complaint  appears  on  the  arms,  neck,  and 
breast,  in  extensive,  bright-red,  irregular  patches,  slightly  elevated. 
The  redness,  at  its  height,  is  very  vivid,  and  continues  about  a  fort- 
night, when  it  assumes  a  pvirplish  hue  in  the  centre. 

Treatment. —  Light  diet,  gentle  purgatives  (21),  soda  bath  to  al- 
lay the  tingling  and  secure  sleep,  and  the  mineral  acids  (63),  with 
bitter  tonics,  comprise  all  that  is  required,  except  sponging  with 
water,  and  friction. 

Watery  Pimples. 

We  now  come  to  a  class  of  diseases  character-zed  by  watery  pim- 
ples. Wilson  says  they  are  distinguished  by  "  effusive  inflammation  of 
the  derma,"  which  means  that  there  is  inflammation  of  the  true  skin, 
which  causes  water  to  be  poured  out  on  top  of  the  derma,  and  under- 
neath the  scarf-skin,  causing  the  latter  to  be  lifted  up  in  the  form  of 
small  or  large  blisters,  or  vesicles.  At  first  the  fluid  in  these  pimples 
is  transparent,  but  in  a  short  time  becomes  milky.  Sometimes  this 
fluid  al^orbs ;  at  other  times,  it  dries  up,  and  with  the  cuticle  scales 
off  as  scurf. 


Eczema  and  Salt  Rheum. 

Eczema  is  an  inflammatory,  acute  or  chronic,  non-contagious  skin 
disease  characterized  at  first  by  redness,  little  pimples,  vesicles  or 
pustules  and  is  attended  by  more  or  less  burning  itching.  This  pro- 
cess terminates  either  in  the  formation  of  crusts  as  the  result  of  dried 
sticky  serum,  or  else  in  the  formation  of  fine  scales. 

No  skin  disease  has  such  a  variety  of  aspects  nor  such  grades  of 
inflammation.  There  is  generally  more  or  less  oozing  of  the  blood- 
serum,  which  dries  and  thickens,  forming  crusts.  There  is  usually 
more  or  less  thickening  of  the  skin,  making  it  like  leather ;  there  is 
generally  some  considerable  scaling. 

Eczema  may  subside  in  a  few  weeks  never  to  return,  or,  what  is 
more  probable,  may  lapse  into  a  chronic  state  and  continue  for  months 
and  years,  with  bothersome  symptoms,  which  are  extremely  annoying. 

Salt  Rheum  is  a  chronic  eczema  of  this  last  variety. 

Treatment. —  In  the  acute  stage  of  eczema,  soothing  lotions,  pow- 
ders, or  ointments  should  be  used,  such  as  372,  373,  374,     Some  are 


SKIN   DISEASES. 


145 


)ttled,  red, 
id  loins,  in 
red  border, 
ome  inter- 
neck,  and 
r  elevated, 
•ut  a  fort- 

)ath  to  al- 
;63),  with 
ging  with 


itery  pim- 
imation  of 
true  skin, 
nd  under- 
le  form  of 
le  pimples 
times  this 
icle  scales 


ious  skin 
esicles  or 
This  pro- 
t  of  dried 

grades  of 
he  blood- 
s  usually 
;  there  is 

•,  what  is 
ir  months 
,nuoying. 


)ns,  pow- 
Some  are 


better  treated  with  powders,  some  by  lotions;  the  itching  «nd  heat 
are  best  relieved  by  373.  8  ""  "  "e*!- 

In  the  more  chronic  variety  some  stimulating  ointments  are  needed, 
like  375  Carbolic  ac.d,  10  or  15  grains  to  the  ounce  of  oleate  of 
zinc  ointment,  is  an  admirable  remedy  for  the  itching  and  burnine 
Salicylic  acid,  10  grains  to  the  ounce  of  benzoated  zinc  ointment 
llz'^r  T^y  ««'-^i««fl>le,  while  tarry  preparations  generally  are 
the  most  satisfactory  in  this  chronic  stage. 

^.ill!,  w  ""'"^'^  however,  w  often  so  stubborn  to  treatment  as  the 
different  forms  of  eczema.     The  cure  often  will  be  slow  and  medi- 

cTl  wrnt  ^  ''^'^^''*    '''^  ^°^^^  ^^"^^^^«  ''  «--^  -<!--  «P- 

•  ^K?*T  "**  J"®"**  i"  Children— After  oiling  freely  the  crusts  over 
night  and  washing  off  wi^h  suds  in  the  morning,  appl^  Salicylic  acll 
1  part,  tincture  benzoin  2  parts,  vaseline,  50  part«.    The  very  chronic 
thick,  and  indurated  skms  require  360,  and  in  many  cases  219,  espe- 

L^^i^  .       V?'  *^">^«]«  regulated  and  the  hygiene  of  the  skin  a^ 
tended  to,  while  tonics  and  general  systemic  measures  are  often  called 

Tetter^  Shingles.^  Herpes. 

After  a  slight  feverish  attack,  lasting  two  or  three  days,  clusters 
of  small  transparent  pimples,  filled  sometimes  with  a  colorIes8,Tom2 
times  with  a  brownish  lymph,  appear  on  the  cheeks  or  forehead,  or 

mt^^Z'T  '■  ~  ^""^  ^*  *T'  ^'^  *^«  ^^^y-  The  pimples  are  a 
little  larger  than  m  eczema,- about  the  size  of  a  pea.  After  a  few 
days  the  vesic  es  break,  pour  out  their  fluid,  and  form  brown  or  yel 

Z  Si:  T.*'"  '^.'^"*  '^'  *?*^  day, leaving  the  surface^red 
and  irritable.  The  eruption  is  attended  with  heat,  itehing,  tingling, 
orm  ofl  ^««^l«««"«f«'f  P««ially  at  night.  Ringworm  is  a  cur  ou^ 
form  of  herpes,  in  which  the  inflamed  patehes  assume  the  form  of  a 
nng.  Shingles  usually  attack  the  aged  about  the  ribs  of  one  side, 
and  are  evidences  of  impaired  health  and  nutrition.  They  are  verv 
prostrating  and  require  tonics  from  the  start.  ^ 

Treatment.— Light  diet,  gentle  laxatives.  If  the  patient  be  ad- 
vanced in  life,  and  feeble,  a  tonic  (75)  will  be  desirable.  For  exter- 
nal applicatjon,  belladonna  (173),  o J  an'ointment  of  sulphuret  of  lime, 
(174),  or  elder-flower  ointment,  ete.  (175).     Equal  parts  of  chloral 

Itch.— Scabies. 

n^l^'ft^^ -^'f"^^  *""  '^*''''  ^""^  "^^^«'  *^°"gh  it  is  much  less  com- 
mon than  in  former  years.     It  is  found  frequently  among  the  ^o^ 


••'  r'  irtiiiiii' 


■i^ 


146 


SKIK  PI8KA8E8. 


whose  nondition  in  life  does  not  give  them  the  means  to  guard  at  all 
pointw  against  it ;  l)iit  it  is  most  common  among  such  as  neglect  per- 
sonal cleanliness. 

Symptoms. —  An  eruption  of  distinct,  cone-like,  watery  pimples, 
whicli  are  transparent  at  the  summits,  and  are  accompanied  by  an  ex- 
cessive itching,  which  is  made  worse  by  high-seasoned  food,  by  drink- 
ing liqUor,  and  by  the  heat  of  the  bed.  When  these  pimples  are 
scratched  and  torn,  a  sticky,  watery  fluid  is  poured  out,  which  forms 
small  scabs ;  and,  in  time,  if  the  disease  is  not  cured,  these  scabs  be- 
ing torn  off,  extensive  sores  are  made. 

Cause. —  It  will  excite  the  wonder  of  many  readers  to  state  that 
animals  of  so  small  a  size  as  scarcely  to  be  seen  with  the  naked  eye 
exist  in  the  skin  of  man.  Yet  such  is  the  fact ;  and  it  is  the  presence 
of  these  minute  creatures,  or  the  effect  of  their  presence,  which  con- 
stitutes the  disease  called  itch.  The  little  creature  (^acarus  scabiei, 
by  name),  a  species  of  mite,  is  one  seventy-seventh  part  of  an  inch  in 
lengtli ;  and  when  closely  inspected  under  the  microscope,  is  really  a 
beautiful,  I  may  say  an  elegant,  animal.  Here  are  a  front,  a  side,  and 
a  back  view  of  liim,  well  done  by  the  artist. 


Fro.  78. 


FIO.  74. 


FlO.  75. 


His  Method  of  Attack. —  When  placed  upon  the  skin,  the  little 
fellow,  like  the  squirrel  and  other  ground-animals,  sets  himself  to 
make  a  hole  through  the  scarf-skin  with  his  head  and  fore  feet.  Into 
this  he  pushes  his  whole  body.  He  then  begins  to  burrow  himself  in 
the  derma  or  true  skin  —  making  a  channel  many  times  his  own 
length,  at  the  end  excavating  a  chamber  where  he  sleeps,  and  whence 
he  goes  out  to  do  his  day's  work  at  mining,  or  boring  for  food.  When 
tired  of  this  sleeping  apartment,  he  digs  onward  and  scoops  out  an- 
other. 

This  travelling,  and  boring,  and  turning  about  in  an  organ  as  sen- 
sitive as  the  true  skin,  must,  of  course,  occasion  a  tickling  and  itch- 
ing ;  and  from  this  circumstance  the  disease  took  its  name  of  itch. 
But  this  itching  is  not  painful.  James  the  Fii-st  is  said  to  have  re- 
marked that  the  itch  was  fitted  only  for  kings  —  so  exquisite  is  the 


SKIN   DISRASIS. 


141 


uard  at  iill 
Jglect  per- 

y  pimplcH, 
I  by  lui  ex- 
,  by  tlriiik- 
iinples  are 
Wch  forniH 
scabs  be- 


state  that 
naked  eye 
e  presence 
vhich  con- 
Ma  scabieu 
an  inch  in 
is  really  a 
I  side,  and 


the  little 
limself  to 
feet.  Into 
himself  in 
}  his  own 
id  whence 
od.  When 
)8  out  an- 

au  as  sen- 
and  itch- 
le  of  itch. 
)  have  re- 
iaite  is  the 


onjoymentofscratchiMjj.     Probably  it  is  a  royal  luxury.     He  ll.at  as 
'  ™^V'"'"8t  persons  would  consent  to  have  it  all  done  by  roval  fin- 
ffers.     They  have  been  used  for  meaner  purposes. 

Treatment.—  Whatever  will  kill  the  little  animal  descrik-d  above, 
will  cure  the  itch.  Various  agentw  have  been  employed  for  this  pur- 
pose, but  none  have  been  found  equal  k,  sulphur.  The  compound 
sulphur  mntment  is  a  sovereign  ren.edy  for  the  disease.  Four  ounces 
of  this  should  be  well  rubbed  into  the  skin,  before  the  fire,  morning 
and  evening,  for  three  or  four  days.  This  will  put  v  end  to  the 
whole  colony  of  these  sovereign  squatters  upon  forbidden  soil. 

1  wo  ounces  of  sulphuret  of  potash,  and  the  same  amount  of  soft- 
soap,  dissolved  in  a  pint  of  water,  and  applied  well  to  the  skin,  is 
used  in  many  cases  with  good  effect. 

Caustic  potaah,  one  part  to  twelve  part«  of  water,  applied  in  a  sim- 
ilar way,  18  sartl  to  be  a  pretty  sure  remedy. 

A  solution  of  the  chloride  of  lime,  used  as  a  wash,  will  often  effect 
a  cure. 

The  ointment  of  the  American  hellebore  sometimes  does  well. 

liefore  applying  any  of  these  preparations,  let  the  skin  be  washed 
with  warm  water  and  soap,  and  well  dried.  Be  sure  the  parasite  is 
killed  before  ceasing  treatment.  Best  to  continue  few  days  longer 
than  what  is  apparently  needed.  ^ 

Rupia. 

This  is  from  a  Greek  word  which  means  dirt,  from  the  dirtK!olored 
crusts  which  are  formed  after  the  breaking  of  the  large  waterv  pim- 
ples. The  vesicles  are  like  those  of  eczema  and  herpes,  except  that 
they  are  laryer.  This  is  distinguished  from  all  other  skin  diseases  by 
the  formation  of  unhealthy,  foul,  and  burrowing  sores,  which  pour 
out  a  reddish  matter  in  such  quantities  that  it  collects  and  dries  upon 
the  sore,  and  forms  a  crust  of  great  thickness,  —  sometimes  of  the 
size  of  an  oyster-shell.  Rupia  has  its  origin  in  a  weakly  and  debili- 
tated constitution,  and  cannot  be  cured  without  renovating  the  whole 
system.     It  is  a  manifestation  either  of  syphilis  or  lupus. 

Treatment.-  Warm  baths  once  or  twice  a  week,  with  generous 
and  nutritious  diet.    Tonic  medicines  (63)  (51)  C67)  (61)  (65)  will 
be  required.     For  external  treatment,  dust  the  surface  of  the  ulcers 
with  cream  of  tartar,  or  apply  nitrate  of  silver  (214)  r219)  r220^ 
white  vitrol,  etc.     See  syphilis.  ^       ^  <.     ">>' 

Pemphigus.  — Pompholix. 

The  first  of  these  t^rms  is  from  the  Greek,  and  means  a  bubble  : 
the  second,  pompho  IX,  is  from  the  same  language,  and  means  a  water- 
bubble  This  IS  still  more  applicable  to  the  disease  in  hand,  which 
consists,  in  fact,  in  the  raising  up  of  the  scarf^kin  in  the  shape  of 


148 


SKIN    DIBIA8S8. 


hubbleH,  containing  a  watery  fluid.  These  hubbies  ar<i  just  liko  rom- 
mon  blisters.  They  vary  from  the  size  of  a  split  pea  to  that  of  n 
hen's  egg.  They  rise  up  very  rapidly,  and  break  in  Lwo  or  three 
days,  leaving  a  raw  surface  which  soon  becomes  co\-orcd  by  a  thin 
crust. 

Treatment. —  Similar  to  that  for  Hupia,  with  the  luldition  of  iodide 
of  potassium  (140),  and  applying  the  stick  nitrate  of  silver  to  the 
whole  surface  of  the  ulcer,  and  a  short  distance  l)eyond  it  on  all  sides, 
or  the  ointment  (176).    See  treatment  for  syphilis. 


Mattery  Pimplei, 

Another  natural  group  of  skin  diseases  are  distinguishod  by  an 
eruption  of  pimples,  filled,  not  with  water,  like  those  just  described, 
but  with  matter.  The  pimples  of  this  class  are  not  transparent,  or 
whitish,  but  opaque  and  yellow  from  the  first.  The  matter  is  poured 
out  upon  the  true  skin,  and  raises  up  the  scarf-skin,  in  the  same  way 
at  lie  watery  pimples.  As  in  the  preceding  diseases,  too,  the  drying 
up  of  the  matter  forms  crusts.  But  these  pimples  are  never  so  small 
as  those  of  eczema,  uor  so  large  as  those  of  pemphigus. 

Crusted  Tetter.  —  Impetigo. 

This  eruption  consists  at  first  of  slightly-elevated  pustules  or  pim- 
ples, closely  congregated,  with  an  inflamed  border.  These  break,  and 
the  surface  becomes  red,  excoriated,  shining  and  full  of  pores,  through 
which  a  thin,  unhealthy  fluid  is  poured  out,  which  gradually  hardens 
into  dark,  yellowish-green  scabs.  These  scabs  sometimes  look  like  a 
dab  of  honey  dried  upon  the  skin.  This  has  given  impetigo  the  name 
of  "honey  disease,"  or  honey  scab.  This  honeyed  look  is  well  repre- 
sented in  the  crusts  which  form  on  the  lips  and  ears  of  children. 
Sometimes  these  scabs  cover  nearly  the  whole  face,  and  are  called  the 
milk  crust.  This  is  putting  the  agreeable  words  milk  and  honey  to 
rather  questionable  uses !  When  this  crusted  tetter  invades  the  head 
or  scalp,  it  causes  the  hair  to  fall,  and  becomes  what  is  called  a  scall. 
Impetigo  may  be  simple,  or  contagious,  or  syphilitic. 

Treatment. —  The  vapor  bath,  and  water  dressing.  The  following 
ointments  are  useful :  oxide  of  zinc,  white  precipitate,  or  diluted  ni- 
trate of  mercury  (178).  Hydrocyanic  acid  (221),  applied  externally, 
has  a  fine  effect.  The  crusts  should  first  be  removed  by  a  weak  lye 
made  from  hard-wood  ashes,  or  potash ;  then,  after  applying  one  of 
the  ointments  above,  or  the  lotion,  cover  the  part  with  oil-skin.  If 
the  crusts  are  on  the  head,  the  hair  should  be  cropped  off  before  the 
remedies  are  applied.  When  of  syphilitic  origin,  treat  as  for  that 
disease. 


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SKIN   DI8EAS1E8. 


149 


Papulous  Scall.  —  Ecthyma. 


The  mattery  pimple  called  ecthyma  is  developed  on  a  highly  in- 
flamed skin.  The  bladders  are  about  the  size  of  a  split  pea,  and  are 
surrounded  by  a  broad  ring  of  redness.  They  are  generally  separate, 
not  clustered  like  impetigo.  They  are  scattered  over  various  parts  of 
the  body,  and  are  followed  either  by  a  hard  black  crust,  or  by  a  sore. 
The  disease  is  either  acute  or  chronic.  The  latter  attacks  weakly 
children,  and  persons  reduced  by  sickness  or  low  living. 

Treatment. —  For  the  acute  form,  give  a  generous  diet,  with  oint- 
ment (176),  and  the  cold  sponge-bath  on  the  sound  parts.  Use 
(176)  (176)  (214)  (211)  for  external  application.  Hygienic  treat- 
ment, tonics,  and  stimulants  are  called  for ;  iron,  quinine,  arsenic,  and 
nux  vomica. 


Scaly  Eruptions. 

The  scaiy  eruption  is  called  a  dry  tetter.  It  is  an  inflammation  of 
the  true  skin,  and  is  distinguished  from  the  rashes  and  pimples  by 
the  alteration  of  the  scarf-skin.  The  diseases  forming  this  group  are 
three  in  number, —  lepra,  psoriasis,  and  pityriasis. 

Leprosy.  —  Lepra, 

In  this  disease,  the  eruption  makes  its  appearance  as  a  small,  sal- 
mon-red spot,  raised  a  little  above  the  surrounding  skin,  and  consti- 
tuting, in  fact,  a  flat  pimple,  almost  as  large  at  the  top  as  at  the  bot- 
tom. On  top  of  this  pimple  the  scarf-skin  becomes  rough,  and  after 
a  little  while  a  thin  scale  is  produced.  New  layers  are  added  to  its 
under  surface,  and  it  accordingly  grows  thicker.  It  has  a  bright, 
silvery  lustre.  These  scaly  spots  multiply,  and  become  the  form  of 
leprosy  called  lepra  guttata,  from  the  Latin  gvtta,  a  drop,  the  scales 
looking  like  drops  of  water  on  the  skin. 

But  the  eruption  more  frequently  spreads  out  into  circular  patches, 
of  the  size  of  a  fifty-cent  piece.  These  generally  appear  below  the 
elbows  and  knees,  and  on  the  breast  and  shoulders,  and  back  of  the 
hands.  Sometimes  the  entire  hand  is  covered  with  scales  of  a  pecu- 
liar silvery  whiteness.     These  patches  heal  from  the  centre. 

Psoriasis. 

This  differs  from  lepra  in  the  eruption  being  more  irregular.  The 
spots  sometimes  come  out  in  thick  clusters,  and  blend  in  various 
ways.  Instead  of  appearing  in  distinct  circular  forms,  as  in  leprosy, 
the  patches  are  irregular,  and  of  every  size.  Instead  of  one  well- 
formed  and  thick  scale,  there  are  many  small  and  thin  ones.  And 
instead  of  a  depressed  centre  with  rising  edges,  the  surface  m  level. 
While  leprosy  is  a  circular  dry  tetter,  this  is  an  irregular  dry  tetter. 


150 


SKIN   DISEASES. 


Treatment Pyrogallic  acid  in  ointment,  10  to  40  gr.  to  oz.  Ap- 
ply daily ;  it  discolors  the  skin  for  a  while.  Chrysoplianic  acid  in 
same  strength  is  the  best  remedy  known.  It  also  discoloi-s  the  skin 
and  inflames  the  neighboring  skin  for  a  while.  Recently  the  thyroid 
gland  of  the  sheep  has  been  used  in  five-grain  ta.blet8  three  times 
daily  as  an  internal  medicine  with  much  success. 

Pityriasis. 

This  is  much  like  the  two  preceding,  except  that  it  gives  rise  to 
a  copious  production  of  very  small  bran-like  scales.  Indeed,  its  name 
is  from  the  Greek,  and  means  chaff  or  bran.  It  is  a  branny  tetter. 
It  may  occur  on  any  part  of  the  body. 

Treatment. —  When  the  skin  is  highly  inflamed  and  stiff  with  heat, 
pain,  and  itching,  the  diet  should  be  light,  and  the  drinks  of  a  cooling 
and  unexciting  kind.  The  warm  bath  and  gentle  friction  of  the  skin 
are  useful.  Laxatives  or  tonics  may  be  employed,  according  to  the 
indications, —  frequently  laxatives  first,  and  tonics  afterwards.  The 
specific  remedies  for  curing  the  disease  are  unknown ;  iodide  of  potas- 
sium (140),  arseniate  of  iron  (68),  Fowler's  solution,  in  two-drop 
doses,  three  times  a  day ;  or  Donovan's  solution,  in  five-drop  doses, 
three  times  a  day.  For  extevnal  application,  use  a  naphthaline  oint- 
ment](177),  zinc  o'ntment,  white  precipitfite  ointment,  diluted  nitrate 
of  mercury  ointment,  or  solution  of  corrosive  sublimate  (212). 


\ 


Dry  Pimples. 

These  are  distinguished  by  the  high  degree  of  irritation  of  the 
skin  which  they  create.  They  are  exceedingly  troublesome,  not  only 
from  the  distress  and  itching  they  occasion,  but  because  they  are 
likely,  in  consequence  of  this,  to  be  torn  into  painful  and  obstinate 
sores. 

When  appearing  in  children,  they  are  called  red  gum,  and  tooth- 
rash.  In  grown  persons,  one  form  is  named  lichen,  and  another,  dis- 
tinguished by  excessive  itching,  prurigo. 

In  this  form  of  pimpljs,  the  fluid  is  not  poured  out  upon  the  sur- 
face of  the  true  skin,  —  as  in  several  of  the  preceding  diseases,  —  bat 
is  collected  within  the  tissue  of  this  organ,  and  the  pimples  feel  hard 
under  the  finger. 

The  tooth-rash  of  infants  is  always  accompanied  with  some  fever- 
ishness,  aused  generally  by  irritation  of  the  gums  from  growing  teeth, 
occasionally  by  flannel  worn  next  the  skin. 

Lichen  has  a  variety  of  forms.  In  one  case  the  pimples  are  of  a 
bright  red,  in  another,  bluish  or  livid.  In  one  case  they  appear  in 
circular  groups,  in  another  they  produce  great  disorganization  of  tlie 
akin,  and  occasion  terrible  suffering. 


.MlStX:, 


SKIN    DISEASES. 


151 


jr.  to  oz.  Aj)- 
lianic  acid  in 
•loi-s  the  skill 
ly  the  thyroid 
i  three  times 


gives  rise  to 
eed,  its  name 
ranny  tetter. 

iff  with  heat, 
1  of  a  cooling 
1  of  the  skin 
rding  to  the 
ivards.  The 
ide  of  potas- 
in  two-tlrop 
-drop  doses, 
thaline  oint- 
uted  nitrate 

:2i2). 


ition  of  the 

le,  not  only 

le  they  are 

obstinate 

and  tooth- 
nother,  dis- 

»n  the  sur- 
ises,  —  but 
feel  hard 

)nie  fever- 
v^ing  teeth, 

3  are  of  a 
appear  in 
on  of  the 


Prurigo  is  a  still  more  cruel  disease  tluin  lichen.  '.  ..o  pimples  are 
not  very  manifest,  but  the  skin  is  thickened  or  swollen,  and  con- 
densed. The  suffering  from  it  is  terriMe.  It  gives  one  no  sleep, 
night  or  day.  That  form  of  it  called  ant-bite  prurigo  gives  the  sen- 
sation of  millions  of  ants  eating  the  flesh,  or  as  many  red-hot  needles 
piercing  it.  This  renders  the  existence  of  many  elderly  persons  a 
terrible  burden. 

Treatment. — Careful  diet,  and  gentle  aperients  and  tonics,  accord- 
ing to  the  condition  of  the  system.  Externally,  the  cold  salt-water 
sponge-bath,  and  glycerine,  vinegar  and  water,  applied  with  a  soft 
sponge.  Tar  and  sulphur  are  among  the  more  successful  remedies  in 
fighting  this  rebellious  disease  (362).  Iron,  quinine,  cod-liver  oil. 
For  relieving  the  terrible  itching  of  the  private  parts,  which  females 
sometimes  suffer,  I  have  found  morphine  (223),  for  external  use, 
very  effectual. 

Lupus. 

This  makes  its  appearance  in  the  form  of  one  or  more  circular 
elevations,  of  a  dull  red  or  salmon-color,  and  partially  transparent. 
When  pressed  under  the  finger,  these  elevations  are  found  to  be  soft, 
and  when  the  finger  is  removed,  they  are  flat  and  whitened.  They 
generally  appear  on  the  face,  and  particularly  the  nose. 

In  another  and  worse  form  of  the  disease,  the  tubercles  are  harder; 
and  after  a  time,  they  become  covered  with  thin  brown  scabs,  which 
are  scratched  off,  and  followed  by  others, 
and  these  by  others,  until  ulcers  appear, 
which  are  sometimes  slow  and  sometimes 
rapid  in  their  progress.  The  whole  nose 
has  been  destroyed  by  them  in  a  month. 
(See  Fig.  76.)  This  is  one  of  the  dis- 
eases which  Eriismus  Wilson  thinks,  and, 
in  my  judgment,  correctly,  to  be,  like 
scrofula,  the  result  of  the  syphilitic  poi- 
son, filtered  through  the  blood  of  several 
generations.  It  is  a  disease  which  is  the 
most  destructive  in  the  shortest  time  of 
all  diseases. 

Treatment. —  The  internal  remedies 
are  iodide  of  ai-senic  (141),  and  iodide 
of  potassium  (140)  ;  the  external,  vine- 
gar of  Spanish  flies  ;  and  to  promote  the 
healing  of  the  ulcers,  a  weak  solution  of  nitrate  of  silver  (211)  (214) 
is  adapted. 

Hardly  any  disease  has  been  treated  by  so  many  different  remedies. 
At  present  the  prospect  of  a  cure  is  good,  as  certain  anti-tubercular 


FlO.  76. 


1^.^: 


152 


SKIN   DISEASES. 


lymph  injections  have  been  found  effective ;  but  no  time  should  be 
lost  in  immediately  consulting  a  surgeon,  as  ite  growth  can  be  ar- 
rested, and  the  disease  may  be  exterminated  by  early  treatment. 

Warts  and  Corns. —  Verruca  —  Tylod%  —  Clovtis. 

In  the  derma  or  true-skin  there  are  a  great  many  small  arteries, 
veins,  and  nerves,  unit  d  together,  and  formed  into  loops  (see  Fig. 
43),  resembling,  in  shape,  the  peaks  of  miniature  mountains.  These 
are  called  papillce.  These  loops,  frequently,  without  any  apparent 
cause,  take  on  a  disposition  to  grow,  and  by  extending  themselves 
upward,  they  carry  the  scarf-skin  along  with  them,  which  is  thickened; 
and  together  they  form  what  is  called  tvarts.  Corns  are  formed  by  a 
somewhat  similar  growth  of  the  papillae,  brought  about  by  the  pres- 
sure and  friction  of  tight  boots  and  shoes. 

Treatment. —  For  warts,  take  a  piece  of  diachylon  plaster,  cut  a 
hole  in  the  centre  the  size  of  the  wart,  and  stick  it  on,  the  wart  pro- 
jecting through.  Then  touch  it  daily  with  aqua  fortis.  Nitrate  of 
silver  sometimes  answers  well  for  touching  it.  They  may  be  taken 
off  very  neatly,  sometimes,  by  tying  a  string  tight  around  them. 
Corns  should  be  shaved  down  close,  after  being  soaked  in  warm 
water  and  soap,  and  then  covered  with  a  piece  of  wash-leather,  or 
buckskin,  on  which  lead  plaster  is  spread,  a  hole  being  cut  in  the 
leather  the  size  of  the  corn.  They  may  be  softened,  so  as  to  be  easily 
scooped  out,  by  rubbing  glycerine  on  them.  Manganic  acid  destroys 
warts  and  corns  rapidly.  Bunions,  which  affect  the  joint  of  the  great 
toe,  must  be  treated  with  fomentations,  and  sugar  of  lead  water 
(224),  when  there  is  considerable  inflammation,  with  rest  in  a  hor- 
izontal position.  But  the  best  cure  for  corns  and  bunions  is  to  put 
away  tight  shoes.  Wear  a  bunion-plaster  for  some  time  to  take  the 
pressure  off  of  the  corn  or  bunion. 

Mother's  Marks. — Naevus. 

The  small  vessels  of  the  skin,  called  capillaries,  suffer  certain  al- 
terations of  structure  which  pass  under  the  name  of  mother's  marks. 
These  marks  are  simply  a  great  dilatation  of  theie  minute  blood-ves- 
sels. They  vary  in  size  from  a  mere  point  to  a  patch  of  several 
inches  square. 

The  smallest  of  all  is  the  spider  mark.  It  is  a  small  red  point, 
from  which  several  little  straggling  vessels  spread  out  on  all  sides. 
Sometimes  this  is  of  the  size  and  appearance  of  a  red  currant ;  at 
other  times,  of  a  strawberry  or  raspberry ;  and  occasionally  it  is  even 
much  larger,  and  is  compared  to  a  lobster. 

When  the  circulation  is  active  through  them,  or  the  individual  is 
excited  by  exercise,  or  by  moral  causes,  these  marks  are  of  a  bright 
red  color.     Some  are  naturally  livid  and  dark-colored,  and  look  like 


b«.U4l 


SKIN  mSRASKS. 


153 


me  should  he 
th  can  be  ar- 
'eatment. 

•  Clovus. 

mall  arteries, 
ops  (see  Fig. 
tains.  These 
any  apparent 
g  theniselves 
is  thickened; 
i  formed  by  a 
by  the  pres- 

plaster,  cut  a 
the  wart  pro- 
.  Nitrate  of 
nay  be  taken 
round  them. 
ed  in  warm 
sh-leather,  or 
?  cut  in  the 
i  to  be  easily 
icid  destroys 
;  of  the  great 

lead  water 
est  in  a  hor- 
)ns  is  to  put 

to  take  the 


r  certain  al- 
ler's  marks, 
blood-ves- 
of  several 

red  point, 
all  sides, 
iurrant;  at 
it  is  even 

dividual  is 
a  bright 
look  like 


blackberries,  and  black  currants.  The  blueness  of  these  is  owing  to 
the  vessels  being  still  more  stretched  and  dilated,  and  to  the  conse- 
(juent  slower  passage  of  the  blood  through  them,  which  gives  more 
time  for  its  change  from  the  arterial  red  to  the  venous  blue. 

Treatment. —  If  the  mark  is  not  making  progress,  it  had  better  be 
let  alone,  or  only  subjected  to  gentle  pressuie  by  piitting  a  piece  of 
soap-plaster  over  it.  When  its  course  is  threatening  mischief,  it  is 
sometimes  cured  by  pencilling  a  small  portion  of  its  surface,  from 
time  to  time,  with  nitric  acid.  They  may  be  operated  on  with  safety 
by  electrolysis  and  other  methods. 

Disordered  State  of  the  Nerves  of  the  Skin. 

Itching. —  Pruritus.  This  is  supposed  to  be  dependent  on  an  al- 
tered condition  of  the  nerves  of  the  skin,  and  consists  in  a  painful 
sensation  of  itching.  There  is  no  perceptible  alteration  in  the  ap- 
pearance or  structure  of  the  skin.  This  itching  is  thought,  generally, 
to  be  a  result  of  sympathy,  through  the  nerves,  with  some  diseased 
and  excited  condition  of  a  distant  part.  The  itching^  is  brought  on 
by  the  most  trifling  causes,  and  for  hours  may  deprive  the  sufferer  of 
every  particle  of  repose.  It  more  frequently  affects  the  fundament, 
or  the  private  parts,  particularly  the  scrotum. 

Treatment. —  As  this  disease  is  only  a  symptom  of  several  others, 
the  constitutional  treatment  belongs  under  the  heads  of  these  other 
diseases.  The  local  applications  for  relieving  the  itching  are,  a  solu- 
tion of  sugar  of  lead  (224),  hydrocyanic  acid  (363),  of  corrosive  sub- 
limate (212),  diluted  nitrate  of  mercury  ointment,  and  poppy  fomen- 
tations. Also  (223).  Tonics  are  often  of  first  importance.  Weak 
solutions  of  carbolic  acid  or  soda  water  at  tim6s  suffice. 

Disorders  Affecting  the  Color  of  the  Skin. 

Colored  Patches. —  Maculae.  The  depth  of  color  in  the  skin  de- 
pends on  the  amount  of  a  certain  coloring  matter,  called  pigment,  in- 
corporated with  the  deeper  and  softer  portion  of  the  scarf-skin.  In 
the  scarf-skin  of  the  inhabitants  of  northern  latitudes,  there  is  but 
little  of  this  pigment ;  in  that  of  the  dwellers  of  Africa,  there  is  a 
great  deal ;  among  the  inhabitants  of  Southern  Ev\rope,  the  quantity 
is  intermediate  between  tlie  two. 

The  depth  of  color  in  the  skin  depends  on  the  energy  of  its  action. 
In  the  tropics,  where  light  and  heat  are  in  excess,  the  skin  is  stimu- 
lated to  great  action,  just  as  vegetation  is,  and  the  color  is  increased 
and  intensified.  This  is  illustrated  every  year  before  our  eyes.  In 
summer,  under  the  heat  of  the  sun  and  the  flood  of  light,  the  pigment- 
forming  power  is  increased,  and  the  fairest  skin  is  browned ;  while 
the  withdrawal  of  these  forces  leaves  the  winter's  scarf  without  pig- 
ment, and  blazoned.  .. 


154 


SKIN   DI8EASBH. 


What  the  sun  aiul  light  do,  uadei'  iiiituml  circumstances,  (hscased 
action  may  effect.  Hence  we  occasiDUiilly  meet  with  alterations  of 
color  in  the  skin,  from  a  disordered  state  of  the  system.  We  wit.'iesK 
the  formation  of  patches  of  dark  color  and  irregular  shape  on  various 
parts  of  the  body.  Sometimes  they  are  raised  al)Ove  the  level  of  tlio 
skin,  and  are  called  moles.  At  other  times,  they  have  no  elevation, 
and  spread  over  the  whole  body. 

Occasionally,  from  some  peculiarity  of  constitution,  the  pigment  is 
diminished,  and  white  patches  appear  all  over  the  body.  At  other 
times,  a  black  person  will  become  completely  white.  Such  are  called 
albinos. 

In  many  cases  the  coloring  of  the  skin  has  varieties  of  tint,  as  when 
pei-sons  of  light  complexion,  are,  in  the  summer  season,  covered  with 
yellow  si)ots,  like  stains.  These  spots  are  known  by  the  name  of 
freckles,  or,  in  learned  language,  lentigo. 

Treatment. —  It  is  generally  best  not  to  meddle  with  a  mole.  If  it 
be  very  unsightly,  let  it  be  removed  by  two  incisions,  biking  out  an 
elliptical  portion  of  skin,  and,clo8ing  the  wound  with  sticking  plaster. 
In  the  case  of  bleached  places,  apply  the  shower  bath,  tonics,  and  a 
stimulating  liniment  (168)  to  the  faded  spots.  For  the  change  of 
color  Ccalled  sunburn,  a  liniment  (191)  of  lime-water,  etc.,  is  the  best 
preparation.  For  freckles,  use  recipe  360,  or,  perhaps,  still  better, 
364. 


Disorders  *of  the  5weat-Qlands. 

The  perspiration  is  sometimes  greatly  increased  above  nature's  de- 
sign. This  is,  technically,  idrosis.  In  other  instances  there  is  too 
little  sweating.  This  ^  called  anidrosis.  Sometimes  the  perspiration 
is  so  altered  in  its  physical  qualities  as  to  have  some  peculiar  smell. 
This  is  osmidrosis.  In  some  rare  instances,  according  to  old  writers, 
the  sweat  was  changed  in  color.  This  was  chromidrosis.  And  now 
and  then  a  case  occui-s  of  bloody  perspiration,  of  which  the  most 
memorable  case  on  record  is  that  of  the  Redeemer  of  men,  who,  in 
the  garden,  sweat  great  drops  of  blood.  Several  cases  of  this  are  re- 
corded in  medical  l)ooks.     It  is  called  hcemidrosis. 

The  proper  action  of  the  skin  being  so  vitally  important  to  health, 
these  changes  often  involve  very  serious  consequences. 

Treatment. —  Either  too  much  or  too  little  sweating  can  generally 
be  corrected  by  the  cold  or  warm  bath,  friction,  tonics,  and  proper 
clothing.  Small  doses  of  jaborandi,  also  ergot  and  strychnine,  are 
among  the  best  internal  medicines  (365). 

Disorders  of  the  Oil -Glands  and  Tubes. 

That  the  skin  may  be  liml)er,  healthy,  and  fit  for  use,  it  is  neces- 
sary to  have  it  oiled  every  day.     For  this  object,  the  Creator  lias 


ices,  diseased 
ilterations  of 

We  witness 
[)e  on  various 

level  of  the 
no  elevation, 

e  pigment  is 
y.  At  other 
z\\  are  called 

tint,  as  when 
levered  with 
ihe  name  of 

mole.  If  it 
^ing  out  an 
:ing  plaster, 
onics,  and  a 
I  change  of 
,  is  the  best 
still  better, 


lature's  de- 
lere  is  too 
erspiration 
iliar  smell. 
Id  writers, 
And  now 
the  most 
n,  who,  in 
;lus  are  re- 

to  health, 

generally 
id  proper 
mine,  are 


is  neces- 
eator  has 


SKIN  DISEASES. 


155 


wisely  provided,  by  placing  in  the  true  skin  a  largo  number  of  very 
Huuill  glands  and  tubes,  whose  office  it  is  to  prepare  and  pour  out 
upo!i  the  surface  the  proper  amount  of  oil.  The  gland,  regular  little 
oil-pot,  is  in  the  true  skin ;  and  from  it  a  ptece  of  hose  or  tube  runs 
up  through  the  scarf-skin,  through  which  the  oily  fluid  is  poured  out. 
Some  of  these  tubes  are  spiral,  others  are  straight.  On  some  partH 
these  vessels  do  not  exist;  on  othera  they  are  (juite  abundant,  —  as  on 
the  face,  nose,  ears,  head,  eyelids,  etc.  They  produce  the  wax  of  the 
ears;  and  on  the  head,  they  open  into  the  sheath  of  the  hair,  and  fur- 
nish it  with  a  hair-oil  or  pomatum  better  than  the  chemist  can  make. 
These  little  vessels  are  always  at  work,  when  the  skin  is  healthy ; 
and  no  persons  need  W  afraid  to  wash  all  over  every  day,  lest,  as  the 
Boston  Medical  Journal  taught,  the  skin  will  be  injured  by  having 
the  oil  removed  from  it.  You  might  as  well  be  afraid  to  eat  a 
meal  of  victuals,  lest  the  saliva  should  all  Iw  swallowed  with  it,  and 
none  be  left  for  future  use.  There  is  oil  enough  where  that  upon 
the  skin  comes  from,  and  the  vessels  which  produce  it  are  not  injured 
by  work,  any  more  than  the  muscles  of  the  legs  are  by  walking. 

Qrubs  or  Worms. —  But,  unfortunately,  the  skin  is  not  well  taken 
care  of  in  all  cases,  as  in  cities  and  towns  where  sedentary  habits  pre- 
vail. Here,  the  actions  of  the  skin,  instead  of  being  regular  and  com- 
plete, are  often  sluggish  and  imperfect ;  and  the  contents  of  the  oil- 
cells  and  tubes,  instead  of  flowing  easily,  become  hard  and  impacted, 
and  the  vessels  are  not  emptied.  When  this  matter  beconies  station- 
ary, dry,  and  hard,  it  distends  the  tube,  and  fills  it  to  the  suiiace;  and 
then  coming  in  contiict  with  the  dust 
and  smoke  of  the  atmosphere,  the  ends 
become  black,  and  look  like  the  heftds 
of  worms.  These  spots  are  common 
on  the  nose  and  face  of  persons  who 
have  a  sluggish  skin.  They  may  be 
squeezed  out  by  pressing  tlie  nails  on 
each  side  of  them.  These  are  called 
gruhs  and  tvorms,  or,  technically,  come- 
dones. When  this  matter  produces  in- 
flammation of  the  tube,  there  is  then  a 
black  spot  in  the  middle  of  a  red  pimple, 
and  the  disease  is  called  spotted  acne. 
Now  and  then  the  oily  matter  becomes  very  hard,  producing  spine- 
like growths,  and  even  horns  (Fig.  77)  ;  and  again,  it  collects  and 
forms  soft  tumors,  as  wens,  etc.  These  are  technically  called  encysted 
tumors.  Sometimes  the  action  of  the  glands  is  too  great,  and  oil  is 
poured  out  so  profusely  that  the  face  shines  with  it.  At  other  times 
there  is  so  little  that  the  skin  is  dry  and  hai-sh.  In  the  hardened 
oily  matter,  which  constitutes  grubs,  are  found  small  animals,  which 
Ur.  Wilson  calls  the  "animal  of  the  oily  product  of  the  skin."  On 
page  156  are  three  views  of  him.  , 


156 


SKIN    DISEASES. 


Treatment— For  roughness  and  harshness  or  skin,  wasli  with  «.. 
and  water  every  night,  and  rub  well  into  the  skin  XThe  fi  T„  i 

V     ;,  a  weejc.     Vr,  rub  the  skin  every  morning  with  a  damp 


Via.  78. 


FlO.  79. 


FlO.  80, 


«ao„    ^      •'^       -^  ,    applied.     Ihe  spinous  variety,  or  porcuninA  dis- 

TrnTtwii  I'dr   F  '^"'"'r^  ?•  '*'r^  *^«  "««  -^  the^olntm  ft 
iifl*  ^^;    *^"'  S^""^'  stimulate  the  skin    by  washintr  it 

W«l    '""f  rP""*^'  '""''^  ^  •^^y'  ^'^d  rubbing  briskly  witi  a    oLe 
towel;  and  by  using  the  corrosive  sublimate  (225)  a/aTotion 
A  spare  diet  will  do  much  towards  improving  ih^  skin  i^' many 

^^  S  (352rrheal"-^"^'  '^^^^^^  *^^ '°^^  ^^^'^  ^^  (^^^I 

Barbers'  Itch. -Jackson's  Itch.  — Sycosis. 

iin^^^i!^  ""^"^  much  like  acne,-  only  differing  from  it  in  its  loca- 
tion     It  appears  chiefly  on  the  haiiy  parte  of  the  face,-  th?  chin 

of  theTec^'  uV'^T  ''  *^  ,"'^^^ '"'  ^h«  «y«brows,  'and  the  nap 
ot  the  neck.     It  consists  in  little  conical  elevations,  which  maturate 

pimples  are  of  a  pale  yellowish  color.    In  a  few  days  they  burst  and 
n  stTflnUrZ  ""!'  ''''"V'^r  ^*^^'  '^^^"-'^  cruL.""These 

nesl'o'f  the'ski:;."  '""'''  '^  ^  ^^^"'"^  «^"«^*^-  "^  ^^^  -^  tight- 
duH  ^.nl'^'^'J'  supposed  to  be  brought  on  frequently  by  using  a 
fnlraVd%tT"o?yeai^^^^^^"^^^^^^^ 


..      -t-^ 


SKIN   DISEASES. 


157 


wli  with  soap 
the  bath,  and 
sulphur,  etc. 
vith  a  damp 


80. 

ice,  the  lini- 
rcupine  dis- 
ing  a  large 
le  ointment 

washing  it 
[ith  a  coarse 
ation. 
in  many 

first  (360) 


SIS. 

its  loca- 

the  chin, 

the  nape 

maturate 

m.    These 

burst,  and 

These 

pimples 

md  tight- 

y  using  a 
'or  many 


Treatment. —  The  most  important  part  of  the  treatment  is  the  re- 
moval of  the  cause.  The  beard  must  not  be  pulled  with  a  dull  razor; 
the  shaving  had  better  be  discontinued  altogether,  and  the  beard  be 
merely  cropped  off  with  scissors  instead.  All  intemperance  in  eating 
and  drinking,  and  exposure  of  the  face  to  heat,  must  be  avoided.  A 
light,  cool  diet  will  do  much  towards  curing  the  disease. 

The  nitrate  of  mercury  ointment,  and  a  solution  of  oxalic  acid,  are 
the  best  applications.  If  one  does  not  succeed,  try  the  other.  Black 
wash  is  to  be  used  when  the  face  is  much  inflamed. 

Disorders  of  the  Hair  and  Hair-Tubes. 

The  hair  is  an  appendage  of  the  scarf-skin,  and  is  intended  to  be 
both  useful  and  ornamental. 

It  is  subject  to  several  disorders.  It  may  grow  too  long,  or  too 
thick,  or  it  may  appear  in  an  improper  place.  This  last  happens  in 
the  case  of  those  little  spots  and  patches  which  disfigure  the  face, 
and  are  '^alled  moles.  The  hair  may  be  defective  in  its  growth,  or 
may  fall  off  prematurely  from  various  causes,  or  in  the  natural  course 
of  things  from  old  age.  This  last  is  called  calvities.  It  may  change 
its  color,  too,  under  a  great  variety  of  circumstances,  and  at  nearly 
every  age.  It  is  not  very  uncommon  to  find  a  single  lock  varying  in 
color  from  that  which  surrounds  it.  Old  age,  the  winter  of  life,  nat- 
urally brings  the  frosted  locks;  but  they  frequently  appear  also  upon 
the  heads  of  younger  perso  s.  Strong  mental  emotions,  such  as  fear. 
grief,  or  sorrow,  may  bring  a  bleaching  of  the  hair  in  a  brief  period, 
or  even  suddenly.  Byron,  in  his  "  Prisoner  of  Chillon,"  beautifully 
refers  to  this  fact :  —  -  . 

"  My  hair  is  gray,  but  not  with  years, 
Nor  grew  it  white 
In  a  single  night, 
As  men's  have  grown  from  sudden  fears." 

Porrtgo. — There  is  a  troublesome  disease  of  the  hair  and  hair-tubes 
called  porrigo.  It  begins  with  the  formation  of  a  thin  layer  of  scurf 
either  around  single  hairs,  or  in  patches  which  enclose  several.  These 
patches  frequently  have  a  circular  form,  which  give  to  the  affection 
the  character  of  a  ringworm.  The  hair-tubes  are  generally  a  little 
elevated,  in  the  shape  of  papillae,  which  gives  to  the  diseased  scalp 
the  appearance  of  "goose-flesh."  These  hairs,  losing  their  proper 
nourishment  and  healthiness,  break  off  at  unequal  distances  from  the 
skin,  leaving  their  rough  ends  twisted  and  bent,  and  matted  into 
thick  grayish  and  yellow  jrusts.  Upon  the  surface  of  these  crusts 
may  generally  be  seen  the  ends  of  a  few  hairs,  looking  like  the  fibres 
of  hemp  or  tow.  The  scratching  causes  inflammation  of  the  skin  after 
a  time,  and  matter  is  poured  out,  which  still  further  mats  the  hair, 
and  thickens  the  crusts.  There  are  several  varieties  of  this  disease, 
differing  slightly  from  each  other ;  but  this  general  description  will 
answer  all  practical  purposes  for  this  work. 


■«*?- 


158 


SKIK   DIHEARRS. 


The  reader  will  often  notice  ii  diHease  of  tlio  liair-plands,  clmrarter- 
ized  l)y  a  yellowish  and  dirty-looking  powder,  covering  the  acalp  iuid 
hairs.  This  matter  is  eoUected  at  the  mouths  of  the  follieles,  and 
considerable  of  it  is  strung  upon  the  hairs  like  Insads.  Pull  out  ii 
hair,  and  the  roof  will  Ikj  fk)und  thin,  dry,  and  starved  in  its  ajjpear- 
ance.  In  this  <lisease,  it  is  difficult  to  keej)  the  hair  cleansed,  or  to 
prevent  its  falling  off. 

FavuSr — Still  another  disease,  called /rt7'M«,  is  known  hy  the  collec- 
tion of  a  yellow  substance,  at  first,  around  the  cylinder  of  the  liair. 
This  8ul)staiu',e,  after  a  ♦inie,  spreads  out  upon  the  scurf  skin,  and 
dries  into  yellow  crusLs,  in  the  form  of  a  cup,  around  the  base  of  each 
hair.  A  numlier  of  these  cups,  collected  together,  look  like  the  cells 
of  a  honey-comb.  This  disease  is  contagious,  and  is  communicable 
by  contjict  to  any  part  of  the  skin. 

Treatment. —  For  removing  the  hair  from  particular  parts  of  the 
scalp,  it  is  common  to  resort  to  depilatories.  Of  these,  the  recipes 
260,  261,  262,  are  frequently  used,  and  are  as  good  iw  those  adver- 
tised ;  indeed,  they  are  the  same.     Forceps  are  the  Inist  means. 

To  prevent  loss  of  hair,  and  to  restore  it  when  lost,  the  circulation 
should  be  stimulated  in  the  small  vessels  of  the  scalp.  With  this 
view,  washing  the  head  every  morning  with  cold  water,  drying  it  by 
friction  with  a  rough  towel,  and  brushing  it  to  redness  with  a  stiff 
hair-brush,  are  excellent.  To  these  should  l)e  added  some  stimulating 
ointment  (183),  or  liniment  (257),  (258),  (2o9).  These  last  are  about 
the  best  known  preparations  for  causing  the  growth  of  the  hair. 

Ringworm  of  the  scalp  requires  attention  to  the  diet,  and  such 
remedies  as  will  improve  the  general  health,  with  stimulating  appli- 
cations externally  (267),  (258),  (259).  366  is  the  newest  and  best 
mode. 

To  color  the  hair,  several  preparations  are  used.  Of  these,  163  is 
about  the  l)est.  It  produces  a  beautiful  black.  A  preparation  of  sul- 
phur and  sugar  of  lead  ^264)  is  the  famous  compound  recommended 
by  General  Twiggs,  and  extensively  used.  Preparations  of  nitrate  of 
silver  (265),  (266),  (311)  a.e  much  in  use  in  some  quiirters.  They 
perhaps  give  a  finer  black  to  thp  hair,  but  they  render  it  dry  and  crisp, 
and  they  will  stain,  the  skin,  if  care  is  not  used  iii  applying  them. 

Use  care  in  the  use  of  these  remedies. 

In  Favus,  the  two  great  objects  to  be  gained  are,  to  remove  all  lo- 
cal causes  of  irritation,  and  to  excite  the  diseased  hair-glands  to 
healthy  action.  The  first  object  is  affected  by  cutting  off  the  hair 
with  the  scissors,  and  removing  the  crusts  by  washing  the  scalp  with 
castile  soap  and  water.  It  may  be  well  first  to  wet  the  crusts  through 
with  corrosive  sublimate  (212),  in  weak  solution.  The  washing  with 
foap  and  water  should  be  repeated  every  day,  and  b§  followed  by 
rubbing  into  the  scalp  a  stimulating  ointment  (183).  A  very  weak 
solution  of  tlu!  nitrate  of  mercury  (226),  applied  every  other  day, 
with  a  camel's  hair  brush,  sometimes  produces  excellent  effects. 


'^ 


y 


iida,  cliftnvcter- 
the  scalp  and 
folliclcH,  iin«l 
1.  Pull  out  ii 
in  its  a|)j)ear- 
leanaud,  or  lo 

by  the  oollec- 
'  of  the  liiiir. 
;uif  skiu,  and 
0  hiiso  of  each 

like  the  cells 
;©niniunicable 

parts  of  the 
e,  the  reiiipes 

those  adver- 

nieans. 
he  circulation 
1.  With  this 
,  drying  it  hy 
9  with  a  stiff 
e  stimulating 
last  are  about 
the  hair. 

iet,  and  such 
ilating  appli- 
vest  and  best 

lese,  163  is 
■ation  of  sul- 
ecom  mended 
of  nitrate  of 
rtere,     They 

y  and  crisp, 
ng  them. 

niove  all  lo- 
ir-glands to 
off  the  hair 
scalp  with 
ists  through 
ashing  witii 
followed  by 
very  weak 
other  day, 
effects. 


SKIN    DISKABES. 


159 


Lice. 


PediculofliA  or  Lice  is  a  contagious,  animal,  parasitic  affection, 
chara(;t<'ii/tMl  by  the  presence  of  pediculi  in  the  skin  and  scratch- 
marks  of  the  sufferer  ensuing  from  the  annoying  itching.  There  are 
a  number  of  varieties  classified  according  to  the  peculiar  parasite  and 
its  location.     They  all  cause  great  discomfort  and  itching. 

The  Pediculosis  Capitis,  or  head-louse,  is  found  in  the  scalp,  and 
is  a  long, oval  l)ody  with  six  legs  furnished  with  nails;  it  has  an  oval 
head  with  two  prominent  eyes  and  two  horns.  The  ova  or  nits  are 
small  whitish  iMxlies  closely  glued  to  the  hair 
and  look  like  small  pieces  of  dandruff.  One  or 
two  are  deposited  on  a  hair. 

They  occur  for  the  most  part  in  poorly  nour- 
ished children  brought  up  under  bad  hygienic 
surroundings,  and  thence  communicated  to 
others.  They  cause  extreme  itching  and  scratch- 
ing, so  that  often  the  irritation  is  unbearable  and 
the  sticky  serum  of  the  blood  mats  together  the 
hair,  forming  crusts.  Sleep  is  often  interfered 
with  and  ill  health  results.     (See  Fig.  81.) 

Pediculosis  Corporis,  or  body-louse,  is  gen- 
erally the  property  of  the  clothing ;  it  is  some- 
what larger  than  the  head-louse  and  deposits  it« 

eggs  in  the  seams  of  the  clothing,  remaining  on  the  body  only  long 

enough  to  gain  sustenance.     The  young  are  hatched  in  five  or  six 

days.      The    louse    reproduces    again    in 

eighteen  days.      As  the  parasite    crawls 

about  it  produces   extreme   itching   and 

the  scratcliing  follows,  resulting  in  long 

lines  of  excoriation.     The  chief  locations 

for  this  parasite  are  the  back,  chest,  abdo- 
men and  thighs.       The  middle-aged  and 

elderly  are  more  apt  to  be  attacked  than 

the  young.    Here  unclcanliness  again  is  a 

prime  factor  in  their  occurrence.  (Fig.82.) 

Pediculosis  Pubis,  or  crab-louse,  is  a 
smaller,  shorter,  stouter  parasite  than  the 
two  I  receding,  and  attacks  the  pubes  par- 
ticularly, but  is  also  found  in  the  axillae 
and  over  the  eyelashes  and  beard  of  the 
male.  Thoy  may  be  seen  clinging  closely  to 
the  skin  with  remarkable  tenacity.  They 
occur  on  adults  and  pioduce  the  same  lesions  as  the  other  varieties. 
They  are  generally  the  result  of  promiscuous  sexual  intercouree. 
(  Fig.  83.) 


Kio.  81. 
BEAD- LOUSE, 


FlO.  «i. 
BODT-LODSE. 


1«0 


SKIN   DISEASES. 


Treatment. —  The  main  object  in  the  tieatr 
ment  of  these  filthy  diseases  is  the  destruction 
of  the  parasite.  The  lesions  they  produce 
disappear  with  the  disappearance  of  the  ani- 
mal. It  need  hardly  be  said  that  strict  clean- 
liness of  person  is  a  sine  qua  non.  The  rem- 
edies usually  employed  in  their  extermination 
are  the  mercurials,  sulphur,  carbolic  acid,  to- 
bacco, etc. 

cBA^LouBB.  I^  case  of  the  head-louse  the  most  effica- 

cious method  of  treatment  consists  in  saturating  the  head  over  night 
with  petroleum  and  washing  off  with  soap  in  the  morning.  In  young 
children  the  hair  may  be  cut  to  get  rid  the  more  easily  of  the  nits, 
but  this  is  not  necessary.  The  applications  of  petroleum  may  have 
to  be  repeated  several  times  and  the  hair  frequently  washed  with  soft 
soap,  soda  washes,  vinegar,  etc.,  to  get  rid  of  the  nits.  If  the  louse 
be  of  the  body  variety  the  treatment  must  be  directed  to  the  clothing, 
which  is  to  be  changed  often  and  either  boiled  or  baked.  This  pro- 
cess is  to  be  repeated  until  no  more  parasites  are  found.  The  itching 
of  the  body  is  best  allayed  by  carbolic  acid  lotions  (one  teaspoonful 
to  pint  of  water). 

The  crab-louse  is  best  treated  by  the  well-known  mercurial  oint- 
ment, or  blue  ointment,  and  is  to  be  washed  off  with  soap  and  water 
each  morning.  It  must  be  persisted  in  till  no  more  crabs  are  found 
and  no  further  itching  is  noticed. 


Bed-Bugs. 

The  best  preventives  against  these  annoying  bugs  is  corrosive  sub- 
limate and  pyrethrum  powder.  Purchase  a  small  bottle  of  the  corro- 
sive sublimate  tablets,  usually  sold  at  the  druggists  for  surgical  pur- 
poses, and  dissolve  one  in  a  quart  of  water.  This  solution  is  to  be 
freely  used  about  the  cracks  of  the  bed,  after  it  has  been  taken  apart, 
and  also  about  any  wooden  furniture  of  the  room  as  well  as  the  wood- 
work of  the  room.  The  powder  is  then  to  be  used  freely.  This  pro- 
cess is  to  be  repeated  several  times. 

The  bites  themselves  are  best  relieved  by  carbolic  lotions,  vinegar 
and  water,  ammonia  and  water,  etc. 

Freckles. 

This  is  a  disease  of  the  pigment  layer  of  the  skin  and  consists  in 
a  deposit  of  the  coloring  matter  of  the  skin  in  irregular  shapes, 
of  the  size  of  a  pin-head  or  pea,  and  are  yellowish,  brown  or  even 
blackish,  occurring  for  the  most  part  on  the  face  and  back  of  the 
hands.  They  may  be  few  and  scattered  or  exceedingly  abundant 
and  cover  a  large  area.  All  ages  are  subject  to  them  except  in  very 
young  children.     The  light<;omplexioned  are  more  subject  to  them. 


1 


SKIN   DISEASES. 


161 


t  in  the  treat- 
le  destruction 
;hey  produce 
B  of  the  jini- 
t  strict  clean- 
t.     The  reiii- 
xterniination 
3olic  acid,  to- 
most  effica- 
d  over  night 
g.    In  young 
5^  of  the  nits, 
m  may  liave 
lied  with  soft 
If  the  louse 
the  clothing, 
.     This  pro- 
The  itching 
teaspoonful 

rcurial  oint- 
p  and  water 
8  are  found 


rrosive  sub- 
f  the  corro- 
irgical  pur- 
)n  is  to  be 
aken  apart, 
s  the  wood- 
This  pro- 

ns,  vinegar 


consists  in 
ar  shapes, 
^n  or  even 
ck  of  the 
abundant 
pt  in  very 
;  to  them, 


while  the  red-haired  seldom  escape  them.  Sunlight  develops  them  so 
that  many  have  them  conspicuously  only  in  summer.  The  possession 
of  freckles  is  a  matter  greatly  of  idiosyncrasy,  as  many  people  never 
have  them,  no  matter  how  much  they  may  be  subjected  to  the  sun. 

Treatment. —  One's  aim  in  treatment  should  be  toward  destro}'ing 
the  pigment  layisr  by  some  corrosive  agent,  like  corrosive  sublimate, 
which  perhaps  is  the  best  remedy. 

Two  grains  tc(  the  ounce  in  water  will  in  most  cases  prove  suffi- 
ciently strong.  The  susceptibility  of  the  skin  to  this  remedy  and  the 
extent  of  the  area  involved  have  much  to  do  with  the  strength  of  the 
remedy  employed.  This  remedy  is  poisonous  and  is  to  be  used  with 
care.  Do  not  get  it  near  the  lips,  but  to  effect  a  cure  it  must  be  per- 
sijted  in  for  quite  a  while. 

A\' ashing  the  face  in  buttermilk  several  times  a  day  is  excellent. 

Corns. 

Of  all  the  minor  ailments  of  the  human  body,  few  are  more  dis- 
tressing than  the  inflamed  corn.  They  consist  of  a  thickening  of  the 
outside  or  horny  layer  of  the  skin.  As  a  secondary  change,  conse- 
quent on  long  iriitatiou,  the  nerve  and  blood  supply  increase  and  an 
extreme  tenderness  is  produced,  amounting  often  to  incapacity  to 
walk  or  work.  They  are  caused  mechanically  by  the  undue  pressure 
of  the  boot  against  the  joint  or  biy  one  toe  pressing  against  another. 
Too  short  a  boot,  which  causes  pushing  out  of  *he  big  toe  joint,  too 
narrow  a  boot,  causing  crowding  of  the  large  joints,  are  the  more  fre- 
quent causes  of  the  com. 

Bunion. 

The  bunion  is  produced  by  wearing  too  short  a  boot,  as  a  rule,  and 
consists  in  the  gradual  displacement  of  the  big-toe  joint,  so  that  fi- 
nally there  is  an  actual  deformity.  The  corn  usually  is  added  to  this 
deformity. 

Treatment. —  The  outer  layers  of  the  corn  should  be  softened  and 
scraped  off  by  a  sharp,  thin  knife.  The  softening  process  may  be  ef- 
fected by  soaking  in  a  soda  solution,  or  better  still,  by  the  following 
mixture :  — 

Salicylic  acid one-half  ounce 

Extract  cannabis  indica ten  grains 

Collodion one  scruple 

This  is  to  be  applied  each  night.  Care  is  to  be  exercised  in  not 
paring  the  corn  too  closely  lest  bleeding  occur  and  poisoning  ensue 
from  the  unclean  knife  that  may  be  used.  Pressure  of  the  boot  must 
be  avoided  by  the  substitution  of  another  form  of  boot  and  also  per- 
haps by  wearing  a  plaster  with  a  hole  in  the  center,  thus  distributing 
the  pressure  over  a  greater  area.     When  trimmed  the  corn  is  to  be 


i! 


r 


162 


SKIN   DISEASES. 


likewise  covered  by  a  corn-plaster  bound  on  the  foot  by  strips  of 
adhesive  plaster.  Painting  with  iodine  often  takes  out  the  sore- 
ness and  hardens  the  skin  so  that  it  may  be  more  readily  cut.  In- 
flamed corns  should  be  poulticed  and  treated  like  any  pus  wound. 
Spirits  of  turpentine  will  often  take  the  soreness  out  of  a  corn.  Ab- 
sorbent cotton,  or  better,  wool,  worn  between  the  toes,  will  prevent 
or  cure  a  corn  between  the  toes. 


Dandruff. 

This  is  a  Hjsease  of.  the  sebaceous  glands  of  the  scalp,  characterized 
by  a  large  secretion  of  the  sebaceous  matter  and  forming  crusts  or 
scales.  The  secretion  may  be  so  thick  and  oily  as  to  mat  together 
the  hair,  or  so  dry  as  to  fall  off  the  head  in  a  shower  when  the  head 
is  combed.  It  is  the  most  frequent  cause  of  baldness.  Tlie  crown 
of  the  head  is  the  most  frequent  location  of  this  disease. 

Treatment.  —  Inasmuch  as  those  subject  to  this  disease  are  often 
below  par  in  health,  such  constitutional  remedies  as  cod-liver  oil  and 
iron  are  valuable  adjuncts  in  bringing  about  a  cure.  Should  the 
amount  of  scales  be  considerable,  especially  if  there  are  crusts,  as  in 
the  case  of  little  children,  the  best  procedure  consists  in  oiling  the 
scalp  over  night  wit'i  some  bland  oil,  wearing  a  flannel  cap,  and  wash- 
ing off  the  oil  in  the  morning  with  soft-soap  and  water.  The  follow- 
ing blood  tonic  is  an  admirable  one  for  adults :  — 

Tincture  of  iron one  ounce 

Dilute  phosphoric  acid one  ounce 

Syrup  of  lemon two  ounces 

Take  one-half  teaspoonful  in  a  wineglass  of  water  three  times  daily. 
Use  a  glass  tube  to  avoid  staining  the  teeth.  The  scalp  needs  a 
shampoo  once  or  twice  a  week ;  the  following  will  be  found  to  be  a 
suitable  one:  — 

Green  soap eight  ounces 

Alcohol four  ounces 

Put  a  little  here  and  there  over  the  scalp  and  then  rub  up  with 
warm  water.  The  scalp  may  then  be  stimulated  night  and  morning 
with  a  little  of  the  following  lotion  :^ — 

Tincture  of  cantharides three  dr9,chm8 

Tincture  of  capsicum three  drachms 

Castor  oil two  drachms 

Alcohol two  ounces 

Spirits  rosemary two  ounces 

Another  good  remedy  for  daily  use  :  — 

Hydrate  of  chloral two  drachms 

Water four  ounces 


■Ml 


SKIN   DISEASES. 


163 


by  strips  of 
ut  the  sore- 
ily  cut.     In- 

pus  wound. 
1  corn.  Al> 
will  prevent 


iharacterized 
ig  crusts  or 
nat  together 
en  the  head 
Tlie  crown 

use  are  often 
liver  oil  and 

Should  the 
trusts,  as  in 
n  oiling  the 
p,  and  wash- 

The  follow- 


unce 
bnce 
unces 


imes  daily, 
needs  a 
ind  to  be  a 


ounces 
unces 

)  up  with 
id  morning 

Irtichms 

Irachms 

achms 

nces 

noes 


ichms 
nces 


The  yolk  of  two  eggs  well  rubbed  into  the  scalp  and  afterwards 
washed  off  with  hot  water  is  ilso  a  good  cleansing  agent  and  sham- 
poo. 

For  very  stubborn  cases  the  following  lotion  applied  night  and 
morning  will  be  found  efficacious :  — 

Corrosive  sublimate 12  grains 

Glycerine 4  drachms 

Alcohol 6  ounces 

Spirits  rosemary 4  drachms 

Whatever  method  is  pursued,  the  application  must  be  persevered 
in  and  applied  from  twice  daily  to  once  every  few  days  according  to 
progress  made  and  severity  of  case.  .  • 

Baldness. 

This  disease  is  generally  the  outcome  either  of  some  constitutional 
weakness  and  requires  general  tonic  treatment  like  iron  and  cod-oil, 
or  is  the  result  of  some  local  lesion  of  the  scalp  proper.  i'  nen  due 
to  sypliilis,  the  hair  falls  out  suddenly  and  quite  extensively ;  the 
eyebrows  also  saffer  the  same  way.  Its  treatment  is  to  be  conducted 
on  the  same  plans  as  directed  under  treatment  of  the  syphilitio  dis- 
ease. Eczema,  scrofulous  blood,  etc.,  may  also  be  the  exciting  cause 
of  baldness.  Baldness  may  ensue  in  areas  only,  and  oftentimes  is  as 
complete  as  though  no  hair  had  ever  grown  there.  This  form  is  apt  to 
be  very  stubborn  and  requires  very  irritating  treatment,  like  blisters 
or  the  rubbing  in  of  strong  carbolic  acid  once  a  day  for  a  number  of 
days  before  ceasing  treatment. 

The  baldness  of  old  age  is  of  course  irremediable,  but  may  be  ar- 
rested by  attention  to  the  general  health  and  the  employment  of  rem- 
edies mentioned  under  the  consideration  of  dandruff. 

As  has  been  mentioned,  dandruff  is  the  most  fertile  source  of  bald- 
ness. When  once  the  scalp  is  clean  and  the  dandruff  is  cured  the 
following  lotion  will  be  found  to  be  of  great  value  in  those  cases  of 
baldness  characterized  by  the  hair  falling  out  in  small  patches :  — 

Carbolic  acid one  drachm 

Alcohol one  and  a  half  ounces 

Castor  oil two  drachms 

Oil  bitter  almonds ten  drops 

Strong  carbolic  acid  itself  may  be  rubbed  in  the  inveterate  cases. 
The  following  lotion  also  contains  desirable  ingredients :  — 

Tincture  cantharides     .     .     .     one  and  a  half  ounces 
Tincture  capsicum    ....     one  and  a  half  ounces        '  ; 

Castor  oil two  drachms 

Cologne one  ounce 


MHi 


DISEASES  OP  THE  BRAIN  AND  NERVES. 


Thf,  brain  and  spinal  column  are  the  great  centres  of  the  nervous 
system. 

The  brain  produces  sensation,  thought,  and  voluntary  motion.  When 
this  organ  is  diseased,  therefore,  we  may  expect  one  of  these  functions 
to  be  either  disturbed  or  destroyed. 

Of  Sensation  there  are  various  disturbances,  pervsrsions,  and  sus- 
pensions, caused  by  disease  of  the  brain  and  nerves ;  such  as  nausea, 
giddiness,  specks  floa./ing  Vnjfore  the  eyes,  ringing  in  the  ears,  decep- 
tive tastes  and  sr  lells,  latolerable  itching,  neuralgic  pains,  boisterously 
high  spir'  a,  depression  without  apparent  cause,  anxiety,  and  dread. 

Thought,  in  like  manner,  is  disturbed  and  perverted  in  many  ways. 
There  is  high  delirium,  dullness  and  confusion,  loss  of  memory,  weak- 
ened judgment,  and  every  degree  of  stupor,  down  to  l  utire  loss  of 
consciousness. 

Voluntary  Motion  is  perverted  and  destroyed  in  muscular  twitch- 
ings,  trembling  of  the  limbs,  spasmodic  stiffness,  involuntary  jerk- 
ings,  convulsions,  muscular  debility,  and  palsy. 

The  brain  is  composed  of  three  parts, —  the  cerebrum,  the  cerebel- 
lum, and  the  medulla  oblongata.  These  are  all  contained  witliin  the 
skull  bones,  and  are  immediately  covered  by  three  membranes,  called 
the  dura  mater,  the  arachnoid,  and  the  pia  mater.  The  dui  mater  is 
a  strong,  fibrous  membrane  lying  next  to  the  skull-bones.  1  arach- 
noid is  a  serous  membrane,  lying  next  below,  and  the  pia  matei  hich 
means  pious  mother,  is  a  vascular  membrane,  lying  next  to  the  brain, 
dipping  into  it  in  places,  and  containmg  the  vessels  which  bring  to  it 
all  its  nutrient  materials.     Hence  its  name. 

These  membranes  are  all  liable  to  be  inflamed,  —  and  so  is  the 
brain. 

Inflammation  of  the  Dura  Mater. 

The  inflammation  of  this  membrane  does  not  often  occur  sponta- 
neously ;  but  it  happens  frequently  from  external  injuries,  as  blows 
upon  the  head. 

After  a  blow  upon  the  head  which  stuns  him,  a  man  may  recover 
himself,  and  for  some  days  remain  in  perfect  health.     Then  he  has 

164 


■'•^sattm 


tm 


DISEASES  or   THE    BRAIN  AND   NERVES. 


166 


SBVE8. 


;he  nervous 

ion.  When 
le  functions 

ns,  and  sus- 
t  as  nausea, 
ears,  decep- 
wisterously 
nd  dread. 

many  ways, 
aory,  weak- 
ire  loss  of 

liar  twitch- 
itary  jerk- 

the  cerebel- 
witliin  the 
lies,  called 
mater  is 
arach- 
tei,  hich 
the  brain, 
jring  to  it 

so  is  the 


sponta- 
as  blows 

y  recover 
1  he  has 


liiiin  in  the  head,  is  restless,  cannot  sleep,  has  a  (lushed  face,  red  eyes, 
hot  skin,  hard  pulse,  rigor,  nausea,  vomiting,  —  ending  with  convul- 
sions and  delirium. 

This  disease  is  often  caused  by  what  is  called  otitis,  or  inflamma- 
tion of  the  internal  ear.  In  such  ca»es,  iiiHammation  will  arise  within 
the  tympanum,  causing  intense  earache  ;  matter  conies  at  length  from 
the  external  ear,  but  the  pain  does  not  stop ;  the  patient  shivers,  be- 
comes drowsy,  perhaps  delirious,  and  finally  sinks  into  stupor.  The 
dura  mater  is  inflamed. 

Treatment.  —  When  the  disease  arises  from  inflammation  in  the 
ear,  leeches  are  to  be  applied  behind  the  ear,  and  blisters  and  other 
irritants  afterwards.  Other  modes  of  treatment  will  be  mentioned 
after  the  next  two  forms  of  disease. 

Inflammation  of  the  Arachnoid  and  Pia  Mater. 

Arachnitis. 

These  two  membranes  are  generally  inflamed  together.  They 
are  so  intimately  connected  that  each  involves  the  other  in  its  own 
troubles. 

Generally  this  is  divided  into  three  stages :  — 

The  Irritative,  characterized  by  wakefulness,  irritable  temper,  re- 
pugnance to  strong  light,  and  contraction  of  the  pupils. 

Tlie  Infiammatory  Stage,  known  by  transient  pains  in  the  head, 
alternating  with  similar  ones  in  the  bowels,  increased  restlessness  and 
irritability,  a  quick  and  t«nse  pulse,  an  expression  of  discontent  on 
the  face,  the  eye-brows  knit  and  frowning,  the  eye-lids  half  closed, 
retching  and  vomiting,  deep  sighing,  and  torpid  bowels. 

The  Depressing  Stage,  in  which  the  delirium  is  more  continuous, 
the  countenance  has  a  look  of  surprise  and  stupor,  the  pupils  are  con- 
tracted or  dilated,  the  white  of  the  eyes  injected  and  red,  the  pupils 
rolled  up  during  sleep,  constant  sleepiness,  inattention  to  surrounding 
objects,  torpidity  of  mind,  gradually  increasing  until  complete  coma 
closes  all  the  senses. 

The  disease  does  not  always  exhibit  all  these  symptoms,  or  come  on 
in  the  regular  way  described.  Sometimes  the  first  thing  noticed  is  a 
long-continued  paroxysm  of  general  convulsions.  Again  these  con- 
vulsions will  come  on  after  violent  pains  in  the  head,  and  are  attended 
with  screaming. 

Inflammation  of  the  Brain.      Brain  Fever. 

Encephalitis. — Phrenitis. 

Acute  and  general  inflammation  of  the  brain  and  its  membranes 
has  two  stages.  ' 

The  Stage  of  Excitement,  in  which  there  is  intende  and  deep-seated 
pain  in  the  head,  extending  over  a  large  part  of  it,  a  feeling  of  tight- 


■■  '\ 


166 


DISEASES   OF  THE    DRAIN   AND   NERVES. 


V 


rifcos  across  the  forehead,  throbbing  of  the  temporal  arteries,  a  Hushed 
face,  injected  eyes,  looking  wild  and  b?  lliant,  contraction  of  the  pupils, 
great  shrinking  from  light  and  violent  sound,  delirium,  want  of  sleep, 
general  convulsions,  a  parched  and  dry  skin,  a  quick  and  hard  pulse, 
a  white  tongue,  thirst,  nausea  and  vomiting,  and  constipation  of  the 
bowels. 

The  Stage  of  Coliapse,  in  which  there  are  indistinct  mutterings, 
dull  and  perverted  hearing  and  vision,  double  vision,  the  piipil  from 
being  contracted  expands  largely  and  becomes  motionless,  twitchings 
of  the  muscles,  tremors  and  palsy  of  some  of  the  limbs,  a  ghastly  and 
cadaverous  countenance,  cohl  sweats,  profound  coma,  and  death. 

The  disease  will  not  show  all  these  symptoms  in  any  one  case.  It 
runs  a  rapid  course,  causing  death,  sometimes,  in  twelve  or  twenty- 
four  hours ;  or  it  may  run  two  o:  three  weeks. 

Treatment.  —  This  should  be  energetic,  and  administered  early. 
The  measures  usually  employed  are  hot  foot-baths.,  and  the  application 
of  cold  to  the  head.,  with  occasional  mustard  poultice  to  legs. 

General  Blood-letting.  —  This  is  much  approved  by  many ;  for 
myself,  I  do  not  like  it.  Wet  cups  and  leeching  are  about  tlie  extent 
to  which  I  would  ever  carry  the  abstraction  of  blood  in  these  diseases. 
These  may  sometimes  be  applied  with  advantage  to  the  neck,  and  be- 
hind the  ears. 

Cold  Applications.  —  These,  applied  to  the  head,  are  of  great  im- 
portance. First,  shave  the  head,  and  put  on  cloths  wetted  in  water 
as  cold  as  it  can  be  made,  changing  them  often ;  or,  put  powdered 
ice  in  a  flexible  bladder,  and  lay  it  upon  the  head,  —  taking  care  not 
to  make  it  too  heavy.  Heat  in  a  few  cases  is  better  borne. 

Cathartics.  —  These,  while  the  inflammation  is  in  the  active  stage, 
should  be  thorough  and  energetic.  To  effect  it,  many  use  calomel 
and  other  forms  of  mercury.  They  are  not  needed.  Croton  oil  is  one 
of  the  best  articles  (31),  or  colocynth,  gamboge,  etc.  (82),  without 
the  oil,  or  the  compound  powder  of  jalap. 

In  the  stage  of  collapse,  if  tliere  is  pallor  of  the  countenance,  a 
feeble  and  flying  pulse,  great  debility  and  tremors,  coldness  of  the 
extremities,  etc.,  give  wine  and  other  stimulants. 

See  that  the  bladder  is  emptied  every  day. 

The  feet,  in  the  early  stage  of  the  complaint,  should  be  bathed  in 
warm  water,  or  mustard  and  water  (242).  Mustard  draughts  must 
also  be  put  upon  the  feet. 

The  tincture  of  veratrum,  given  in  full  doses,  to  bring  down  the 
pulse,  and  produce  sweating,  must  not  be  omitted.     Give  (351). 

Softening  of  the  Brain.  —  Ramollissement. 

Inflammation  of  the  brain,  when  it  has  run  its  course,  sometimes 
leaves  this  organ,  or  portions  of  it,  in  a  softened  condition.     The 


4p 


5s,  a  flushed 
f  the  pupils, 
int  of  sleep, 
hard  pulse, 
tion  of  the 


mutteriugs. 
pupil  from 

twitchings 
ghastly  and 

death, 
le  case.     It 
or  twenty- 

ered  early, 
application 

rS. 

many;  for 

the  extent 

se  diseases. 

ck,  and  be- 

f  great  ini- 

d  in  water 

powdered 

g  care  not 

tive  stage, 
36  calomel 
I  oil  is  one 
),  without 

benance,  a 
S8  of  the 


)athed  in 
its  must 

own  the 
J51). 


imetimes 
n.     The 


niSEASES   OP  THE    BRAIN   AND   NERVES. 


167 


same  mischief  may  happen  to  the  bruin  from  the  blood-vessels  which 
run  to  it  being  diseased,  so  as  not  to  be  able  to  carry  blood  for  its 
proper  nourishment. 

Symptoms. — The  most  remarkable  symptom  of  this  disease  is  the 
rigid  contraction  of  the  muscles  which  draw  up  the  limbs ;  the  hand 
may  be  clenched  and  pressed  against  the  shoulder,  or  the  heel  carried 
up  to  the  hip. 

The  other  symptoms  are  various,  —  tingling  and  numbness  in  the 
ends  of  thu  fingers  ;  perverted  vision,  and  sometimes  blindness  ;  par- 
alysis of  one  limb,  or  half  the  body;  difficulty  of  answering  ques- 
tions ;  forgetfulness,  making  it  difficult,  at  times,  for  the  patient  to 
remember  his  own  name.     General  treatment  is  indicated. 

Suppuration  and  Abscess  of  the  Brain. 

When  a  diseased  brain  is  examined  after  death,  sometimes  matter 
is  found  mixed  in  with  the  softened  portion.  This  shows  that  suppu- 
ration took  ;jlace.  At  other  times,  the  matter  is  found  in  a  cavity, 
which  shows  that  an  abscess  had  formed  during  life. 

The  symptoms  of  these  mischiefs  are  convulsions  in  the  earlier 
stages,  and  palsy  in  the  latter.  Surgical  methods  now  often  save 
life,  and  cause  a  cure  in  these  cases. 

Induration  of  the  Brain. 

Instead  of  softening  the  brain,  inflammation  sometimes  does  the 
very  opposite,  —  it  hardens  it,  —  producing  a  change  something  like 
that  which  happens  to  white  of  Qg^  when  dipped  in  hot  water. 

Convulsions  appear  as  the  result  of  this  change,  as  in  suppuration 
and  abscess  ;  palsy  much  more  seldom. 

Tumors  bf  the  Brain. 

Tumors  infect  the  brain  occasionally,  —  growing  around  it,  on  all 
sides,  pressing  themselves  into  its  substance,  and  causing  many  dis- 
turbances. Cancers  and  hydatids  are  found  there.  The  signs  which 
these  irritating  bodies  produce  are  like  those  of  other  diseases  of  the 
brain,  and  therefore  cannot  be  distinguished  daring  life.  Syphilis  is 
often  the  cause  of  them,  and,  when  due  to  this,  may  be  cured. 

Delirium  Tremens.—  Drunkard's  Delirium. 

Mania  a  Potu. 

This  is  often  mistaken  for  brain-fever ;  but  it  is  quite  a  different 
disease.  It  is  not  the  result  of  inflammation  of  the  brain,  but  of  irri- 
tation. It  is  important  to  distinguish  it  from  inflammation,  because 
the  remedies  wWch  are  employed  for  that  would  be  injurious  if  used 
for  this. 


V 

I 


I  .i 


ij^ 


108 


DISEASES   OP   THE    BRAIN   AND   NERVES. 


The  Symptoms  art;  incosaant  talking,  fidgeting  with  the  hands, 
trembling  of  the  limlw,  a  rapid  pulse,  profuse  sweating,  utter  sleep- 
lessness, and  a  mingling  of  the  real  with  the  imaginary  in  the  hiiHy 
talk.  The  patient  is  apt  to  think  some  one  is  about  to  do  him  a 
great  injury,  yet  is  unwilling  to  be  alone.  His  face  is  pale  and  sal- 
low (sometimes  red  and  flushed),  his  eye  is  rolling,  quick  and  ex- 
pressive, his  speech  stuttering  and  inarticulate, —  bodily  and  mentally, 
he  is  busy  day  and  night,  and  can  with  difficulty  be  confined  to  his 
bed  or  room.  As  the  disease  advances,  and  he  has  been  long  without 
sleep,  he  imagines  vermin  to  be  crawling  upon  his  scalp  and  body ; 
troops  of  rats  run  across  his  bed,  or  look  at  him  out  of  the  wall ; 
giant  boxers  confront  him,  and  he  squares  off  for  a  round  at  fisti- 
cufis ;  animals,  figures  of  all  shapes,  and  horrible  monsters  frighten 
his  imagination ;  devils  laugh  at  liim,  and  dance  before  him.  In  long 
and  sleepless  houi-s,  he  Uilko  and  chatters  with  these  spectral  phan- 
toms, —  now  beckoning  them,  now  shrinking  from  them,  till  he  wears 
out  and  sinks  from  exhaustion.  This  is  a  disease  of  drunkards  and 
opium  eaters.  The  attack  generally  occui's  in  consequence  of  the 
withdrawal  for  three  or  four  days  of  the  accustomed  stimulus. 

Treatment. —  Opium  and  its  preparations  are  the  sovereign  rem- 
edy. Give  one-third  of  a  grain  of  morphia;  if  this  does  not  quiet  the 
patient,  give  thirty  drops  of  laudanum  every  two  houra,  till  sleep  is 
produced.  Sleep  will  cure  him,  and  notliing  else  will.  A  draught 
or  two  of  his  accustomed  drink,  brandy,  gin,  or  whatever  it  may  be, 
will  also  generally  dispose  him  to  sleep,  if  he  be  not  already  in  drink. 

Recently,  a  very  effectual  remedy  has  been  found  in  the  use  of 
tepid  baths,  prolonged  from  four  to  ten  hours,  in  connection  with 
cold  applications  to  the  head.  In  connection  with  this,  small  doses 
of  opium  are  required ;  but  the  treatment  may  yet  prove  to  be  very 
valuable  by  enabling  us  to  dispense  with  excessive  doses  of  opium. 
Twenty  grains  of  chloral  may  be  given  every  hour  till  patient  sleeps. 

Inebriety. 

In  the  beginning  of  the  present  century  insanity  was  regarded  as  a 
visitation  of  God's  displeasure  and  not  as  a  disease  subject  to  scientific 
investigation  and  amenable  to  treatment.  Inebriety  is  regarded  now 
as  insanity  was  some  hundred  years  ago,  the  disease  being  consid- 
ered irremediable.  Alcohol  is  a  poison,  and  like  other  poisons  is  cap- 
able of  destroying  life.  In  large  doses  it  becomes  a  powerful  irritant 
or  a  narcotic  producing  coma  and  death.  It  being  constantly  intro- 
duced into  the  system  produces  a  general  disease  in  the  system.  We 
believe  inebriety  can  be  cured  like  any  other  disease,  but  is  subject  to 
relapses  like  other  diseases. 

The  "  alcohol  habit,"  under  the  title  Inebriety,  oftentimes  has  the 
symptom  or  outward  manifestation  of  diseased  conditions,  which  an- 
tedate the  alcoholic  craving,  and  are  its  predisposing  and  exciting 
causes  which  retard,  and  sometimes  even  prevent  a  cure. 


in 


DISEASER  OF  THE   BRAIN   AND   NERVES. 


169 


m 


the  liHiul.s, 
utter  sleep- 
in  the  hiisy 
0  do  him  a 
ale  and  sal- 
ick  and  ex- 
id  mentally, 
fined  to  his 
ong  without 
and  lx)(ly ; 
if  tlie  wall ; 
ind  at  fisti- 
ere  frighten 
m.  In  long 
ctral  phan- 
ill  he  wears 
nkards  and 
ince  of  the 
ulus. 

!reign  rem- 
it quiet  the 
ill  sleep  is 
A  draught 
it  may  be, 
ly  in  drink, 
the  use  of 
[ction  with 
mall  doses 
io  be  very 
of  opium, 
ent  sleeps. 


irded  as  a 

scientific 
rded  now 
g  consid- 
►ns  is  cap- 

1  irritant 
itiy  intro- 
»m.    We 

ubject  to 

has  the 
vhich  an- 
exciting 


In  thu  popular,  and  too  ofttm  in  tlu;  professional  mind,  alcohol  in 
regarded  as  the  cause  and  root  of  the  wliole  evil  of  inebriety.  We 
desire  to  assert  that  inebriety  is  frequently  dependent  upon  caa'^es 
with  which  alcohol  has  nothing  to  du.  There  is  a  neurotic  craving 
—  it  may  lie  congenital,  it  may  be  developed  as  the  result  of  disease 
or  accident.  This  craving  demands  the  various  forms  of  narcotic 
stimulants,  those  that  first  excite,  then  produce  narcosis  more  or  less 
complete.  Alcohol  fuUills  this  condition,  is  easily  accessible,  reason- 
ably inexpensive,  and  is  the  one  drug  that  meets  a  morbid  craving 
that  seenus  to  be  almost  universal. 

We  do  not  fail  to  recognize  the  deteriorating  effects  of  alcohol 
manifested  principally,  at  least,  more  pronouncedly  upon  the  nervous 
system  as  seen  in  the  various  forms  of  insanity.  We  also  note  the 
degenerating  effects  of  alcohol  on  lung,  liver,  kidney  or  other  organs 
and  tissues  of  the  body ;  or  as  a  special  poison  in  the  same  sense  that 
lead,  arsenic  and  tobacco  produce  their  effects. 

We  believe  that  the  great  majority  of  inebriates  become  so  from  he- 
redity, environment  and  disease,  that  produces  physical  degeneracy 
and  pushes  them  over  and  plunges  them  into  inebriety. 

The  patient  with  fever  craves  and  may  drink  water  freely,  exces- 
sively and  injuriously.  The  diabetic  is  an  aqua-maniac  in  a  certain 
sense,  but  in  neither  case  do  we  recognize  the  aqua-mania  or  water 
craving  as  the  disease,  but  rather  r.s  proceeding  from  certain  abnor- 
mal conditions  whiclj  we  readily  recognize.  So  the  liquor  thirttt  is 
the  result  of  morbid  ('onditions  that  produce  an  abnormal  desire, 
which  alcohol  seems,  temporarily  at  least,  to  satisfy. 

The  excessive  use  of  Jilcohol,  while  it  is  oftentimes  the  cause  of 
various  diseases  of  the  nervous  system,  and  also  a  frequent  cause  of 
insanity,  is  also  the  precursor  or  initiatory  symptom  of  certain  disepses 
of  the  nervous  system  and  also  of  insanity. 

The  paretic  will  crave  and  use  alcohol  in  the  earlier  stages  of  his 
malady.  The  victim  of  nervous  syphilis  is  addicted  to  it,  more  es- 
pecially in  the  later  stages,  when  the  nervous  system  becomes  in- 
volved. 

Any  depressing,  exhausting,  or  painful  disease  may  produce  the 
alcoholic  craving,  alcohol  being  sought  for  its  stimulating  properties. 

Alcohol,  moreover,  is  second  only  to  opium,  ether,  or  chloroform 
as  an  anaesthetic ;  indeed,  has  been  used  aa  a  substitute  for  the  latter. 
Hence,  persons  find  experimentally  that  alcohol  relieves  pain,  and 
its  use  is  carried  to  a  harmful  extent,  its  deleterious  effects  produced, 
and  inebriety  established. 

It  is  possible  that  a  healthy  individual,  with  good  peraonal  and^j 
family  history,  may  use  alcohol  sociably  or  as  a  matter  of  custom,  un-  / 
til  the  habit  becomes  firmly  established. 

The  alcohol  breaks  down  the  constitution,  invades  and  degenerates 
the  nervous  system,  and  thus  develops  inebriety,  because  the  alcoho- 
lic degenerations,  or  even  functional  disturbances  of  the  nervous  sys- 


170 


DISEABRS    OF   THE   BKAIN    AND    NEKVSa 


teni,  are  the  very  coiulitioiiH  tinder  which  inebriety  is  estuhliHhed. 
We  say  this  is  i)OH8il)le,  but  wo  assert  again  that  l)tihinc{  the  hu-^v 
majority  of  inebriates  will  Ihj  found  a  defective  family  or  persomil 
history,  not  only  complicating  but  causing  the  inebriety ;  retaidinp, 
oftentimes  preventing  a  cure. 

It  can  be  thus  seen  that  inebriety  is  but  a  symptt)m  — a  flag  of 
distress  hung  out  by  the  nervous  system.  As  some  one  hius  aptly 
said,  "neuralgia  is  the  cry  of  a  diseased  nerve,"  so  the  "  drink-craze'' 
is  the  cry  of  the  neurasthenic  for  a  stimulant,  of  the?  puin-tortured 
nerve  for  an  amesthetic,  of  the  victim  of  insomnia  for  a  hypnotic. 

Not  any  patient  that  applies  for  relief  to  the  pliysician  needs  a 
more  careful  examination  than  does  the  inebriate.  You  may  rest  as- 
sured that  there  is  some  underlying  cause,  probably  several  that  must 
be  removed  if  we  would  restore  the  inebriate  to  his  former  habits  of 
sobriety.  If  he  is  found  suffering  from  the  later  manifestations  of 
syphilis  he  will  need  special  treatment  for  this  condition,  especially 
if  the  nervous  system  is  involved  ;  a  painful  stricture  of  the  urethra 
may  require  division. 

Chronic  malarial  poisoning  with  its  complicating  disorder  of  stom- 
ach, liver  and  spleen,  will  demand  special  treatment.  In  a  cfuie  on 
record  the  irritation  of  a  tape-worm  produced  a  tendency  to  the  ex- 
cessive use  of  alcohol,  which  tendency  passed  away  when  the  wonn 
was  expelled. 

In  a  word,  a  large  majority  of  inebriates  are  diseased  persons,  and 
tliat  primarily  and  antecedent  to  their  inebriety,  which  is  appended 
to  and  aggravates  their  diseased  condition. 

Special  diseases,  therefore,  require  special  treatment,  irrespective 
of  the  inebriety,  if  we  would  cure  the  inebriate.  In  this  connection 
we  may  ask,  are  there  any  drugs  that  we  can  substitute  for  alcohol 
that  will  take  its  place,  and  satisfy  the  inebriate,  as  a  substitute  for 
alcohol  ? 

Opium  and  the  salts  of  morphia  will  do  so  in  a  marked  degree,  al- 
though cocaine,  chloral  and  the  bromides  have  been  so  used. 

The  use  of  opium  or  morphia  is  not  uncommon  among  inebriates 
who  desire  to  "  leave  off  alcohol."  The  inebriate,  as  a  rule,  is  a  con- 
genital neurotic.  From  birth  almost,  he  reaches  out  for  some  drug 
that  will  gratify  or  meet  his  neurotic  craving.  The  alcohol  and  the 
opium  habit  to  the  inebriate  are  convertible  habits,  and  the  inebriate, 
like  a  pendulum,  will  swing  from  alcohol  to  opium ;  not  infrequently 
the  two  habits  are  combined,  as  in  the  form  of  tinct.  opii,  constitut- 
ing a  mixed  habit,  in  which  the  effects  of  both  alcohol  and  opium 
have  to  be  considered.  Occasionally  a  case  is  presented  in  which 
morphia  is  used  hypodermically,  and  the  alcohol  used  in  the  usual 
manner.  In  cases  where  opium  addiction  is  associated  with  the  habi- 
tual use  of  alcohol,  the  opium  habit  is  of  paramount  importance  and 
the  alcohol  assumes  a  secondary  place. 

The  fact  that  opium  can  sutetitute  alcohol  is  the  keynote  to  many 
vaunted  secret  cures,  in  the  so-called  "  narcotic  treatment  "  for  alco- 


estHblishod. 
>''  the  liiij,r(. 

01'  personal 
■;  retaidiiiy, 

—  a  flag  of 
i«  has  aptly 
Iriiik-craze  " 
uin-t«rturt'(l 
i.Vpnotio, 
ian  needs  a 
may  rest  as- 
al  that  must 
pr  hahits  of 
'estatioiLs  of 
I,  especially 
the  urethra 

ler  of  stoni- 
a  case  on 

"■  to  tlie  ex- 
the  wonu 

ersons,  and 
J  appended 

rrespective 
connection 
or  alcohol 
Jtitute  for 

degree,  al- 

inebriates 

is  a  con- 

^me  drug 

and  the 

nebriate, 

iquently 

eonstitut- 

id  opium 

n  which 

le  usual 

the  habi- 

ance  and 

to  many 
for  alco- 


re 


DIBIASEB  OF  THE  BRAIN  AND   NIRVES. 


171 


hoi.  It  simply  substitutes  one  habit  for  another,  and  as  long  as  the 
victim  is  taking  the  so-called  remedy  he  is  reasonably  comfortable. 
Mut  I  admit  if  the  "  narcotic  treatment "  was  carefully  practiced,  in 
judicious  hands  it  might,  in  conjunction  with  such  other  remedial 
measures  as  would  best  eradicate  the  primal  causes  of  the  inebriety, 
prove  useful,  if  not  curative,  in  cases  oi  inebriety. 

Are  there  any  drugs  that  are  specifically  l)eneHcial  for  the  treatment 
of  inebriety  as  such  ?  We  would  state  that  drugs  that  act  directly  as 
a  stimulant  to  the  nervou.,  lystem  are  of  value.  Strychnia  is  a  type 
of  this  class  of  drugs,  and  one  of  the  best  of  it  class. 

Luton,  of  Rheims,  Belgium,  was  the  first  to  point  out  its  value  in 
alcoholism.  Then  the  Russians  used  it  largely  and  it  was  known  as 
tiie  "  Russian  treatment,"  and  finally,  the  Americans  adopted  its  use 
in  such  cases. 

Strychnia  has  proved  serviceable  as  both  abortive  and  curative  in 
acute  alcoholic  delirium,  as  well  as  useful  in  the  more  chronic  forms 
of  alcoholism.  It  seems  to  be  tolerated  in  such  cases  —  in  cases  of 
alcoholic  poisoning  under  normal  conditions,  we  have  no  record  of 
the  value  of  strychnia  as  an  antidote  ;  interesting  experiments  might 
l)e  made  on  the  lower  animals  with  the  view  of  determining  this 
point.  Strychnia  is  an  excellent  cardiac  tonic,  and  one  of  the  best 
respiratory  stimulants,  and  might  be  used  in  general  medicine  in 
cases  in  which  aicohol  is  oftentimes  prescribed. 

Oxide  of  zinc,  during  the  past  twenty  years,  has  been  used  with 
advantage  in  cases  of  chronic  alcoholic  intoxication. 

Quinine  has  been  used  more  particularly  in  the  later  or  convales- 
cent period  of  the  treatment  of  alcoholism. 

The  so-called  "  Red  Cinchona  Cure  "  for  a  time  interested  the  pub- 
lic. Rational  medicine  does  not  recognize  any  special  drug  or  speci- 
fic remedy  as  a  universal  cure  for  inebriety,  nor  does  clinical  experi- 
ence form  any  basis  for  such  a  claim.  From  the  very  nature  of  the 
case,  such  a  remedy  would  be  impossible.  The  aetiology  of  inebriety 
is  dependent  on  such  a  variety  of  causes  and  its  environments  and 
complications  so  numerous  that  any  one  remedy  could  not  fulfill  all, 
or  even  meet  the  more  important  of  these  conditions.  However  val- 
uable drugs  may  be  to  meet  certain  indications  in  the  various  condi- 
tions incident  to  inebriety,  we  believe  that  so  far  as  the  curative 
treatment  of  inebriety  is  concerned,  drugs  must  assume  a  secondary 
place,  valuable  as  they  may  be  in  their  respective  spheres. 

In  the  treatment  of  the  alcohol  habit  we  place  first:  Restraini  and  \ 
seclusion  in  a  special  asylum  for  a  definite  period,  and  totat  abstinence  J 
duri'iig  this  period. 

In  a  few  words,  concisely  expressed,  this  statement  includes  the 
plan  now  adopted  by  the  leading  asylums  of  this  country  and  of 
Europe  for  the  recovery  of  the  inebriate.  It  involves  restraint, 
(legal,  if  need  be),  seclusion,  a  special  institution,  in  which  all  the 
latest  and  best  methods  of  dealing  with  the  inebriate  are  procurable, 
a  sufficient  period  in  which  to  apply  these  measures,  and  we  need 


172 


DIHRABK8   or   TIIK   BRAIN   AMD   NRRVIS. 


V 


hurdl)'  iiclJ,  a  long  period  of  total  abstinence  from  ail  alcoholic  limiois. 
Wo  need  hardly  add  that  diet,  rest,  recreation,  liygienic  Hnrronndin^p*, 
and  the  exhibition  of  appropriate  drugs  are  all  included  in  the  al)ove 
plan. 

The  cauHes  of  degeneration  Iniing  removed,  i\w  fa(!torH  of  regenera- 
tion l)eing  brought  into  action,  new  formation  of  nerve,  nniHcle  uiii) 
tissue  must  supplant  degenerated  tissue,  if  haply  organic  disease  him 
not  resulted  in  irrepamble  injury. 

We  have  hinted  at  an  hysterical  element  in  the  history  of  inebriety. 
The  inebriate,  whatever  may  be  his  condition,  is  largely  intluenced 
by  his  surroundings. 

In  the  light  of  such  an  hysterical  element  in  the  clinical  history  of 
inebriety,  we  can  readily  account  for  the  apparent  success  of  the  so- 
called  temperancie  movements  that  sweep  over  comn  unities  periodi- 
cally and  effect  many  apparent  euros,  or  rather,  in  the  language  of 
the  day,  reformations.  Such  an  element  will  also  explain  why,  after 
such  a  tidal  wave  of  excitement,  relapses  take  place  oftentimes  in 
large  numbers,  and  the  period  of  excitement  is  followed  by  a  period 
of  reaction. 

The  occurrence  of  relapses  is  readily  accounted  for  by  the  fact  that 
the  stimulus  of  the  period  of  excitement  buoys  up  the  inebriate  for 
the  time  Ixjing,  during  which  strong  mental  emotion  is  a  powerful 
factor.  He  is  keyed  up,  as  it  were,  for  the  time,  and  sustained  by  a 
moral  stimulus.  When  this  is  withdrawn,  reaction,  followed  by  cor- 
responding depression,  sets  in,  and  the  old  method  of  stimulation  is 
again  imperatively  demanded  and  yielded  to. 

Why  some  inebriates  go  through  such  a  period  of  excitement  and 
do  not  relapse,  and  why  othere  do,  can  be  accounted  for  by  the  fact 
that  the  former  are  in  a  reasonable  degree  of  physical  health,  and  are 
not  bui'dened,  dragged  down  and  handicapped,  either  by  disease  that 
is  non-alcoholic,  or  that  is  the  result  of  alcoholic  degeneration.  The 
inebriates  so  affected  are  not  influenced,  or  if  at  all,  only  temporarily, 
by  the  so-called  "  temperance  revivals  "  that  appear  and  disappear 
with  almost  stated  regularity  in  large  and  small  communities  and  we 
must  add  do  good,  but  only  in  the  channel  indicated. 

It  is  also  operating  through  this  hysterical  feature  of  inebriety 
that  charlatanism  may  effect  a  temporary,  possibly  a  permanent  suc- 
cess in  a  certain  class  of  cases. 

In  cases  where  the  hysterical  element  largely  preponderates,  we  be- 
lieve psycho-therapeutical  agencies,  or  even  those  that  appeal  to 
purely  mental  conditions,  will  be  of  service,  but  they  will  not  cure  a 
cirrhosed  liver,  lung,  or  kidney,  or  remove  the  physical  causes  upon 
which  the  inebriety  may  depend.  In  addition  to  those  measures  that 
appeal  to  the  higher  moral  nature,  there  ought  also  to  be  combined 
such  as  meet  certain  intelligent  wants.  To  this  end  all  reasonable 
amusements,  entertainments,  and  especially  such  occupations  as  will 
interest  the  person  and  keep  him  busy,  should  be  encouraged,  if  not 
made  compulsory. 


V  . 


DI8KAHE8   OK  THE    tiUAIK   AND   NKKVKS. 


173 


f>li('  liiiuors. 
rroundingH, 
"  the  above 

^f  regeneni- 
nuiHcIe  mid 
•liHi'iise  iuM 

•f  in(d)riety. 
'  iiiHuenoeU 

il  luHtoryof 
of  the  80- 
ies  peiiodi- 
Higiiage  of 
why,  ftfter 
/ontimeH  in 
by  a  period 

le  fact  that 
ebriate  for 
V  powerful 
[lined  bv  a 
red  by  cor- 
iiuhition  is 

mient  and 
)y  the  fact 
h,  and  are 
sease  that 
The 
nporarily, 
isappear 
8  and  we 

inebriety 
nent  suc- 

68,  we  be- 
ppeal  to 
ot  cure  a 
868  upon 
urea  that 
jorabined 
iBsonable 
as  will 
,  if  not 


Incidentally  I  may  mention  hypnotism  iw  having  Imhmi  used  espe- 
cially by  French  [ihysiciauH,  with  some  l)eneflt  in  cases  of  chronic  al- 
coiiolism.  I  have  no  data  to  give,  and  have  not  had  any  personal 
experience  with  it. 

The  Bi-Chloride  of  Gold  cure,  known  as  the  Keeley  cure,  is  in 
many  cases  successful,  but  not  in  all.  Would  advise  its  use  as  a  List 
resort;  though  we  think  its  use  sometimes  leads  to  insanity  and 
suicide.     It  cures  at  all  events  for  the  time  being. 

If  the  t(!mper.in('e  advocates  would  supply  light,  warm,  cheerful 
places  of  resort  with  h(tt  and  temperance  drinks,  supplied  with  pool 
imd  billiard  bibles  where  the  poor  could  spend  their  evenings  and 
meet  each  other  and  amuse  themselves  at  v  reasonable  expense,  and 
establish  cooking  schools  for  the  wives  vf.  •  •  they  could  learn  how 
to  cook  nourishing  and  palatable  food  which  would  supply  the  body 
with  the  nourishment  which  it  must  have  and  recjuires,  we  believe 
it  would  do  more  towards  tempci'ance  than  all  the  laws  that  could 
be  passed. 

Enlars^ement  of  the  Brain.  —  Hypertrophy. 

This  is  chiefly  a  disease  of  childhood.  It  consists  in  an  unnatural 
growth  of  the  brain.  Sometimes  the  skull  grows  with  it,  and  there 
may  not  be  any,  or  only  slight,  symptoms  of  disease. 

The  complaint  is  sometimes  congenital,  —  the  child  being  born 
with  a  head  far  above  the  natural  standard  Jt  size.  Sometimes  a 
child's  head,  from  this  disease,  will  reach  the  size  of  p''  adult's  by 
the  time  it  is  five  or  six  yeara  old.  This  is  not  necessarily  a  disease, 
though  children  that  suffer  from  it  are  very  apt  to  die  finally  of  some 
affection  of  the  brain. 

Symptoms. —  Dullness  of  intellect,  indifference  to  external  objects 
great  irritability  of  temper,  inordinate  appetite,  giddiness,  and  an  ha- 
bitual headache,  which  at  times  is  very  severe.  In  addition  to  these, 
there  are,  at  times,  convulsions,  epileptic  fits,  and  idiocy.  There  is  a 
peculiar  projection  of  the  parietal  bones,  which  serves  well  to  distin- 
guish this  disease  from  acute  hydrocephalus. 

Treatment. —  As  far  as  possible,  suspend  and  repress  all  exercise 
of  the  mind.  Take  the  child  from  school  as  soon  as  the  disease  is 
discovered,  and  put  it  to  the  most  active  muscular  exercise  in  the 
open  air.  The  moment  there  is  any  excitement  of  the  brain,  or  heat 
on  the  top  of  the  head,  apply  cold  water,  ice,  or  cold  evaporating 
lotions.  If,  as  the  child  grows  up,  the  signs  of  mischief  increase,  the 
diet  must  be  simple,  and  carefully  regulated.  Bread  and  milk  only 
is  sometimes  advisable. 

Shrinkin,?  of  the  Brain,  — Atrophy. 

This  is  a  disease  in  which  the  volume  of  the  brain  is  diminished. 
Thei-e  are'  two  forms  of  't;  one  is  congenital,  the  brain  not  being 


i '  i 


174 


DISKABE8    OF  THE   BKAIK   AND   NERVES. 


properly  developed  at  birth ;  the  other  occurs  in  consequence  of  dis- 
ease either  in  the  membranes  or  the  arteries.  The  symptoms  are  not 
distinguishable  during  life  from  those  of  other  brain  affections,  and 
therefore  it  can  only  be  treated  according  to  general  jjrinciples. 

Water  in  the  Head. — Acute  Hydrocephalus. 

This,  like  enlargement  of  the  brain,  is  likewise  a  diseaso  of  child- 
hood, and  often  attacks  scrofulous  children. 

Being  an  inflammatory  disease,  if,  is  important  to  have  early  notice 
of  its  existence,  and,  if  possible,  to  be  aware  of  its  approach  ;  which 
we  may  be,  frequently,  by  observing  the  following  premonitory 

Symptoms ;  namely,  a  disturbance  of  the  digestive  functions,  indi- 
cated by  a  capricious  appetite, — the  food  at  one  time  being  disliked, 
at  another  devoured  greedily;  a  foul  tongue,  offensive  breath,  enlarged 
and  sometimes  tender  belly,  torpid  bowels,  stools  light-colored  from 
having  no  bile,  or  dark  from  vitiated  bile,  fetitV,  sour-smelling,  slimy 
and  lumpy.  The  child  loses  its  healthy  look,  and  grows  paler  and 
thinner.  Its  cv-stomary  spirit  and  activity  are  gone  ;  it  is  heavy,  lan- 
guid, dejected ;  it  is  fretful,  irritable,  uneasy ;  and  sometimes  is  a  lit- 
tle tottei-ing  in  its  gait. 

After  these  warning  symptoms,  the  disease  may  begin  in  one  of 
three  ways :  — 

The  pains  in  the  head  become  more  severe  and  frequent,  and  are 
sharp  and  shooting,  causing  the  little  patient  to  wake  and  shriek  out. 
As  the  drowsy  state  advances,  the  shrieking  gives  place  to  moaning. 
Beside  these  symptoms,  there  are  stiffness  in  the  back  of  the  neck, 
pain  in.  the  liml)s,  great  tenderness  of  the  scalp,  vomiting,  sighing, 
intolerance  of  light,  knitting  of  the  brows,  increased  disturbance  of 
stomach  and  bowels.  This  stage  may  last  ten  '  o  fourteen  days,  the 
chi'd  growing  more  weak  and  peevish. 

.iVnother  form  of  attack  is  marked  by  acute  pain  in  the  head  and 
high  fever,  convulsions,  flushed  face,  brilliant  eyes,  intolerance  of  light 
and  sound,  pain  and  tenderness  in  the  belly,  stupor,  great  irritability 
of  stomach,  causing  retching  and  vomiting  upon  every  attempt  to  sit 
up  in  bed. 

The  third  mode  of  attack  is  very  insidious,  —  the  early  symptoms 
being  mild  and  hardly  noticeable,  or  not  even  occurring  at  all.  In 
such  case,  the  convulsions  or  palsy  come  suddenly,  without  notice, 
bringing  swift  and  unexpected  destruction.  This  has  soraetiriies  been 
called  water-stroke. 

The  First  Stage  is  the  period  of  increased  senisibiiity  and  excite- 
ment, caused  by  inflaaimation,  in  which  the  pulse  is  quick  and  irreg- 
ular. 

The  5econd  Stage  is  one  of  diminished  sensibility,  or  lethargy,  dur- 
ing which  water  is  effused  upon  the  brain,  and  the  pulse  is  slow. 


■'*»»■    TSBB 


DISEASES  OF  THE  BRAIN  AND   NERVES. 


17B 


ence  of  dis- 
;om8  are  not 
ections,  and 
iciples. 

alus. 

wo  of  child- 

oarly  notice 
ach;  which 
nitory 

ictions,  indi- 
ng  disliked, 
th,  enhvrged 
olored  from 
dling,  slimy 
8  paler  and 
I  heavy,  lan- 
mes  is  a  lit- 

ti  in  one  of 

;nt,  and  are 
[  shriek  out. 
to  moaning, 
f  the  neck, 
ng,  sighing, 
turbance  of 
sn  days,  the 

le  head  and 

ace  of  light 

irritability 

empt  to  sit 

symptoms 
at  all.  In 
3ut  notice, 
tithes  been 

md  excite- 
I  and  irreg- 

^argy,  dur- 
slow. 


The  Third  Period  is  one  of  palsy  and  convulsions,  with  squinting 
of  the  eyes,  rolling  of  the  head,  stupor,  and  a  rapid,  thread-like  pulse. 

Treatment.  — The  first  or  inflammatory  stage  of  the  fever  is  very 
important,  and  must  be  controlled  for  five  or  six  days.  Scammonv  and 
croton  oil  (33)  may  be  chosen  for  this  purpose.  Apply  cold  water, 
ice,  etc.,  to  the  head.     Use  tinct.  veratrum  viride  or  (355). 

In  the  second  stage,  put  blisters  upon  the  back  of  the  neck,  and  one 
upon  the  bowels  if  they  are  very  tender. 

In  the  third  stage,  effusion  having  taken  place,  use  the  warm  bath, 
or  the  vapor  bath,  —  also  digitalis,  squills,  and  iodide  of  potassium, 
(144),  (128),  (302),  (130).  The  effusion,  if  permanent,  may  be 
drawn  off. 

Confine  the  child  to  a  darkened  room,  of  moderate  temperature,  — 
excluding  all  noise  and  causes  of  excitement,  and  let  him  lie  upon  a 
hair  mattress,  with  his  head  somewhat  elevated. 

Diet.  —  Gruel  only  during  the  stage  of  excitement,  —  during  that 
of  collapse,  it  should  be  nourishing,  but  mild  and  easy  of  digestion, 
as  beef  tea,  plain  chicken  or  mutton  broth,  and  animal  jellies.  At 
the  same  time,  support  the  patient  by  the  cautious  use  of  the  aromatic 
spirit  of  ammonia,  ten  drops  every  four  hours,  valerian,  wine  whey, 
and  infusion  of  gentian,  columbo,  or  qua8><ia,  (64),  (66). 

Dropsy  of  the  Brain.  —  Chronic  Hydrocephalus. 

Acute  hydrocephalus  is  an  inflammation;  chronic  hydrocephalus, 
now  to  be  considered,  is  a  dropay.  It  often  begins  before  birth.  It 
consists  in  the  accumulation  of  enormous  quantities  of  water  within 
the  brain,  sometimes  within  its  ventricles,  at  other  times  upon  its 
surface.  When  it  occurs  soon  after  birth,  it  advances  slowly  and 
imperceptibly,  —  the  enlargement  of  the  head  being  the  first  thing 
noticed. 

The  skull  being  tender  in  infancy,  it  separates  at  the  fontanelles, 
as  the  fluid  accumulates,  and  the  head,  at  times,  attains  an  enormous 
size, — so  great  that  the  child  cannot  carry  it  upright,  but  lets  it  droop 
laterally  upon  the  shoulder,  or  forward  upon  the  breast. 

As  the  disease  advances,  the  senses  become  blunted,  the  child  is 
deaf  or  blind,  the  intellect  is  weakened,  perhaps  idiocy  appears,  the 
flesh  and  strength  pass  away,  convulsions  and  paralysis  come  in  their 
turn,  and  a  stupor  is  apt  to  occur  which  ends  in  death. 

Treatment.  —  The  remedies  may  be  external,  or  internal,  or  both. 

Internal  Remedies.  —  These  should  be  purgatives  (33),  (31),  or 
diui-etics  and  alteratives  (302),  (145),  (144). 

External  Remedies.  —  Apply  an  ointment  of  the  iodide  of  potas- 
sium to  the  «(;dlp  every  night  (185).  A  tight  bandage  applied  over 
the  whole  head  will  sometimes  have  a  favorable  effect.     Another  ex- 


1 1' 


:^ 


{; 


.Xiffyre' 


176 


niSEABKS  OF   THE   BRAIN   AND   NEKVE8. 


pedient  is  to  puncture  the  skull  and  draw  off  the  water.  Tapping 
the  brain  has  effected  a  cure  in  many  cases,  and  perhaps  promises  the 
most  relief  of  any  remedy  we  have.  In  newly-born  ciiildren  with  this 
affection,  it  is  the  best  means. 


FIO.  84. 


m 


Diseases  of  the  Spinal  Cord. 

Thkiie  are  few  diseases  more  interesting,  as  a  study, 
than  those  which  affect  the  nervous  cord  which  runs 
through  the  centre  of  the  back-bone.  This  cord  is  a 
continuation,  an  appendage  or  tail  of  the  brain.  (See 
Figure  84.)  It  is  the  seat,  and  centre  of  certain  ner- 
vous functions,  called  reflex,  by  which  so  many  move- 
ments take  place  which  are  not  under  the  control  of  the 
will. 

In  order  that  we  may  feel  what  takes  place  in  any 
part  of  the  body  or  limbs,  and  that  the  will  may  have 
power  to  move  such  part,  it  is  necessary  that  nervous 
matter  should  be  continuous  and  unbroken  between  the 
part  in  question  and  the  brain. 

If  the  spinal  cor- .  be  cut,  broken,  or  crushed  at  any 
point,  all  those  parts  which  receive  nei-ves  from  helow 
the  injury,  lose  their  power  of  motion  and  their  feel- 
ing. When  the  injury  \s  in  the  upper  part  of  the  cord, 
the  breathing  and  the  circulation  will  stop,  and  death 
is  the  immediate  consequence.  If  the  middle  portion 
of  the  cord  be  the  seat  of  the  injury,  the  bowels  and 
other  organs  may  lo6e  their  motion  and  feeling ;  if  the 
lower  portion,  then  the  lower  limbs  only  will  be  the 
sufferers. 

Diseiise  or  injury  in  the  upper  part  of  the  cord  is 
therefore  much  more  dangerous  than  the  same  thing 
the  lower. 


Inflammation  of  the  5pinal  Cord. 

The  membranes  which  surround  the  cord  may  be  inflamed  just  as 
those  are  which  enclose  the  brain ;  but  as  the  cavity  running  through 
the  spine  is  quite  small,  there  cannot  very  well  be  inflammation  of 
the  membranes  without  its  involving  the  cord  at  the  same  time. 

Symptoms.  —  Pains,  often  intense,  running  along  the  spine,  extend- 
ing out  into  the  limbs,  and  made  worse  by  motion.  They  are  similar, 
in  some  respects,  to  rheumatic  pains.  There  is  rigid  contraction,  and 
sometimes  violent  spasms  of  the  muscles  of  the  back  and  neck,  —  so 
great,  at  times,  as  to  bend  the  body  back  into  the  shape  of  a  hoop ; 
also  a  feeling  of  constriction  in  various  parts,  as  if  they  were  girt  by 
a  tight  string;  a  sense  of  suffocation;  retention  of  urine;  a  most 


DISEASES  OF  THE   BRAIN   AND  NERVES. 


177 


'.  Tapping 
jfomises  the 
en  with  this 


aa  a  study, 
which  runs 
8  cord  is  a 
rain.  (See 
certain  nei- 
nany  move- 
introl  of  the 

iace  in  any 
1  may  have 
aat  nervous 
aetween  the 

shed  at  any 
from  below 
[  their  feel- 
of  the  cord, 
,  and  death 
die  portion 
bowels  and 
ing;  if  the 
will  be  the 

;he  cord  is 
lame  thing 


led  just  as 
lig  through 
imation  of 
time. 

le,  extend- 
Lre  similar, 
Action,  and 
leck,  —  so 
|f  a  hoop; 
pre  girt  by 
a  most 


obstinate  constipation  and  frequent  chills  or  rigoi-s.  The  pain  which 
is  felt  along  the  cord  is  aggravated  by  rapping  upon  the  spine,  but 
not  by  pressure. 

The  above  symptoms  are  supposed  to  be  the  result  of  inflammation 
predominating  in  the  membranes.  When  its  seat  is  more  particularly 
in  the  substance  of  the  cord,  the  symptoms  are,  —  convulsive  affec- 
tions of  the  head  and  face,  inarticulate  speech,  loss  of  voice,  squint- 
ing, and  difficulty  of  swallowing,  if  the  extreme  upper  part  of  the 
cord  is  iaflamed;  if  the  disease  l)e  slightly  lower,  difficulty  of  breath- 
ing. Irregular  action  of  the  heart,  and  tightness  of  the  chest;  if  lower 
still,  vomiting,  pain  in  the  belly,  sensation  of  a  cord  tied  round  the 
abdomen,  pain  and  heat  in  passing  water,  retention  of  the  urine,  ina- 
bility to  retain  the  urine,  desire  to  go  to  stool,  or  involuntary  stools. 

Spasm  and  stiffness,  then,  are  the  results  of  inflammation  of  the 
merabranes ;  convulsions  and  palsy,  of  the  same  affection  of  the  cord. 

Treatment,  — When  the  inflammation  is  acute,  apply  a  few  leeches 
or  wet  cups  along  the  sides  of  the  spine.  In  chronic  inflammation, 
powerful  friction,  or  mustard  draughts,  stimulating  liniments  (1 90), 
or  plasters,  will  generally  answer  the  purpose. 

Apoplexy. 

Apoplexy  is  that  condition  in  wliich  all  the  functions  of  animal 
life  are  suddenly  stopped,  except  the  pulse  and  the  breathing ;  —  in 
which  there  is  neither  thought,  nor  feeling,  nor  voluntary  motion ;  in 
which  the  person  falls  down  suddenly,  and  lies  as  if  in  a  deep  sleep. 

Modes  of  Attacki  —  There  are  at  least  thi'ee  ways  in  which  this  ter- 
rible disease  may  make  its  assault. 

The  First  form  of  atta  jk  is  a  sudden  falling  down  into  a  state  of 
insensibility  and  apparently  profound  sleep,  —  the  face  being  gen- 
erally flushed,  the  breathing  stertorous  or  snoring,  the  pulse  full  and 
not  frequent,  with  occasional  convulsions. 

From  this  mode  of  attack  some  die  immediately,  others  get  entirely 
well,  and  others  get  off  with  the  exception  of  paralysis  on  one  side, 
or  the  loss  of  speech,  or  some  one  of  the  senses. 

• 

The  Second  form  of  attack  begins  with  sudden  pain  in  the  head. 
The  patient  becomes  pale,  faint,  sick,  and  vomits,  —  has  a  cold  skin 
and  feeble  pulse,  and  occasionallj'  some  convulsions.  He  may  fall 
down,  or  may  be  only  a  little  confused,  but  will  soon  recover  from  all 
the  symptoms,  except  the  headache, — this  will  continue,  and  the  pa- 
tient will  sooner  or  later  become  heavy,  forgetful,  unable  to  connect 
ideas,  and  finally  sink  into  insensibility,  from  which  he  never  rises. 

This  mode  of  invasion,  though  not  appearing  so  frightful  as  the 
first,  is  of  much  more  serious  import. 


M 


i 


178 


DISEASES  OF   THE  BRAIN   AND  NERVES. 


In  the  Third  form  of  attack  there  is  sudden  loss  of  power  on  one 
side  of  the  body,  and  also  of  speech,  but  not  of  consciousness.  The 
patient  retains  his  mind,  and  answers  questions  either  by  words  or 
signs.  This  may  be  called  paralytic  apoplexy.  The  patient  may 
either  die  soon,  or  get  well,  or  live  for  years  with  imperfect  speech, 
or  a  leg  dragging  after  him,  or  an  arm  hanging  useless  at  his  side. 

The  Persons  Attacked  are  apt  to  have  large  heads,  red  faces,  short 
and  thick  necks,  and  a  short,  stout,  square  build,  though  it  occui-s 
often  among  those  ^^hn  are  thin,  pale,  and  tall.  The  tendency  to  it 
increases  in  advanced  life. 

The  Forerunners  of  apoplexy  are  headache,  vertigo,  slight  attacks 
of  palsy,  double  vision  or  seeing  two  objects  when  there  is  but  one, 
faltering  speech,  inability  to  remember  certain  words,  sometimes  a 
sudden  forgetfulness  of  one's  own  name,  a  frequent  losing  of  the 
thread  of  ideas  attempted  to  he  pursued,  and  occasionally  an  unac- 
countable dread,  for  which  no  reason  can  l)e  given. 

Erciting  Causes. —  Whatever  hurries  the  circulation  of  the  blood, 
as  strong  bodily  exercise,  is  an  exciting  cause.  So  are  all  those  things 
which  cause  the  blood  to  flow  towards  the  head,  as  coughing,  sneez- 
ing, laughing  and  crying,  straining  at  stool  when  costive,  lifting  heavy 
weights,  singing,  and  playing  on  wind  instruments.  To  these  may 
be  added,  exposure  to  the  sun,  the  bad  air  of  crowded  rooms,  holding 
the  head  down,  or  turning  it  around  to  look  backward,  tight  cravats 
worn  about  the  neck,  and  exposure  to  severe  cold. 

Treatment. —  If  the  patient  have  the  appearance  of  suffering  from 
fulness  of  blood  in  the  head,  as  evinced  by  redness  and  turgescence 
of  the  face  and  throbbing  of  the  temporal  arteries,  and  if  the  pulse 
be  full  and  hard,  feeling  like  a  tense  vibrating  rope  under  the  finger, 
place  him  in  a  half-recumbent  posture,  with  his  head  raised ;  loosen 
his  clothes,  particularly  his  neck-cloth  and  shirt  collar,  and  whatever 
may  press  upon  the  neck,  and  then  as  quickly  as  possible  apply  cold 
wet  cloths  to  his  head,  changing  them  often.  Ice  is  still  better,  if  it 
may  be  had.  Apply  wet  cups  to  the  nape  of  the  neck,  and  mustard 
draughts  to  the  soles  of  the  feet. —  at  the  same  time  applying  tight 
ligatures  around  the  limbs,  to  pievent  the  blood  from  returning 
rapidly  in  the  veins.  The  ligatures  should  be  gradually  removed 
when  the  patient  recovers  his  consciousness^  Also  administer  a 
stimulating,  purgative  injection  (246),  and  place  t  vo  drops  of  ci-oton 
oil,  rubbed  up  with  a  little  pulverized  loaf  sugar,  far  back  upon  the 
tongue.  Repeat  the  injection  every  fifteen  minutes,  till  the  Ixtwels 
are  thoroughly  moved.  This  is  one  of  the  few  diseases  suitable  for 
bleeding. 

If  the  patient  be  old,  and  the  pulse  small  and  feeble,  with  no  ful- 
ness or  beating  of  the  temporal  arteries,  or  swelling  of  the  veins  of 
the  neck  and  forehead,  the  countenance  being  pinched,  and  the  skin 


DISEASES   OF  THE   BRAIN    AND   NERVES. 


179 


ower  on  one 
sness.  The 
by  words  or 
patient  may 
feet  speeeli, 
b  his  side. 

I  faces,  short 
^h  it  occui-8 
ndency  to  it 

light  attacks 
B  is  but  one, 
sometimes  a 
asing  of  the 
Jly  an  unac- 

jf  the  blood, 
those  things 
rhing,  sneez- 
iifting  heavy 
)  these  may 
ams,  holding 
tight  cravats 

ffering  from 

turgescence 

if  the  pulse 

ir  the  finger, 

ised ;  loosen 

lid  whatever 

apply  cold 

better,  if  it 

,nd  mustard 

(lying  tight 

returning 

ly  removed 

minister  a 

)S  of  croton 

upon  the 

the  bowels 

lUitable  for 

irith  no  ful- 
Ihe  veins  of 
Id  the  skin 


liloodlesB  and  cold,  the  cupping,  purging,  and  applying  the  ligature 
iiuist  be  omitted.  In  this  case  it  will  l)e  lietter  to  apply  warm 
ttannels  and  hot  bricks  to  the  surface,  and  administer  ammonia 
and  camphor  (283),  (135)  internally. 

To  prevent  future  attacks,  gentle  tonics  should  l)e  used,  and  the 
skin  should  be  kept  healthy  by  daily  bathing  and  friction.  The 
towels  must  not  1  >e  permitted  to  become  costive.  The  diet  should 
Im  light,  chiefly  vegetivble,  and  almost  entirely  so  in  hot  weather. 
The  food  should  be  well  chewed.  Tho  mind  should  be  kept  cheer- 
ful and  hopeful,  and  free  from  great  excitement.  The  sexual 
passion  should  l)e  restrained,  and  very  rarely  indulged.  Intoxicating 
drinks  should  be  abandoned,  if  used,  and  all  tight  cravats  l)e  dis- 
carded from  the  neck.  Direct  rays  of  the  hot  sun  in  summer  should 
\m  carefully  shunned.  No  food  should  be  taken  for  three  hours 
lief  ore  retiring,  and  a  mattress  only,  of  some  degree  of  hardness, 
should  be  slept  upon, —  the  head  being  always  well  elevated.  To 
these  precautions,  I  would  add  dipping  the  feet  every  night  before 
retiring  in  cold  water;  and,  if  any  tendency  to  cold  feet  be  sx- 
perienced,  dusting  pulverized  cayenne  in  the  bottoms  of  the 
stockings. 

Sunstroke. —  Coup  de  Soleil. 

This  is  much  like  apoplexy;  in  fact,  it  is  a  kind  of  apoplexy.  It 
occurs  in  warm  climates,  or  on  very  hot  days  in  temperate  regions,  by 
exposure  to  the  sun. 

It  begins  by  hesidache,  tliirst,  dizziness,  and  sometimes  difficult 
breathing  and  bilious  vomiting.  The  patient  drops  down  senseless, 
ivs  in  apoplexy,  and  unless  immediate  relief  is  obtained,  soon  dies. 

Treatment. —  Take  the  patient  immediately  into  the  shade,  and 
employ  about  the  same  remedies  as  for  apoplexy  (361).  Apply  ice 
to  the  head. 

Palsy.  —  Paralysis. 

Palsy  is  a  loss  of  the  power  of  voluntary  motion  and  feeling,  one 
or  both  coming  on,  sometimes  gradually,  but  more  often  suddenly, 
and  extending  at  one  time  to  a  part,  at  another  time  to  the  whole 
lx)dy.  It  is  a  kind  of  station-house  on  the  way  to  apoplexy,  where 
passengers  stop,  not  merely  to  stay  over  night,  but  to  rest  many  days, 
or  even  years. 

A  great  injury  inflicted  upon  the  brain,  either  by  pressure  or  other 
cause,  will  induce  a  complete  loss  of  motion  and  feeling,  and  this  ex- 
tending to  the  whole  structure,  brings  likewise  a  loss  of  conscious- 
ness, which  is  apoplexy.  A  smaller  degree  of  pressure,  or  a  less 
injury  upon  the  same  brain,  would  occasion  a  loss  of  motion  only,  or, 
if  a  loss  of  feeling  were  experienced  also,  it  would  only  extend  to  a 
part  of  the  body,  and  consciousness  would  remain.  This  would  be 
palsy.  The  disease  is  like  apoplexy  in  kind,  but  stops  short  of  it  in 
degree. 


t  < 


180 


DISEASES  OF  THE  BRAIN  AND   NRRVKR. 


Hctniphlegia. 

When  palsy  affects  an  entire  half  of  the  body,  dividing  it  through 
the  centre  of  the  face,  necl:  body,  etc.,  from  head  to  foot,  it  is  called 
hemipMegia.  It  is  more  nearly  allied  to  apoplexy  than  any  other 
form  of  the  disease,  and  is  generally  ushered  in  by  pretty  well-marked 
apoplectic  symptoms. 

Symptoms Sometimes  there  are  no  premonitory  symptoms ;  but 

often  before  the  attack  there  are  flushed  face,  swelling  of  the  veiris 
about  the  head  and  neck,  verti  a  sense  of  fullness,  weight,  and 
sometimes  pain  in  the  head,  ring  the  ears,  drowsiness,  indistinct 

articulation  of  wordis,  or  even  loa.s  peech,  confusion  of  mind,  loss 
of  memory,  and  change  of  disposition,  —  amiable  persons  being  made 
sullen  and  peevish,  and  irritable  ones  mild  and  simpering.  After 
the  attack,  the  countenance  generally  acquires  a  vague  expression ; 
the  mouth  is  drawn  to  one  side ;  the  lower  lip  on  the  palsied  side 
hangs  down,  and  the  spittle  dribbles  away.  The  speech  is  altered, 
and  the  mind  is  generally  impaired. 

In  some  instances,  the  patient  recovers  in  a  longer  or  shorter  time ; 
in  others,  little  or  no  improvement  takes  place,  and  the  patient,  after 
remaining  helpless,  often  for  a  long  time,  dies  either  from  gradual 
exhaustion,  or  suddenly  from  apoplexy. 

Causes. —  Hemiphlegia  and  paraphlegia  are  caused  by  pressure 
upon  the  brain,  by  the  effusion  upon  it  of  blood  or  water,  by  a  tumor, 
by  mechanical  injuries,  by  the  striking  in  of  eruptions,  and  by  intem- 
perance in  eating  and  drinking.  Paraphlegia  often  results  from  dis- 
ease or  injury  of  the  spinal  marrow. 

Paraphlegia. 

This  form  of  palsy  divides  the  body  transversely,  at  the  hips,  and 
confines  itself  to  the  lower  extremities,  and  to  the  parts  about  the 
pelvis. 

Symptoms. — When  it  arises  from  affections  of  the  brain,  it  is  at- 
tended by  pain  in  the  head,  giddiness,  drowsiness,  dimness  of  sight, 
and  impaired  memory.  Numbness  is  sometimes  felt  in  the  upper  ex- 
tremities as  a  forerunner  of  this  form  of  palsy.  At  first  there  is  a 
slight  stiffness  and  awkwardness  of  the  motion  of  the  legs,  which 
continue  to  increase  till  a  cane  is  needed  to  balance  the  body  and 
make  it  steady.  From  a  paralysis  of  the  neck  of  the  bladder,  the 
stream  of  urine  grows  more  feeble,  and  finally  dribbles  away  involun- 
tarily. The  bowels  are  for  a  time  costive,  but  when  the  circular 
muscle  which  closes  the  fundament  becomes  palsied,  the  feces  pass 
without  consent  of  the  will. 

When  disease  of  the  spinal  cord  is  the  cause  of  the  complaint,  it 
is  apt  to  come  on  gradually ;  languor  and  weakness  are  felt  in  the 


DISEABL:^  Or   THE   BRAIN   AND   NRRVES. 


181 


'  it  through 
it  is  called 
any  other 

irell-marked 

ptoms ;  but 
f  the  veins 
veight,  and 
1,  indistinct 

mind,  loss 
jeing  made 
ng.  After 
sxpression ; 
ulsied  side 

is  altered, 

orter  time; 
tient,  after 
m  gradual 

Y  pressure 
ly  a  tumor, 
.  by  intem- 
8  from  dis- 


hips,  and 
ibout  the 


it  is  at- 
of  sight, 
upper  ex- 
here  is  a 
rs,  which 
x)dy  and 
dder,  the 
involun- 

circular 
ces  pass 

)laint,  it 
in  the 


knees,  the  legs  are  not  easily  directed  in  walking,  —  Ixsing  throv/n 
across  each  other,  causing  tripping  and  stumbling.  By  degrees  the 
loss  of  power  increases  in  the  thighs  and  legs,  until  at  length  the 
whole  lower  extremities  become  palsied  and  useless. 


Local  Palsy. 

Palsy  is  called  local  when  it  is  confined  to  a  single  limb,  or  muscle, 
or  locality.  One  of  these  forms  is  called /acmi  palsy.  It  affects  one 
half  the  face  only,  and  is  a  good  specimen  of  these  affections.  It 
removes  all  power  of  expression  from  one  half  of  the  face,  and  leaves 
the  features  still,  blank,  and  unmeaning.  With  the  affected  side  of 
the  face,  the  patient  cannot  laugh,  or  weep,  or  frown,  or  express  any 
feeling  or  emotion,  while  the  features  of  the  other  side  are  in  full 
play.  Among  the  ignorant,  who  do  not  comprehend  the  extent  of 
the  evil,  the  drolluess  of  the  expression  excites  laughter. 

Shaking  Palsy. 

The  nature  of  this  form  of  palsy  is  well  expressed  by  its  name. 

Symptoms. —  The  first  symptom  of  this  complaint  is  a  weakness 
and  tremor  of  the  head  or  hand.  In  about  a  year  the  other  hand,  or 
the  lower  extremities  become  affected ;  and  the  patient  begins  to  lose 
his  balance  in  walking.  Then  the  trembling  becomes  perpetual ;  no 
limb  or  part  remains  still.  Reading  and  writing  are  no  longer  possi- 
ble, and  the  hand  cannot  even  carry  the  food  to  the  mouth.  The 
balance  cannot  be  maintained  in  walking ;  there  is  a  tendency  to  fall 
forwards,  and  to  avoid  it,  the  patient  is  obliged  to  run  or  move 
quicker,  and  upon  the  toes. 

At  a  later  period,  the  tremor  continues  during  sleep ;  there  is  in- 
creased weakness ;  the  body  is  bent  forward,  the  speech  becomes  in- 
distinct, swallowing  difficult,  and  the  bowels  torpid.  At  last  the 
urine  and  feces  pass  involuntarily,  and  delirium  and  coma  bring  life 
to  a  close. 

Lead  Palsy. 

In  this  disease  the  muscles  of  the  forearm  are  palsied,  so  that  the 
wrists  "  drop,"  as  it  is  said,  and  the  hands  hang  down  when  the  arms 
are  stretched  out.  It  is  caused  by  the  gradual  introduction  of  lead 
into  the  system.  It  is  a  disease,  therefore,  peculiar  to  painters,  — 
particularly  those  who  use  carbonate  of  lead,  or  white  lead,  as  it  is 
called.     It  is  generally  the  sequel  of  painter's  colic. 

Treatment. —  A  sudden  and  severe  attack  of  palsy  requires  the 
same  treatment  as  apoplexy.  When  the  bowels  a^re  obstinately  con- 
stipated, they  must  be  moved  by  scammony  and  croton  oil  (31),  (32) 
and  by  injections  (246). 


182 


niSBABKS  OF  THR   BRAIN   AND  NKRVE8. 


When  all  tho  syniptomH  of  (lutennination  of  l)l()o(l  to  the  head  have 
disappeared,  and  t\w  diHeawe  hius  Ixjconie  strictly  clironic,  excitinjr 
remedieH  must  he  employed,  as  frictions,  stimulating  liniments,  blis- 
ters, stimulating  baths,  cold  affusion,  and  electricity.  Among  the  in- 
ternal remedies,  strychnine  has  the  best  reputation  (85),  (80).  The 
tincture  of  the  poison  oak  is  well  recommended  (284).  An  altera- 
tive (145)  should  likewise  be  used. 

Apply  counter-irritants  along  the  track  of  the  spine,  such  as  blis- 
ters, the  moxa,  the  compound  tar-plaster,  and  the  pitch-plaster. 

At  firat  the  diet  should  l)e  light ;  but  after  the  more  aciive  symj)- 
toms  have  disappeared,  it  should  l)e  nutritious,  and  sometimes  stimu- 
lating.     Flannel  undeVclothes  should  always  be  worn  next  the  skin. 

For  lead  palsy,  the  best  remedies  are  iodide  of  potassium,  or  sul- 
phuretof  potassium.  The  dose  of  either  of  these  is  from  three  to  ten 
grains,  three  times  a  day,  dissolved  in  water,  one  ounce  of  the  salt  to 
six  ounces  of  water,  and  taken  in  simple  syrup.  The  affected  limb 
should  also  be  soaked  an  hour  each  day  in  a  gallon  of  water,  with 
half  an  ounce  of  sulphuret  of  potassium  dissolved  in  it. 

Hydrophobia. — Rabies. 

The  bite  of  the  mad  dog,  or  mad  wolf,  or  other  hydrophobic  ani-, 
mal,  is  the  most  dangerous  of  all  poisoned  wounds,  because  it  is  apt 
to  be  followed  by  a  disease  for  which  there  is  no  cei^tain  remedy. 
Fortunately,  the  human  subject  is  not  as  susceptible  to  the  effects  of 
the  poison  as  some  of  the  lower  animals ;  for  only  about  one-tenth  of 
those  bitten  are  attacked  by  hydrophobia. 

Symptoms. —  The  interval  between  the  bite  and  the  appearance  of 
the  disease  varies  from  twelve  days  to  two  months.  The  wound 
heals  like  any  other  bite  of  a  similar  animal.  After  a  time,  the  scar 
begins  to  have  darting,  lancinating  pains,  which,  if  it  be  a  limb  that 
was  bitten,  run  up  towards  the  body.  Sometimes  it  feels  cold,  or 
stiff,  or  numb,  or  becomes  red,  swelled,  or  livid,  and  occasionally 
breaks  open,  and  discharges  matter.  The  patient  feels  a  strange  anx- 
iety, is  depressed  in  spirit,  has  an  occasional  chill,  and  disturbed 
sleep,  and  spasmodic  twitches.  The  pulse  is  above  its  natural  state, 
both  in  quickness  and  strength,  and  the  nervous  system  is  very  im- 
pressible. The  senses  are  all  more  acute;  trifling  noises  produce 
agitation,  and  the  eyes  are  so  disturbed  by  the  light  that  the  patient 
sometimes  hides  himself  in  a  dark  place.  The  appetite  is  lost.  This 
is  the  first  stage. 

Thirst  now  appears,  and  he  attempts  to  drink.  But  the  moment 
water  approaches  his  mouth,  a  spasmodic  shudder  comes  over  him ; 
he  pushes  it  back  with  horror ;  the  awful  fact  of  his  condition  flashes 
upon  him ;  and  he  cries  out,  "  What  I  have  dreaded  has  come  upon 
me." 

Thenceforward  he  can  swallow  no  fluids  ;  complains  of  pain  and 


ipuMiia 


head  havo 
!,  exciting 
lent*!,  hlis- 
»iig  the  in- 
86).  The 
An  alteia- 

;h  as  bliH- 
ster. 

Dive  syinp- 
Ties  8timu- 
t  the  skin, 
im,  or  Kul- 
iree  to  ten 
the  salt  to 
ected  limb 
^ater,  with 


ihobic  ani-, 
e  it  is  apt 
n  remedy. 
!  effects  of 
le-tenth  of 

earance  of 

he  wound 

,  the  scar 

limb  that 

s  cold,  or 

[casionally 

nge  anx- 

disturbed 

ral  state, 

very  im- 

produce 

le  patient 

1st.    This 

moment 
/er  him; 
^n  flashes 

le  upon 

)ain  and 


DISEASES   OF  THE   ORAIN   AND   NERVES. 


188 


stiffness  about  his  neck ;  is  thrown  into  convulsions  by  the  sight  of 
water,  or  even  the  sound  of  liquids  agitated  in  a  vessel,  or  by  a 
breath  of  air  blowing  upon  him,  by  a  bright  light,  oi-  by  the  glare  of  a 
mirror.  His  throat  is  full  of  a  viscid,  glary  matter,  wliich  he  con- 
tinually tries  to  clear  away.  Thus,  between  convulsions,  in  which 
lie  struggles,  and  sometimes  strives  to  bite  his  attendants,  and  com- 
parative stillness,  during  which  he  suffers  great  depression  of  spirits, 
lie  passes  three  or  four  days,  and  then  dies  either  in  a  spasm,  or  from 
exhaustion. 

Treatment. —  Cut  off  the  bitten  part,  or  apply  dry  cupping,  or 
suction,  at  once.  Also  the  caustic  potash.  The  internal  remedies 
heretofore  employed  have  had  little  success.  Perhaps  nothing  now 
known  promises  more  than  to  have  the  patient  vaccinated  by  the 
recently  discovered  virus.  The  tincture  of  scullcap,  in  two  or  three 
dram  doses,  will  allay  the  nervous  agitation,  and  is  always  worth 
using.  It  has  been  proposed  to  clear  the  throat  of  the  tough  mucus 
by  cauterizing  it  with  a  strong  solution  of  nitrate  of  silver  (219),  ap- 
plied with  a  shower  syringe.     The  remedy  is  worthy  of  a  trial. 

Some  of  the  Western  physicians  declare  the  red  duckweed,  or  scar- 
let pimpernell,  to  be  an  absolute  remedy  for  this  disease,  and  cite 
some  quite  remarkable  cases  of  its  success.  Four  ounces  of  this 
plant,  in  the  dried  state,  are  directed  to  be  boiled  in  two  quarts  of 
strong  beer  or  ale,  until  the  liquid  is  reduced  one  half.  The  liquid 
is  to  be  pressed  out  and  strained,  and  two  drams  of  laudanum  added 
to  it.  The  dose  for  a  grown  person  is  a  wane-glassful  every  morning 
for  three  mornings.  A  larger  dose  is  required  if  the  disease  have 
begun  to  show  itself ;  and  if  the  case  be  fully  developed,  the  whole 
may  be  taken  in  a  day.  The  wound  is  to  be  bathed  with  the  same 
decoction.  The  medicine,  it  is  said,  produces  profuse  sweating.  It 
is  worth  a  trial. 

Considerable  has  been  said  of  late  of  a  remedy  used  in  some  parts 
of  Europe,  and  said  to  be  effectual.  It  is  the  "  golden  cenotides  " 
{cetonia  aurata),  or  common  rose-beetle,  found  in  large  quantities  on 
all  rose-trees.  A  similar  insect  is  said  to  infest  the  geranium-plant. 
When  collected,  they  are  dried  and  powdered ;  and  given  in  this 
form,  relieve  excitement  (so  it  is  said)  of  the  brain  and  nerves,  and 
throw  the  patient  into  a  sound  sleep.  Immediate  suction  and  disin- 
fection of  the  wound  is  admirable,  followed  by  caustics. 

Muscular  and  Nervous  Derangements  from 

Wounds. 

In  some  persons,  a  very  small  local  injury  will  produce  violent  dis- 
turbance of  the  nervous  system.  Some  will  faint  and  be  thrown  into 
convulsions  and  vomiting  from  causes  scarcely  greater  than  the  prick 
of  a  needle ;  and,  before  Morton  gave  the  world  the  boon  of  ether,  it 


i 


184 


D18RA8K8  OF  THK   liRAIN  AND   NKRVBR. 


wHH  not  very  unoominoii  for  (lerBoiiH  to  die  under  tliu  ku'iUi  of  tlx* 
Hurg«5on.  Olio  of  tho  most  serious  disturbancws  from  wounds,  of  )i 
nervous  and  niusuular  uhuructor,  is 


V 


Locked  Jaw. —  Tetanus. 

This  is  spnsmodic  contraction,  with  rigidity,  or  stififness,  of  the 
voluntary  musules.  Sometimes  this  rigidity  is  {urtial,  at  other  tinieH 
univeraal  throughout  tlie  system. 

Tetanus  is  produced  hy  two  causes,  exposure  to  cold  (idiopatiiic), 
and  bodily  injuries,  particularly  the  injury  of  a  nerve  (tniuniatic;  te- 
tanus). This  last  is  the  most  frequent,  —  p'irhaps  the  only  form  of 
the  complaint. 

The  Symptoms  are  long-continued,  violent  and  painful  contraction 
or  cramp  of  the  voluntiiry  muscles.  At  first  there  is  diiTiculty  and 
uneasiness  in  turning  the  head,  with  inahility  to  open  the  mouth 
easily,  —  then  the  jaws  close  gradually,  but  with  great  firnnieHs ; 
swallowing  now  becomes  difficult,  and  a  pain,  starting  from  the 
breastbonti,  pierces  through  to  the  back, —  probably  caused  by  cramp 
of  the  diaphragm  or  midriff.  The  cramps  now  extend  to  the  muscles 
of  the  body,  the  limbs,  the  face,  the  tongue,  etc.,  which  continue  in  a 
state  of  rigid  spasm,  —  being  swelled  and  hard  in  the  centre,  —  till 
the  disease  yields,  or  tho  patient  dies.  At  times  the  abdominal 
muscles  are  so  tense  as  to  make  the  belly  as  hard  as  a  board.  Occa- 
sionally the  patient  is  drawn  backward  into  tho  shape  of  a  hoop,  so 
as  to  rest  on  his  head  and  heels  (epiathotonos) ;  at  other  times  he  iri 
drawn  forward  in  the  shape  of  a  ball  (emprosthotonoa) .  All  the  con- 
tractions are  attended  with  intense  pain.  It  is  the  racking  of  the  en- 
tire body  with  cramps  like  those  which  sometimes  attack  the  calf  of 
the  leg.  So  violent  are  the  contractions  that  the  teeth  are  dometimes 
broken  by  them,  and  the  tongue  is  often  badly  bitten.  In  the  mean 
time,  the  appearance  of  the  sufferer  is  frightful.  The  forehead  is 
wrinkled,  the  brow  knit,  the  eye-balls  motionless  and  staring,  the 
nostrils  spread,  the  corners  of  the  mouth  drawn  back,  the  set  teeth 
exposed,  and  all  the  features  fixed  in  a  ghastly  grin. 

Treatment. —  The  only  known  remedies  for  this  disease  are  chlo- 
roform and  ether,  taken  either  into  the  stomach,  or  by  inhalation,  in 
quantities  sufficient  to  contr:)!  the  spasm,  and  to  be  pursued  as  long 
as  they  continue  to  occur.  The  costiveness  must  be  removed  by  one 
or  two  drops  of  croton  oil,  administered  in  a  spoonful  of  gruel.  Re- 
lieve the  nerve  or  remove  the  foreign  body  from  wound. 

Epilepsy.—  Epileptic  Fits. 

This  disease  has  been  sometimes  called  the  failing  aickneaa,  but 
generally  passes  under  the  more  vague  title  of  fit$. 


DISBASEH   UK   THE    lilUIN    ANU    NKRVBH. 


185 


nif((  (if  till' 
oiiiuIh,  of  u 


lesH,  of  tlie 
uther  timeH 

(Uoputliio), 
uiiniitic  te- 
lly form  of 

contraction 

RRculty  and 

the  mouth 

firmnt'HH ; 

5  from  the 

i  by  cranij) 

he  muscles 

ntinue  in  a 

ntre,  —  till 

abdominal 

,rd.     Occa- 

a  hoop,  so 

limes  lie  m 

.11  the  con- 

of  the  en- 

le  calf  of 

sometimes 

;he  mean 

irehead  is 

iiring,  the 

set  teeth 


are  chlo- 
alation,  in 
■id  as  long 
ed  by  one 
■uel.     Re- 


kneM,  but 


Symptoms. —  The  diseaso  in  characterized  by  a  temporary  Iosh  of 
fonBciouHnesH,  strong  spasnm  and  intervals  lietween  the  tits.  The  at- 
tack is  sudden,  generally  witlumt  warning,  and  attended  with  a  loud 
cry,  when  the  piuient  falls  down,  is  senseless  and  convulsed,  struggles 
violently,  breathes  with  enibarrasHment,  has  a  turgid  and  livid  face, 
foams  at  t'le  mouth,  bites  his  tongue,  has  a  choking  in  the  windpipe, 
and  appears  to  'o  at  the  point  of  death.  I'resently,  in  from  five 
minutes  to  half  an  hour,  and  by  degrees,  tiiese  symptoms  diminish, 
and  at  length  cease;  and  the  patient  falls  into  an  apparent  sleep.  In 
a  short  time  more  he  recovei-s,  and  is  aj)parently  well.  These  attacks 
come  again  and  again,  and  at  irregular  intervals. 

This  is  the  worst  form  of  the  disease ;  there  is  another  class  of 
oases  in  which  the  symptoms  are  much  lighter, —  there  being  no  tur- 
gescence  of  the  face,  no  foaming  at  the  mouth,  no  cry,  no  convul- 
sions ;  but  merely  a  sudden  and  brief  suspension  of  consciousness,  a 
fixed  gaze,  a  feeling  of  confusion,  or  a  totter,  from  all  of  which  the 
recoveiy  is  speedy. 

Causes. —  These  are  numerous,  —  as  worms,  disturbance  from  indi- 
gestible food  in  the  stomach  and  Iwwels,  difficult  teeth-cutting,  ner- 
vous irritation,  either  direct  or  by  sympathy,  sexual  excesses  and 
masturbation,  disease  or  injury  of  the  brain  or  spinal  marrow,  gall 
stones  in  the  excretory  duct  of  the  liver,  stone  or  gravel  in  the  kid- 
neys and  bladder,  fright,  distress  of  mind,  passion,  great  loss  of  b^ood, 
and  many  others. 

Treatment. —  But  little  can  be  done  during  the  fit,  except  to  pro- 
tect the  patient  from  being  injured  by  the  violence  of  the  coBvulsions. 
To  do  this,  place  a  piece  of  leather,  cork,  or  other  substance  not  too 
hard,  between  the  back  teeth  to  prevent  the  tongue  from  being  bitten. 
Remove  the  neckcloth,  and  unbutton  the  shirt-collar.  If  the  stomach 
and  bowels  are  suspected  to  be  overloaded,  give  an  injection  (246). 

The  treatment  during  the  intervals  must  depend  on  the  cause  of 
the  disease.  If  worms  be  the  cause,  expel  them  ;  if  the  attacks  be 
excited  by  difficult  teething,  Icnce  the  gums ;  if  by  uterine  disturb 
ances,  search  out  the  nature,  and  give  the  treatment  recommend  jd 
under  the  proper  head ;  if  masturbation,  command  its  entire  discon- 
tinuance as  the  only  hope  of  relief ;  if  the  complaint  arise  from  in- 
digestible food,  great  attention  must  be  given  to  the  diet  and  general 
health. 

In  all  cases,  indeed,  the  diet  should  be  carefully  regulated,  being 
light,  nutritious,  and  easy  of  digestion.  The  sleep  should  be  taken 
at  regular  houi-s,  and  daily  exercise  in  the  open  air  be  insisted  upon. 
The  bowels  must  be  kept  regular,  by  the  food,  if  possible ;  if  not,  by 
mild  laxatives.  Apply  along  the  spinal  column  195,  once  a  day,  rub- 
bing it  well  in ;  also,  now  and  then,  mustard  poultices. 

In  addition  to  these  remedies,  give  pills  of  iron  and  quinine  (72). 
one  after  each  meal, — also  oxide  of  zinc  (270),  which  is  one  of  our 


186 


DIIKAHEB  OP  THK   HRAIN   AND   NBRVRS. 


very  bent  remedieH.  Of  tho  pills,  one  nhould  Ik;  taken  three  timcN  ;i 
day.     Kruniitle  nf  Hodium,  1  driiin  in  24  luiurH,  nioHtly  at  Iwdtime. 

We  can  Holdoni  go  amiHH  in  giving  medicine  calculated  to  relievo 
nervous  irritation,  and  to  huild  up  the  general  HyHtem.  For  tliiH  pur- 
pose,  the  valtM'ianate  of  quinine,  and  tho  extract  of  hlack  cohosli  (7i)) 
are  well  adapted.  Citrate  of  iron  and  strychnine  (316),  is  a  very  val- 
uable remedy. 

It  is  said  that  a  black  silk  handkerchief  thrown  over  tho  face  of  ii 
person  in  a  fit,  will  immediately  bring  them  out  of  it.  It  is  an  ex- 
periment easily  tried ;  and  having  seen  it  in  a  respectable  medical 
journal,  I  give  it  for  what  it  is  worth.  The  bromides  in  large  doses, 
long-continued,  sometimes  cure  epilepsy  (367). 


Catalepsy.  —  Trance. —  Ecstasy. 

Cataleptic  fits  are  simply  what  is  known  to  all  the  world  under 
the  name  of  trance ;  and  ecstasy  is  a  modification  of  the  same  nervous 
disorder.  It  is  a  state  in  which  the  mind  becomes  so  intensely  al>- 
sorbed  in  something  outside  of  its  earthly  tenement,  that  it  withdraws 
all  control  over  the  body,  and  all  -apparent  co:i'iection  with  it,  leav- 
ing it  as  if  dead.  There  is  a  very  light  tick'ng  of  the  heart,  just  pe: 
ceptible  to  a  cultivated  ear,  but  the  breast  does  not  rise  and  fall  with 
breathing,  tho  features  are  all  inexpressive  and  still,  the  eyes  are  wide 
open  and  motionless,  apparently  staring  after  the  departed  intellect; 
and  the  body  and  limbs  are  entirely  passive, —  remaining  unmoved 
where  they  are  placed  by  others,  however  tiresome  and  uncomfortable 
the  position.  In  a  word,  a  person  in  catalepsy  is,  in  appeamnco,  like 
a  marble  statue,  or  like  a  human  body  suddenly  turned  to  stone,  or, 
like  Lot's  wife,  to  a  pillar  of  salt.  There  is  as  little  feeling,  or 
thought,  or  consciousness,  as  if  the  bowl  had  been  instantaneously 
brokei<  at  the  cistern,  and  the  apparent  death  were  real. 

It  is  a  peculiarity  in  this  disease  that  the  patient,  on  recovery 
fron  a  fit,  lakes  up  the  thread  of  conscious  life  just  where  it  was 
broken  by  the  attiick.  Thus,  if  she  were  lifting  a  cup  ci  water  to 
the  mouth,  she  would  hold  it  steadily,  with  the  mouth  open,  till  the 
return  of  consciousness,  and  then  place  it  to  the  lips,  as  if  no  inter- 
ruption had  occurred ;  or,  if  convei-sing,  and  in  the  midst  of  a  sen- 
tence, the  unfinished  words  would  be  uttered  at  the  end  of  the  fit, 
even  though  it  should  last  many  days. 

Persons  in  a  cataleptic  fit  have  much  the  appearance  of  one  in  the 
mesmeric  state ;  and  the  statue-like  position  in  which  an  attack  fixes 
a  patient,  reminds  one  of  the  manner  in  which  the  psychologists,  so 
called,  will  arrest  a  man  under  iheir  influence,  and  mttke  him  im- 
movable, with  one  foot  raised  in  the  act  of  stepping. 

The  disease  attacks  females  much  more  often  than  males. 

The  premonitory  symptoms  are  much  like  those  of  epilepsy,  and 
the  treatment  should  be  about  the  same. 


three  times  ii 
it  Iwdtinip. 
0(1  to  relieve! 
For  tliiH  iMii- 
:  cohosii  ('(!•) 
is  II  very  val- 

tho  face  of  a 

It  is  an  ((X- 

:4ihle  niedieui 

»  large  doses, 


world  under 
lame  nervous 
intensely  iil>- 
it  withdraws 
ivith  it,  leiiv- 
art,  just  pe; 
and  fall  with 
3ye8  are  wide 
ed  intellect; 
ug  unmoved 
iicomfoTtable 
earance,  like 
to  stone,  or, 
!  feeling,  or 
antaneously 

on  recovery 
here  it  was 
rf  water  to 
)en,  till  the 
if  no  inter- 
st  of  a  sen- 
1  of  the  fit, 

one  in  the 
attack  fixes 
ologists,  so 
ce  him  im- 

BB. 

ilepsy,  and 


DISEASEtl  or  TlIK    IIUAIN   ANU   MKRVIS. 


Saint  Vltu8*8  Dance.— CAorga. 


187 


This  diaeaae  is  chiefly  confined  to  children  and  youth  between  the 
ages  of  eigh*.  and  fourteen.     Hut  few  cases  occur  after  pul)erty. 

Symptoms. — The  coniplaiht  affects  mostly  the  muscles  and  the 
limlw.  It  excites  curious  antics, —  such  as  we  should  suppose  would 
occur  if  a  part  of  the  muscles  of  voluntjvry  motion  had  hatched  a 
mimic  reUdlion,  broken  away  from  the  control  of  the  will,  and  in 
sheer  niiHchicf  and  wantonness,  were  tripping  their  fellow  muscles, 
and  playing  tricks  with  the  patient.  A  few  of  the  muscles  of  the 
face  or  lindw  Ixigin  their  mischievous  pranTcs  by  slight  twitches, 
which,  by  degrees,  l)ecomo  more  energetic,  and  spread  to  other  parts. 
The  face  is  twisted  into  all  kinds  of  ridiculous  contortions,  as  if  the 
patient  were  making  mouths  at  8dmel)ody.  The  hands  and  arms  do 
not  remain  in  one  position  for  a  moment.  In  attempting  to  carry 
food  to  the  mouth,  the  liand  goes  part  way,  and  is  jerked  back,  starts 
again,  and  darts  to  one  side,  then  to  the  other,  then  niouthward 
again;  and  each  movement  is  so  quick,  and  nervous,  and  darting, 
and  diddling,  that  ten  to  one  the  food  drops  into  the  lap.  If  the  at- 
tempt be  made  to  run  out  the  tongue,  it  is  snatched  back  with  the 
quickness  of  a  serpent's,  and  the  jaws  snaj)  together  like  a  fly-trap. 
The  lower  limbs  are  in  a  state  of  perpetual  diddle ;  the  feet  shuffle 
with  wonderful  diligence  upon  the  floor,  as  if  inspired  with  a  cease- 
less desire  to  dance. 

It  is  supposed  by  some  that  the  disease  consists  in  a  partial  palsy 
of  a  part  of  the  muscles.  The  will  in  that  case  not  being  able  to 
control  the  palsied  muscles,  when  it  commands  the  others  to  move, 
tlieir  action  is  not  balanced,  and  they  twitch  the  face  and  limbs  into 
all  the  capricious  and  fantastic  shapes  we  witness. 

Others,  and  probably  with  more  truth,  hold  that  the  "seat  of  the 
disease  is  in  the  cerebellum  or  little  brain.  It  is  supposed  to  he  one 
of  the  functions  of  this  organ  to  preside  over  and  regulate  the  loco- 
motion,—  that  it  holds  the  office  of  chief  engineer,  and  that  its 
duties  are  to  keep  the  muscles  in  subjection  to  the  will.  The  com- 
bined and  consenting  action  of  several  muscles  is  needed  for  every 
movement.  It  is  the  business  of  the  cerebellum  to  maintain  this 
oneness  of  purpose  and  action  —  to  see  that  no  muscle  flinches  so  as 
to  disturb  the  harmony  of  the  movement.  When  the  cerebellum  is 
diseased,  all  is  confusion, —  just  as  the  locomotive  runs  from  the 
track  when  tho  engineer  is  smitten  with  palsy. 

The  disease  is  not  dangerous,  but  when  it  continues  for  many 
years  it  is  apt  to  weaken  the  mind,  and  it  sometimes  very  nearly 
destroys  it. 

Causes. — Whatever  excites  and  weakens  the  nervous  system,  as 
powerful  emotions  of  the  mind,  overworking  the  mind,  reading  ex- 
citing novels,  eating  too  much  meat,  fright,  striking  in  of  eruptions, 
self-pollution,  etc. 


I 


m 


188 


DISEASKS   OF   THE   BRAIN    AND   NERVES. 


Treatment. —  In  the  first  plane,  remove  all  causes  of  excitement. 
Take  the  patient  from  school,  and  require  some  sort  of  cheerful  out- 
door exercise,  daily.  Take  away  all  books,  and  be  careful  not  to  do 
anything  to  occasion  anger  or  fear,  or  any  kind  of  injurious  excite- 
ment.    Apply  spinal  ice-bags  gradually  and  regularly. 

In  the  second  place  regulate  the  diet  —  making  it  more  animal 
ard  stimulating  if  it  has  been  to  low,  and  more  vegetable  and  cool- 
ing if  it  has  been  too  high. 

In  the  third  place,  if  the  above  changes  have  not  been  sufficient 
for  the  purpose,  open  and  regulate  the  bowels  with  some  gentle 
phyBio  (30),  (34)  for  a  few  days. 

In  the  last  place,  build  u^^^  the  nervous  system  with  oxide  of  zinc 
pills  (270),  three  a  day ;  or  iron  (63),  (80),  or  black  cohosh,  scull- 
cap,  etc.  (79),  or  the  compound  valerian  pill  (81).  Sulphate  of 
zinc  (82)  will  sometimes  succeed  ^hon  the  oxide  fails ;  and  where 
there  is  scrofula,  the  iodide  of  zinc  is  to  be  used. 

To  these  remedies  should  be  added  the  shower-bath,  beginning 
with  tepid  water,  and  making  it  a  little  colder  every  day.  If  the 
shower-bath  frightens  the  patient,  or  is  not  otherwise  well  borne,  take 
the  sponge  bath.  "  Fowler's  Solution  "  has  the  most  marked  effect 
on  the  disease.  Three  drops  gradually  increased  till  coryza  ensues ; 
stop  and  begin  again. 

Chronic  Chorea. 

This  can  hardly  be  said  to  amount  to  a  disease.  It  consists  rather 
in  uncouth  tricks,  arising  from  some  slight  disorder  of  particular 
muscles,  and  grown  into  a  fixed  habit,  such  as  shaking  of  the  head 
every  three  to  twenty  seconds,  repeated  squinting  of  the  eyes  in  con- 
nection with  a  peculiar  knitting  of  the  eyebrows,  wrinkling  of  the 
nose,  shrugging  of  the  shoulders,  lifting  the  ears  up  and  down,  or 
even  moving  the  whole  scalp  back  and  forth.  These  movements  are 
commonly  made  without  a  consciousness  of  it ;  and  generally  there 
is  no  power  to  suspend  them  without  a  painful  effort  which  cannot 
be  easily  continued. 

No  medical  treatment  is  of  any  avail.  These  tricks  can  only  be 
corrected  by  great  wajtchfulness  and  effort  on  the  part  of  the  person 
suffering  from  them,  and  in  many  cases,  not  even  by  such  means. 


Cramps. 

Cramp  is  expeiienced  .n  the  calves  of  the  legs,  the  thighs,  the 
stomach,  the  breast,  the  womb,  etc.  It  is  a  very  painful,  sudden,  and 
violent  contraction  of  one  or  more  muscles.  The  part  is  sometimes, 
as  the  phrase  is,  "  drawn  up  into  knots."  When  it  attacks  the  stom- 
ach, it  is" a  very  dangerous  affection.  Women  are  subject  to  it  about 
the  third  or  fourth  month  of  pregnancy. 

They  occur  more  frequently  at  night  as  the  result  of  over-fatigue 


i>i  Uii  liii»rii|-Y'V.'j 


DISEASES   OF   THE   BRAIK   AND   NERVES. 


189 


excitement, 
heerful  out- 
il  not  to  do 
ious  excite- 

lore  animal 
3  and  cool- 

ti  sufficient 
)me   gentle 

ide  of  zinc 
hosh,  scuU- 
Julphate  of 
and  where 

beginning 
ly.  If  the 
borne, take 
rked  effect 
'za  ensues ; 


sists  rather 

particular 

f  the  head 

3'es  in  con- 

ng  of  the 

down,  or 

lements  are 

lly  there 

ch  cannot 

m  only  be 
^he  person 
leans. 


pighs,  the 
iden,  and 
bmetimes, 

(the  atom- 
it  about 

pr-fatigue 


and  indigestion  during  the  day.  These  spasmodic  contractions  often 
occur  in  the  abdomen  and  are  accompanied  by  diarrhoea  due  to  indi- 
gestion. Abdominal  cramps  are  also  a  symptom  of  locomotor  ataxia 
and  other  spinal  diseases.  The  cramp  of  swimming  is  often  due  to 
an  over-straining  of  some  one  group  of  muscles  not  hitherto  much 
used,  the  sudden  fatigue  causing  cramp.  They  may  be  also  of  ner- 
vous origin.  Rheumatism  is  not  infrequently  the  sole  cause  of  pain- 
ful muscular  spasms. 

Causes. —  Drinking  cold  water  when  very  hot  and  perepiring,  ex- 
posure to  damp  night  air,  debility,  indigestible  food,  and  excesses  in 
eating  and  drinking,  and  particularly  over-straining  the  muscles. 

Treatment. —  Moderate  the  excessive  labor  and  straining  of  the 
muscles  which  produce  the  cramps.  When  an  attack  occurs  in  the 
legs,  tie  a  cord  or  handkerchief  tight  around  the  leg  above  the  af- 
fected muscle.  This  will  generally  produce  instant  relief.  Aiso 
briskly  rub  the  parts  with  hot  water,  alcohol,  ammonia,  spirits  of  can- 
phor,  paregoric,  or  laudanum. 

When  it  occurs  in  the  stomach,  apply  warm  fomentations,  or  what 
is  better,  a  mustard  paste  (165).  Take  hot  Jamaica  ginger  or  neuro- 
pathic drops.  The  bowels,  if  confined,  should  be  opened  with  an  in- 
jection. 

Cramps  of  the  limbs  which  afflict  women  in  the  family  way,  can 
only  be  mitigated,  not  cured,  till  after  confinement.  As  a  palliative, 
high  cranberry  bark,  scuUcap,  etc.  (87),  will  be  found  useful. 

Pain  of  the  Nerves.  —  Neuralgia. 

This  disease  affects  one  tissue  only, —  the  nervous ;  and  has  one 
83anptom, —  pain. 

In  apoplexy,  the  nerves,  rendered  powerless  and  senseless  by  an  ex- 
ternal force,  are  like  a  man  under  a  bank  of  earth  which  has  slid 
down  upon  him.  In  palsy,  they  are  suddenly  bereft  of  feeling  and 
motion  by  a  blasting  scourge  within, —  as  one  is  smitten  down  by  a  ' 
pervasive  charge  from  a  magnetic  battery.  In  epilepsy^  the  nerves 
are  grasped  and  for  a  time  held  senseless  by  an  unseen  power,  in 
which  they  struggle,  as  a  man  strives  in  the  folds  of  the  anaconda. 
In  catalepsy,  they  are  suddenly  stiffened  into  senseless  strings,  for 
such  automatic  use  as  the  bystander  may,  for  the  time,  choose  to 
make  of  them.  In  chorea,  they  are  set  to  dancing  by  an  invisible  ex- 
hilaration, as  a  man  is  suddenly  crazed  by  brandy. 

In  neuralgia,  the  nerves  are  neither  crushed,  nor  collapsed,  nor  re- 
strained for  a  time,  nor  stiffened,  nor  exhilarated.  They  simply  have 
their  sense  of  feeling  intensely  exalted ;  they  are  filled  with  pain. 
The  pain  is  generally  of  a  peculiarly  darting,  piercing  character.  The 
patien,  sometimes  calls  it  tearing  pain.  It  comes  on  in  sudden  par- 
oxysms, with  intervals  of  freedom  between.     The  attacks  are  some- 


190 


DISEASES   OF  THE   BKAIN   AND  NERVES. 


times  like  an  electric  shock,  and  are  so  agonizing  as  to  bring  a  tem- 
porary loss  of  reason.  Occasionally  there  is  great  tenderness  of  the 
parts  affec  '  and  some  fulness  of  the  blood-vessels  in  the  neighbor- 
hood ;  but  generally  the  signs  of  inflammation  are  all  absent,  except 
pain. 

Neuralgic  pains  occur  in  almost  every  part  of  the  system.     One  of 
the  most  familiar  forms  of  the  disease  is  known  under  the  name  of 


.  Tic  Douloureux. 

It  occurs  in  those  branches  of  the  fifth  pair  of  nerves  which  go  to 
the  face.  (See  Fig.  85.)  Sometimes 
one,  sometimes  all  of  the  three  branches 
are  affected,  but  more  often  the  middle 
branch  only.  When  the  uppor  branch 
is  the  seat  of  the  disease,  the  pain  is  in 
the  forehead,  the  brow ,  the  lid,  and  some- 
times the  ball  of  the  eye.  The  eye  is 
generally  closed  during  the  pain,  and 
the  skin  of  the  forehead  is  wrinkled. 
When  the  affection  is  in  the  middle 
nerve,  the  pain  is  preceded  by  a  prick- 
ing sensation  in  the  cheek,  and  twitch- 
ing of  the  lower  eyelid.  Soon  it  spreads 
in  quick  and  piercing  pangs  over  the 
cheek,  reaching  the  lower  eyelid,  the 
sides  of  the  nostrils,  and  the  upper  lip. 
If  in  the  lower  branch,  it  sends  its  light- 
ning shafts  to  the  chin,  the  gums,  the 
tongue  and  even  up  the  cheek  to  the  ear. 

Face-Ache. —  There  is  a  species  of  nervous  pain  called  face-ache, 
which  does  not  quite  amount  to  tic  douloureux,  but  is  nevertheless 
veiy  afflictive.  It  occurs  principally  in  the  jaw,  which  seems  to  be 
filled  with  pain.  No  one  spot  seems  to  be  more  affected  than  another. 
From  the  jaw  the  pain  often  goes  to  the  whole  head,  but  it  has  not 
the  stabbing  intensity  which  generally  characterizes  neuralgia.  It 
often  proceeds  from  defective  teeth. 

Hemicrania. 

This  is  a  neuralgic  pain,  confined  to  one  side  of  the  head, —  gen- 
erally the  brow  and  forehead.  Sickness  of  the  stomach  often  attends 
it,  and  in  many  cases  it  is  periodical, — coming  on  at  a  certain  hour 
every  day,  and  lasting  a  given  time,  and  then  passing  away.  . 

It  may  be  caused  by  whatever  debilitates  the  system,  as  hysterics, 
suckling  an  infant  too  long,  or  low  diet.  In  fever  and  ague  districts 
it  is  frequently  produced  by  miasm.  In  many  instances,  the  cause 
cannot  be  discovered. 


FlO.  86. 


DIBEASKS   OF   TUB   BRAIN  AND  NBRVES. 


191 


ring  a  teni- 
ness  of  the 
le  neighbor- 
ient,  except 

m.  One  of 
3  name  of 


which  go  to 


face-ache^ 

levertheless 

lems  to  be 

,n  another. 

it  has  not 

Igia.     It 


|ad, —  gen- 
attends 
un  hour 

I  hysterics, 
districts 
the  cause 


Sciatica. 

This  is  a  pain  beginning  at  the  hip,  and  following  the  course  of 
the  sciatic  nerve.  Occasionally  it  is  an  inflammatory  complaint; 
sometimes  is  connected  with  an  affection  of  the  kidney;  but  fre- 
quently it  is  a  purely  neuralgic  or  nervous  pain ;  and  I  have  there- 
fore thought  it  best  to  place  it  here,  with  nervous  diseases. 

Besides  the  various  forms  of  neuralgia  now  noticed,  the  disease 
occurs,  —  sometimes  with  great  severity,  —  in  the  female  breast,  in 
the  womb,  in  the  stomach,  in  the  bowels,  in  the  thighs,  in  the  knee, 
and  even  in  the  feet.  In  many  of  these  cases  the  disease  is  not  where 
the  pain  is  felt,  but  in  the  brain  or  spinal  marrow,  and  consequently 
the  true  source  of  the  complaint  very  often  escapes  detection.  An 
excellent  Episcopal  clergyman  in  Northern  New  York,  the  Rev.  M. 

B ,  with  whom  I  studied  Latin  and  Greek  preparatory  to  college, 

had  a  neuralgic  pain  in  the  knee  so  intense,  persistent  and  exhausting, 
that  the  limb  had  to  be  cut  off  at  the  thigh  to  save  his  life. 

Treatment. —  This  must  be  as  diversified  as  the  causes  of  the  dis- 
ease.    For  a  general  Bi  use  368. 

For  tic  douloureux,  and  some  other  forms,  give  internally,  valerian- 
ate of  ammonia  (88);  also  89,  90,  91,  92,  93,  316,  and  84,  as  tonics. 

For  external  use  in  tic  douloureux,  and  other  neuralgic  affections, 
the  prescriptions  188,  196,  lb/,' 198. 

For  the  face-ache,  above  mentioned,  muriate  of  ammonia  (134),  in 
half  dram  doses,  is  a  very  valuable  remedy. 

When  the  disease  is  caused  by  miasm,  and  has  a  periodic  character, 
like  ague,  it  must  be  treated  with  quinine  (67),  (79),  and  if  there  be 
a  low  state  of  the  blood,  iron  (72),  (93)  must  be  given  at  the  same 
time.     The  galvanic  battery  often  acts  like  magic  in  neuralgia. 

The  shower-bath,  exercise  in  the  open  air,  and  whatever  else  will 
build  up  the  general  health,  must  be  used  according  to  circumstances. 

Neuralgic  pain  of  various  kinds  often  yields  readily  to  some  one  of 
the  many  coal-tar  products  like  phenanthrene,  antikamnia  and  ammo- 
nol:  say  10  grains  of  either  every  two  to  four  hours  according  to  the 
intensity  of  the  pain.  The  last  named  product  is  quite  harmless  and 
produces  no  numbness  or  faintness  which  is  said  to  follow  at  times 
the  use  of  some  of  the  others. 

Avoid  rich  or  fatty  foods.  Live  on  a  plain  nourishing  diet.  Take 
exercise  out  of  doors  as  much  as  possible. 

Derangement  of  Mind.  —  Insanity. 

Most  writers  on  this  disease  have  attempted  a  definition  of  it.  I 
have  never  seen  one  which  suited  me.  Here  is  mine.  Insanity  is  a 
wrench  of  marCs  nature,  which  sets  his  intellectual  and  moral  faculties 
awry  in  their  relations  with  the  external  world. 


:;f 


192 


DISEASES   OF  THE   BRAIN   AND   NERVES. 


Ill  a  state  of  mental  and  moral  health,  he  looks  straight  at  the  out- 
ward world,  and  sees  it  as  it  is  ;  insanity  gives  him  an  angular  con- 
nection with  it  and  he  sees  it  as  it  is  not;  its  objects  have  all  changed 
their  relative  places ;  objects  at  the  right  in  the  panorama  of  life  have 
moved  to  the  centre,  or  gone  quite  over  to  the  left ;  whil'i  things  at 
the  top  have  gone  to  the  bottom,  and  those  in  the  lowest  places  have 
taken  the  highest.  With  the  thoroughly  insane,  the  world  has  gone 
back  to  chaos. 

These  persons  have  their  sensibility  very  much  altered  and  per- 
verted. Errors  of  the  senses  and  illusions  cheat  them.  In  niaiiv 
cases,  they  cannot  read  because  the  lettei-s  are  mingled  in  a  confused 
mass.  They  often  do  not  recognize  their  friends,  and  regard  them 
as  strangers  or  enemies. 

They  become  awkward  in  the  mechanical  use  of  their  hands,  and 
their  touch  loses  the  power  to  coirect  the  errors  of  the  other  senses. 
Hence  they  are  cheated  in  regard  to  the  size,  form,  and  thickness  of 
bodies. 

They  are  haunted,  at  times,  with  smells  which  have  no  existence, 
and  thjey  hear  voices  distinctly  speaking  to  them  from  clouds,  or  from 
trees ;  and  these  voices  have  the  familiar  tones  of  a  friend,  reliitive, 
or  enemy. 

The  insane  lose  the  power  of  comparing  ideaa.  They  associate 
things  the  most  unlike,  and  often  in  a  ridiculous  way. 

They  also  lose  the  control  of  themselves,  and  come  under  the  do- 
minion of  their  passions  ;  and  then  they  will  do  acts  which  they  them- 
selves disapprove.  One  of  strict  integrity,  of  unblemished  morals,  and 
of  excellent  standing,  becomes  insane,  and  immediately  steals  what  he 
does  not  want,  makes  infamous  i  )roDosals,  and  indecent  gestures,  and 
is  in  every  respect  the  opposite  of  ^lis  past  self. 

The  insane  often  become  averse  to  those  who  were  previously 
among  the  most  <lear  to  them.  For  acts  of  kindness,  they  repay 
abuse.  They  fly  from  their  best  friends.  This  is  the  result  of  their 
fear  and  jealousy ;  for  they  are  very  cowardly  and  jealous.  This  alien- 
ation from  friends  is  almost  a  characteristic  of  insanity,  and  is  one  of 
its  saddest  features.  The  moral  affections  are  always  disordered,  per- 
verted, or  annihilated  in  insanity.  So  much  is  this  a  leading  feature 
of  the  disease,  that  it  is  only  when  the  insane  begin  to  recover  their 
moral  affections,  when  they  begin  to  wish  to  see  their  children  and 
friends,  to  fold  them  onc«  more  in  their  arms,  and  to  enter  the  family 
circle  and  renew  its  joys,  that  we  can  count  upon  any  certain  signs 
of  a  cure. 

The  insane  have  a  thousand  strong  fancies  in  regard  to  themselves. 
One  thinks  himself  inspired  of  God,  and  charged  with  the  convei-sion 
of  the  world ;  while  another,  equally  sincere,  believes  the  devil  has 
entered  into  him,  and  that  the  pains  of  hell  are  already  taking  hold 
of  h'm,  and  he  curses  God,  himself,  and  the  universe.  Still  another 
is  the  "  monarch  of  all  he  surveys,"  and  much  more ;  he  governs  the 


-Al-:^ 


DISEASES   OF  THE   BKAIN   AMD   NERVES. 


193 


t  at  the  out- 
.ngular  con- 
all  changed 
,  of  life  have 
\<i  things  at 
places  have 
>rld  has  gone, 

•ed  and  per- 
i.  In  many 
n  a  confused 
regard  them 

r  hands,  and 
other  senses. 
.  thickness  of 

no  existence, 
3uds,  or  from 
end,  relative, 

hey  associate 

mder  the  do- 
sh  they  them- 
|d  morals,  and 
teals  what  he 
gestures,  and 

previously 
they  repay 
3sult  of  their 
This  alien- 
md  is  one  of 
ordered,  per- 
,ding  feature 
•ecover  their 
children  and 
sr  the  family 
sertain  signs 

I  themselves. 
_  convereion 
le  devil  has 
taking  hold 
Still  another 
[governs  the 


world,  and  directs  the  stars.  One  has  all  knowledge,  and  affects  to 
teach  the  wisest.  Another  is  proud,  and  withdraws  from  his  fellows, 
bidding  them  not  to  come  into  his  presence  without  proper  acts  of 
homage, —  calling  himself,  it  may  be,  a  king. 

There  are  five  kinds  of  insanity.  I  will  speak  of  each  of  them 
briefly. 

Melancholy.  —  Lypemania. 

This  is  characterized  by  moroseness,  fear,  and  prolonged  sadness. 
The  melancholic  person  is  lean  and  slender,  with  black  hair,  and  a 
pale  and  sallow  countenance.  His  skin  is  brown  or  blackish,  and 
dry  and  scaly.  His  physiognomy  has  a  fixed  appearance,  the  muscles 
of  the  face  are  drawn  tight,  the  eyes  are  motionless,  and  directed  to 
one  point,  the  look  is  askance  and  suspicious,  and  the  general  expres- 
sion is  one  of  sadness,  fear,  and  terror.  He  desires  to  pass  his  days 
in  solitude  and  idleness.  He  walks  as  if  aiming  to  shun  some  dan- 
ger.    His  ey<  iind  ear  are  on  the  watch  for  evil. 

These  persons  do  not  sleep  much.  They  are  kept  awake  by  fear, 
jealousy,  and  hallucinations.  If  their  eyes  close,  they  see  phantoms 
which  terrify  them. 

Their  secretions  are  disordered.  The  urine  is  either  abundant  and 
clear,  or  scanty  and  muddy.  They  sometimes  retain  their  urine  for 
days.  One  patient  did  not  dare  to  make  water  lest  he  should  drown 
the  world,  but  was  finally  persuaded  to  it  by  the  assurance  that  he 
would  extinguish  a  fire  which  was  devouring  a  city. 

Insanity  on  One  Subject. —  Monomania. 

This  is  a  chronic  affection  of  the  brain,  not  attended  by  fever,  and 
characterized  by  a  derangement  of  the  intellect,  the  affections,  or  the 
will,  upon  one  subject  only.  The  patient  seizes  upon  a  false  princi- 
ple, and  draws  from  it  injurious  conclusions,  which  modify  and  change 
his  whole  life  and  character.  In  other  cases  the  intellect  is  sound, 
but  the  affections  and  disposition  being  perverted,  their  acts  are 
strange  and  inconsistent.  These  they  attempt  to  justify  by  plausible 
reasoning. 

Mania. 

This  is  also  a  chronic  affection  of  the  brain,  generally  without 
fever.  The  countenance  of  the  maniac  is  sometimes  flushed,  at  other 
ti  .es  pale.  The  hair  is  crisped  ;  the  eyes  injected,  shining  and  hag- 
gard. Maniacs  dislike  the  light,  and  certain  colors  horrify  them. 
Their  ears  are  sometimes  very  red,  and  are  disturbed  by  a  tingling, 
and  a  rumbling  sound.  Noise  excites  and  disturbs  them.  They  suf- 
fer from  false  sensations,  illusions  and  hallucinations;  and  their  ideas 
come  with  great  rapidity,  and  are  confused  and  without  order.   Their 


Ui 


194 


DISEASES   OF  THE   UUAIN   AND   NRKVKS. 


affections  are  in  a  state  of  turmoil,  and  their  judgments  are  all  erro- 
neous. 

Unlike  the  monomaniac,  their  delirium  extends  to  all  subjecte. 
Their  entire  intellect,  affections  and  will,  are  a  chaotic  wreck. 

Dementia. 

Herk  is  another  chronic  affection  of  the  brain,  without  fever,  in 
which  the  sensibility,  the  intellect,  and  the  will,  are  all  weakened. 
Demented  persons  have  not  the  power  to  concentrate  their  minds  on 
anything,  and  can  form  no  correct  notions  of  objects.  Their  ideas 
float  after  each  other  without  connection  or  meaning.  They  speak 
without  any  consciousness  of  what  they  are  saying. 

Many  of  them  have  lost  their  memory,  or,  like  old  person-*,  they 
rememl)er  nothing  recent, —  forgetting  in  a  moment  what  is  just  said 
or  done. 

The  demented  have  neither  desires  nor  aversions ;  neither  hatred 
nor  love.  To  those  once  most  dear  to  them,  they  are  totally  indif- 
ferent. They  meet  friends  long  absent  without  emotion,  and  part 
from  their  dearest  ones  without  a  pang.  The  events  of  life  passing 
around  them  awaken  in  them  no  interest,  l^ecanse  they  can  connect 
themselves  neither  with  the  past  nor  the  future ;  they  have  no  remem- 
brances nor  hopes.  Their  brain  is  inactive  ;  it  furnishes  no  ideas  or 
sensations.  They  are  no  longer  active,  but  passive  beings ;  they  de- 
termine nothing,  but  yield  themselves  to  the  will  of  others. 

They  have  a  pale  face,  a  dull  eye,  moistened  with  tears,  an  uncer- 
tain look,  and  a  physiognomy  without  expression.  They  sleep  pro- 
foundly, and  for  a  long  time,  and  have  a  voracious  appetite. 

Idiocy. 

Idiocy  is  in  the  condition  in  which  the  intellectual  faculties  have 
never  been  manifested.  We  are  not  to  infer  disease  from  it,  any  more 
than  we  infer  it  in  the  lower  animals  from  the  absence  of  intellect. 

In  idiocy  there  is  no  mind,  oecause  the  brain  is  not  large  enough 
to  be  the  organ  of  intelligence.  It  always  dates  back,  therefore,  to 
the  beginning  of  life.  Everything  about  the  idiot  betrays  a  defective 
organization.  The  demented  person,  the  monomaniac,  etc.,  once  had 
intelligence  ;  the  idiot,  never.  They,  in  many  cases,  may  be  cured ; 
he  is  hopelessly  incurable.  They  had  blessings  which  have  been  taken 
from  them ;  to  him,  none  were  ever  given.  They  were  once  the  pride 
and  hope  of  their  friends ;  he,  from  his  birth,  was  the  smitten  and 
blasted  one  of  his  family.  He  never  reaches  an  advanced  age, — 
rarely  living  beyond  thirty  years. 

These  remarks  are  sufficient  to  show  the  difference  between  idiocy 
and  other  forms  of  mental  d  mgement.  In  the  other  forms  of  in- 
sanity there  are  brains  enougli,  but  they  are  diseased  ;  in  this  there  is 
no  disease ;  the  smallness  of  the  brain  is  the  primal  and  fatal  defect. 


•'.i_j_^__ 


DISEASES  OF  THE   DKAIN   AND   NRIiVES. 


195 


are  all  erro- 

ill   subjectB. 
reck. 


lut  fever,  in 

11  weakened, 

sir  minds  on 

Their  idesw 

They  speak 

•erson-i,  they 
t  is  just  said 

iither  hatred 
totally  indif- 
)n,  and  part 
life  passing 
can  connect 
fe  no  remem- 
3  no  ideas  or 
igs ;  they  de- 
jrs. 

rs,  an  uncer- 
ey  sleep  pro- 
)ite. 


.culties  have 
it,  any  more 
f  intellect, 
urge  enough 
therefore,  to 
;  a  defective 
,c.,  once  had 
ly  be  cured ; . 
been  taken 
Ice  the  pride 
mitten  and 
ced  age,— 

Iween  idiocy 
forms  of  in- 
this  there  is 
Katal  defect. 


This  form  of  menUil  derangement  is  caused  by  a  defective  develop- 
ment of  the  brain.  That  the  other  forms  are  produced  by  disease  of 
the  brain,  there  can  be  no  doubt. 

Some  have  supposed  insanity  to  be  a  mental  disorder  merely,  hav- 
ing nothing  to  do  with  the  body.  They  might  as  well  suppose  the 
delirium  of  fever  to  he  a  disease  of  the  mind  only. 

Insanity  is  an  unsoundness  of  the  brain  and  nerves  which  proceed 
from  it,  in  every  instance.  At  first  it  is  probably  only  excitement  of 
the  brain  ;  but  this,  long  continued,  becomes  a  chronic  inflammation. 
The  brain  and  nerves  of  an  insane  person  are  undoubtedly  sore,  and 
hence  the  painful  thoughts  and  feelings  which  afflict  them.  When 
the  soreness  is  much  increased,  they  are  violent  and  furious  ;  when 
it  subsides,  they  are  calm.  In  consequence  of  this  inflammation  and 
soreness  of  the  brain,  an  insane  person  can  no  more  think,  or  reason, 
or  will,  or  feel  correctly,  than  a  person  with  an  inflamed  stomach  can 
dig6st  food  well,  or  than  one  with  inflamed  eyes  can  see  v/'ell. 

Causes  of  Insanity. —  Hereditary  predisposition  ;  painful  subjects 
of  thought  or  feeling  long  revolv  od  in  the  mind ;  injures  feelings 
which  cannot  be  resented,  mortified  pride,  perplexity  in  business ; 
disappointed  affection  or  ambition  ;  great  political,  religious,  or  social 
excitements ;  sudden  and  heavy  strokes  of  misfortune  in  the  loss  of 
property  and  friends ;  and  in  general,  whatever  worries  the  mind  for 
a  long  time,  and  creates  a  deep  distress,  may  be  a  cause  of  insanity. 

But  one  of  the  most  prolific  causes,  and  worthy  of  special  mention, 
is  masturbation,  or  self-pollution, —  a  vice  contracted  by  thousands  of 
ycung  people,  both  male  and  female. 

Besides  the  above,  I  may  mention  several  physical  causes,  as  con- 
vulsions of  the  mother  during  gestation,  epilepsy,  montlily  disorders 
of  women,  blows  upon  the  head,  fevers,  loss  of  sleep,  syphilis,  exces- 
sive use  of  mercury,  worms  in  the  bowels,  and  apoplexy. 

Chances  of  Cure. —  Idiotism  is  never  cured. 

Melancholy  and  monomania  are  cured  when  recent,  and  do  not  de- 
pend upon  organic  disease. 

Dementia  is  sometimes,  though  seldom,  cured. 

Chronic  insanity,  of  long  standing,  is  not  easily  cured. 

Insanity  which  has  been  produced  by  moral  causes,  acting  suddenly, 
is  generally  curable ;  if  the  causes  have  acted  slowly  and  long,  the 
cure  is  more  doubtful. 

Excessive  study  causes  insanity  which  is  hard  to  cure. 

If  caused  or  continued  by  religious  ideas,  or  by  pride,  it  is  not 
often  cured.  , 

Insanity  caused  and  maintained  by  masturbation  is  cured  with 
great  difficulty. 

Treatment. —  The  treatment  of  the  insane  is  now  almost  confined, 
as  it  should  be,  to  public  hospitals.  In  these  institutions,  all  the 
means  are  provided  which  humanity  has  been  able  to  devise,  to  lift 


106 


DISKARKS   OF   THK    BRAIN   AND    NKRVKS; 


t'roui  these  unfortunate  beings  the  terrible  shadow  which  iK  uiMtii 
thera.  Here  they  have  safety,  comfort,  recreation,  friendly  guardians, 
rest,  and  medicine. 

They  have  safety  from  the  annoyances  which  well-meaning  but 
mistaken  friends  at  homo  almost  always  commit  in  contradicting,  iind 
reasoning  with,  persuading,  and  threatening  them ;  for  only  in  these 
humane  institutions  has  it  been  well  learned  that  to  do  so  is  no  wiser 
than  to  pei-suade,  scold,  or  threaten  a  neumlgic  pain  in  the  face,  an 
inflammation  in  the  stomach,  or  a  felon  upon  the  finger.  They  are 
safe,  too,  from  the  impertinent  scrutiny  of  neighbors,  the  hootings  of 
unthinking  boys  in  the  streets,  and  especially  from  the  causes,  wliat- 
ever  they  are,  which  have  produced  the  disease.  And  so  far,  this  is 
just  the  treatment  they  want,  —  no  contradiction,  no  impertinent 
scrutiny  from  neighbons,  no  abuse  in  the  streets,  and  a  withdrawai  of 
the  causes  which  have  produced  the  disease. 

In  these  institutions,  too,  they  have  comforts.  They  have  clean 
rooms,  galleries,  lodges,  bathing-rooms,  yards  and  gardens  for  exer- 
cise and  walking,  safe,  quiet,  well-aired  bed-rooms,  and  clean  and 
comfortable  beds  ;  cheerful  dining  rooms,  and  plain,  wholesome,  and 
nutritious  food.     And  this,  likewise,  is  the  treatment  they  require. 

They  have  recreation,  —  dances,  cards,  l>ack-gammon,  chequei-s, 
chess,  billiards,  nine-pins,  walking  parties,  riding  parties,  gardening, 
and  an  indulgence  in  those  arts  of  painting,  music,  drawing  and 
architecture  for  which  they  may  have  a  taste.  And  suc;h  recreations 
are  powerful  instruments  in  the  cure  of  all  disorders  of  the  nervous 
system. 

Here,  too,  they  have  friendly  guardians,  who  have  long  studied 
their  complaints,  and  have  imbued  their  souls  with  a  sympathy  which 
goes  down  into  the  depths  of  their  sufferings,  and  allies  itself  with  all 
their  sorrows  ;  —  men  and  women  who  are  willing  to  act  the  part  of 
guardian  angels ;  to  be  their  friends ;  who  know  how  to  gain  their 
confidence ;  and  who  use  the  influence  acquired  by  love,  in  leading 
them  back  towards  health  and  happiness.  And  this,  too,  in  curing 
the  insane,  is  of  great  consequence,  for  none  can  do  them  good  till 
they  have  their  confidence,  and  this  can  be  gained  only  by  love  and 
wisdom. 

In  these  insane  asylums,  they  find  rest.  When  the  brain  is  hot 
from  inflammation,  and  they  are  raving  from  delirium,  they  are  here 
withdrawn  from  the  noisy  crowd,  and  shielded  from  the  rude  shocks 
of  the  world.  If  need  be,  they  are  placed  in  solitary  rooms,  where 
silence  spreads  its  soothing  stillness  through  their  excited  brains. 
And  it  is  of  the  greatest  importajice  that  the  sore  and  torn  feelings 
should  rest ;  for  rest  allays  excitement,  and  'irings  sleep ;  and  with- 
out a  proper  amount  of  sleep  recovery  is  :       possible. 

Finally,  in  these  institutions,  they  receive  the  best  medical  treat- 
ment. They  have  warm  and  cold  bathing,  judiciously  administered ; 
they  have  simple  cathartics  when  the  bowels  are  bound,  as  salts,  cas- 


■'>^«k;;S' •^•j'*3«'j(t?jyk»?-ii£i<u*-\^::<»i*A'^ij.*^ 


iv. 


DISEASES   OK  THE    BRAIN   AND    NERVKS. 


197 


;h  is  updii 
guardians, 

janing  but 
[ictiiig,  and 
ly  in  these 
is  no  wiser 
lie  face,  an 
They  are 
bootings  of 
uses,  \vhat> 
far,  this  is 
ni  pertinent 
hdrawal  of 

have  clean 
s  for  exer- 
clean  and 
esome,  and 
T  require. 
,  chequei-H, 
gardening, 
iwing  and 
recreations 
le  nervous 

ig  studied 

ithy  which 

with  all 

le  part  of 

jain  their 

n  leading 

in  curing 

good  till 

love  and 

lin  is  hot 
are  here 
e  shocks 
us,  where 
brains, 
feelings 
and  with- 

cal  treat- 
nistered ; 
lalts,  cas- 


tor oil,  and  magnesia ;  tonics  for  debility,  such  aa  quinine,  iron,  cas- 
sia, columbo,  chamomile ;  and  quieting  medicines  for  their  excite- 
ment, such  as  opium,  morphine,  cicuta,  hyoscyamus,  belladonna,  stra- 
monium, scuUcap,  and  valerian.  Prescription  74  is  a  combination 
n)uch  used.  Here,  too,  broth,  gruel,  and  milk,  are  administered  by 
the  forcing  pump  to  such  as  Uike  a  fancy  not  to  eat,  —  an  expedient 
which  has  saved  many  lives.  Fruits  of  all  kinds,  as  strawberries, 
cherries,  currants,  plums,  apples,  peaches,  and  grapes,  are  allowed 
freely.  Cold  water,  sweetened  or  otherwise,  is  the  drink.  To  these 
things  are  added  lively  conversation,  and  whatever  will  divert  the 
mind  from  reflection,  and  internal  imaginings  and  revery. 

Thus  I  have  indicated,  very  briefly,  the  treatment  which  the  insane 
receive  in  public  institutions.  That  the  chances  of  recovery  in  these 
humane  retreats  is  much  greater  than  at  home,  does  not  admit  of  a 
doubt.  When  it  is  not  convenient  to  send  an  insane  person  to  a  hos- 
pital, the  treatment  should  be  as  near  like  the  one  here  sketched  as 
circumstances  will  permit. 

Hypochondria. 

The  common  names  of  this  disease  are  low  spirits,  spleen,  vapors, 
nypo,  and  the  blues.  It  produces  constant  fear,  anxiety,  and  gloom. 
Business,  pleasures,  the  acquisition  of  knowledge,  and  all  the  useful 
pui-suits  of  life,  become  insipid,  tasteless,  and  even  irksome  to  the  hy- 
pochondriac. His  mind  is  full  of  the  belief  that  something  dreadful 
is  about  to  befall  him.  He  is  either  going  to  be  sick,  or  to  die,  or 
lose  his  property  or  friends.  He  has  no  mind  to  engage  in  any  busi- 
ness, nor  does  he  wish  to  go  anywhere,  or  to  see  anybody.  Night 
and  daj'^  his  spirits  are  down  to  zero,  and  his  heart  has  a  load  too 
heavy  to  bear.  He  is  wholly  occupied  with  his  troubles  and  his  feel- 
ings. He  thinks  he  has  various  diseases,  and  wears  out  his  friends 
by  talking  of  his  sufferings.  He  feels  of  his  pulse  often,  looks  at  his 
tongue  in  the  glass,  and  several  times  a  day  asks  a  friend  if  he  does 
not  look  pale  or  sick. 

The  external  senses  manifest  symptoms  of  derangement  as  well  as 
the  thoughts,  feelings,  emotions,  and  passions.  There  are  roarings  in 
the  ears,  like  a  waterfall,  or  the  noise  of  a  distant  carriage.  Floating 
black  specks,  or  bright  sparks,  are  seen  before  the  eyes.  These  indi- 
cate a  slight  fulness  of  the  blood  vessels,  and  perhaps,  in  some  in- 
stances, sparks  of  electricity  passing  to  or  from  the  eye,  and  are  in  no 
proper  sense  subjects  for  the  alarm  they  cause.  At  one  time  the  per- 
son will  feel  as  large  as  a  barrel,  at  other  times  not  larger  than  a 
whip-stock;  the  head  will  feel  light  or  heavy,  large  or  small.  The 
skin  will  twitch  in  different  parts,  or  feel  numb,  or  have  the  sensation 
of  spiders  crawling  on  it.  The  smell  and  taste  become  perverted ; 
the  hypochondriac  will  smell  odors  and  flavors,  at  times,  where  there 
are  none. 


108 


DIHKA8K8   OF  Till   BRAIN   AND   NKRVB8. 


V 


These  errors  of  tin'  HenneH  arc  all  owing  to  soiin'  Hliglit  dJHordt'r  of 
the  organH  of  sense ;  and  they  are  no  more  wonderful  than  that  the 
mind  should  perceive  personal  danger,  poverty,  and  death  itself,  when 
none  of  these  things  are  impending. 

These  persons  are  subject  to  fainting  turns,  when  the  hreatliing 
will  appear  to  stoj),  the  body  become  cold,  the  face  pale ;  there  will 
be  distress  in  the  region  of  the  heart,  which  will  apparently  stop  l)eat- 
ing,  and  the  ])erson  will  feel  as  if  dying.  At  the  same  time  the  mind 
will  remain  clear.  These  nervous  spells  are  alarming,  but  pass  off 
without  danger. 

These  persons  become  changed  in  their  moral  dispositions.  They 
are  jealous,  fjike  a  joke  as  an  affront,  and  feel  the  greatest  distress  at 
any  apparent  lack  of  attention  or  neglect  on  the  part  of  friends. 
They  put  the  worst  construction  upon  the  actions  of  friends.  They 
are  irritable,  fretful,  peevish,  and  fickle. 

The  complaint  is  distressing,  but  does  not  appear  to  shorten  human 
life. 

The  seat  of  the  disease  is  in  the  brain  and  nerves.  It  is  caused  hy 
anxiety,  care,  disappointment,  working  the  brain  too  hard,  diseases  of 
the  liver  and  stomach,  costiveness,  sedentary  habits,  excessive  vene- 
real indulgence,  and  masturbation. 

Treatment. —  This  cHsease  is  more  easily  prevented  than  cured.  It 
would  be  almost  entirely  prevented  in  this  country  if  in  childhood  we 
were  all  taught  to  be  contented  with  humble  competence,  to  love  ac- 
tive labor,  and  to  think  it  honorable,  instead  of  struggling  after 
wealth,  and  falling  into  unhappiness  when  it  does  not  come. 

Remedies. —  Of  all  the  remedies  for  this  complaint,  that  which  is 
most  important  is  active  employment  out  of  doors.  The  human  body 
was  made  for  motion.  Without  it  the  blood  cannot  be  distributed  to 
the  several  organs.  The  senses,  —  the  eye,  the  ear,  the  touch,  — 
should  be  much  in  communion  with  nature.  In  this  way  they  are 
strengthened.  Nature  is  their  great  physician.  Man  is  a  creature  of 
aensation ;  and  if  too  much  occupied  with  feelings,  thoughts,  and  deep 
reflections,  the  nerves  will  be  irritated,  and  begin  to  give  deceptive 
sensations.  A  very  nervous  man  should  fly  to  some  active  occupa- 
tion, if  he  would  be  rid  of  suffering. 

The  open,  fresh  air  is  very  important  to  restore  the  system  to 
soundness. 

Temperance,  both  in  eating  and  drinking,  will  do  much  for  this 
class  of  patients,  yet  they  are  the  very  persons  who  eat  largely,  and 
they  often  fly  to  the  excessive  use  of  stimulants  to  drive  away  their 
sorrow.     By  so  doing,  they  aggravate  the  disease. 

Amusements  are  very  important  for  hypochondriacs.  Lively  com- 
pany, cheerful  and  witty  conversation,  with  mirth  and  laughter,  lively 
songs  and  instrumental  music,  are  all  desirable ;  and  so  are  gunning, 
fishing,  riding,  billiard-playing,  und  travelling. 


.  1  .    ~v-    ^  . 


niBKABKS   OF   THK    HKAIN    AND    NRRVR8. 


199 


•liHonltT  of 
ill  that  the 
iUelf,  when 

)  breatliinfj 
;  tlwre  will 
y  Htop  l)eat- 
le  th(!  mi  IK  I 
)ut  pa8H  off 

0118.     They 

b  distress  at 

of   friends. 

nds.     They 

rten  human 


Never  allow  these  patientw  to  Im-  alone,  and  to  have  time  to  brood 
over  their  mi.sery.  See  that  they  go  early  to  l)ed,  and  rise  betimes  in 
the  morning.  The  warm  bath,  the  (!old  shower,  or  sponge  ba'h,  with 
brisk  frietion,  arc.  not  on  any  account  to  be  omitted.  The  diet  should 
bo  light,  nutiitious,  ;«ii(l  generous  ;  but  fate,  acids,  liquors,  and  coffee,, 
must  Im*  forbidden. 

But  little  medicine  will  be  required.  If  there  be  costiveness,  let 
cracked  whaat  lie  eaten ;  if  this  does  not  answer,  a  little  rliubarb 
and  bicarlioiiate  of  potassa  (85),  or  leptaiidrin,  podophyllin,  etc.  (86), 
may  be  given  as  required  by  the  .symptoms.  A  teaspoonful  of  cal- 
cined magnesia  once  a  day,  or  the  infusion  of  tboroiighwort,  drank 
cold,  will  often  answer  an  excellent  purpose.  A  1m)w1  of  warm 
motherwort  tea,  with  a  teaspoonful  of  spirits  of  camphor  in  it  will  do 
well  in  fits  of  fainting  when  there  is  a  sensation  of  dying.  A  tea- 
spoonful of  sulphuric  ether  mayl)e  given  at  the  same  time.  If  there 
be  debility,  tonics  are  sometimes  useful  (50),  (49),  (54),  (55). 


8  caused  l)y 
,  diseases  of 
essive  vene- 

m  cured.  It 
tiildhood  we 
to  love  ac- 
'gling  after 
ne. 

at  which  is 
uman  body 
tributed  to 
touch,  — 
ly  they  are 
reature  of 
I,  and  deep 
deceptive 
ve  occupa- 

system   to 

for  this 
rgely,  and 
iway  their 

ively  com- 
ter,  lively 
gunning. 


Hiccous^h. —  Singultus. 

Thw  is  a  sudden,  jerldng  spasm  of  the  midriff,  occurring  every  few 
niomentti  in  bad  cases,  causing  the  air  to  he  driven  out  of  the  lungs 
with  such  suddenness  as  to  produce  a  noise  something  like  the  invol- 
untary yelp  of  a  puppy.  It  is  generally  caused  by  acidity  of  the 
stomach,  which  irritates  the  nerves  distributed  to  i^  neighborhood, 
and  is  not  diflRcult  to  remove ;  but  when  it  occurs  towards  the  close 
of  some  acute  and  gi-ave  disease,  it  is  sometimes  a  sign  that  dissolu- 
tion is  at  hand. 

Treatment. —  Startle  the  person  suffering,  by  exciting  surprise,  or 
fear,  or  anger;  or  let  a  few  small  draughts  of  cold  water  l)e  taken  in 
quick  succession;  or,  let  the  brf;ath  be  held  as  long  as  possible.  If 
the  stomach  is  sour,  take  a  te».jpoonful  of  bicarbonate  of  soda,  dis- 
solved in  half  a  tumblerful  ot  cold  water.  To  expel  wind  from  the 
stomach,  if  it  be  present,  take  some  warm  aromatic  essence  of  pep- 
permint, ether,  or  conpound  spirits  of  lavender.  But  one  of  the 
most  effectual  remedies  is  heavy  pressure  made  upon  the  collar  hones. 
It  is  simple,  and  very  effectual.  Cocaine,  one-eighth  grain  every  fif- 
teen minutes,  is  a  very  simple  and  often  efficacious  remedy. 

Fainting. — Syncope. 

Fainting  is  preceded  by  a  distress  .about  the  heart,  a  swimming 
of  the- head,  sometimes  sickness  at  the  stomach,  colt'ness  of  the  hands 
and  feet,  and  a  loss  of  sight,  or  a  sense  of  things  growing  dark.  The 
breathing  diminishes,  the  pulse  becomes  small,  the  face  deadly  pale, 
and  the  patient  wilts  down,  and  becomes  more  or  less  unconscious  of 
what  is  passing  around. 

Whatever  causes  debility,  particularly  of  the  nervous  system,  will 


-weic- 


200 


DIBRA8C8   OK  THE   BHAIN    AND   NKHVB8. 


predispoHe  to  fainting.  Peraons  much  wetiktuuMl  l)y  dlHeivHc,  faint 
easily,  especially  when  tiiey  attempt  to  stand  Htill.  When  on  their 
feet,  such  persouH  HJiould  keep  moving.  Fainting  Ih  HonietinieH  in- 
duced by  Hudden  surpriHeH  and  eniotionH,  hy  violent  pains,  by  the 
aight  of  human  blood,  and  by  irritation  of  tlie  coats  of  the  stomach 
by  indigestible  food. 

Treatment. —  I^ay  the  ]>atient  upon  the  baek,with  the  head  low;  let 
freah  air  into  tlie  room  instantly,  and  apply  gentle  friction.  Sprinkle 
a  little  coM  water  upon  the  face,  and  hold  spirits  of  camplutr,  etlier, 
hartshorn,  or  vinegar  to  the  nose,  —  rubbing  a  little  of  the  spirits  of 
camphor  U})on  the  forehead,  and  about  the  nostrils.  As  soon  iis  tiie 
ptitient  can  swallow,  give  a  teaspoonful  of  compound  spirits  ot  lav- 
ender, with  ten  drops  of  water  of  ammonia  in  it. 

Persons  subject  to  fainting  should  not  go  into  crowded  assenihlies 
where  the  air  is  biid  ;  neither  should  they  wear  tight  dresses,  or  allow 
themselves  to  get  excited.  Cold  bathing,  a  well-regulated  diet,  and 
vegetable  tonics,  will  do  much  to  break  up  the  habit. 


V 


\ 


Dizziness  of  the  Head. —  Vertigo. 

This  affection  makes  objects  which  are  stationary  appear  as  if 
moving,  or  as  the  phrase  is,  "  turning  round."  When  seized  with  it, 
one  will  have  a  sensation  as  if  falling,  and  objects  about  him  will 
seem  to  be  in  motion. 

It  is  caused  by  irritation  of  the  nerves  of  the  stomach  in  dvspep- 
sia,  by  long  application  of  the  mind,  by  a  weakened  nervous  system, 
by  hysterics,  and  by  a  fulness  of  the  blood-vessels  of  the  head. 
When  it  proceeds  from  most  of  these  causes,  it  is  not  dangerous  ;  but 
when  caused  by  impending  apoplexy,  it  is  a  symptom  of  very  serious 
import. 

f  Treatment.  —  Find  out  the  cause  and  remove  that,  and  the  dizzi- 
/  BjBss  will  disappear.  If  it  come  from  dyspepsia,  eat  lightly ;  if  from 
'  costiveness,  open  the  bowels  either  by  coarse  food,  by  daily  cold 
\  water  injections,  or  by  some  gentle  physic.  Avoid  coffee,  ardent 
I  spirits  and  late  suppers,  and  take  much  exercise.     Keep  the  feet 


Iwarm,  and  the  head  cool.     See  to  the  liver  ^d  heart. 


/ 


Disturbed  Sleep.  — Nijr'- 


..  —  Incubus. 


In  this  complaint  the  sleep  is  di  generally  by  some  fright- 

ful image.  Whatever  of  an  alarm.  ^naracter  is  presented  to  the 
raind  in  sleep,  causes  fear,  or  some  other  painful  emotion,  the  same 
as  when  awake.  And  when  the  attempt  is  made  to  resist,  or  to  flee 
from  the  danger,  it  is  ineffectual,  because  the  muscles  are  locked  fast 
in  sleep.  The  fear  being  increased  by  the  inability  to  escape,  the 
sleeper  makes  all  sorts  of  horrible  noises,  indicating  distress  of  mind. 
The  danger  seen  is  as  real  to  the  sleeper  as  if  he  were  awake,  and  he 


niBEAHES   OF  THE    BKAIN    AND    NEKVB8. 


201 


AciiHo,  faint 
iMi  on  tlieir 
uutinieH  in- 
liiis,  by  tho 
he  Htomach 

!ad  low ;  let 
I.  Sprinklo 
|»li()r,  otlicr, 
w  Hpii'iUt  (if 
8()on  aH  tli(5 
irits  ot  lav- 

[  asseuiblies 
es,  or  allow 
d  diet,  and 


ppear  an  if 
zed  with  it, 
ut  him  will 

in  dvspep- 
3U8  system, 
the  head, 
jerous ;  but 
rery  serious 

:i  the  dizzi 
|ly ;  if  from 
laily  cold 
:ee,  ardent 
sp  the  feet 


/ 


9US. 

bme  fright- 
Ited  to  the 
the  same 
,  or  to  flee 
locked  fast 
Escape,  the 
Is  of  mind. 
Ike,  and  he 


tries  to  do  jiiHt  what  he  would  if  awake.  Sometiniea  the  Nonsution  is 
that  some  h(!avy  weij;fht,  or  perhaps  some  horribh'  monster,  is  iipoii 
the  breast,  nearly  pressing  the  brcatii  out  of  the  l)0(iy. 

At  times,  the  power  of  motion  'is  not  almcnt,  and  then  disturbed 
dreams  may  eanse  one  t(»  talk,  or  to  rise  and  walk,  or  run.  Children 
will  laugh  or  cry,  or  scream,  which  shows  that  their  minds  are  agi- 
tated by  different  passions.  Persons  who  indulge  gloomy  ..nd  troub. 
lous  thoughts  in  their  waking  hours  are  apt  to  be  disturbed  with 
sleep-walking,  sleep-talking,  and  frightful  drear.is,  as  of  falling  down 
precipices,  during  the  hours  for  repose. 

There  is  nothing  very  wonderful  al)out  these  disturbances  of  sleep. 
It  is  only  neciessary  that  there  should  be  an  unusual  sensitiveness  of 
the  brain,  or  that  a  hearty  supper,  eaten  late,  should  irritate  the 
nerves  of  the  stomach,  atul  that  distressing  tlioughts  should  be  dwelt 
upon  during  the  day  and  evening,  in  order  to  produce  all  the  walk- 
ing, talking,  dreaming  of  hobgoblins,  shipwrecks,  fires  and  polar 
beai-s,  which  distress  so  many  unfortunate  sleepers. 

In  night-walking  there  is  simply  a  little  more  wakefulness  than  in 
night-talking,  and  in  this  latter,  more  than  when  one  falls  from  a  high 
place,  and  in  this  perhaps  slightly  more  than  in  real  ineuhuif,  when 
one  is  in  tin  greatest  peril,  but  cannot  move  at  all. 

Treatment.  —  When  sleeping  persons  groan,  or  make  any  noise 
indicating  nightmare,  shake  them,  and  they  will  come  out  of  it  at 
once.  As  these  troubles  are  often  caused  by  a  weakened  still e  of 
the  nerves,  much  out-door  exercise  should  be  taken.  The  diet  should 
l)e  simple,  and  well  regulated.  The  suppers  should  be  light,  and 
never  taken  late.  The  evening  should  be  spent  in  some  pleasant 
amusement,  which  will  drive  awoy  care ;  and  the  last  hours  of  wake- 
fulness be  occupied  with  pleasant  reflections.  One  afflicted  witli 
nightmare  should  not  lie  upon  the  back,  nor  with  the  hands  over  the 
head.  Acidity  of  the  stomach,  and  costiveness,  if  they  exist,  should 
be  removed  by  neutralizing  mixture. 

Headaches. 

These  are  not  alwajrs  caused  by  disorders  of  the  brain  and  nerves, 
but  they  frequently  are,  and  this  seems  the  proper  place  to  speak  of 
them. 

It  is  unwise  ever  to  neglect  headaches.  They  are  sources  of  great 
suffering,  and  often  lead  to  serious  derangements  of  the  health.  In 
childhood  they  have  a  more  serious  meaning  than  in  adult  life. 
They  often  indicate  the  approach  of  scarlet  fever,  or  measles,  or  of 
other  diseases. 

Headaches  are  more  common  among  the  civilized  than  the  uncivil- 
ized ;  more  frequent  among  females  than  among  males ;  among  those 
of  sensitive  feeling  than  among  the  more  obtuse ;  among  those  who 
think  much  than  among  those  who  think  little  ;  among  the  sedentary 
than  among  the  active. 


•■Sfssssr- 


....ikU~kiMi»^'^ 


202 


DISEASES   OF   THE   BRAIK   AND   NERVES. 


ni 


Causes  of  Headaches.  -They  are  dependent  on  various  causes, 
as  derangement  of  the  circulating  system,  of  the  digestive  organs,  of 
the  nervous  system,  etc.  Among  those  dependent  on  disturbance  of 
the  circulation,  are 

Headaches  from  Eye  Diseases.  —  Myopia,  or  nearnsightedness ; 
Hypermetropia,  or  far-sightedness ;  Astigmatism,  or  the  inability  to 
see  equally  well  horizontel  and  vertical  lines,  as  well  as  other  irieg- 
ularities  of  vision,  are  frequent  sources  of  headache.  These  head- 
aches are  caused  by  overtaxing  certain  groups  of  muscles,  or  by  fixing 
the  eyes  too  long  on  one  objective  point,  as  experienced  in  prolonged 
study  or  reading,  especially  under  unfavorable  circumstances.  These 
headaches  are  more  or  less  similar  in  their  symptomatology.  The 
ache  is  generally  dull,  situated  mostly  in  forehead  and  over  eyes,  but 
may  also  be  spread  from  base  of  brain  to  the  eyes  ;  oftentimes  it  is 
accompanied  by  nausea,  especially  after  prolonged  use  of  eyes  under 
improper  conditions. 

The  treatment  of  these  headaches  consists  in  absolute  rest  of  the 
eye,  in  case  of  overwork,  and  the  fitting,  by  a  competent  oculist,  of 
such  glasses  as  will  rectify  the  irregularity  in  the  eye  proper. 

Astigmatism  is  a  common  source  of  headaches,  and  often  is  so  in- 
sidious in  its  development  as  to  escape  attention.  A  rough  test 
may  be  made  by  drawing  several  horizon*^"'  and  several  vertical 
lines  in  close  proximity,  and  then  placing  pt  fio»;>e  distance  (15  to  20 
feet)  from  the  eye.  If  either  set  cannot  i  «  as  clearly  seen  without 
blurring  as  the  other,  you  have  good  cause  t,^  su'  iect  Astigmatism, 
and  should  consult  an  oculist.  Do  not  dally  .„i  these  eye-head- 
aches, as  you  will  be  doing  -v  permanent  injury  to  your  eyes. 

Tea  and  Coffee  Headaches  —  In  the  nervous,  and  oftentimes  in 
the  gouty  and  rheumatic  person,  the  use  of  tea  or  coffee  will  cause 
violent  headaches.  Tobacco  likewise  after  prolonged  use  shows  a 
tendency  to  head'^ches.  The  ie  luxuries  of  life  should  be  discontin- 
ued at  once  for  at  least  or  j  month.  An  extra  strong  cup  of  black 
coffee,  to  be  sure,  will  stop  the  headache  for  the  time  being,  but  only 
adds  fuel  to  the  fjre  in  the  long  run.  Bromo-caffeine,  as  ordinarily 
sold  by  the  druggists,  taken  in  teaspoonful  doses  every  half  hour, 
will  relieve  the  malady.  We  would  strongly  advise  any  one  that  has 
constant  or  periodical  headaches,  if  he  uses  eithe"  tea  or  coffee,  and 
especially  coffee,  to  leave  them  off  entirely  for  three  months.  It  may 
be  the  sole  cause,  and  if  caused  by  tea  or  coffee,  there  is  no  possi- 
bility of  their  cure  by  medicines  while  you  continue  their  use. 

Plethoric  Headaches. — These  are  dependent  on  a  general  fulness 
of  blood.  They  are  of  two  kinds.  One  is  occasional,  and  lasts  but 
a  few  hours.  The  other  lasts  for  dajrs  or  weeks.  It  occurs  most 
often  in  the  night  or  morning.  Persons  whose  occupations  require 
stooping  have  it  most.  A  little  dizziness  is  generally  felt  on  rising 
up  from  a  stooping  posture.     It  is  brought  on  by  the  bad  air  of 


DISEABKH  OK   THE   BKAIN   AND   NKRVE8. 


203 


•10U8  causeH, 
fe  organs,  of 
sturbance  of 

sightedness ; 

inability  to 

other  irieg- 

These  head- 

or  by  fixing 

in  prolonged 

nces.    These 

ology.     The 

krer  eyes,  but 

sntimes  it  is 

f  eyes  under 

rest  of  the 
it  oculist,  of 
oper. 

'ten  is  so  in- 
.  rough  test 
eral  vertical 
ce  (15  to  20 
seen  without 
astigmatism, 
sse  eye-head- 
yes. 

tentimes  in 
;  will  cause 
jse  shows  a 
>e  discontin- 
up  of  black 
ig,  but  only 
ordinarily 

half  hour, 
ne  that  has 

coffee,  and 
It  may 

is  no  possi- 

use. 

sral  fulness 
lasts  but 

Bcurs  most 

|)ns  require 
on  rising 

I  bad  air  of 


crowded  rooms,  and  is  attended  by  costive  bowels,  short  breath,  and 
a  white  furred  tongue. 

Tfie  persistent  headache  is  accompanied  by  a  sense  of  fulness,  and 
sometimes  of  throbbing  over  the  brows  and  temples,  with  a  sensation 
of  dizziness,  and  of  mist  before  the  eyes.  The  sufferer  feara  exertion 
and  is  constantly  looking  for  a  rush  of  blood  to  the  head.  Nature 
sometimes  relieves  this  form  of  headache  by  a  diarrhoea,  or  by  bleed- 
ing from  the  nose. 

There  is  another  form  of  plethoric  headache,  differing  slightly  from 
the  above,  in  which  there  is  too  much  blood,  and  it  is  made  too  fast, 
but  it  does  not  circulate  so  rapidly.  The  muscles  are  not  very  firm, 
and  the  heart  does  not  propel  the  blood  with  much  force.  This  form 
of  headache  is  connected  with  congestion. 

Headaches  of  Indigestion. — These  are  caused  either  by  taking 
improper  articles  of  food,  or  by  eating  too  much  of  those  which  are 
proper.  The  sensation  in  the  head  is  not  always  a  pain,  but  some- 
times only  a  dull  weight,  attended  by  languor  and  disinclination  for 
exertion ;  a  tongue  white  in  the  centre,  and  pale  red  at  the  tip  and 
edges ;  cold  and  numb  fingers ;  slight  nausea ;  languid  and  feeble 
pulse ;  dim  and  indistinct  sight ;  eyes  aching  when  employed ;  and 
difficulty  in  fixing  the  attention. 

Sick  Headaclie.  —  This  has  received  its  name  from  the  constant 
nausea  or  sickness  at  the  stomach  which  attends  the  pain  in  the 
hf  ^d. 

This  headache  is  apt  to  begin  in  the  morning,  on  waking  from  a 
deep  sleep,  or  after  sleeping  in  a  close  room,  and  when  some  irregu- 
larity of  diet  has  been  committed  on  the  day  before,  or  for  several 
previous  days.  At  first  there  is  a  distressingly  oppressive  feeling  in 
the  head,  which  gradually  merges  into  a  severe,  heavy  pain  in  the 
temples,  frequently  attended  by  a  sense  of  fulness  and  tenderness  in 
one  eye,  and  extending  across  the  forehead.  There  is  a  clammy,  un- 
pleasant taste  in  the  mouth,  an  offensive  breath,  and  the  tongue  cov- 
ered with  a  yellowish-white  fur.  The  sufferer  desires  to  be  alone, 
and  in  the  dark.  The  hands  and  feet  are  cold  and  moist,  and  the 
pulse  feeble. 

Accompanying  these  symptoms,  there  is  a  depressing  sickness  at 
the  stomach,  which  is  increased  by  sitting  up,  or  moving  about. 
After  a  time,  vomiting  comes,  and  relief  is  obtained. 

Bilious  Headaclie.  —  This  is  most  common  in  summer  and  au- 
tumn. It  a^icts  persons  of  dark  complexion  with  black  hair  and 
melancholy  dispositions.  There  are  two  kinds,  one  is  due  to  an  ac- 
cumulation of  bile  in  the  system  ;  the  ^<ther,  to  a  large  secretion  of 
bile. 

Ir;  the  first  variety  the  skin  is  dingy  and  sallow,  the  spirits  de- 
pressed, the  bowels  costive,  and  there  is  wind  in  the  stomach,  with  a 
dull,  aching  pain  on  the  right  shoulder.   The  pain  is  in  the  forehead, 


204 


DISEASES  OF  THE   BRAIN   AND   NERVES. 


eyebrows  and  eyelids,  and  the  "  white  of  the  eye  "  is  a  little  yellow- 
ish. The  tongue  has  a  brown  fur,  and  is  cracked  in  the  centre. 
There  is  a  bitter  taste  in  the  mouth  on  waking  in  the  morning,  after 
restless  nights,  and  frightful  dreams. 

In  the  second  variety,  which  is  due  to  an  "  overflow  of  bile,"  the 
symptoms  are  much  like  those  of  the  first  kind,  but  the  pain  is  not  so 
continuous.  In  addition  to  the  symptoms  named,  there  is  a  throb- 
bing, rending  pain  in  the  head,  the  skin  is  hot  and  the  face  flushv  1, 
the  limbs  are  sore,  and  there  is  a  luminous  halo  or  ring  around  ob- 
jects looked  at,  and  a  feeling  of  giddiness. 

Nervous  Headaches.  —  These  are  more  common  among  females 
than  males.  They  occur  most  frequently  among  persons  of  high  sus- 
ceptibility, who  are  easily  elevated,  and  as  easily  depressed.  They 
are  often  connected  with  indigestion. 

The  pain  is  usually  acute  and  darting,  and  is  made  worse  by  light, 
with  a  feeling  as  if  the  temples  were,  being  "  pressed  together,"  and 
a  "  swimminess  "  in  the  head.  There  is  sometimes  a  sense  of  sink- 
ing, with  a  dread  of  falling,  and  great  despondency  and  restlessness. 
The  bowels  are  generally  costive,  and  the  sight  dim.  The  pain  comes 
on  most  commonly  in  the  morning,  lasts  through  the  day,  and  abates 
in  the  evening. 

Hysteric  Headache There  is  a  nervous  headache  dependent  on 

the  hysterical  condition.  It  is  generally  confined  to  one  small  spot, 
frequently  over  the  eyebrow,  and  is  sometimes  compared  to  a  wedge 
or  nail  driven  into  the  skull. 

Headache  from  Exhaustion.  —  Still  another  species  of  nervous 
headache  arises  from  extreme  exhaustion,  produced  by  great  loss  of 
blood,  by  diarrhoea,  or  by  over-suckling.  The  pain  is  generally  on 
the  top  of  the  skull,  and  is  often  compared  to  the  beating  of  a  small 
hammer  on  the  head. 

Brow  Ague. —  This  is  intermittent  in  its  character,  and  is  brought 
on  b}'  exposure  to  cold  and  moisture  in  damp  and  marshy  districts ; 
and  in  this  respect  is  much  like  ague. 

Meg^rims. —  This  is  most  frequent  among  females.  It  is  often  de- 
pendent on  the  same  causes  as  Brow  Ague,  and  is  also  produced  by 
long  and  exhausting  watching  over  sick  children,  distress  of  mind, 
and  indigestion. 

In  both  the  above  forms,  the  pain  is  intermittent,  seldom  lasting 
long,  but  being  of  a  sharp,  piercing  character  like  that  of  tic  doulou- 
reux. Tin  pain  of  Megrims  usually  begins  at  the  inner  angle  of  the 
eye,  and  extends  towards  the  nose ;  the  parts  being  red  and  sore,  and 
the  eye-ball  tender.  In  Brow  Ague,  pain  and  great  tenderness  cover 
an  entire  half  of  the  head,  compared  by  the  patient,  sometimes,  to 
"  an  opening  and  shutting  of  the  skull."  It  begins  with  a  creeping 
sensation  over  the  scalp. 


DISEASES   OF   THE   BRAIN   AND   NERVES. 


205 


ie  yellow- 
be  centre, 
ling,  after 

bile,"  the 
1  is  not  so 
i  a  throb- 
ie  flushv  1, 
round  oh- 

g  females 

high  8U8- 

id.     They 

J  by  light, 
ther,"  and 
e  of  sink- 
jtlessness. 
lain  comes 
bud  abates 

endent  on 
mall  spot, 
)  a  wedge 

nervous 
it  loss  of 
erally  on 

a  small 

brought 
iistricts ; 

often  de- 
duced by 
of  mind, 

lasting 
I  doulou- 
Jle  of  the 
lore,  and 
tes  cover 
limes,  to 
ireeping 


Rheumatic  Headaches. —  These  generally  affect  persons  who  have 
been  subject  to  rheumatism,  and  are  often  brought  on  by  uncovering 
the  head  when  sweating.  The  pain  is  usually  in  the  brow,  (he  tem- 
ples, or  the  back  of  the  head,  and  is  dull  and  aching,  —  rather  an  in- 
tense soreness  than  a  real  pain ;  and  the  painful  part  is  excessively 
tender  upon  pressure.    The  skin  is  moist,  but  not  hotter  than  natural. 

Treatment. —  In  considering  the  treatment,  I  will  take  up  the  same 
order  in  which  I  have  spoken  of  the  different  forms  of  headache. 

Plethoric  Headaches. —  Not  much  medicine  should  be  taken  for 
these,  if  it  can  be  avoided.  A  diuretic  (131)  may  be  taken  twice  a 
day,  and  an  occasional  dose  of  gentle  physic  at  night,  followed  by  (7) 
in  the  morning.     This  will  generally  give  great  relief. 

Meat  should  be  taken  but  once  a  day,  and  the  whole  diet  should 
l)e  spare,  the  appetite  never  being  fully  satisfied.  All  spirituous  drinks, 
including  distilled  and  fermented,  should  be  let  alone,  and  coffee  like- 
wise. 

Much  exercise  should  be  taken  in  the  open  air.  The  hair  should 
be  kept  short,  and  the  head  elevated  during  sleep.  Bleeding  at  the 
no3e,  when  it  occurs,  must  not  be  too  suddenly  stopped.  Two  drops 
of  the  tincture  of  aconite  root  with  three  of  the  fluid  extract  of  gel- 
semium  repeated  once  a  half  hour  for  three  or  four  times  will  be 
found  to  be  of  great  value  in  the  treatment  of  this  form  of  headache. 

The  hot-water  bottle  applied'  to  thr  o  part  of  the  spine  between  the 
head  and  shoulder  blades  will  also  give  great  relief. 

Congestive  Headaches. —  The  exercise,  diet,  mode  of  sleeping, 
etc.,  should  be  the  same  as  in  plethoric  headaches.  In  this  complaint, 
there  is  too  much  blood  in  the  head,  and  it  inclines  to  stagnate.  The 
feet  and  hands  are  cold  ;  and  gloves  and  stockings  of  wool,  and  other 
bad  conductors  of  heat  from  the  body,  must  be  worn. 

Occasionally  a  little  gentle  physic  (319)  is  desirable  to  induce  the 
bowels  to  act  every  day.  If  there  is  great  debility,  iron  (71),  (74), 
(75),  (320),  will  be  required.  The  ic3  bag  applied  to  the  last  six  or 
eight  inches  of  the  spine  will  call  the  blood  to  the  extremities.  The 
aconite  and  gelsemium  recipe  as  given  above  is  also  very  useful. 

Headache  of  Indigestion. —  If  the  pain  come  immediately  after  a 
meal,  and  can  be  traced  to  something  eaten,  an  emetic  (2)  may  be 
taken,  if  the  person  be  tolerably  strong.  If  the  pain  come  on  some 
hours  after  eating,  take  rhubarb  and  magnesia  (28),  (14),  or  fluid 
magnesia.  \VTien  the  system  is  debilitated,  take  a  warm  draught 
(322)  in  the  morning  after  a  light  breakfast,  or  twice  a  day,  a  bitter 
with  an  alkali  (323).  If  the  stomach  be  very  irritable,  bismuth,  at 
meal  times  (324),  (326).  When  it  occurs  after  a  debauch,  take  re- 
cipe (325). 

Sick  Headache. —  When  it  results  from  food  taken,  a  draught  of 
warm  chamomile  tea,  or  a  little  weak  brandy-and-water,  will  generally 


:<1 


PI 


206 


DISEASES   OF  THE    BKAIN   AND   MEKVEU. 


I  it 


/  r 


give  relief.  If  the  sickness  continue,  soda  and  water,  with  a  little 
ginger  may  do  well,  or  a  mustard  poultice  upon  the  stomach  (166) 
may  be  required.  As  soon  as  it  can  be  kept  on  the  stomach,  a  dose 
of  physic  (826)  must  be  tivken ;  and  if  relief  does  not  come  after  the 
operation  of  this,  give  a  bitter  and  an  aromatic  (327).  The  patient 
must  have  perfect  rest.  If  there  be  great  lack  of  tone  in  the  system, 
the  mineral  acids  (328),  (329)  will  be  excellent. 

The  diet  must  he  carefully  regulated,  Jis  in  plethoric  and  conges- 
tive headaches.  Cocaine,  one-eighth  grain  every  fifteen  minutes  till 
the  nausea  stops,  and  then  a  dose  of  physic  is  an  excellent  method  of 
treatment.  Ten  grains  of  amenonol  (ammonol)  every  hour  will 
stop  the  pain,  and  very  often  tlie  same  amount  of  phenacetine  will 
accomplish  the  same  result. 

Bilious  Headaches. —  These  are  generally  connected,  more  or  less, 
with  some  affection  of  the  liver. 

During  an  attack,  if  the  suffering  be  great,  attended  by  nausea, 
give  an  emetic  (2).  In  milder  cases,  give  Tecipe  (321).  If  there  be 
costiveness,  give  recipe  (330)  at  night,  and  (7)  in  the  morning. 

A  few  doses  of  podophyllin,  leptandrin,  etc.  (34),  (36),  (39),  to  re- 
lieve the  liver  when  the  bile  does  not  flow  fast  enough,  will  diminish 
the  frequency  and  force  of  the  attack.  The  fluid  extract  of  dande- 
lion, taken  for  some  time,  often  does  good  service. 

The  diet  should  be  light,  and  chiefly  vegetable,  and  exercise  in  tlie 
open  air  must  not  be  omitted.  The  daily  sponge-bath,  with  friction, 
is  excellent, 

Nervous  Headaclies. — The  first  thing  to  be  done  is  to  relieve  the 
pain,  and  this  may  generally  be  accomplished  either  by  preparation 
(331),  or  (332),  or  (333),  or  (88),  or  (93),  or  two  or  three  drops  of 
tincture  of  nux  vomica  in  a  spoonful  of  water,  taken  three  times  a 
day.     351  will  be  found  usually  to  be  of  most  service. 

In  simple  nervous  headache,  diet  is  of  the  greatest  importance  ;  in 
hysterical  cases,  exercise  ;  in  headaches  from  exhaustion,  tonics  (81), 
(79),  r63),  (73),  (64),  (61),  (60). 

Of  the  simple  remedies  found  on  the  druggists'  counter  bromide 
of  caffein  in  effervescent  form  is  very  efficacious. 

Riieumatic  Headaches. —  Take  a  light  diet,  with  but  little  animal 
food.  Wear  warm  clothing,  and  avoid  exposure  to  wet  feet  and  damp- 
ness generally,  and  go  to  a  mild  climate,  if  convenient. 

When  the  local  pain  is  great,  apply  hot  fomentations,  or  a  stimula- 
ting liniment  (334),  or  a  mustard  poultice,  to  the  back  of  the  neck. 
In  the  beginning  of  the  treatment,  a  little  physic  at  night  (335)  is 
useful.  10  grs.  potassium  iodide,  gradually  increased,  in  water,  is 
the  best  medicine. 

Before  closing  this  chapter  on  headaches,  let  me  enter  a  respectful 
protest  against  the  indiscriminate  use  of  the  thousand  and  one  reme- 
dies advertised  to  cure  headaches  ;  for  in  a  great  majority  of  cases  it 


with  a  little 
omach  (166) 
mach,  a  doso 
>me  after  tlie 
The  patient 
1  the  system, 

and  conges- 
minutes  till 
it  method  of 
y  hour  will 
lacetine  will 

nore  or  less, 

by  nausea, 
If  there  be 
jrning. 
(39),  to  re- 
ill  diminish 
b  of  dande- 

rcise  in  the 
th  friction, 

relieve  the 
jreparation 
36  drops  of 
3e  times  a 

rtance  ;  in 
nics  (81), 

sr  bromide 

tie  animal 
md  danip- 

a  stimula- 
the  neck. 
;  (335)  is 
water,  is 

•espectful 
•ne  reme- 
f  cases  it 


DISEASES   OF   THE   BRAIN   AND   NERVES.  207 

given    away  by  patent   ^edi^Cl^L'^^^^^^^ 
cures  for  headaches.     These  vendera  hav?l  ''''""*^'^«^    ^heir  specific 
since  the  introduction  into  LlSrof  thA   Ti  '"  '^"'"''«^«  "^  ^^^e, 
samples  of  headache  cures  may  S  found   "°^^-<^';  Products,  so  that 
little  while.     For  the  molt  Z7 thJ  °"  ''"^^  doorsteps  every 

H.  acetenilide  or  antiSnr^cauro'f  T^^^  "^  ^^**  '^  ^"«^^ 
with  other  coal-tar  producte      It  l\  cheapness  as  compared 

them  all,oftencausing  Wueness  of  tt'T'^'^fl'^"  ""^^^  ^^™f"l  of 
dizziness,  faintness,  etc^  W  other  8imS«r^^''/"?"""«^  °^  *^«  heart 
ger  may  be  expected,  and  yet  no  on^oulbf  ^^^^^^  "'"^^  '^^°- 

without  the  consent  and  a^ppiSri  of  thf  f^.^r*'?  ^  *''"  ^^"^^dies 
of  phenacetine  for  an  aduKDeated  f^"/"""^^  Physician.     8  grains 
will  cure  more  headaches  of  ^1  5^117°  ^?"'  *'°'^'  ^«  doubt 
drug.    LactopheninandLlnolaresirn7.^"  '^^  °'^^^  «^"^^« 
headache  which  have  the  ^^^1^  J^         Jf  ^^"^^^  "^"^^dies  for 
duct«  without  any  of  their  iScte     AnfT^  '^'^'"*  ^  ««^^-*^^  P^o- 
cine  of  the  coal-tar  group,  enioys  a  Jart^ff^       '  proprietaiy  medi- 
but  for  general  neuralgic  pa  n  and,???'  "1  '^"^^  ^°'  headaches 
eve^two  to  four  houS  a?^rdL"g^o^K  TrL^t-^^^^^  ^°- 
stop  a  large  proportion  of  these  aches    ^^^f^^^^.'^^  "^  the  pain,  will 
the  bromides  are  always  safe  and  nffl      ^    ^^'^""^  combinations  of 
aches,  especially  if  neTe-elemen?  is  Itrnr   '  !?"''^*  ^"  ^'^""^  head- 
caffein,   bromoieltzer,    bromc^oda   eiV  '^'''  '^T'''''''  ^romo- 
small  bottles  in  an  eff  rvesc'rand'  p^iaS:  f^"'"^  ^^'  "^   ^ 


«.Ts>^!S5;3aiEEas3 


DISEASES  OF  THE  THEOAT. 


The  diseases  which  seat  themselves  in  the  throat,  and  in  the  great 
cavity  of  the  chest,  have  occupied  a  large  share  of  my  attention  for 
the  last  ten  years.  My  practice  in  these  complaints  has  been  largo, 
— being  drawn  from  every  part  of  the  United  States,  and  the  British 
Provinces.  No  class  of  diseases  from  which  men  suffer  are  more  nu- 
merous than  these,  and  none  have  so  generally  baffled  the  skill  of  the 
profession.  For  this  reason,  I  wish  to  present  here  a  brief,  practical, 
and  common-sense  view  of  these  complaints,  which  shall  be  of  real 
value  to  the  thousands  of  families  who  consult  these  pages. 

Increase  of  Throat  Diseases. —  A  striking  increase  in  the  number 
of  throat  diseases  has  been  witnessed  within  the  last  few  years.  A 
person  suffering  from  any  of  them  will  find,  on  speaking  of  his  com- 
plaint, that  a  number  of  his  neighbors  are  afflicted  with  troubles  of  a 
similar  kind.  I  have  thought  that  in  some  of  their  forms  these  dis- 
eases have  fastened  upon  the  throats  of  not  less  than  half  our  popu- 
lation. And  when  it  is  considered  that  they  are  the  natural,  and  if 
unmolested,  the  certain  harbingers  of  lung  disease,  it  is  wise  to  make 
a  note  of  the  above  fact.  As  I  shall  describe  them  in  the  nasal  cavi- 
ties, the  pharynx,  the  fauces,  etc.,  they  all  have  a  natural  proclivity 
downwards.  From  these  upper  cavities  they  pass,  by  one  short  step, 
into  the  larynx, —  the  cavity  where  the  voice  is  formed,  —  and  then, 
by  another  equally  short  and  easy  stage,  into  the  body  of  the  wind- 
pipe. It  is  a  singular  fact  that  their  progress  is  always  from  the 
upper  breathing  passages  downward,  and  never  from  the  lower  pas- 
sages upward.  They  afford  a  parallel  to  the  order  of  progression  in 
the  moral  world,  in  which  evil  tendencies  are  toward  a  lower  depth. 

A  Mistake  Corrected.  —  Before  describing  the  several  diseases 
which  belong  to  this  family,  I  wish  to  correct  the  mistake  which  so 
generally  classes  them  all  under  the  term  Bronchitis. 

They  all  consist  in  a  simple  inflammation,  acute  or  chronic,  either 
of  the  mucous  membrane  lining  the  several  cavities  to  be  spoken  of, 
or  of  the  small  glands  or  follicles  connected  with  that  membrane ; 
and  each  disease  takes  its  name  from  its  particular  location.  Thus, 
the  inflammation  of  the  membrane  lining  the  upper  part  of  the  throat, 
or  pharynx,  is  called  Pharyngitis.     Inflammation  in  the  top  of  the 

208 


i.     -..JiBMH 


in  the  great 
itention  for 
been  largi;, 

the  British 
re  more  nu- 

skill  of  the 
jf,  practical, 
.  be  of  real 


the  number 
V  years.     A 
of  his  corn- 
roubles  of  a 
IS  these  dis- 
f  our  popu- 
iural,  and  if 
ise  to  make 
nasal  cavi- 
|1  proclivity- 
short  step, 
and  then, 
the  wind- 
Is  from  the 
lower  pas- 
jgression  in 
|wer  depth. 

il   diseases 
|e  which  so 

bnic,  either 
spoken  of, 
lembrane ; 
hn.    Thus, 

(the  throat, 
pop  of  the 


DISEASES  OF   THE   THHOAT. 


windpipe,  or  larynx,  is  Laryngitis.  In  the  windpipe,  or  trachea,  it  ia 
IVachitis.  In  the  bronchial  tubes,  it  is  Bronchitis.  As  the  bronchial 
tubes  exist  nowhere  except  in  the  lungs,  below  the  division  of  the 
windpipe,  there  can  be  no  Bronchitis  in  the  throat.  Nevertheless,  it 
is  the  same  disease  with  Laryngitis  and  Pharyngitis,  and  differs  from 
them  only  in  being  in  a  more  dangerous  place. 

As  the  windpipe  descends  into  the  chest,  it  divides  below  the  top 
of  the  breast-bone  into  two  branches,  one  going  into  the  right,  the 
other  into  the  left  lung.  These  branches  divide  and  subdivide  very 
minutely,  and  send  their  ramifications  into  every  part  of  the  pulmon- 
ary tissue.     Thus  situated,  Meckel  has  compared  the  windpipe  to  a 


Fro.  86. 

hollow  tree  with  the  top  turned  downward, — the  larjmx  and  trachea 
representing  the  trunk,  and  the  bronchial  tubes,  with  their  innumera- 
ble subdivisions,  the  branches  and  twigs.     (Fig.  86.) 

If  the  reader  will  now  understand  that  the  trunk  and  branches  of 
this  bronchial  tree  're  hollow  throughout,  and  lined  with  a  delicate 
and  smooth  mucous  membrane,  and  that  the  diseases  to  be  described 
are  inflammation  either  upon  this  membrane  or  the  small  glands  con- 
nected with  it,  causing  swelling,Tedness,  unhealthy  discharges,  rough- 
ness, etc.,  he  will  have  a  good  general  idea  of  them. 

Nasal  Catarrh. 

I  TAKE  these  diseases  in  the  order  of  their  location.  Nasal  Catarrh 
consists  in  inflammation,  which  begins  behind  and  a  little  above  the 


■WRSrTBBBSSSS!?' 


310 


DISEASES  OF   THE   THROAT. 


m 


veil  of  the  palate,  and  extends  upward  from  thence  into  the  nose.  It 
is  an  exceedingly  troublesome  complaint,  and  afflicts  great  numbers. 
It  passes  under  the  name  of  Catarrh  in  the  Head. 

The  inflammation  is  not  confined  to  the  nasal  cavities.  It  extends 
frequently  to  the  air-cavities,  called  antrums  and  ainvses,  which  cover 
a  considerable  portion  of  the  face,  and  extend  to  the  lower  part  of  the 
forehead.  Persons  sometimes  feel  as  if  their  whole  face  were  in- 
volved in  the  disease,  and  were  almost  in  a  state  of  rottenness,  —  so 
great  is  the  amount  of  matter  discharged  from  the  head.  Such  free 
discharges  cannot  be  wondered  at  when  we  reflect  that  all  the  air 
cavities  in  the  face  are  lined  with  the  same  mucous  membrane  which 
lines  the  nose,  and  that  they  all  communicate  w  ith  the  nasal  cavities. 

The  "  horn  ail,"  among  cattle,  is  a  similar  inflammation  of  the  inner 
surface  of  the  horns ;  and  the  "  horse  distemper  "  is  an  inflammation  of 
the  air  cavities  in  the  head  of  the  horse,  and  is  much  the  same  disease 
with  our  catarrh  in  the  head. 

The  catarrh  often  creates  a  perpetual  desire  to  gtoallow,  and  gives 
the  feeling,  as  patients  express  it,  "  as  if  something  were  sticking  in  the 
upper  part  of  the  throat" 

When  the  inflammation  has  existed  a  long  time,  and  ulceration 
has  taken  place,  puriform  matter  is  secreted,  and  drops  down  into  the 
throat,  much  to  the  discomfort  of  the  patient.  Indeed,  this  is  one  of 
the  most  distressing  features  of  the  complaint,  as  this  matter  often 
descends  into  the  stomach  in  large  quantities,  causing  frequent  vom- 
iting, and  a  general  derangement  of  the  health.  Many  times  the  suf- 
ferer can  only  breathe  with  the  mouth  open.  Upon  rising  in  the 
morning  a  great  effort  is  required  to  clear  the  head  and  the  extreme 
upper  part  of  the  throat.  There  is  occasionally  a  feeling  of  pressure 
and  tightness  across  the  upper  part  of  the  nose ;  and  the  base  of  the 
brain  sometimes  suffers  in  such  a  way  as  to  induce  headache,  vertigo, 
and  confusion.  The  smell  is  frequently  destroyed,  and  sometimes 
the  taste.  The  inflammation  sometimes  gets  into  the  Eustachian 
tubes,  the  mouths  of  which  are  behind  and  a  little  above  the  veil  of 
the  palate,  and  extends  up  the  lining  membrane  to  the  drum  of  the 
ear,  causing  pain  or  deafness,  and  occasionally  both.  In  addition  to 
this  catalogue  of  evils,  there  is  often  added  inflammation  and  elon- 
gation of  the  uvula  or  soft  palate. 

Treatment.  —  The  following  is  a  fair  illustration  of  my  mode  of 
treatment:  — 

Mr. ,  of  Boston,  came  under  treatment  for  a  bad  case  of  ca- 
tarrh in  the  head,  complicated  with  follicular  disease  of  the  pharynx, 
or  upper  part  of  the  throat.  In  addition  to  nearly  all  the  symptoms 
mentioned  above,  he  had  a  stench  from  the  nose  exceedingly  offen- 
sive to  all  about  him.  So  much  had  the  disease  worn  upon  him  that 
he  had  become  bilious,  sallow,  dejected,  and  low  in  strength  and  flesh. 

When  it  is  said  that  to  all  these  were  added  a  cough  and  loss  of  aj)- 
petite,  with  insidious  approaches  of  hectic,  it  will  not  be  surprising 


BT?-,-^ 


DISEASES  OF  THP!   THROAT. 


211 


the  nose.  It 
it  numbers. 

It  extends 
wrhich  cov(!r 
:  part  of  the 
ce  were  in- 
snness,  —  so 
Such  free 
/  all  the  air 
brane  which 
isal  cavities. 
of  the  inner 
immation  of 
lame  disease 

',  and  gives 
ioking  in  the 

I  ulceration 

wn  into  the 

lis  is  one  of 

latter  often 

quent  vom- 

nes  the  suf- 

jing  in  the 

le  extreme 

of  pressure 

jase  of  the 

he,  vertigo, 

sometimes 

Eustachian 

the  veil  of 

•um  of  the 

,ddition  to 

and  elon- 

ly  mode  of 

[a&e  of  ca- 
pharynx, 
[symptoms 
iigly  offen- 
him  that 
I  and  flesh, 
[loss  of  aj)- 
surprising 


tliat  his  friends  saw  the  most  serious  results  impending,  even  tliougli 
assured  by  me  that  the  disease  had  not  yet  tiikisu  a  firm  hold  of  Km 
lungs.  The  first  tiling  done  for  him  was  to  cut  <»ff  the  uvula.  Five 
days  after,  I  began  to  bathe  the  whole  nasal  cavity,  thiee  times  a 
week,  with  a  shower  syringe,  by  pushing  the  smooth  bulb  up  behind 
the  veil  of  the  palate,  and  throwing  instantaneously  a  most  dv<^licate 
shower  of  medicated  fluid  up  both  sides  of  the  septum.  The  upper 
part  of  the  throat  was  likewise  bathed  by  the  use  of  a  shower  syringe 
made  expressly  for  that  part,  and  the  larynx,  or  place  where  the  voice 
is  formed,  by  a  long,  bent  instrument  made  to  reach  this  part  of  the 
tliroat.  The  solution  used  consisted  of  half  a  dram  of  crystals  of  ni- 
trate of  silver  dissolved  in  one  ounce  of  soft  water. 

The  nitrate  of  silver  powder  was  inhaled  once  a  day  with  the  pow- 
der inhaler.  In  this  way  the  nasal  cavities  and  throat  were  kept 
cleansed,  and  the  articles  used  gradually  subdued  the  inflammation, 
setting  up  a  new  and  healthful  action  in  place  of  the  diseased  one. 
The  stomach  was  relieved  of  the  offensive  matter  which  had  daily 
and  nightly  gone  down  into  it,  and  the  system  of  the  poisonous  ef- 
fects of  its  absorption.  The  great  danger  which  threatened  the  lungs, 
and  which  would  soon  have  been  realized  in  their  destruction,  passed 
away.  The  skin  gradually  resumed  its  P'-oper  color ;  the  aopetite, 
flesh,  spirits,  and  strength  came  back,  and  Mr.  B.  has  been  oince  in 
the  enjoyment  of  good  health,. pursuing  his  business  cheerfully. 

When  the  above  treatment  fails,  as  it  does  occasionally,  I  am  in 
the  habit  of  changing  the  solution,  using  sometimes  a  weak  solution 
of  acid  nitrate  of  mercury,  twenty  drops  to  an  ounce  of  water.  In 
other  cases,  a  solution  of  sulphate  of  zinc  serves  a  good  purpose.  A 
dilution  of  the  tincture  of  arnica-flowers  is  a  preparation  of  some 
value  in  these  cases.  There  are  other  preparations,  too  numerous  to 
mention,  which  I  am  in  tKe  habit  of  using.  I  will  add,  that  the 
nitrate  of  silver  powder,  snuffed  once  a  day,  a  pinch  at  a  time,  is  far 
more  successful  than  any  other  snuff  ever  made,  but  should  be  used 
only  in  severe  cases»  and  with  caution. 

Nasal  catarrh  is  such  a  common  affliction  in  the  Eastern  States,  as 
to  be  a  widespread  curse.  Douching  the  nose  with  salt  and  water 
(warmed)  cleanses  the  nose  of  the  foul  mucus.  The  douche  should 
be  from  a  bag  hanging  only  a  little  higher  than  the  head,  or  it  may  be 
given  by  means  of  a  common,  blunt-pointed  syringe,  care  being  taken 
not  to  use  too  strong  force,  nor  to  point  the  syringe  in  the  direction 
of  the  eyes.  The  stream  of  water  should  be  directed  straight  ahead 
parallel  with  the  floor ;  the  mouth  must  be  open,  and  the  patient  as- 
sume the  position  of  the  countryman  when  gazing  or  gauking  at  the 
sights  on  his  first  visit  to  the  city.  The  water  then  runs  down  the 
throat  and  also  out  of  the  other  nostril.  This  process  should  be  em- 
ployed on  both  sides  till  the  head  is  clean.  The  cablets  put  up  by  all 
wholesale  druggists,  called  "Carl  Seller's  alkaliae  tablets,"  is  the  best 
remedy  for  a  nasal  douche.     The  subsequent  treatment  is  best  ad- 


!t-?«?«H9SSS? 


212 


DI8EA8RR   OF   THR   THROAT. 


W1 


vised  b}'  a  physician,  and  usually  consistH  in  thu  use  of  soiue  inloila- 
tion  or  spray. 

Inflammation  of  the  Pharynx.  —  Pharyngitis. 

This  is  an  inflammation  of  the  upper  and  back  part  of  the  throat, 
or  all  that  part  which  can  be  teen  when  the  mouth  is  stretched  open. 
It  causes  a  redness  of  the  mucous  membrane  lining  the  part,  which 
is  deep  in  proportion  to  the  intensity  of  the  inflammation.  This 
complaint  is  generally  connected  with  the  one  I  am  about  to  desciilMi; 
and  since  the  treatment  is  the  same  the  reader  is  referred  to  what 
next  follows. 

Adenoid  Growths. 

In  young  children  a  very  disagreeable  catarrhal  affection  often  ex- 
ists in  the  naso-pharynx  just  behind  and  above  the  uvula.  This  is 
caused  by  continued  catarrh  till  at  last  small  growth's  occur  like 
proud-flesh,  and  not  infrequently  block  up  the  passage  from  the  nose 
to  the  mouth,  to  that  extent  that  not  only  is  loud  snoring  produced  at 
night,  but  breathing  becomes  difficult  by  day.  In  severe  cases  the  njv 
per  jaw  becomes  angular,  and  the  face  assumes  a  peaked,  pinched  look. 
These  growths  are  extremely  common  in  children,  and  are  produc- 
tive of  much  mischief.  The  inability,  in  severe  cases,  to  properly 
breathe  deprives  the  lungs  of  their  proper  amount  of  oxygen,  so  that 
the  little  one  suffers  in  nutrition  and  growth. 

Treatment  consists  in  scraping  away  with  a  scoop,  or  even  with 
the  finger,  these  soft,  granulating  masses.  The  effect  is  almost  mar- 
vellous :  the  child  breathes  quietly,  without  snoring,  the  color  re- 
turns to  the  cheeks,  and  the  blood  receives  a  new  supply  of  food  from 
the  full  supply  of  oxygen.  In  modern  times,  nothing  has  been  in- 
augurated in  the  treatment  of  children's  throat  and  nose  diseases  so 
beneficial  and  happy. 

Clergymen's  Sore  Throat.  —  Follicular  Pharyngitis. 

This  disorder  made  its  appearance  in  this  country  in  1830,  and  the 
attention  of  the  profession  was  first  drawn  to  it,  as  a  distinct  disease, 
in  1832.  Some  have  supposed  its  origin  to  have  had  a  hidden  con- 
nection with  the  epidemic  influenza  which  spread  over  the  civilized 
world  in  1830,  and  affected  all  classes  of  persons ;  but  this  is  only 
conjecture.  In  its  early  developments  it  attracted  notice  chiefly  by 
its  visitations  upon  the  throats  of  the  clergy.  Hence  its  popular 
name  of  Clergymen  s  Sore  Throat.  It  was  soon  found,  however,  to  at- 
tack all  classes  of  persons  indiscriminately,  whether  engaged  in  any 
calling  which  required  a  public  exercise  of  the  voice  or  otherwise.  It 
was  noticed  more  by  public  speakers  and  singers,  on  account  of  the 
greater  inconvenience  it  gave  them. 

The  disease  consists  in  a  chronic  inflammation  of  the  mucous  fol- 


DI8EABBS  OF  THE  THROAT. 


918 


tine  iiilialii- 

igitis. 

tlio  throat, 
tched  open, 
part,  which 
tion.  This 
to  descrilw; 
ed  to  what 


in  often  ex- 
a.  This  is 
occur  like 
ni  the  uose 
iroduced  at 
vses  the  nj)- 
iiched  look, 
ire  produc- 
to  projiprly 
jen,  so  that 

even  with 
ilmost  mar- 
color  re- 
food  from 
been  in- 
Idiseases  so 


wngitis. 

iO,  and  the 
act  disease., 
Idden  con- 
civilized 
kis  is  only 
[chiefly  by 
popular 
Iver,  to  at- 
\d  in  any 
prwise.  It 
it  of  the 


Holes,  or  glands,  connected  with  the  mucous  membrane  which  lines 
the  throat  and  windpipe.  The  ottice  of  these  little  glands  is  to  secrete 
ii  fluid  to  lubricate  the  air  pa.ssages.  When  inflamed,  they  spread  an 
acrid,  irritating  Huid  over  surrounding  part8,  which  excites  inflamma- 
tion in  them.  Hence  a  geneml  inflammation  of  the  upper  [)art  of  the 
throat  or  pharyngitis  usually  attends  the  follicular  diseiwe,  and  I 
shall  speak  of  the  two  together.  This  inflammation  of  the  glands 
and  the  membrane,  being  neglected,  iis  it  generally  is,  lingers  on  from 
month  to  month,  or  from  year  to  year,  making  in  some  cases  slow 
progress,  in  othera  more  rapid,  —  made  a  little  worse  and  its  step 
slightly  quickened  by  every  fresh  cold,  and  finally  results  in  ulcera- 
tion. The  expectoration  thenceforwanl  becomes  puriform,  and  finally 
undistinguishable  from  that  of  consumption,  with  all  the  symptoms 
of  which  the  patient  finally  dies.  Indeed,  l)efore  its  nature  was  un- 
deiTntood  by  the  profession,  it  wiw  considered  the  most  fatal  form  oi 
consumption,  l)ecause  it  could  Ikj  affected  only  in  a  very  small  de- 
gree, if  at  all,  by  medicines  taken  into  the  general  system.  For  the 
milder  cases  one  will  find  great  comfort  in  the  use  of  the  troches  of 
cubebe  and  ammonia,  the  inhalation  of  benzoin  with  steaming  water, 
also  from  such  throat-tablets  as  the  Chloramine. 


Inflammation  of  iVIucous  Membrane  and  Qlands 
of  Larynx.  — '■  Follicular  Laryngitis. 

A  FEW  strong  and  beautifully  formed  cartilages  unite  to  form  a 
curious  and  convenient  box  or  cavity  at  the  top  of  the  windpipe, 
called  the  larynx.  Across  this  enclosure  are  stretched  two  remark- 
able ligaments,  called  the  vocal  cords.  They  are  from  half  to  three 
quarters  of  an  inch  in  length,  and  are  rendered  more  or  less  tense  by 
the  small  muscles  with  which  they  are  connected.  Just  above  these 
cords  are  two  cavities,  which,  with  the  ligaments,  act  an  important 
part  in  the  formation  of  the  voice.  Here  is  produced  the  sound, 
which  is  modified  and  articulated  by  the  tongue,  the  lips,  and  the 
r.i'^al  cavities. 

When  disease  reaches  this  cavity,  and  the  fluid  secreted  to  lubri- 
cate ihese  cords  becomes  acrid,  the  voice,  from  this  and  other  causes, 
is  made  hoarse ;  and  when,  at  length,  these  ligaments  are  altered  in 
structure  by  inflammation  and  ulceration,  the  voice  suffers  a  gradual 
extinction.  I  haro  treated  a  large  number  suffering  entire  loss  of 
voice,  and  am  happy  to  say  it  has  been  generally  restored,  where  the 
lungs  have  not  been  involved  in  the  disease,  '^here  is  often  also  a 
little  sensitiveness,  or  even  soreness,  in  some  cases,  in  the  region  of 
the  larynx,  which  may  be  felt  by  pressing  upon  that  prominence  in 
front  of  the  throat,  called  Adam's  apple. 


icous  fol- 


214 


DI8RA8R8  OF  TIIK  THROAT. 


t^ 


Inflammation  in  the  Windpipe.—  Tracheitis. 

This  complaint  and  the  one  preceding  it  differ  only  in  their  local- 
ity  from  those  deHcribed  in  the  upper  cavities  ;  and  they  are  more 
alarming,  IwcauHc  two  removes  nearer  the  citadel  of  life.  Happily, 
we  know  that  the  seat  of  these  diseases  may  be  easily  reached,  and 
we  have  a  shower  syringe,  so  arranged  as  to  pour  the  remedial  i.gent 
directly  upon  them,  without  any  loceniting  disturbance  of  the  parts. 

Symptoms. —  The  approach  of  these  disorder  is  often  so  insidious 
as  hardly  to  attract  notice, — sometimes  for. months,  or  even  yeans, 
giving  no  other  evidence  of  their  presence  than  the  annoyance  of 
something  in  the  throat  to  be  swallowed  or  hawked  up, —  an  increased 
secretion  of  mucus,  and  a  sense  of  wearisomeness  and  loss  of  power  in 
the  throat,  after  public  speaking,  singing,  or  reading  aloud.  At 
length,  upon  the  taking  of  a  severe  cold,  the  prevalence  of  an  epi- 
demic influenza,  or  of  an  unexplained  tendency  of  disease  to  the  air- 
passages  and  lungs,  the  throat  of  the  patient  suddenly  becomes  sore, 
its  secretions  are  increased  and  rendered  more  viscid,  the  voice  grows 
hoarse,  the  difficulty  of  speaking  is  aggravated,  and  what  was  only 
an  annoyance  becomes  an  affliction,  and  a  source  of  alarm  and  dan- 
ger. These  diseases  clearly  belong  to  the  family  of  consumption,  and 
need  early  attention. 

Causes. —  It  is  amusing  to  reflect  upon  the  theories  which  writers 
were  in  the  habit  of  constructing,  a  few  years  since,  to  account  for 
the  throat  affection  among  the  clergy.  It  was  attributed  by  some  to 
speaking  too  often,  by  others  to  speaking  too  loud.  One  class  of 
writers  thought  it  arose  from  muffling  the  neck ;  another,  from  a 
strain  of  voice  on  the  Sabbath  to  which  it  wajs  not  accustomed  on 
other  days. 

The  cause  lies  deeper  than  any  of  these  trifling  things.  As  it  con- 
cerns ministers  it  may  generally  be  expressed  in  two  words,  —  labor, 
anxiety. 

The  clerical  order  are  placed  just  where  they  feel  the  force  of  the 
high-pressure  movements  of  the  age.  They  are  the  only  class  of 
recognized  ingtructors  of  adult  men,  and  are  obliged  to  make  great 
exertions  to  meet  the  wanta  of  their  position.  The  extremely  trying 
circumstances  in  which  they  are  often  placed,  too,  in  these  exciting 
times,  by  questions  which  arise  and  threaten  to  rupture  and  destroy 
their  parishes,  weigh  heavily  upon  their  spirits,  and  greatly  depress 
the  vital  powers.  And  when  we  add  to  this  the  fickle  state  of  the 
public  mind,  and  often  the  shifting,  fugitive  character  of  a  clergy- 
man's dwelling  place,  and  the  consequent  liability  to  poverty  and  want 
to  which  himself  and  family  are  exposed,  we  have  a  list  of  depressing 
causes  powerfully  predisposing  to  any  form  of  disease  which  may 
prevail. 


niSEASEB   OF  THE   THROAT 


216 


heitis. 

their  looal- 
y  are  more 
Happily, 
cached,  and 
ledial  i.gent 
f  tlie  parts. 

so  insidiouH 
even  years, 
noyance  of 
bii  increased 
of  power  ill 
vloud.  At 
I  of  an  epi- 
I  to  the  air- 
comes  sore, 
voice  grows 
it  was  only 
n  and  dan- 
[uption,  and 

lich  writers 
iccount  for 
by  some  to 

e  class  of 
ler,  from  a 

tomed  on 

I  As  it  con- 
3,  —  labor, 

|rce  of  the 
class  of 
[ake  great 
|ely  trying 
exciting 
Id  destroy 
ly  depress 
Ite  of  the 
la  clergy- 
land  want 
Bpressing 
lich  may 


It  will  Im)  pardoned  me,  I  think,  if  I  Kuggest  here,  that  tho  nature 
of  a  clergyman's  calling  is  of  so  serioiiH  a  eh.  \ctor,  that  ho  some- 
times  (;arri(!H  himself  with  too  much  Hcdateness,  keeps  himself  too 
much  braced  up,  and  does  not  allow  himself  hours  enough  of  that 
cheerful,  light-hearted  abandon,  which  is  essential  to  the  health  of 
every  sedentary  man  of  mental  habits.  The  hard-thinking  and  hard- 
working minister,  who  will  retain  his  health  and  save  his  throat,  must 
have  some  moments,  at  UniHt,  when  the  weighty  responsibilities  of  his 
oJfice  are  lifted  up  from  his  soul,  and  he  becomes,  for  the  hour,  the 
jocund,  playful  boy  of  earlier  days.  How  far  he  can  consistently  re- 
lax and  let  himself  down,  or  in  my  view  of  the  matter,  raise  himself 
up  to  the  simplicity  and  mirth  of  childhood,  he  alone  can  be  the  judge. 
As  a  physician,  I  prescribe ;  as  a  minister,  he  must  decide  how  far 
my  prescription  can  be  followed. 

Reading  Sermons. —  There  is  one  practice,  which,  though  it  has 
not  much  to  do  with  inducing  this  disease,  does  frequently  aggravate 
it  when  once  established  ;  I  mean  the  habit  of  reading  sermons  from 
manuscripts,  —  especially  when  it  is  done  in  a  sort  of  mechanical 
way.  Every  person  who  has  suffered  from  throat-ail  has  doubtless 
noticed  that  to  read  aloud,  for  half  an  hour,  from  a  book,  occasions 
more  fatigue  and  irritation  in  the  throat  than  extemporaneous  speak- 
ing, in  the  same  tones,  for  one  or  two  hours.  The  reason  is,  that  in 
the  latter  case  the  mind  conceives  the  thought  in  season  for  the  or- 
gans of  speech  to  fall  into  a  natural  attitude,  and  utter  it  with  ease. 
The  two  work  hannoniously  together, —  the  instruments  of  articula- 
tion following  the  mind,  and  easily  and  naturally  uttering  its  concepn 
tions.  Whereas  in  the  case  of  reading,  the  mind  itself  is,  at  least 
partially,  ignorant  of  what  is  coming  until  it  is  just  upon  it,  so  that 
the  organs  of  speech,  being  warned  of  what  is  to  be  done  only  at  the 
moment  their  service  is  required,  do  their  work  under  a  perpetual 
surprise  and  constraint.  The  difference  is,  in  some  respects,  like  that 
between  walking  freely  at  large,  without  regard  to  where  the  feet  are 
put  down,  and  being  obliged  to  step  exactly  in  the  footprints  of  some 
traveller  who  has  gone  before.  In  the  latter  case,  the  muscles  tire 
much  sooner,  because  they  work  in  fetters. 

I  have  thus  spoken  particularly  of  the  clergy,  though  it  is  not  by 
any  means  they  only,  but  all  classes  Oi  people  who  are  afflicted  with 
tliis  dangerous  malady. 

These  diseases  often  begin  with  a  cold.  But  colds  are  seldom  taken 
except  when  the  nervris  system  is  depressed,  so  that  they  are,  in  fact, 
to  be  traced  back  to  the  same  cause  which  I  have  assigned  to  catar- 
rhal or  throat  complaints  themselves. 

These  Complaints  Worse  at  Night. —  It  is  worthy  of  note,  that  all 
these  complaints,  and  many  others,  are  worse  during  the  night.  This 
is  easily  explained  when  we  remember  that  the  atmosphere  has  the 
least  amount  of  electricity  in  it  at  three  o'clock  in  the  morning,  and 
that  the  first  minimum  atmospheric  pressure,  which  happens  twice  a 


I 


216 


DISEA8K8   OF   THE   THROAT. 


day,  occurs  not  far  from  the  same  hour.  From  three  to  four  in.  thr 
mom'.ng,  therefore,  the  nerve-power  sinks  to  its  lowest  ebb;  and  those 
diseases  which  owe  their  existence  to  anxiety,  overwork,  etc.,  suffer, 
at  this  time,  their  greatest  daily  aggravation.  Death  occura,  too,  more 
often  during  these  hours,  than  in  any  other  poi-tion  of  the  twenty- 
four. 

Treatment. —  Some  years  ago  these  diseases  were  thought  to  be 
incurable ;  and  by  all  the  appliances  of  medical  art  then  known,  they 
were  so.  But  time  has  brought  a  successful  method  of  treatment,  as 
well  as  a  clearer  knowledge  of  their  nature. 

This  treatment  consists  in  what  is  called  topical  medication,  or  the 
applying  of  the  medicine  directly  to  the  diseased  part.  The  medici- 
nal agent  more  extensively  used  than  any  other  is  a  solution  of  crys- 
tals of  nitrate  of  silver.  This  substance  is  not,  however,  adapted  to 
every  case, —  other  articles  succeeding  better  in  some  instances.  Mod- 
ern chemistry  has  given  us  a  variety  of  agents  from  which  the  skilful 
physician  may  select  a  substitute,  should  the  nitrate  of  silver  fail. 

The  operation  of  appljdng  this  and  other  substances  to  the  air  pas- 
sages, is  a  delicate  one,  requiring  tact  and  experience.  Surgeons  had 
supposed  it  an  anatomical  impossibility  to  introduce  an  instrument 
into  the  larynx  ;  but  this  has  been  practically  demonstrated  to  be  a 
great  mistake. 

Instruments. —  The  instrument  devised  and  used  by  Dr.  Horace 
Green  is  a  piece  of  whalebone,  bent  at  one  end,  to  which  is  attached 
a  small,  round  piece  of  sponge.  This,  dipped  in  the  solution,  is  dex- 
terously introduced  into  the  laryngeal  cavity,  and  applied  directly  to 
the  diseased  part. 

I  formerly  used  this  instrument  myseK,  and  am  happy  to  know, 
that,  notwithstanding  its  defects,  it  was  generally  successful.  Yet 
where  the  larynx  was  highly  inflamed,  with  a  swollen  and  ulcerated 
condition  o*.  the  epiglottis  and  lips  of  the  glottis,  I  am  sure  I  some- 
times had  the  singular  powers  of  the  nitrate  of  silver  put  at  defiance 
by  an  irritation  evidently  produced  by  the  eponge  of  the  probang. 
Upon  its  introduction,  in  such  cases,  the  parts  contract  upon  and 
cling  to  it,  and  suffer  aggravated  irritation,  almost  laceration,  upon 
its  withdrawal,  however  carefully  effected. 

Laryngeal  Shower  Syringe. —  Such  defects  in  the  probang  led  me 
to  contrive  an  instrument,  which  I  call  a  Laryngeal  Shower  Syringe. 
It  is  in  the  form  of  a  syringe,  the  barrel  and  piston  of  which  are 
made  of  glass,  silver,  or  gold,  as  may  be  desired.  To  this  is  attached 
a  small  tube,  made  of  silver  or  gold,  long  enough  to  reach  and  enter 
the  throat,  and  bent  like  a  prolong,  with  a  globe  or  bulb  at  the  end, 
from  a  quarter  to  a  third  of  an  inch  in  diameter,  pierced  with  very 
minute  holes,  which  cover  a  zone  around  the  centre  about  one-third 
of  an  inch  in  breadth. 

This  silver  bulb  I  daily  introduce  into  highly  inflamed  and  ulcer- 


DISEASES  OF   THB   THROAT. 


217 


'  four  ill  til,' 
<;  and  thoso 
,  etc.,  suffer, 
irs,  too,  more 
the  twenty- 
ought  to  be 
known,  they 
treatment,  as 

jation,  or  the 
The  medici- 
ition  of  crys- 
r,  adapted  to 
ances.  Mod- 
h  the  skilful 
ilver  fail. 
)  the  air  pas- 
Surgeons  had 
1  instrument 
ited  to  be  a 

r  Dr.  Horace 
ii  is  attached 
ition,  is  dex- 
d  directly  to 

)y  to  know, 
jssful.  Yet 
id  ulcerated 
lure  I  some- 

at  defiance 
le  probang. 
It  upon  and 

ition,  upon 

ing  led  me 
\er  Syringe. 

which  are 
lis  attached 

and  enter 
}.t  the  end, 

with  very 

one-third 

land  ulcer- 


ated larynges,  generally  without  any  knowledge  of  its  presence  on 
the  part  of  the  patient,  until  the  contained  solution  is  discharged. 
The  instrument,  being  charged,  is  carried  to  the  proper  place,  when  a 
delicately  quick  pressure  upon  the  piston  causes  veiy  fine  streams  to 
flow  through  the  holes  in  the  form  of  a  delicate  shower,  and  all  sides 
of  the  walls  of  the  larynx  are  instantaneously  bathed. 

How  Introduced. —  The  introduction  of  this  instrument  into  the 
larynx  is  easy.  Upon  the  approach  of  any  foreign  substance,  the  epi- 
glottis instinctively  drops  down  upon  the  entrance  to  the  larynx, 
guarding  it  against  improper  intrusions.  It  has  been  found,  however, 
that  when  the  root  of  the  tongue  is  firmly  depressed,  this  cartilage 
cannot  obey  its  instinct,  but  stands  erect,  its  upper  edge  generally  ris- 
ing into  view.  Availing  himself  of  this,  the  surgeon  has  only  to  de- 
press the  tongue  with  a  spatula,  bent  at  right  angles,  so  that  the  left 
hand  holding  it  may  drop  below  the  chin  out  of  the  way,  and  as  the 
epiglottis  rises  to  view,  slip  the  ball  of  the  instrument  over  its  upper 
edge,  and  then  with  a  quick  yet  gentle  motion,  carry  it  dovmward  and 
forward,  and  the  entrance  is  made.  I  have  often  admired  the  faith- 
fulness of  this  epiglottic  sentinel,  who,  when  overborne  by  superior 
force,  stands  bolt  upright,  and  compels  us  to  enter  the  Sacred  temple  of 
speech  directly  over  his  head  ! 

Pharyngeal  Shower  Syringe. —  For  washing  the  upper  part  of  the 
throat,  I  construct  the  instrument  with  a  straight  tube,  with  holes 
over  the  outer  end  of  the  globe,  and  extending  to  the  centre.  This 
washes  instantaneously  the  fauces  and  pharynx,  but  does  not  throw 
the  solution  back  upon  the  tongue.  Its  main  advantage  over  the 
probang  is,  that  it  Imthes  every  part  of  the  fauces  and  pharynx  in- 
stantaneously, and  does  not  subject  the  patient  to  the  coughing  and 
gagging  which  follow  the  slower  and  rougher  process  of  drawing  the 
sponge  from  side  to  side  across  the  cavity  of  the  throat. 

Nasal  5hower  Syringe. —  Inflammations  in  the  back  passages  to 
the  nose,  called  catarrh  in  the  head,  have  been  almost  inaccessible  by 
any  reliable  healing  agent,  and  consequently  incurable.  The  probang 
could  only  reach  a  short  distance,  and  occasioned  great  suffering.  I 
have  had  a  syringe  constructed  with  the  tube  bent  at  an  angle  of 
forty-five  degrees,  and  the  ^lobe,  very  small,  pierced  with  a  few  fine 
holes  at  the  upper  end.  Carrjang  this  globe  up  behind  the  velum 
palati,  with  a  single  injection  I  wash  both  passages  clear  throu  gh.  I 
have  had  the  pleasure  of  curing  a  large  number  of  bad  cases,  of  many 
years'  standing,  to  the  surprise  and  delight  of  the  patients. 

About  nineteen-twentieths  of  the  physicians  who  have  examined 
these  instruments,  and  so  far  as  my  knowledge  extends,  all  who  have 
used  them,  think  them  much  better  than  the  probang.  As  to  patients, 
I  have  yet  to  see  one  who  will  allow  the  sponge  to  be  used  after  try- 
ing both. 

Have  Superseded  the  Probang. —  In  my  own  practice  the  syringes 


■onti 


mmmm 


218 


DISEASES   OF  THE  THROAT. 


have  superseded  the  probang  altogether.  My  reasons  may  be  briefly 
stated.  I  have  already  said  there  is  less  irritation  produced.  A  piece 
of  sponge  drawn  over  an  inflamed  surface,  especially  when  clung  to 
by  the  irritated  and  quivering  paits,  mast  necessarily,  in  some  cases 
at  least,  aggravate  the  symptoms  of  disease.  To  tliis  consideration 
add  the  comfort  of  the  patient  during  the  operation.  It  is  so  quickly 
and  delicately  done  with  the  syringe,  that  it  is  scarcely  known  when 
tiie  act  is  performed.  The  straight  syringe  does  not  touch  the  throat 
at  all.  On  touching  the  probang  to  the  throat,  the  nitrate  of  silver 
unites  with  the  mucus  upon  the  surface,  instantly  covering  the  sponge 
with  an  albuminous  pellicle,  something  like  that  which  lines  the  shell 
of  an  Q^g,  preventing,  in  a  degree,  the  further  pressing  out  of  the 
solution,  and  rendering  its  contacts  with  other  parts  of  the  surface 
comparatively  powerless.  For  this  reason,  the  sponge  pushed  down 
into  an  ulcerated  bronchus,  as  Dr.  Green  recommended,  must  be  ut- 
terly valueless  as  a  remedial  agent.  Mopping,  as  it  does  in  its  whole 
course,  a  larynx  and  trachea,  lined  in  some  cases  with  puriform  niat> 
ter,  and  generally  with  mucus,  every  inch  of  its  descent  doubles  the 
gravity  of  this  objection.  Let  it  be  considered,  too,  that  in  applying 
the  remedy  to  an  ulcerated  larj'nx,  the  sponge  cauterizes  the  healthy 
parts  above,  in  its  descent,  and  thus  unfits  itself  lor  doing  much  for 
the  diseased  part ;  whereas  the  syringe  retains  its  solution  till  it 
reaches  the  affected  place,  and  then  pours  a  clean  shower  directly 
upon  it,  and  upon  no  other  part. 

Considering  these  manifest  advantages  of  the  syringes,  I  am  sur- 
prised that  any  physician  should  still  use  the  probang, —  especially  as 
one  of  these  instruments,  the  Nasal  Syringe,  accomplishes  an  object 
which  the  probang  cannot  effect  at  all,  not  even  in  a  rough  way.  I 
have  wondered,  too,  how  any  parent  can  allow  a  child,  suffering  with 
croup,  to  be  tormented  by  having  a  sponge  pushed  down  its  throat, 
when  a  syringe  would  give  it  so  much  less  pain. 

I  will  mention  briefly  one  or  two  cases  of  croup  and  diphtheria,  se- 
lected from  a  great  number  treated  by  me  for  the  last  few  years,  where 
the  syringes  were  successfully  used,  after  several  attempts  to  use  the 
probang  had  been  made,  and  failed,  and  where  the  pain  caused  by 
using  was  so  small,  and  the  relief  so  instantaneous  and  complete,  that 
the  patients  were  anxious  for  my  return  to  use  it  again. 

I  was  called  to  see  a  little  boy  of  Mr.  R.,  five  years  old,  who  had 
had  an  attack  of  membranous  croup  some  days  previous ;  and  when 
I  saw  him  the  voice  had  sunk  to  a  whisper,  and  the  cough  was  en- 
tirely muffled,  so  that  I  had  no  doubt  of  the  fatal  termination  of  the 
case,  and  expressed  my  opinion  to  that  effect  to  the  astonished  parents. 
The  probang  had  been  used  by  the  physician  in  attendance,  which 
had  caused  so  much  suffering  that  for  the  two  days  previous  the  par- 
ents had  prohibited  its  use.  It  had  no  doubt  increased  the  irritation, 
besides  nearly  causing  strangulation. 

It  was,  therefore,  with  great  reluctance  that  they  consented  to  let 


DISEASES  OP  THE  THROAT. 


219 


I  to  let 


me  use  the  syringe,  which  I  did,  to  the  great  relief  of  the  little  suf- 
ferer, and  to  the  entire  satisfaction  of  the  parents. 

The  strength  of  the  solution  of  the  crjrstals  of  the  nitrate  of  silver 
used  was  20  grains  to  the  ounce  of  water,  which  I  injected  freely, 
once  in  three  hours  for  the  first  day,  and  then  two  or  thi-ee  times  a 
day  for  two  or  three  days.     His  recovery  was  rapid  and  complete. 

I  will  now  mention  the  case  of  a  young  woman,  with  diphtheria, 
where  the  syringe  was  used  with  success. 

I  was  called  to  see  a  young  lady,  who  had  an  attack  of  diphtheria 
the  day  previous.  Found  her  in  bed,  very  much  prostrated,  breath- 
ing with  great  difficulty,  and  uttering  at  every  inspiration  a  croupal 
sound,  which  at  times  was  followed  by  a  short,  convulsive  cough. 
The  face  was  flushed,  pulse  124,  small  and  feeble,  and  she  complained 
constantly  of  a  sense  of  suffocation  and  of  great  distress  in  the  lar- 
yngeal region. 

On  inspecting  the  throat,  the  fauces  and  the  pharyngeal  mem- 
brane, as  far  down  as  it  could  be  seen,  presented  the  appearance  of  a 
high  degree  of  inflammation.  One  of  the  tonsils  was  nearly  covered 
with  the  diphtheric  membrane,  and  the  upper  and  back  part  of  the 
throat  were  thickly  studded  with  small  white  or  cream-colored  spots. 

The  physician  in  attendance  had  tried  first  a  swab,  or  mop,  as  she 
termed  it,  and  then  the  probang,  which  gave  her  so  much  pain  that 
he  was  obliged  to  give  it  up.  He  then  gave  up  the  case  as  hopeless. 
At  my  earnest  solicitation  she  consented  to  the  use  of  the  syringe. 
With  a  solution  of  the  crystals  of  the  nitrate  of  silver,  of  the  strength 
of  60  grains  to  the  ounce  of  water,  I  injected  freely  the  fauces  and 
the  upper  part  of  the  cavity  of  the  larynx.  For  a  few  moments  the 
difficulty  of  breathing  and  feeling  of  strangulation  was  increased, 
but  very  soon  a  large  amount  of  viscid,  ropy  mucus  was  discharged. 
In  the  course  of  half  an  hour  after  the  use  of  the  syringe,  the  symp- 
toms had  improved,  the  respira- 
tion was  less  laborious,  so  that 
in  a  short  time  the  patient  ob- 
tained some  sleep.  I  was  after- 
ward called,  aa  she  thought  her- 
self worse,  but  found  that  an 
application  of  the  caustic  with  a  syringe  was  all  that  was  required. 
There  was  no  further  trouble  with  the  case. 

These  syringpo  or  similar  ones  can  now  be  bought  of  any  large 
dealer  in  surgic-.i  i.istruments.  Figure  87  represents  the  syringes  as 
they  lie  in  a  case. 

Mode  of  Using. — The  glass  barrel  and  piston  of  my  instruments 
are  delicate,  but  they  ueed  not  be  broken.  I  handle  them  with  the 
same  east,  that  I  do  a  spoon  in  feeding  myself,  and  not  in  a  very  dis- 
similar wfvy.  The  Ir^st  three  fingers  are  placed  on  the  under  side  of 
tlie  barrel,  with  the  thumb  on  the  upper  side,  —  the  index  finger  be- 
ing poised  over  the  end  of  the  piston,  ready  to  drive  it  home  at  the 


rio.  87. 


.  rrM«iiaHCKMMP« 


220 


DISEASES   OF   THE   THROAT. 


V    \ 


proper  instant.  The  motion  of  the  piston  should  be  quick,  so  as  to 
cause  the  streams  to  leap  out  in  jets ;  yet  delicate,  that  they  may  not 
impinge  with  too  much  force  upon  the  diseased  surfaces. 

They  should  be  rinsed  with  water  immediately  after  being  used. 
But  even  with  this  precaution,  a  small  residuum  of  the  nitrate  re- 
mains and  crystallizes,  and  after  a  time  partially  closes  the  holes. 
They  must  then  be  picked  out  with  the  point  of  a  needle. 

When  the  silver  tube  becomes  detsvched  from  the  glass,  it  may  be 
fastened  on  with  common  sealing  wax  ;  first  melting  the  wax  and 
sticking  it  around  the  glass;  then  heatirg  the  silver  over  a  lamp,  and 
pressing  it  on. 

Amount  of  Solution  to  be  Used.  — The  amount  of  solution  to  be 
used  should  be  small.  Half  a  dram  is  enough.  The  piston  of  the 
syringe  need  be  drawn  up  only  from  an  eighth  to  a  third  of  an 
inch.  Strangling  is  not  often  produced  by  these  operations  ;  but  to 
make  its  prevention  still  more  sure,  let  the  patient  be  directed  to  fill 
the  lungs  with  a  long  inspiration  while  the  operator  is  depressing  the 
tongue. 

Strength  of  Solution.  —  The  strength  of  the  solution  in  ordinary 
cases  of  chronic  folliculitis,  etc.,  should  generally  be  about  forty 
grains  of  the  crystals  of  the  nitrate  of  silver  to  the  ounce  of  water. 
But  in  all  acute  diseases  of  the  air  passages,  it  should  be  considerably 
stronger,  —  varying  from  one  to  two  drams.  A  preparation  of  this 
strength  is  powerfully  antiphlogistic  and  sedative.  In  those  cases  of 
chronic  disease,  where  the  inflammation  is  of  a  low  grade,  and  the 
mucous  membrane  is  in  a  relaxed,  atonic  condition,  looking  either 
sodden  and  pale,  or  of  a  dark  color,  like  the  cut  surface  of  beef  some 
days  exposed  to  the  air  (as  is  often  the  case  in  throats  of  literary  dys- 
peptics), then  a  solution  of  fifteen  to  thirty  grains  to  the  ounce  is 
sufficient.  This  strength  acts  as  a  stimulant,  and  is  well  suited  to 
throats  in  such  condition,  but  would  be  injurious  in  high  grades  of 
inflammation.  Catarrh  in  the  head  generally  requires  only  about  this 
strength.  I  am  sorry  to  say,  the  topical  mode  of  treating  throat  affec- 
tions has  been  in  some  places  injured,  in  the  public  estimation,  by  a 
lack  of  knowledge  and  judgment  on  the  part  of  the  operator,  in 
choosing  the  strength  of  his  solution. 

To  determine  the  proper  frequency  of  the  operation,  also  requires 
judgment  and  experience.  In  an  ordinary  case  of  chronic  disease, 
the  treatment  may  begin  by  showering  the  throat  once  a  day  for  a 
week.  Then  the  operation  should  be  repeated  three  times  a  week,  for 
a  shorter  or  longer  period  ;  then  twice  a  week,  and  at  last  once  a  week. 

Attendant  Diseases. —  Among  the  persons  I  am  treating  for  dis- 
eases of  the  air  passages,  many  are  dyspeptic  and  suffer  with  depres- 
sion of  spirits.  So  often  doea  this  symptom  present  itself  that  I  re- 
gard it  as  almost  one  of  the  peculiarities  of  throat  disease.  Persons 
thus  depressed  generally  have  the  dark  and  dingy  look  of  the  face 
which  indicates  functional  derangement  of  the  liver.     They  are  often 


DISEASES  OF  THE   THROAT. 


221 


emaciated,  nervous,  hypochondriacal,  irritable  in  temper,  and  are  ex- 
hausted by  an  excessive  secretion  of  urea.  The  urine  of  such  per- 
sons is  always  acid,  and  loaded  with  crystals  of  oxalate  of  lime. 

An  explanation  of  this  fact  has  been  attempted,  by  supposing  that 
the  oxydation  of  carbon  (of  which  these  persons  have  a  superabun- 
dance), imperfectly  accomplished  in  inflamed  respiratory  organs,  is 
vicariously  effected  in  the  capillaries  of  the  kidneys, —  oxalic  acid 
(C2O2)  instead  of  carbonic  acid  (COj)  being  the  result. 

The  crystals  of  oxalate  of  lime  are  octahedral  in  form,  .d,  in  the 
field  of  a  good  microscope,  are  beautiful  objects  for  inspection. 

Lawyera,  clerygmen,  statesmen,  and,  in  general,  those  who  labor 
hard  mentally,  with  but  little  bodily  exercise,  and  who  have  a  great 
weight  of  care  resting  on  them,  are  the  persons  who  suffer  most  from 
this  complication.  Generally  the  inflammation  in  the  throat  is  of  a 
low  grade,  and  must  not  be  treated  with  a  very  strong  solution  of  ni- 
trate of  silver. 

Of  course  when  these  attendant  diseases  exist,  something  more  is 
needed  than  the  local  treatment.  For  the  troubles  just  described,  the 
treatment  for  hypochondria  and  dyspepsia  will  be  proper. 

Elongation  of  the  Uvula. 

The  uvula  is  the  small  teat-like  or 
pendulous  orptn  which  hangs  down 
from  the  palatine  arch,  just  over  the 
root  of  the  tongue.  It  is  very  apt  to 
get  inflamed,  and  its  parts  becoming  re- 
laxed, it  stretches  out  lengthwise,  so 
that  its  lower  extremity  sometimes  rests 
upon  the  tongue.  (Fig.  88.)  When 
this  happens,  it  flaps  about,  backward 
and  forward,  and  to  the  right  and  left, 
— touching  the  throat  at  various  points, 
and  by  the  tickling  sensation  produced, 
exciting  a  most  incessant,  uncontroll- 
able, and  racking  cough.  Some  of  the 
most  distressing  coughs  I  have  ever 
heard  have  been  produced  and  kept  up 
by  this  cause  alone.  Many  a  fatal  con- 
sumption has  begun  in  this  way.  When 
long  inflamed,  it  often  gets  much  out 
of  shape,  being  sometimes  bent  nearly 
double. 

Treatment.  —  In  some  cases,  the 
uvula,  thus  elongated,  may  be  reduced 
back  to  its  natural  size,  by  an  astrin- 
gent gargle,  composed  of  an  infusion  of 
white-oak  bark,  with  a  little  alum  dis- 


FlO.  88. 


-JP 


222 


DISEASES   OF  THE   THROAT. 


solved  in  it  (282) ;  but  it  will  generally  stretch  out  again  and  again, 
upon  the  appearance  of  any  fresh  cold,  and,  therefore,  the  only  certain 
cure  is  to  cut  it  off. 

To  do  this,  take  hold  of  it  with  a  pair  of  common  forceps,  and 
having  stretched  it  down  a  little,  clip  it  off  above  the  forceps,  with  a 
pair  of  curved  scissors.  Nearly  the  whole  of  it  should  generally  be 
removed.  To  take  off  a  part  only  leaves  a  stump,  which  is  often 
more  objectionable  than  the  whole  organ.  Its  removal  never  injures 
the  speech  in  the  least.  In  many  cases  of  nasal  catarrh,  this  organ 
is  a  sort  of  diseased  centre,  from  which  inflammatory  action  spreads 
upward  into  the  nasal  cavities,  and  no  medicine  or  power  on  earth 
can  effect  a  cure  until  this  offending  member  is  snipped  off. 

Acute  Inflammation  of  the  Tonsils.  —  Tonsilitis. 

The  tonsils  are  chiefly  a  collection  or  mass  of  small  mucous  folli- 
cles or  glands.  They  secrete  a  portion  of  the  fluid  which  keeps  the 
throat  moist. 

There  is  a  class  of  persons  who  suffer  about  every  winter,  some- 
times oftener,  with  an  attack  of  acute  inflammation  of  these  glands, 
which  causes  gioat  suffering  for  several  days.  The  trouble  usually 
is  ushered  in  by  high  fever,  backache,  headache  and  often  by  chills ; 
the  temperature  often  reaches  to  103°  and  104°  F. ;  swallowing  is 
difficult  on  account  of  the  swollen  glands,  while  pain  in  the  ear  is 
not  infrequent.  The  tonsils  are  at  first  swollen,  reddened  and  in- 
flamed ;  later  a  whitish  patch  of  secretion  forms  on  the  surface  of 
the  gland  and  is  distinguished  from  that  of  diphtheria  by  being 
whiter  and  less  tenacious;  if  removed,  the  underlying  surf ao 3  does 
not  bleed  as  in  the  case  of  diphtheria.  It  is,  however,  very  difficult, 
at  times,  to  distinguish  between  the  two  diseases  at  first. 

Another  form  of  Tonsilitis  occurs  without  patches,  and  is  in 
reality  an  inflammation  of  the  substance  of  the  gland  itself.  This 
variety,  often  called  Quinsy,  goes  on  developing  into  an  abscess,  the 
anterior  pillar  of  the  fauces  becomes  intensely  red,  swollen  and 
shiny. 

Treatment.  —  For  the  more  common  variety  some  antipyretic  to 
reduce  the  fever  and  allay  the  intense  aching  of  the  head  and  bones 
is  properly  indicated.  For  this  purpose  10  grains  of  Phenacetine 
(for  an  adult),  repeated  every  two  to  four  hours  according  to  the 
effect  produced,  is  quite  efiicacious.  Ammonol  in  same  dose  may 
also  be  used.  Some  simple  astringent  and  soothing  gargle  will  next 
be  found  to  render  signal  relief.  Tannin,  30  gr.,  strong  Carbolic 
Acid  (96%),  30  drops,  Glycerin,  1  oz.,  and  peppermint  water,  3  oz.,  is 
an  admirable  gargle  for  the  average  case :  this  should  be  used  hourly. 

Equal  parts  of  Glycerin,  Alcohol  and  Water  makes  a  very  sooth- 
ing gargle,  while  equal  parts  of  Peroxide  of  Hydrogen  and  Water  is 
preferred  by  many.  The  diet  should  be  limited  in  amount  and  con- 
sist only  of  liquids. 


'  rK'l 


DISEASES   OF  THE   THROAT. 


223 


md  again, 
ly  certain 

:ceps,  and 
ps,  with  a 
lie  rally  be 
1  is  often 
er  injures 
ihis  organ 
»n  spreads 
on  eartii 


.silitis. 

C0U8  foUi- 
keeps  the 

ter,  some- 
se  glands, 
le  usually 

by  chills; 
lowing  is 
the  ear  is 
id  and  in- 
surface  of 

by  being 
rfao3  does 
r  difficult, 

and  is  in 
If.  This 
scess,  the 
)llen  and 


)yretic  to 

md  bones 

lenacetine 

ig  to  the 

lose  may 

Iwill  next 

Carbolic 

3  oz.,  is 

hourly. 

by  sooth- 

I  Water  is 

and  con- 


The  second  variety,  tending  to  pus  formation,  is  to  be  treated  sur- 
gically by  first  applying  a  solution  of  cocaine  and  lancing.  The 
relief  resulting  from  evacuating  the  pus  is  immediate. 

It  has  been  found  that  Tonsilitis  is  apt  to  be  recurrent  and  that 
he  who  has  suffered  once  is  very  prone  to  have  one  or  more  attacks 
annually  thereafter.  This  class  requires  constitutional  treatment  in 
the  intervals  as  outlined  below. 

These  inflammations  are  likewise  found  to  be  an  expression  often- 
times of  rheumatism,  and  need  corresponding  treatment.  But  the 
only  cure  is  to  be  found  by  cutting  off  the  tonsils,  after  the  inflam- 
mation has  subsided.     This  will  put  an  end  to  the  attacks  at  once. 

Tonsils  which  are  subject  to  these  periodical  attacks  of  acute  in- 
flammation are  always  more  difficult  than  others  to  operate  ujion,  as 
they  are  almost  invariably  bound  down  very  tight  to  the  throat,  and 
cannot  be  raised  up  for  convenient  excision. 

Chronic  Inflammation  of  the  Tonsils. 

In  many  of  the  follicular  diseases  of  the  throat,  these  glands  are 
affected  by  a  chronic  inflammation,  and  are  found  enlarged,  and 
sometimes  very  much  hardened.  In  such  cases  they  secrete  a  thin, 
unhealthy,  irritating  fluid,  which  is  spread  over  the  throat,  increasing 
and  perpetuating  its  disease.  Much  of  this  secretion  finds  its  way 
into  the  stomach,  and  thence  into  the  circulation. 

In  the  throats  of  many  young  persons  and  children,  these  glands 
are  permanently  so  large  as  nearly  to  fill  the  fauces.  The  respiration 
of  many  children  thus  afflicted  is  difficult,  and  when  asleep  they  can 
only  breathe  with  the  mouth  open.  The  defective  breathing  of  such 
children  often  occasions  contractions  of  the  chest,  and  thus  lays  the 
foundation  for  consumption.  From  these  diseased  parts,  the  inflam- 
mation often  spreads  upwards,  into  the  posterior  nares,  and  many 
times  entei-s  the  eustachain  tubes,  causing  deafness  or  pain  in  the  ears. 
Such  children  often  breathe  as  though  they  had  a  bad  cold  in  the 
head.  Their  health  and  safety  require  an  immediate  attention  to 
this  state  of  things. 

Chronic  inflammation  of  the  tonsil,  likewise  the  recui-rent  acute 
form,  may  be  dependent  on  poor  blood  or  rheumatism.  Those  causes 
are  met  by  blood-building  medicines  like  Syrup  of  the  Iodide  of  Iron 
in  10-drop  doses  three  times  daily,  cod  liver  oil,  and  by  some  one  of 
the  many  preparations  of  iron,  arsenic,  and  strychnia  combinations. 
It  is  found  that  genemlly  the  excision  of  the  tonsil  may  be  averted 
by  visiting  the  surgeon,  who  will  hunt  out  the  little  crypts  or  holes 
with  which  the  gland  is  studded,  and  by  gently  cutting  the  narrow 
bridges  which  separate  these  holes,  destroy  these  cavities.  These 
little  holes  retain  small  particles  of  food  and  decomposed  secretion, 
which  after  a  while,  if  allowed  to  remain,  set  up  a  follicular  tonsil- 
itis.    The  size  of  the  gland  is  thus  greatly  diminished  and  the  little 


■ 


224 


ItlSKASES   OK   THK   THROAT. 


secreting  follicle  destroyed.  Many  a  little  Hufferer  can  thus  bo  spartMl 
the  harsher  method  of  excision,  and  bear  with  good  grace,  especially 
if  cocaine  be  used,  what  otherwise  might  be  a  painfiil  and  bloody 
operation.  But,  as  has  been  said,  excision  in  many  cases  must  be 
resorted  to. 

Curability  of  Throat  Diseases.  —  I  have  dwelt  somewluit  upon 
the  preceding  fonns  of  tliroat  disease,  because  they  prevail  to  a  fear- 
ful extent,  and  are,  in  thousands  of  cases,  but  the  first  staj^es  of  fatal 
disease  of  the  lungs. 

If  not  counectetl  with  lung  disease  in  the  heyinning,  my  experience 
in  treating  them  enables  me  to  say,  emphatically,  they  are  generally 
curable. 

But  patients  often  put  the  question  to  me  —  "  If  cured,  will  I  ever 
have  the  complaint  again  ?  "  My  answer  is  —  "  Unless  I  can  plant 
in  your  constitution  a  better  protection  than  your  Maker  put  there  at 
your  creation,  you  will  of  coui-se  be  liable  to  a  second  attack."  But 
then,  where  the  lungs  have  been  entirely  free  from  disease,  I  have 
never  yet  seen  a  case  of  8inii)le  throat  complaint  relapse  and  become 
dangerous  after  proper  treatment  with  the  syringes.  Let  not  those, 
therefore,  who  have  been  benefited,  but  not  entirely  cured  by  this 
treatment,  undervalue  what  hius  been  done  for  them.  Even  in  such 
cases,  the  advantage  derived  to  them  amounts  to  just  the  value  they 
attach  to  the  continuance  of  life. 

Danglers  of  Delay.  —  In  closing  these  remarks,  let  me  warn  the 
reader  against  the  dangers  of  delay.  Many  of  those  who  finally  seek 
medical  attendance  in  these  complaints,  fiist  try  all  nostrums,  and 
tamper  with  their  disease  till  the  case  is  either  critical  or  hopeless. 
Too  many  wait  till  they  are  near  enough  to  the  engulfing  whirlpool 
to  hear  it  roar,  before  they  seek  in  any  practicable  way  to  escape  its 
dangers. 

Many  persons  neglect  a  slight  inflammation  of  the  pharynx,  which 
might  have  been  cured  in  a  few  days,  but  which,  from  long  neglect, 
has  gradually  crept  down  the  windpipe,  spread  over  the  widely  dis- 
tributed mucous  lining  of  the  bronchial  tubes,  and  thus  become  cur- 
able only  in  a  partial  degree,  and  after  long  and  tedious  treatment. 
Hundreds  of  persons  are  now  suffering  from  slight  attacks  of  this 
sort,  who  might  be  rid  of  the  affliction  in  a  week  or  a  fortnight,  but 
who  will  either  carelessly  give  it  no  attention  at  all,  or  resort  to  use- 
less nostrums,  until  it  has  run  through  its  primary  stages  and  invaded 
the  constitution,  and  will  finally  die  of  some  of  the  forms  of  pulmo- 
nary disease. 

A  Cold.  —  Influenza. 

A  SLIGHT  attack  of  the  disease  about  to  be  described,  affecting  only 
here  and  there  -a  person,  and  lasting  only  for  a  few  days,  is  called  a 
cold.     When  it  affects  a  large  part  of  the  community  at  the  same 


DI8EASK8   OF  THE   THROAT. 


225 


be  spaiiMl 
sspecially 
id  bloody 
I  must  be 

bat  upon 

to  a  feai- 

38  of  fatal 

xperienco 
generally 

«rill  I  ever 
can  plant 
it  tbere  at 
3k."  But 
se,  I  have 
1(1  become 
not  those, 
3(1  by  this 
Bn  in  such 
/alue  they 

warn  the 
nally  seek 
■rums,  and 

hopeless. 

whirlpool 

escape  its 

nx,  which 
neglect, 
i^idely  dis- 
come  cur- 
;reatment. 
of  this 
ight,  but 
irt  to  use- 
invaded 
if  pulmo- 


[jting  only 

called  (t 

I  the  same 


time,  lasting  many  days,  or  even  weeks,  it  is  then  an  epidemic,  and 
passes  under  the  name  of  infliiema.  In  tliis  latter  form,  it  sometimes 
spreads  over  a  whole  country,  and  has  at  times,  as  in  1882  and  1894, 
extended  to  nearly  the  whole  civilized  world.  It  often  shows  marked 
severity  in  its  progress,  and  leaves  serious  results  behind. 

Symptoms. —  A  tingling,  with  drjiiess,  and  a  sense  of  fulness  in 
tiie  mucous  membrane  of  the  nose,  are  among  the  first  indications  of 
an  attack  of  this  complaint.  Sneezing  is  a  common  symptom.  Soon 
pain  is  felt  in  the  forehead,  and  breatliing  through  the  nose  becomes 
difficult.  The  eyes  are  red  and  watery,  the  throat  is  sore  ;  there  is  a 
dry  cough,  hoarseness,  thirst,  general  lassitude,  chills,  and  a  desire 
to  get  near  the  fire.  The  mucous  membrane  of  the  nose^  throat, 
windpipe,  and  breathing-tubes  is  inflamed,  red,  swollen,  and  some- 
times painful. 

In  a  short  time,  water  begins  to  run  from  the  nose  and  eyes,  and 
the  cough  becomes  a  little  more  moist.  There  is  also  a  slight  dis- 
charge from  the  throat  and  tubes,  which  gradually  increases,  and,  at 
length,  as  the  disease  declines,  and  becomes  less  acute,  the  expectora- 
tion is  thick  and  yellow. 

Aching  of  the  back  and  limbs,  thirst,  loss  of  appetite,  flashes  of 
heat,  and  chills  whenever  the  patient  is  exposed  to  air  a  little  cooler 
than  he  is  accustomed  to,  are  almost  constant  attendants  upon  the 
disease. 

Causes.  —  It  is  r  ot  always  easy  to  say  what  tho  causes  of  this  com- 
plaint are.  Frequently,  it  can  be  traced  to  an  improper  exposure  to 
cold  or  dampness ;  but  in  a  great  majority  of  cases,  especially  when 
it  takes  the  form  of  influenza,  the  causes  are  not  obvious.  They 
probably  exist  in  some  peculiar  states  of  the  atmosphere,  and  in  a 
depression  of  the  nervous  system. 

The  influence  upon  disease  of  the  different  degrees  of  density  in 
the  air  which  surrounds  us,  and  of  other  circumstances  affecting  it, 
have  not  been  much  studied.  Some  valuable  facts  will  be  drawn 
from  this  source  before  many  years.  The  putting  upon  the  body,  or 
taking  from  it,  several  tons  of  pressuie  every  time  the  barometer  rises 
or  falls,  must  have,  of  itself,  no  small  influence  upon  its  health.  The 
comparatively  new  science  of  Phjrsical  Geography,  by  spreading  be- 
fore us  its  interesting  facts  in  regard  to  temperature,  storms,  atmos- 
pheric currents,  etc.,  is  opeiijiig  the  way  for  the  physician  to  learn  a 
great  deal  more  about  the  cftuses  of  disease  than  he  now  knows. 

Treatment. —  In  mild  cases,  only  the  most  simple  treatment  is  re- 
quired,—  such  as  remaining  in  the  house  for  a  few  days,  soaking  the 
feet  in  warm  water,  taking  a  gentle  sweat,  drinking  warm  infusions 
of  flax-seed,  mullein,  slippery  elm,  or  warm  lemonade,  and  taking 
only  a  spare  vegetable  diet.  If  the  bowels  be  costive,  some  gentle 
phjrsic  (84),  (41)  may  be  used.  A  laxative  drink  (132)  will  like- 
wise be  useful. 


226 


DISEASES   OP  THE   BRAIN   AND   NERVES. 


At  the  outset,  eapecially  when  the  nose  nins  water,  a  small  rloRp  of 
atropia,  jj^  grain,  taken  every  two  honrs  till  the  throat  is  dry,  will 
entirely  arrest  the  disease  at  this  point.  The  coryza  pill  found  at 
the  druggists'  is  a  more  valuable  remedy  still. 

When  the  attack  is  more  severe,  sweating  must  he  induced  by  de- 
cisive meaMures.  This  may  Ikj  affected  by  the  spirit  vapor-bath,  or 
by  putting  the  patient  in  bed,  j)utting  l)ottles  of  hot  water  to  the  feet 
and  sides,  and  administering  warm  drinks,  and  the  compound  tinc- 
ture of  Virginia  snakeroot.  Five  drops  every  hour  of  the  tincture 
of  veratrum  viride  will  often  cause  very  free  perspiration,  and  will 
reduce  the  inflammatioji  upon  the  mucous  surface. 

An  emetic  is  sometimes  very  useful.  To  produce  vomiting,  use 
the  powder  of  ipecac,  ten  to  twenty  grains,  or  the  compound  tincture 
of  lolwlia. 

It  soothes  the  inflamed  mucous  surfaces  very  much  to  inhale  the 
vapor  from  half  a  j)int  of  hot  water,  with  five  drops  of  tincture  of 
veratrum  viride,  or  the  same  amount  of  the  tincture  of  aconite  root. 

If  the  cough  is  severe,  use  the  preparations  recommended  under 
bronchitis  and  consumption. 

In  the  latter  stages  of  the  diseiuse,  if  there  be  debility,  —  as  there 
generally  is, —  quinia,  iron,  nux  vomica,  etc.  (75),  should  be  taken  ; 
or,  to  su[)port  the  nervous  system,  the  extracts  of  scullcap,  and  bone- 
set,  and  the  sulphate  of  quinia  (81)  will  be  found  useful.  At  this 
stage  of  the  complaint,  the  diet  should  be  more  liberal  and  nourishing. 

The  patient  should  not  venture  into  the  open  air  until  the  unpleas- 
ant sense  of  chilliness,  peculiar  to  the  disease,  ceases  to  be  produced 
by  exposure. 

La  Grippe. 

This  is  a  variety  of  influenza  with  which  the  world  has  l>ecome 
well  acquainted  within  the  last  few  years.  Its  history  is  interesting 
and  its  symptoms  and  results  are  sevei'e  and  annoying.  It  is  one  of 
the  most  severe  forms  of  catarrhal  disease  of  the  nose  or  throat  with 
which  we  are  acquainted.  It  owes  its  origin  to  a  germ  which  found 
its  birth  in  the  filth  and  pollution  of  eastern  Europe,  and  has  visited 
the  globe  with  terrible  ravages  on  several  occasions  since  the  Middle 
Ages.  It  spreads  by  travelling  the  most  frequented  paths  of  com- 
merce, and  attacks  those  in  a  depressed  state  of  health.  The  varieties 
of  la  grippe  are  as  numerous  as  that  of  any  other  disease.  The  catar- 
rhal form  is  much  like  that  of  ordinary  head  influenza,  only  it  is  more 
severe  and  prostrating ;  the  bronchial  assumes  the  influenza  type,  at 
first,  but  soon  attacks  the  lungs  and  sets  up  a  severe,  prolonged  and 
harassing  bronchitis ;  the  intestinal  variety,  besides  producing  the 
general  symptoms  of  malaise,  fever,  cough,  severe  aches  and  pains, 
gives  rise  to  a  diarrhoea  which  lasts  many  days  and  is  very  debilita- 
ting; the  most  common  variety,  however,  is  the  rheumatic,  which  is 
ushered  in  by  chills,  fever,  muscular  pains,  coryza,  cough  and  general 


imiiU  doRft  of 

iH  dry,  will 

ill  found  at 

luced  by  dt;- 
ipor-buth,  or 
r  to  the  feet 
1  pound  tinc- 
the  tincture 
on,  and  will 

omiting,  use 
ind  tincture 

o  inhale  the 

tincture  of 

iconite  root. 

nded  under 

—  as  there 
i  be  taken ; 
p,  and  bone- 
il.  At  this 
nourishing. 
;he  unpleas- 
•e  produced 


hfis  l)econie 

interesting 
It  is  one  of 
throat  with 
^hicli  found 

has  visited 
the  Middle 
ihs  of  com- 
he  varieties 

The  catar- 
y  it  is  more 
iza  type,  at 
longed  and 
ducing  the 

and  pains, 
ry  debilita- 
te, which  is 
ind  general 


DISEASES   OF  TIIE   THROAT. 


227 


rheuraat  c  pains.  The  chamcteristic  feature  of  all  of  these  forms  is 
the  great  prostration  which  accompanies  these  symptoms  and  thTolv 
stim«)y  with  which  it  clings  to  the  patient. 

The  sequelae  of  the  dise.wc,  though  much  exaggerated,  are  numer- 
ous^ The  aged  are  often  left  infirm  with  heart  wtakness  the  Zng 
^mglL  """"  '"  ^'««'^««''*'^d  the  middle-aged  with  cLS 

Many  an  undiscovered  disease  has  passed  unnoticed  under  the  dis- 
ZZl:  "  ^"^^''-^  ^^  ^f.  "-l"»l't  served  as  a  bn«.d  mantl  ". 
cover  our  ignorance  of  real  disease  and  been  made  an  easy  refuge  for 

a  dZ;;r'"^V'*'y  ^"^  "'^r'^  ^'  «„!««  cannot  be  uveLstlmated 
and  death  has  not  infrequently  resulted. 

Treatment—  Tlie  onset  is  to  be  met  with  large  doses  of  quinine 
say  10  grains  on  retiring,  by  phenacetine  and  stlol,  10  grains  each 
t..ken  with  some  hot  lemonade  on  retiring.  Tliis  lattef  may  tere 
peate    eveiy  three  hours.     The  coryza  is  checked  by  small  repe^tid 

blets  bought  at  the  druggist's  -  one  taken  every  two  houi-s  till  the 
^ZX/Sn^""  '^^^  ^  ^^^  '^  ''^^'  ^--^     T^«  ^«^ility  is  t: 

Acute  Inflammation  of  the  Epiglottis. 

This  is  the  disease  by  which  our  country  lost  its  most  loved  and 
uncSrr^.  TT'  ^n^'  Washingtoi/  This  complaint  was  not 
undei^tood  at  the  time  of  his  death,  -  the  intelligent  physicians  who 
attended  him  supposing  it  to  be  inflammation  of  the  windpipe.  Fmm 
their  very  clear  description  of  the  symptoms,  we  now  know  it  to  have 
been  an  acute  inflammation  of  the  epiglottis  and  glottis. 

^rom  the  rapid  inflammation  of  the  epiglottis,  water  is  effused  into 
h    hp'n    '^f''  '"  iT  *"  P"^  1"P'  "'^'^  P^^^^'^*  it  fr«°^  shutting  down 

wi&'''*""-*"^i'^  ^'^^^^  ^^^^"«  ^i*^^  ^  severe  chill,  accompanied 
with  some  pain,  and  a  sense  of  stricture  or  tightness  in  the  upper  and 
m  nfS  sw.n  *.h^-t.  The,e  is  eough,  witS  difficult  and  som  ime 
painful  swallowing  These  symptoms  are  soon  followed  by  quick 
andsoorr'  b^^^t^^g-.  Speaking  aloud  is  from  the  first  ifficult, 
thp  W  i^        "''  impossible.    As  the  complaint  runs  it«  rapid  course 

^te^Trlng^^^^^^^^^^  "^°^^  '^«^^"^^'  ^"^  '^^^  --  --^^s^f-  -ml 

nitm  W  fn  vl"  ^'?'&  7"^.«^iately  to  the  parts  a  strong  solution  of 

to  on^  I     i  l      ?'  '''^''*'°^  «^«"^^  b«  of  *he  strength  of  ninety 
to  one  hundred  and  twenty  grains  to  the  ounce  of  soft  water.     It 


228 


UmEAUKH   OF   THE  THKOAX. 


Hhould  be  applied  oveiy  hour  or  two  till  the  feeling  of  suffocation 
subsides,  and  should  be  done  with  the  laryngeal  shower  syringe, 
though  if  this  is  not  at  hand  the  sponge  probang  may  be  used. 

While  this  local  treatment  is  being  employed,  libeml  doses,  from 
five  to  twenty  drops,  of  tincture  of  veratrum  viride  should  be  given 
every  hour,  watching  the  effect,  and  discontinuing  when  the  pulse 
sinks  too  low. 

Hot  fomentations  applied  externally,  and  filling  the  room  with 
steam,  m  recummeiidud  in  cases  of  croup,  would  bu  usef 

Mu  m  ps.  —  Parotitis. 

This  disease  appeal's  ruost  often  among  cliildren ;  but  as  it  is  not 
confined  to  them,  I  have  not  placed  it  among  their  complaints. 

Symptoms. —  It  begins  with  soreness  and  stiffness  in  the  side  of 
the  neck.  Soon  a  swelling  of  the  parotid  gland  takes  place,  which  is 
painful,  and  continues  to  increase  for  four  or  five  days,  sometimes 
becoming  very  large,  and  making  it  difficult  to  swallow,  or  open  the 
mouth  to  receive  food.  After  the  fouith  or  fifth  day  the  swelling 
subsides,  and  disappears  in  from  seven  to  ten  days. 

Both  glands  generally  swell  about  the  same  time,  but  sometimes 
the  swelling  appeara  in  one  only  after  it  has  subsided  in  the  other, 
and  occasionally  the  swelling  is  wholly  confined  to  one  side. 

When  the  swelling  is  great,  there  is  heat,  and  sometimes  fever, 
with  diy  skin,  quick  pulse,  fuired  tongue,  constipated  bowels,  and 
scanty  and  high-colored  urine. 

The  affection  is  sometimes  translated,  as  we  say ;  that  is,  in  females, 
the  breast  swells,  and  in  males,  the  testicles  become  swollen  and  pain- 
ful. This  accident  generally  happens  in  consequence  of  taking  cold 
from  some  imprudence. 

The  disease  is  contagiuus ;  that  is,  it  is  communicated  from  one 
person  to  another. 

Treatment. —  In  mild  cases,  very  little  treatment  is  required. 
Keeping  the  face  and  neck  warm,  avoiding  exposure  to  cold  and 
damp,  drinking  warm  infusions  of  balm,  spearmint,  or  sage,  and  ap- 
ply a  poultice  of  flax-seed  over  the  glands  until  the  patient  is  fully 
relieved ;  or  the  compound  powder  of  jalap,  if  there  be  costiveness, 
is  about  all  that  is  required.  The  diet  should  consist  of  rye  hasty 
pudding,  or  brown  bread  and  sweetened  water. 

If  the  case  be  severe,  and  other  glands  swell,  physic  must  be  freely 
used,  leeches  must  be  applied,  and  cooling  lotions,  or  poultices. 
Sweating  must  also  be  induced  by  the  compound  tincture  ol  Vir- 
ginia snakeroot,  or  by  a  vapor  bath. 

In  young  girls  mumps  often  attack  the  ovaries  and  make  the  in- 
valid a  great  sufferer  for  a  few  days  ;  the  testicle  of  the  male  is  simi- 
larly affected  at  times.  These  complications  call  for  soothing  appli- 
cations and  rest  in  bed. 


mmi 


suffocation 
er  syringe, 
used. 

doses,  from 
d  be  given 
I  the  pulse 

room  with 


w  it  is  not 
lints. 

;he  side  of 
le,  which  is 
sometimes 
ir  open  the 
e  swelling 

sometimes 
the  other, 
le. 

mes  fever, 
Jwels,  and 

in  females, 

and  pain- 

iking  cold 


from 


one 


required. 

cold  and 
e,  and  ap- 
it  is  fully 
)8tivene88, 
rye  hasty 

;  be  freely 
poultices, 
•e  ol  Vir- 

:e  the  in- 
le  is  simi- 
ing  appli- 


DISEASES  OP  THE  CHEST. 


Consumption.-^  Phthisis. 

At  the  head  of  the  .liseases  of  our  cUniute  stands  Consumption,— 
flt  wieir  head  both  .is  it  respects  prevalence  and  fatolity.     SmaU-^x 

ri  „T/r'''  '"^  '^°^r"t  ^'^  ^"'^^«  ^»  *heu  visitations;  but  S 
are  all  their  aggregated  slaughters  compaied  with  the  ce,iseless,  silent 

;::s  Jt  ^i  s^  tiT^  -'''''  -^^^  ^^^y  ^"  «^«^^  ^-^  p^-  th^ 

Boston,  from  its  population  of  476,000,  loses  by  consumption  about 
twenty  per  week,  eighty  per  month,  or  about  nine  hundred  per 
annum.  An  equal  mortality  from  any  disease  not  often  amon/us 
would  send  our  citizens  in  terror  to^^the  countiy,  and  causXe 
stoutest  hearts  to  feel  that  "in  the  midst  of  life  we  are  in  death  " 
Massachus|etts  loses  about  seven  thousand  per  annum;  New  England 
not  less  than  twenty  thousand;  and  with  the  State  of  New  York 

vear  ?'  WhT'"""  "^  ^^'^^^g^f  di«««««  «well  to  forty  thousand  a 
year!  What  an  army  I  Picked  from  the  choicest  I  All  sundered 
vTld  ^rwf".^  ^'  and  leaving  more  blight  and  sorrow  behind  than 
wou  d  perhaps  twice  or  thrice  the  number  whom  any  other  pestilence 
woiUd  have  selected.  The  magnitude  of  the  evil  places  the^question 
of  the  remedy  before  aU  others  that  peitain  to  the  healing  art. 
ih.     ■  fu"^^^  number  of  deaths  occur  in  Massachusetts,  beinff  in 

nni'^  — ^^"'^  °^.""^  '"^  ^""^^y  *^^«  ^^"*i^«d  a»d  fifty.  The  smallest 
number  is  »n  Georgia,  being  about  one  in  two  thousand  one  hundred 

Th;  nLi,  Tv^^f^^o  ^  "'°'*^  unfavorable  as  a  place  of  residence. 
Ihe  Northern  Middle  States,  Western  Central  and  Pacific  Coast 
Stetes  are  most  favorable.  The  most  healthful  for  consumptives,  I 
sTcnFn  <^  '^  the  following  order:  Georgia,  New  Mexico,  Wiscon- 
sin  Colorado  and  Califorma.     A  permanent  residence  in  any  of  them 

iTfp  Z?  '"P'^^rf  '^  ^''^'^  '''  ^'^^  «^g^«'  ^""^  ^i"  S'^'^4  prolong 
ite,  unless  in  the  last  stages,  in  which  case  I  would  strongly  advis! 
tne  patient  to  remain  at  home  among  friends  and  home  comforts. 
Alter  a  change  of  climate  it  is  dangerous  to  return  unless  a  perma- 
nent  cure  has  taken  place. 

Methods  of  Examining  the  Chest.— Before  speaking  further  of 
oonsumption,  I  propose  to  do  what  has  never  been  done,  namely,  to 

229 


230 


DIJBA8ES  OF  THE  CHEST. 


inbu^ict  the  general  reader  very  briefly  in  the  method  of  examining 
the  chest  to  learn  the  existence  of  disease.  Perhaps  this  will  bt^ 
considered  a  departure,  in  some  slight  degree,  from  my  purpose  to 
make  this  entire  book  intelligible  to  the  general  reader.  If  so,  my 
reply  is,  that  there  are  many  school  teachers,  mechanics,  masters  of 
vessels,  and  farmers,  who  have  niquiring  minds,  ar  i  sagacity  enough 
to  learn  the  physical  signs  of  chest-diaease,  and  to  make  them,  in 
many  cases,  practically  useful;  and  that  even  readers  of  little  re- 
flection cannot  fail  to  comprehend  a  portion  of  my  explanations. 

Position  of  the  Patient.  —  In  performing  percussion  upon  the 
front  of  the  chest,  the  patient  should  be  required  to  sit  in  a  square 
position,  with  the  arms  hooked  over  the  corners  of  the  back  of  the 
chair,  and  the  head  thrown  a  little  back. 

Instrument  with  which  to  Thump.  —  The  index  and  middle 
fingers  of  the  right  hand  are  to  be  brought  together,  into  a  line,  and 
used  as  the  percussing  instrument.  The  blow  given  with  these  is  to 
be  smart  and  quick.,  rather  than  heavy. 

Medium  to  Thump  Upon.  —  Either  the  index  or  middle  finger  of 
the  left  hand  is  to  be  pressed  firmly  upon  the  surface  of  the  chest  to 
be  percussed  or  struck,  and  thus  used  as  a  plexiraeter. 

Auscultation.  —  Listening  for  the  purpose  of  hearing  within  the 
chest  the  sounds  produced  by  breathing,  talking,  coughing,  etc.,  is 
called  auscultation. 


Fia.  90. 


Fig.  91. 


Instruments  with  which  to  Listen.  —  The  naked  ear  is  generally 
considered  best  for  hearing  low  and  delicate  sounds ;  but  for  hearing 
loud  and  rough  ones,  it  is  not  so  good  as  the  stethoscope,  repre- 
sented by  Fig.  90.  A  still  better  instrument  is  the  double-eared 
stethoscope,  Fig.  91.  It  magnifies  the  sounds  very  much,  and  is  apt 
to  confuse  an  examiner  not  accustomed  to  it ;  but  when  the  ear  is 
once  familiar  with  it,  the  aid  it  affords  is  very  valuable. 


mmmm 


niSEASES   OF   THE   CHEST. 


231 


examining 

this  will  K' 
purpose  tt» 
If  so,  niy 
,  masters  of 
city  enough 
ke  tliem,  in 
of  little  re- 
nations. 

n  upon  the 

in  a  square 

back  of  the 

and  middle 
)  a  line,  and 
li  these  is  to 


lie  finger  of 
the  chest  to 


f  within  the 
liing,  etc.,  is 


IS  generally 

[for  hearing 

jope,  repre- 

juble-eared 

and  is  apt 

the  ear  is 


The  examiner  should  pass  from  side  to  side,  continually  comparing 
the  sounds  upon  one  side,  with  those  upon  the  other. 

The  patient  must  bo  calm,  and  the  examiner  in  no  hurry. 

Healthy  Sounds.  —  To  become  skilful  either  in  percussion  or  aus- 
cultation, the  examiner's  ear  must  first  be  trained  to  healthy  sounds. 

These  are  best  heard  in  the  child,  iu  whom  they  are  louder  than 
in  the  adult. 

In  describing  the  healthy  sounds  in  the  different  regions  of  the 
chest,  I  shall  refer  the  reader  constantly  to  Figs.  92  and  93. 

C^lavicular  Region.  —  This,  in  Fig.  92,  is  represented  by  1,  1. 
Urjon  thumping  upon  the  collar-bones,  the  sound  given  out  at  the 
breast-bone  end  should  be  very  clear ;  less  clear  in  the  middle  ;  and 
dull  at  the  shoulder  end. 

Subclavian  Region.  —  This  is  represented  by  2,  2,  and  lies  be- 
tween the  collar-bone  and  the  fourth  rib,  on  both  sides.  It  covers  a 
considerable  portion  of  the  Tapper  lobe  of  the  lungs.  The  sound 
upon  striking  this  place  should  be  very  clear. 


Fig.  so. 


FlO.  S3. 


The  Mammary  Region,  represented  by  3,  3,  extends  from  the 
fourth  id  the  seventli  rib,  on  each  side.  In  the  upper  part  of  this 
region,  the  healthy  sound  is  clear ;  but  at  the  bottom  of  it,  on  the 
right,  the  sound  is  deadened  by  the  liver;  on  the  left,  by  the  heart. 

The  Infra-Mammary  Region,  4,  4,  lies  between  the  seventh  rib 
and  the  edge  of  the  cartilages  of  the  false  ribs.  On  the  right  side, 
the  liver  makes  the  sound  dull;  but  under  the  left  side  lies  the 
stomach,  which  is  hollow,  and  the  sound  is  generally  quite  loud. 


I 

II 


it 


DISEASES   OF  THE   CHEST. 


In  th«  5ternal  Region,  5,  6,  7,  wLicb  covei-s  the  breast-bone,  the 
sound  is  generally  clear. 

The  Axillary  Region,  8,  8,  is  in  the  arm-pits.  In  this  the  sound 
should  be  clear. 

The  Lateral  Region,  9,  9,  is  immediately  below  the  above,  and 
yields,  likewise,  a  clear  sound. 

The  Lower  Lateral  Region,  gives  a  dull  sound  on  the  right  side, 
and  on  the  left  a  very  hollow  one. 

Fig.  93  represents  the  back  part  of  the  chest.  In  looking  at  this, 
we  see  the 

Acromial  Region,  represented  by  11, 11.  In  this  space  the  sound 
is  dull,  but  it  has  not  much  meaning. 

The  Scapular  Region,  12,  12,  covers  the  part  occupied  by  the 
shoulder-blades.     It  gives  rather  a  dead  sound. 

The  lntra-5capular  Region,  13,  13,  lies  between  the  shoulder- 
blades,  on  each  side  of  the  back  bone.  If  the  patient's  arms  are 
crossed,  and  the  head  bent  foi-ward,  a  clear  sound  will  be  obtained. 

The  Dorsal  Region,  14, 14,  covers  the  base  of  the  lungs,  and,  in 
health  gives,  a  clear  sound. 

Observation.  —  If,  now,  on  thumping  upon  the  chest,  we  find  a 
(lull,  dead  sound  in  any  spot  where  a  clear  one  oug'at  to  be  yielded, 
we  are  to  conclude  that  underneath  there  is  not  the  usual  quantity 
of  air ;  but  we  cannot  tell  merely,  by  percussing,  whether  tubercles 
are  deposited  there,  "or  the  lung  has  become  solid  by  inflammation, 
or  water  has  been  poured  out  into  the  cavity  of  the  pleura.  This 
point  must  be  determined  by  auscultation,  etc.,  to  be  explained 
gradually  as  we  go  along. 

Auscultation  of  Breathing.  —  On  applying  the  ear  or  the  stetho- 
scope to  the  chest,  two  sounds  are  heard  which  immediately  succeed 
each  other,  —  the  louder  is  produced  by  the  ingoing  breath,  or  in- 
spiration ;  the  weaker  by  the  outgoing  breath,  or  expiration.  These 
sounds  will  be  further  explained  as  we  go  along. 

Auscultation  of  the  Voice  and  Cough.  —  The  chest  of  a  healthy 
person  speaking  communicates  to  the  ear  no  distinct  sound,  but  only 
a  vibratory  sensation,  called,  in  technical  language,  the  pectoral  fre- 
mitus. 

.Over  the  larynx  and  windpipe,  the  examiner  may  hear  natural 
pectoriloquy ;  between  the  shoulder  blades,  in  the  space  correspond- 
ing to  the  roots  of  the  lungs,  natural  bronchophony. 

Philosophy  of  Chest  Sounds.  —  The   fullness  and  clearness  of 

sound  upon  percussion,  depends  upon  the  amount  of  air  in  the  chest. 

The  sounds  called  breathing  murmurs,  are  caused  by  the  expansion 


shoulder- 
arms  are 
btained. 

:s,  and,  in 

ve  find  a 
B  yielded, 
quantity 
tubercles 
mmation, 
ra.  This 
explained 

16  stetho- 
r  succeed 
th,  or  in- 
.     These 

I  healthy 
but  only 
':oral  fre- 

'  natural 
Tespond- 

jness  of 
he  chest, 
cpansion 


DISEASES   OF   THE   CHEST. 

and  contraction  of  the  airKiell.s  or  vesicles,  as  the  air  passes  in  and 
out ;  hence  they  are  called  vesicular  murmurs. 

The  friction  of  the  air  against  the  sides  of  the  windpipe  and  large 
bronchial  tubes  causes  the  blowing  sound  heard  in  those  parts. 

In  children  a  larger  amount  of  air  enters  the  lungs,  and  the  air 
vesicles  are  expanded  with  more  force;  hence  their  breathing  has  a 
ouder   sound,  which  is   called  puerile  respiration.     This  kind  of 
breathing,  heard  in  the  grown  person,  is  a  sign  of  disease. 

I  he  lung  tissue  is  a  bad  conductor  of  sound;  and  the  voice  is  ac- 
cordingly heard  only  over  those  parts  where  large  bronchial  tubes 
are  near  the  surface ;  heard  elsewhere,  it  indicates  disease. 

Division  of  Consumption.  —  Consumption  raay  be  divided  into 

ZS  ^  w^'"  "'  T^  '^'  ^^°^''^^^1-     The  former  has  a   on- 
stitutional,  the  latter  a  local  origin. 

^irst  Stage  of  Tubercular  Consumption. 

Physical  Signs.— Dullness  of  sound  on  and  under  the  collar- 
'riten?ir'Th-^"n"^'^  expirationaugmentedboth  indur^  bn 

^^^Occasionally  a  pulmonaiy,  crumpUng  sound.     Dry,  crackling  rat. 

The  resounding  of  the  voice  increased  at  the  top  of  the  lungs. 

General  Symptoms.  —  A  sense  of  weariness  and  languor. 

Occasionally,  slight,  %ing  pains  about  the  chest  and  fhou  dera 

A  peculiar  sensitiveness  to  the  effects  of  cold  «"«^^aer8. 

Breathlessness  on  moving  quick,  or  ascending  a  hill  or  stairs.       ' 
Ju      7  'i^f''  ^  blue  lividity  of  the  lips  and^  roots  of  the  Wer- 
nails,  and  coldness  of  the  hands  and  feet.  ^ 

tlie  rntMvij'J^  *T.'^'''  "^'^/*  *^^«  '^'^y  ''^Se,  a  cessation  of 
tiie  monthly  turns.     These  usually  stop  later  in  the  disease. 

at  S?!orof°th«'r^^'  ^r"'"*^"^  °^  *"^^^^««  ^^^^'  ^l^ay«  begins 
0  tenest  on  tl«  ^Zf':^T'''\^''^  ^*^«^  *h«"&bt  they 'appeared 
oltenest  ou  the  nght  side  first;  Louis,  Andral  Watson,  Sir  James 
Clarke  and  others,  believed  they  appeared  more  often  on  the  U  sWe 

appear  first  about  as  often  upon  one  side  as  upon  the  other. 
structionnTC'^  crumpling  sound  is  caused  by  a  mechanical  ob- 
lurint Th.  /      expansion  of  the  lungs.     It  is  generally  heard  only 

dtedVv  blow^^  "''  "^  the  breath.     The  soi^d  is  like  that  prS^ 
uiicea  by  blowing  upon  very  fine  paper.  ^ 


234  DISEASES  OF  THE   CHEST. 


Second  5tas;e. 

Physical  Signs*  —  Marked  dullness  of  sound  on  the  collar  bones, 
and  extending  below  them. 

Inspiratory  murmur  diminished  in  duration  and  intensity ;  expira- 
tory murmur  augmented  in  both. 

In  upper  lobes  of  lungs,  moist,  crackling  rattles,  succeeded  by 
mucous  rattles.     Also  bronchial  respiration,  or  tubular  breathing. 

In  lower  lobes  of  lungs,  puerile  respiration. 

Sounds  of  the  heart  heard  under  the  collar  bones. 

Bronchophony  heard  in  the  same  parts  as  bronchial  respiration. 

Qeneral  Symptoms.  —  A  quickened  pulse  ;  slight  fever  towards 
evening,  oftentimes  amounting  to  quite  high  fever. 

Great  susceptibility  to  the  effects  of  cold,  and  liability  to  take  cold 
easily. 

Bowels  generally  costive ;  oftentimes  seat  of  pain. 

The  eye  has  a  peculiar  whiteness  and  lustre. 

The  skin  and  mouth  bcQome  dry  in  the  afternoon ;  chills  occur 
about  midday,  followed  by  fever,  during  which  the  cheeks  are  flushed. 

As  the  second  stage  advances  to  its  close,  a  dry,  burning  heat 
aflflicts  the  palms  of  the  hands  and  soles  of  the  feet. 

Night-sweats  occur  at  this  time. 

Observations.  —  A  hollow,  elastic  body,  containing  air,  gives, 
when  struck,  a  clear  sound.  The  dullness  of  sound  on  percussing 
the  chest,  arises  from  the  absence  of  air  in  the  air-cells,  —  these 
having  been  pressed  together,  or  obliterated  by  the  deposit  of  a  mass 
of  tubercles.  The  destruction  of  these  cells  causes  the  cessation  of 
the  respiratory  murmur. 

This  stage  of  the  disease  is  often  accompanied  by  an  inflammation 
of  the  mucous  membrane  lining  the  air-tubes.  The  air,  pushing  its 
way  through  the  mucous  secretions  in  these  tubes,  forms  bubbles,  the 
bursting  of  which  causes  the  rattle.  The  crepitant  rattle  is  produced 
by  inflammation  around  the  tubercles.  The  moist,  crackling  rattle 
is  caused  by  the  softening  of  the  tubercles. 

The  lungs,  rendered  more  solid  by  the  deposit  of  tubercles,  become 
better  conductors  of  sound ;  and  this  causes  the  beating  of  the  heal-t 
to  be  heard  as  far  off  as  under  the  collar  bones. 

Bronchial  respiration  gives  the  idea  of  air  blown  through  a  tube ; 
cavernous  respiration,  of  air  passing  into  a  large  enclosed  cavity. 

Third  Stage. 

4 

Physical  Signs.  —  In  this  stfl.ge  cavities  are  formed.  If  the  cavi- 
ties be  small,  and  considerable  tuberculated  lung  surrounds  them,  the 
sound,  upon  percussion,  is  still  dull. 


DISEASES   OF   THE   CHEST. 


235 


liar  bones, 

y;  expini- 

ceeded  by 
athing. 

iration. 
ir  towards 

•  take  cold 


lills  occur 
re  flushed, 
ning  heat 


an',  gives, 
percussing 
i,  —  these 
of  a  mass 
ssation  of 

aniniation 
ishing  its 
bbles,  the 
produced 
ng  rattle 

become 
the  heatt 

a  tube; 
,vity. 


;he  cavi- 
;hem,  the 


If  the  cavity  he  large,  and  near  the  surface,  there  is  occasionally  a 
tympanitic  sound  with  musical  tone. 

Sometimes  a  sound  is  heard  like  striking  a  cracked  pot. 

Gurgling;  cavernous  rattle ;  cavernous  breathing;  amphoric  breath- 
ing; now  and  then,  metallic  tinkling;  pectoriloquy;  cavernous  cough. 

General  Symptoms.  —  Great  loss  of  flesh,  and  weakness ;  diarrhoea 
and  nightflweats ;  swelling  of  the  feet  and  legs ;  sore  mouth ;  and 
raising  of  matter  with  specks  of  tubercle  in  it  like  crumbs  of  cheese. 

Observations.  —  The  gurgling  rattle  is  caused  by  air  displacing 
liquids,  and  the  formation  and  bursting  of  bubbles.  It  resembles  the 
sound  produced  by  blowing  through  a  tube  immersed  in  soap-suds. 

Cavernous  breathing  is  notliing  more  nor  less  than  the  sound  pro- 
duced by  air,  breathed  in  and  out,  entering  and  retiring  from  a 
cavity.  The  air  appears,  sometimes,  to  one  listening  with  the  stetho- 
scope, as  if  it  were  sucked  into  his  ear  during  inspiration,  and  blown 
back  again  during  expiration. 

Amphoric  respiration  is  simply  an  augmentation  of  cavernous 
breathing,  and  results,  of  course,  from  an  increase  of  size  in  the 
cavity. 

In  pectoriloquy,  words  uttered  by  the  patient  seem  to  pass  through 
the  stethoscope  into  the  ear  of  the  listener.  The  cavity  pliould  be 
empty,  moderate  in  size,  and  have  dense  walls,  in  ordei  to  furnish 
the  best  specimen  of  this  sound. 

Air  suddenly  driven  backward  through  the  windpipe,  and  out  of 
the  mouth  and  nose,  by  smart  raps  upon  the  chest  over  a  cavity, 
gives  the  sound  of  the  cracked  pot.  It  is  best  heard  when  the  pa- 
tient's mouth  is  partly  open.  The  same  sound  is  produced,  on  the 
same  principle,  by  locking  the  fingers  of  the  two  hands,  and  joining 
the  palms,  so  as  to  leave  a  small  space  or  cavity  between  them,  and 
then  expelling  the  air  from  that  cavity,  by  gently  striking  the  back 
of  one  hand  upon  the  knee. 

Causes  of  Consumption.  — The  hurcan  constitution,  as  shown  by 
Liebig,  in  his  profound  work  on  Animal  Chemistry,  is  governed  by 
two  forces,  the  nervous  and  the  vegetative.  The  former  disposes  the 
particles  composing  the  body  to  a  state  of  motion ;  the  latter  inclines 
them  to  a  position  of  rest. 

In  vegetative  life  there  is  motion  in  one  direction  only,  so  to  speak; 
that  is,  niution  which  tends  to  the  opposite  of  motion,  namely,  rest. 
In  vegetables,  whose  life  is  wholly  under  this  power,  there  is  no  waste ; 
for  here,  all  ultimate  particles,  having  once  taken  a  place  of  rest, 
remain  undisturbed.  In  a  tree,  a  layer  of  matter  once  deposited, 
alwajrs  remains.  Hence  there  is  growth  as  long  as  the  tree  lives. 
There  is  no  power  to  break  up  and  destroy. 

But  in  the  animal  body  there  is  motion  in  two  directions,  or  a 
circuit  of  motion.  Particles  which  under  the  vegetative  force  have 
been  put  to  rest,  are  perpetually  being  displaced  by  the  nervous  energy, 


236 


DISEASES  OF  THE  CIIKST. 


and  reduced  to  unorganized  amorphous  compouiicls,  to  bo  burned  in 
warming  tlie  sj^tem,  or  cast  out  by  the  several  excretory  processes. 

So  constant  Ls  the  action  of  these  two  forces,  that  John  Hunter 
compared  the  human  system  to  a  whirlpool,  into  which  the  particles 
of  matter  are  per[)etually  poured,  under  the  influence  of  the  vegeta- 
tive power,  and  out  of  which  they  are  as  constantly  whirled  by  the 
nervous  force. 

By  a  little  reflection  upon  these  antagonisms,  the  reader  will  see 
that  it  is  just  when  the  vegetative  force  transcends  tlie  nervous,  that 
the  body  increases  in  weight,  and  acquires  that  state  in  which  tlie 
blood  corpuscles  alxiund,  and  the  tendency,  if  to  disease  at  all,  is  to 
that  of  the  inflammatory  kind.  It  is  the  tonic  condition  of  the  sys- 
tem. Nutrition  is  more  rapid  than  destruction.  New  particles  are 
laid  down  faster  than  old  ones  are  taken  up.     The  body  grows. 

On  the  other  hand,  when  the  nervous  force  overmastei-s  the  vegeta- 
tive, when  the  outward  or  centrifugal  motion  of  the  whirlpool  prevails, 
then  it  is  that  the  body  is  attenuated,  the  blood  thinned  and  made 
serous,  and  the  consumptive  or  atonic  condition  is  established.  Noxo., 
there  is  too  much  motion.  The  nutritive  particles,  instead  of  tending 
to  a  state  of  deposit  for  the  rensupply  of  waste  matter,  become  fugi- 
tive in  their  habits,  perpetually  fleeing,  like  convicts  escaped  from 
prison.  Introduce  this  power,  in  excess,  into  the  vegetable  kingdom, 
and  the  matter  deposited  upon  the  tree,  instead  of  remaining  to  swell 
its  bulk,  would  be  driven  off  by  the  nervous  force  ;  and  the  tree,  in- 
stead of  growing,  would  be  annually  lessened,  become  sickly,  and  die 
of  consumption. 

In  Tubercular  Consumption,  the  system  is  like  a  field  deluged  by 
a  flood ;  nothing  can  take  root.  The  repeated  shocks  of  the  nervous 
battery  sent  to  the  absorbents  so  quicken  them  in  their  work  of  re- 
moving waste  matter,  that  they  dislodge  much  which  is  not  yet  worn 
out,  and  assist  in  casting  out  of  the  system  not  a  little  designed  to  be 
used  in  its  renewal.  A  healthy  deposit  is  thus  prevented,  and  nutri- 
tion is  at  an  end.  The  nutritive  arteries,  those  little  builders  of  the 
human  frame,  are  overmastered  by  the  stimulated  lymphatics ;  the 
constructive  material  is  wrested  from  them,  and  borne  beyond  theb 
reach,  and  the  body  wastes  from  want  of  nourishment.  The  blood 
becomes  thin  and  watery;  and  from  the  increased  serous  portion, 
chiefly  albumen,  are  deposited  upon  the  lungs  and  other  tissues  the 
albuminous  tumors  called  tubercles. 

Here  is  found  the  cause  of  that  peculiar  smalliieas  of  bone  and 
muscle,  and  thinness  and  tallness  of  person,  so  peculiar  to  consump- 
tives. The  absorbents,  under  the  power  of  a  very  active  nervous 
system,  take  down  "  the  house  we  live  in  "  faster  than  the  nutritive 
arteries,  confused  by  the  motion  around  them,  can  effect  its  recon- 
struction. It  is  simply  an  unbalancing  of  the  antagonistic  forces, 
which  build  and  pull  down  our  earthly  tenement.  The  men  that  de- 
molish are  more  numerous  and  better  fed  than  the  artisan  buildere. 


1 


DISEASES   OF  THE  CHEST. 


287 


burned  in 
rocesses. 
11  Hunter 
!  particles 
le  vegetii- 
ecl  by  tlio 

r  will  see 
V0U8,  that 
vhich  the 
>  all,  is  to 
f  the  sys- 
cticles  are 

'0W8. 

he  vegeta- 
1  prevails, 
md  made 
3d.  Now, 
)f  tending 
ome  fugi- 
iped  from 
kingdom, 
\g  to  swell 
le  tree,  in- 
y,  and  die 

eluged  by 
e  nervous 
rk  of  re- 
yet  worn 
ned  to  be 
nd  nutri- 
rs  of  the 
tics ;  the 
nd  their 
he  blood 
portion, 
sues  the 


It  is  this  destructively  nervous  force  which  gives  to  consumptive 
persons  their  proverbial  mental  activity ;  which  causes  them  often  to 
dazzle  the  world  with  the  splendor  of  their  gifts,  and  to  bless  their 
friends  with  the  warmth  of  their  affections.  They  are  usually  the 
choice  spirits,  the  idols  of  their  relatives,  and  the  favorites  of  the  com- 
munity in  which  they  live.  Their  mental  movements,  and  the  exer- 
cise of  their  affections,  are  characterized  by  brilliancy  and  warmth. 
Of  all  persons,  they  are  best  fitted  to  enjoy  life,  and  to  impart  happi- 
ness. Loving  all,  they  are  by  all  loved  in  return.  They  are  speci- 
mens of  partially  etherealized  humanity,  stepping  lightly  across  the 
earth,  to  whom  friends  passionately  stretch  out  their  arms,  and  em- 
brace —  their  shadows  I 

These  views  will  appear  the  more  reasonable,  if  we  consider  that 
in  children  the  vegetative  power  is  very  active,  while  the  nervous 
energy  is  comparatively  weak.  The  preponderance  of  the  former 
over  the  latter  causes  the  rapid  growth  of  children.  The  little  arterial 
builders  work  faster  than  the  lymphatic  demolishers.  This  explains 
why  so  few  children  die  of  consumption. 

But  from  the  age  of  seventeen  to  thii-ty-five,  when  the  vegetative 
power  is  losing  something  of  its  extraordinary  activity,  and  the  nerv- 
ous force  is  showing  its  highest  capabilities,  —  then  it  is,  as  this 
theory  indicates,  that  tubercular  consumption  does  its  dreadful  work, 
—  then,  that  *he  outward  world  of  this  physiological  Maelstrom  casts 
upon  the  shores  of  mortalit}''  so  many  thinned,  exhausted,  and  lifeless 
human  forms.  More  than  three-fourths  of  all  who  sink  under  this 
disorder  die  between  the  ages  just  named.  The  brain,  between  these 
points  of  time,  acquires  its  full  size  and  force. 

This  disease  prevails  most,  too,  in  those  countries  where  an  enlight- 
ened civilization  gives  to  the  nervous  system  its  fullest  development, 
as  in  Great  Britain,  France,  and  the  United  States,  and  in  those 
where  the  nutritive  process  is  most  retarded  by  a  relaxing  climate  ; 
and  it  is  scarcely  known  among  those  people  who  are  but  little  en- 
lightened and  have  small  brains,  and  among  those  who  live  in  high 
and  invigorating  latitudes.  As  the  most  enlightened,  however,  are 
generally  found  in  temperate  climates,  and  those  with  the  least  culti- 
vated brains  in  low  latitudes,  the  rule  is  not  perfectly  explained  by 
facts ;  yet  it  shows  itself  sufficiently  to  establish  its  validity,  and  to 
afford  another  proof  of  my  theory. 


)ne  and 
fonsump- 
nervous 
lutritive 
recon- 
forces, 
I  that  de- 
lilders. 


Bronchial  Consumption. 

The  persons  exposed  to  bronchial  consumption  are  generally  of  an 
opposite  habit  to  those  described  above,  —  having  the  nervous  force, 
in  health,  well  subordinated  to  the  vegetative,  the  assimilation  good, 
and  the  blood  well  supplied  with  red  globules.  They  have  usually  a 
full  habit  and  an  active  circulation.  The  absorbents,  and  other  ves- 
sels in  the  lungs,  working  in  the  midst  of  a  large  amount  of  caloric 


238 


DISEASES  OK  THE  CHEST. 


^i:  \ 


evolved  by  an  energetic  i-espiration,  often  ttike  cold,  which  brings  on 
lung-fever  and  pleurisy,  and  these  lay  the  foundation  for  the  ultimate 
destruction  of  the  lungs.  For  the  same  reason,  the  skin  of  this  class 
of  persons  becomes  diseased,  and  more  often  the  inner  skin,  or  mu- 
cous membrane,  and  most  often  that  portion  of  mucous  membrane 
which  goes  down  into  the  lungs  and  lines  the  air-tubes.  It  is  inflam- 
mation of  this  which  constitutes  bronchitis,  and  which  lays  the  foun- 
dation for  true  bronchial  consumption. 

As  that  class  of  persons  who  are  exposed  to  the  tubercular  form  of 
the  disease  suffer  a  general  loss  of  carburetted  hydrogen  in  its  several 
forms,  colliquative  diarrhuia,  sweats,  increased  breatliing,  and  all  con- 
ditions that  carry  fat  out  of  the  system,  so  those  who  suffer  from 
attacks  of  the  bronchial  tj-jjc  of  the  disorder  are  generally  afflicted 
with  the  opposite  condition.     They  have  too  much  carbon. 

It  is  well  ascertained  that  carburetted  hydrogen,  accumulated  in 
the  system,  acts  as  a  poison.  And  that  class  of  bilious  persons  who 
are  subject  to  this  disease  often  have  their  excretions  badly  performed. 
For  this  reason,  carbonaceous  compounds  accumulate  in  the  system, 
and  give  rise  to  the  symptoms  of  morbid  poison  circulating  in  the 
blood.  This  led  Dr.  Madden  to  suspect  the  presence  of  such  poison 
in  the  blood  of  all  consumptive  persons.  Ht(  saw  the  evidence  of  it 
in  numerous  cases,  and  not  distinguishing  the  one  class  from  the 
other,  he  inferred  its  presence  in  all. 


ill 
{ 


Constitutional  Difference. 

The  constitutional  difference  between  the  two  forriis  of  consump- 
tion appeai-fi  to  be  this :  the  tubercular  type  is  usually  attended,  in  its 
origin,  by  a  tolerably  good  state  of  the  digestive  function,  in  connec- 
tion with  bad  assimilation ;  while  the  bronchial  form  generally  has 
its  foundation  laid  in  connection  with  bad  digestion,  accompanied 
with  healthful  assimilation.  In  the  former  case,  the  food  is  well  di- 
gested, the  pabulum  is  properly  prepared,  but  the  nutritive  arteries  do 
not  use  it  for  renewing  the  tissues.  In  the  latter  case,  the  digestion 
is  bad,  the  pa^bulum  poorly  elaborated ;  but  the  re-constructive  vessels, 
under  the  control  of  a  well-developed  system  of  organic  nerves,  use 
it  to  the  best  advantage.  In  the  one  case  there  are  good  brick-waA;er«, 
and  lazy  hvick-layers  ;  in  the  othei:,  the  reverse. 

It  happens,  however,  that  before  the  fatal  close  of  the  disease,  tu- 
bercular patients  usually  become  afflicted,  more  or  less,  with  bad 
digestion,  and  bronchial  patients  with  defective  assimilation  ;  so  that, 
in  the  end,  they  present  us  with  much  the  same  class  of  symptoms. 
Starting  from  opposite  poles  in  life's  celestial  sphere,  they  meet  at 
the  culminating  point  of  death,  and  disappear  under  identical  aspects 
of  the  heavens. 


~1 


DISEASES  OF  THE   CHEST. 


239 


^  brings  oil 
he  ultimate 
if  this  class 
iin,  or  mu- 
menibraiiu 
ft  is  inflam- 
8  the  foun- 

lar  form  of 
its  several 
nd  all  cou- 
uffer  from 
ly  afflicted 

nulated  in 
irsons  who 
jerformed. 
le  system, 
ng  in  the 
ich  poison 
ence  of  it 
from  the 


consurap- 
ied,  in  its 
n  connec- 
3rally  has 
ompanied 
i  well  di- 
rteries  do 
digestion 
e  vessels, 
irves,  use 
k-makers, 

sease,  tu- 
A'ith  bad 
;  so  that, 
Tuptoms. 
'  meet  at 
.1  aspects 


Exciting  Causes  of  Tubercular  Consumption. 

IHE  preponderance  of  the  nervous  force  hein  r  f>,»  uf„+      u-  u 

burned  by  the  steam-engine  are   scarcelT^nL  ^T  ^'^^^ 

^.^N„r  are  the  pa«si„„»  aud  aentimente  le,,  exerci.ed,  or  le„  destruc 

ature,  sleeping  in  damp  sheets,  etc.  Th^se  eS  til  f  ^f  P^'" 
or  depress  the  vee-etativp  nr  ,-r,fl       \T  *"®  nervous  force, 

tubes,^or  the  subTt^^^e  of  the  unTn  tl  """'T  ^'^"^  «^  *^«  '^i- 
encloses  them,  so  Tto  induce  one  form  n^  S.^°^^?^°^  ^'^^k  which 
the  principles  I  have  explained   '  ''^''  '^  consumption  on 

due^t:  XtfofTbtrlsTthTr^^^^^^^^  ^r.o^.  no.^^.ys,  to  be 
cords,  the  upper  mrts  of  fS  f  ^^'^  neighborhood  of  the  vocal 

of  th    sare^^P's^tuberlrTV"''  ""'  ^"^^q^^^^'  ^t  the  ba.es 

5«.7;«.,  which  croi^IytseeT^th'.^rh"^^^^  ''^-  ^^^''^^^ 
and  then  only  after  beinj  steinpd  w,Tk  .  ^^  ^?'''^''  microscope, 
they  absorb      TliPSfl  S  ^'^  f '**'''  ^'^^^'^^  colors  which 

bacflli,  and  appear  u^^^^^^^  ^''  "^  the  rod-shaped  variety  of 

rods  about  TS  :n  leUh  Th?'"^'  ''  ^^"^'  ^'^^^^^  1^»««  or 
person  meaS  tuWculos^^of  some  pa^oH  "•'''  ^P"'"'"  «^  ^ 
they  are  associated  with  tL  preseTc/of  Jl  ^^^'J'rP'^'^S^^  i  when 
the  microscope)  they  are  a  p^ooToTth^^dtrbel^^^^^^^^^    Z^ 


'{ 


240 


mSKARKS  OF  THK   CHEST. 


L    .         ".,*■-/■' 


proper.     The  examination  of  one's  sputum,  therefore,  in  the  early 
part  of  any  prolonged  and  suspicious  cough,  becoi:  es  an  alwolute  ne- 
cessity, since  thereby  one  is  made  aware,  in  the  earliest  stages,  of 
this  dreadful  disease,  and  an  opportunity  offered  of  attacking  it  at  once 
in  ita  incipiency.     This  modern  discovery  has  given  rise  to  much 
experimentation  in  treatment  with  the  aim  in  view  of  killing  out  the 
germ.     Robert  Koch  of  Berlin  announced  to  the  world,  a  shoit  time 
ago,  that  he  had  discovered  an  agent,  which  he  called   Tuberculin 
that  would  eradicate  these   death-producing  germs,  but  time  has 
shown  his  efforts  to  bo  unsuccessful  as  yet,  although  promising  of 
great  results  in  the  future.     These  germs  are  contagious  in  character 
so  that  we  now  can  explain  why  mjtny  contmct  consumption  in  whose 
ancestral  blood  there  never  existed  any  tubercular  taint. 

We  know  that  husband  may  impart  the  disease  to  wife  and  mother 
to  daughter  if  only  the  system  is  in  a  receptive  state  to  offer  a  lode- 
merit  to  the  germs.  These  tiny  but  most  enduring  bacilli  retahi 
their  life  for  an  indefinite  time  in  the  midst  of  dust  and  other  dried 
secretions,  so  that  a  practical  point  is  that  all  persons  suffering  from 
tuberculous  diseases  should  be  exceedingly  careful  where  they  spit 
and  with  whom  they  sleep.  To  raise  the  sputum  into  small  paper 
cups  which  may  be  burned  is  a  common  and  very  prudent  custom 

Ihis  discovery,  while  not  disproving  the  old  theory  of  heredity 
nevertheless  explains  many  a  case  of  acquired  Phthisis,  and  clears  uj 
many  an  old-fashioned  theory. 

These  are  indisputable  facts  from  which  the  medical  profession  at 
present  hope  to  derive  practical  benefit  by  the  discovery  of  some 
germicide  which  may  be  applicable  and  safe  for  internal  administra- 
tion. 

Can  Consumption  be  Cured  ?  —  In  many  caaes  it  can.     It  may  be 
cured,  first,  by  the  absorption  of  the  tubercles.     The  celebrated  John 
Hunter  shows,  in  his  work  on  the  blood,  that  the  absorbent  vessels 
have  a  sort  of  elective  a#m«y,  by  which  they  take  up  and  remove  "all 
adventitious  new  matter,  as  tumors"  (tubercles  are  albuminous  tu- 
mors), more  easily  "  than  those  parta  which  were  originaUy  formed  " 
Were  this  not  so,  an  activity  in  these  vessels  equal  to  the  removal  of 
tubercles  would  cause  them  to  waste  all  the  tissues,  and  aggravate 
rather  than  cure  consumption.      Probably  this  does  occur  where 
proper  hygienic  means  are  not  used  to  quicken  the  excretions.     This 
hygienic  treatment,  to  be  spoken  of  hereafter,  is  not  generally  em- 
ployed,-certainly  not  as  effectually  as  it  should  be.     Here  is  the 
source  of  Laennec's  fatal  remark,  so  often  quoted  and  so  widely  en- 
dorsed, that  nature's  efforts  towards  effecting  a  cure  are  injurious, 
and  those  of  art  are  useless."     Laennec's  position  cannot  be  true,  if 
Hunter  s  statement  is  correct.     If  the  absorbents,  by  an  elective  in- 
stinct, take  up  adventitious  matter  rather  than  the  natural  tissues, 
filv^  reason  why  they  reverse  this  rule  in  consumption  is,  that  by 
a  weakened  state  of  the  constitution,  the  ultimate  particles  are  not 


DISEASES  OF  THE  CHEST. 


241 


1  tho  early 
il)8olute  ne- 
t  stages,  of 
ig  it  at  once 
ie  to  much 
ing  out  tlio 
I  shoit  time 
Tuberculin, 
it  time  has 
romising  of 
n  character, 
on  in  whose 

and  mother 
offer  a  lodg- 
lacilli  retain 
other  dried 
ffering  froiu 
re  they  spit 
small  paper 
it  custom, 
of  heredity, 
nd  clears  up 

)rofession  at 
pry  of  some 
1  administni- 

It  may  be 
)rated  John 
mt  vessels 
remove  "all 
iminous  tu- 
[ly  formed." 
removal  of 

aggravate 
3cur  where 
lions.     This 
[nerally  em- 

[ere  is  the 

widely  en- 
injuriom, 

be  true,  if 
lelective  in- 
1ml  tissues, 

is,  that  by 
lies  are  not 


well  put  together^  and  are  more  easily  Uiken  apart  than  those  of  the 
adventitious  tul)ercular  tumors  ;  and  if  we  would  restore  these  vessels 
to  their  natural  activity,  we  must  improve  assimilation,  and  knit  the 
unloving  molecules  into  a  firmer  brotherhood.  We  must  make  the 
flesh  hard,  so  that  the  absorbents  cannot  pick  it  to  pieces.  Do  this, 
and  "nature's  efforts  to  effect  a  cure"  will  not  "bo  injurious." 

A  second  form  of  euro  is  the  reestablisbment  of  the  assimilative 
function,  the  building  up  of  the  geneml  health,  the  arresting  of  the 
tubercular  deposit,  the  reducing  of  tubercles  already  formed  to  an 
indolent  state  ;  and  then,  by  a  strict  observance  of  the  laws  of  health, 
keeping  them  in  that  condition  through  life. 

A  third  mode  of  cure  is  the  healing  of  the  cavities  after  the  tuber- 
cles have  softened,  broken  down,  and  been  expelled  in  the  form  of 
expectoration. 

A  fourth  method  of  cure  is  a  change  of  tubercles  to  calcareous 
matter.  These  calcareous  tubercles,  Laennec  says,  "are  consequent 
to  tuberculous  affections  that  have  been  cured"  And  Andral,  at  one 
time,  hoped  to  learn  how  to  effect  cures  by  changing  tubercles  to 
"  the  calcareous  phosphate." 

I  have  had  several  cases  of  cure  by  this  last  method,  and  have 
quite  a  collection  of  calcareous  substances  which  my  patients  have 
coughed  up,  —  one  of  which  was  raised  in  my  presence  by  a  lady 
who  was  a  few  years  before  in  hopeless  consumption,  but  is  now  in 
good  health. 

Treatment.  —  This  should  be  of  two  kinds,  local  and  general. 

The  local  treatment  of  consumption  is  by  the  inhalation  of  vapors 
and  powders  into  the  lungs.  It  has  been  practised,  more  or  less,  by 
individuals,  for  many  yeai-s,  particularly  in  Europe ;  but  for  some 
unaccountable  reason,  the  profession  generally  have  never  used  it, 
and  do  not  know  much  about  it.  I  had  the  honor,  some  years  ago, 
to  bring  it  freshly  before  the  American  public,  in  some  articles  writ- 
ten for  popular  reading,  since  which  time  it  has  been  rapidly  gaining 
public  confidence,  and  is  now  attracting  much  attention.  Convejdng 
the  rsmedy  directly  to  the  diseased  parts,  it  strikes  the  common- 
sense  mind  as  eminently  reasonable  and  necessary. 

I  shall  speak  of  inhalation,  therefore,  very  earnestly,  not  as  a 
palliative  of  consumption  only,  but  as  far  more,  as  a  remedy.  After 
long  and  patient  use,  my  experience  allows  nie  to  say,  that  I  know 
it,  in  many  cases,  to  be  such ;  and  knowing  this,  I  should  be  criminal 
not  to  press  it  upon  the  public;  for  it  is  the  great  multitude  of 
sufferers,  pressing  fast  through  the  gate  of  death,  who  need  to  hear 
words  of  hope. 

Consumption  a  General  Disease.  —  It  is  not  denied  that  con- 
sumption is  a  general  disease,  needing  constitutional  treatment;  but 
it  has  also  a  local  development  in  the  lungs,  first  in  the  form  of  al- 
buminous tumors,  called  tubercles,  and  then,  after  the  softening. 


I  T  t' 


242 


DISEASF.S   OF   THE   CHEST. 


breaking  down,  and  discharge  of  these,  in  the  more  formidable  shape 
of  ulcerous  cavities,  whicli,  beginning  at  the  summit,  devour  thu 
lungs  down  to  the  base.  Can  it  be  reasonable  to  api)ly  no  remedy 
directly  to  this  local  disease  ?  Not  so  does  our  profession  deal  witli 
other  local  diseases.  To  an  inflamed  skin  we  apply  poultices,  cold 
compresses,  solutiouK  of  acettite  of  lead,  nitrate  of  silver,  etc. ;  to 
leprous  or  scaly  affections,  sulphuret  of  potash,  bichloride  cf  mer- 
cury, zinc  ointment,  nitrate  of  mercury  ointment,  sulphur,  creosote, 
etc. ;  to  weak  and  inflamed  eyes,  sulphate  of  copper,  sulphate  of 
zinc,  nitrate  of  silver,  and  opium  ;  to  chronic  ulcers  upon  the  skin, 
tannin,  pulverized  rhubarb,  opium,  or  cinchona ;  and  to  an  inflamed 
tliroat,  nitrate  of  silver  and  other  articles.  These  are  but  specimens 
of  the  thousand  cases  in  which  we  use  local  remedies.  Why,  then, 
when  the  mucous  membrane,  ,vhich  lines  the  air  tubes,  becomes  in- 
flamed through  all  its  branches,  should  we  neglect,  by  the  inhalation 
of  medicated  vapor,  to  apply  a  remedy  directly  upon  the  whole  in- 
flamed surface  ?  Why,  when  tubercu'  matter  is  l)eginning  to  be 
deposited  upon  the  surface  of  the  air  cells,  and  of  the  small  bronchial 
tubes,  shouhl  not  the  vapor  go  right  to  those  parts,  and  cause,  as  it 
woidd,  the  immediate  expulsion  of  tliiu  offending  and  dangerous 
matter  ? 

Uneducated  common  sense  sees  the  reasonableness  of  these  sug- 
gesvions  at  a  glance.  Many  a  person,  with  jjulmonary  disease,  dies 
of  suffocation,  not  because  there  is  not  muscidar  strength  to  expel 
the  matter  which  is  strangling  him,  but  because  the  lungs  below  the 
large  pellets  of  mucus,  which  plug  up  the  bronchial  tubes,  cannot  be 
inflated,  and  have  therefore  no  means  of  driving  out  the  offending 
substance.  Yet  a  proper  medicated  vapor,  drawn  in  with  the  breath, 
would  either  dissolve  the  mucus,  or  rouse  up  the  expiring  membrane 
to  cast  it  off. 

If  the  reader  were  to  place  one  end  of  a  stethoscope  directly  over 
the  disease  upon  the  breast  of  a  person  in  the  third  stage  of  consump- 
tion, and  should  then  ask  him  to  talk,  the  words  spoken  would  seem 
to  rise  up  through  the  instrument,  and  enter,  well  articulated,  into 
his  ear.  This,  in  technical  language,  is  c»X\edi  pectoriloquy, — a  word 
signifying  chest-talking.  It  implies  a  cavity  in  the  lung.  If  now  the 
patient  be  asked  to  cough,  a  gurgling  and  splasliing  sound  will  be 
heard.  This  denotes  that  the  cavity  is  partly  filled  with  fluid,  which 
is  dashed  about  by  the  air  explosively  driven  through  it  by  the  portion 
of  lung  below.  Here  we  have  an  excavated  ulcer,  with  aU  its  filthy 
contents,  composed  of  pus,  mucus,  serum,  and  dissolved  tubercles, 
lying  in  it  day  and  night  to  aggravate  its  unhealthy  condition.  What 
more  reasonable,  what  more  necessary,  than  that  a  soothing,  altera- 
tive, or  astringent  vapor  should  be  drawn  into  this  cavity,  to  cause 
its  sides  to  heal,  and  its  absorbents  to  remove  this  fluid?  A  surgeon 
who  should  permit  an  ulcer  upon  the  surface  of  the  body  to  remain 
in  that  condition  without  a  local  dressing  would  be  deemed  unfit  to 
practise  his  profession. 


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Sciences 

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23  WEST  MAIN  STREET 

WEBSTER,  N.Y.  14580 

(716)872-4503 


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DISEASES  OF   THE   CHEST. 


248 


Both  in  tubercular  disease  and  in  simple  bronchitis,  the  bronchial 
tubes  almost  always  suffer  some  physical  change.  The  raucous 
membrane  lining  these  tubes  is  generally  softened.  At  other  times 
the  tubes  become  enlarged  through  their  whole  length,  so  that  many 
of  them,  from  tJie  size  of  a  quill,  reach  the  bigness  of  the  finger  of  a 
glove.  In  still  other  caseS;  the  straining  produced  by  coughing 
causes  a  tube  to  belly  out  at  some  point,  forming  a  sack,  which  is 
generally  filled  with  mucus  or  purulent  matter.  At  still  other  times, 
a  tubercle  will  press  against  a  tube  so  as  to  flatten  it  and  convert  it 
into  a  musical  instrument,  the  air,  as  it  is  diawn  laboriously  through, 
producing  a  high  or  low  note,  according  to  the  size  of  the  pipe. 
These  physical  changes  are  all  produced  by  causes  which  the  inhala- 
tion of  a  suitable  vapor,  at  tlie  proper  time,  would  almost  infallibly 
remove.  How  strange  that  this  remedy,  —  so  simple,  so  effectual, 
so  easily  comprehended,  —  should  have  been  so  little  used  I 

Right  at  this  vital  point  in  the  lungs,  where  the  blood  runs  in  a 
ceaseless  current,  —  where  the  whole  of  it  goes  every  two  minutes  to 
renew  its  vitality  by  contact  with  atmospheric  air,  —  we  have,  in 
thousands  of  cases  daily  occurring,  inflammation  Avith  roughening  or 
softening  of  membrane,  with  its  consequent  harsh  breathing ;  we  have 
mucus,  tough  or  glairy,  to  impede  and  interrupt  respiration ;  we  have 
tubercles  in  the  hard  or  soft  state,  adding  to  the  general  embarrass- 
ment, and  not  only  lessening  the  vitality  of  the  blood,  but  disturbing 
all  the  sympathies  of  the  system ;  —  and  yet  the  practice  has  been, 
and  is,  to  attack  these  central  distm-bers  of  life  only  through  the  cir- 
cuitous path  of  the  stomach,  lacteals,  etc. 

I  have  investigated  faithfully  the  effects  of  the  various  substances 
proposed  for  inhalation  by  European  physicians,  and  have  explored  a 
wide  field  of  new  remedies,  not  before  used,  several  of  which  have 
proved  to  have  qualities  of  great  remedial  power. 

The  chief  remedies  I  employ  for  inhalation  are  the  following . 

Alterative  Inhalant,  composed  of  iodine,  six  grains ;  iodide  of 
potassium,  twelve  grains  ;  tincture  of  ipecac,  one  ounce  ;  tincture  of 
balsam  of  tolu,  six  drams ;  ethereal  tinctui-e  of  conium,  one  and  a  half 
drams ;  alcohol,  half  a  pint.  These  are  to  be  mixed.  The  dose  is 
one  to  two  teaspoonfuls,  to  be  inhaled  ten  or  fifteen  minutes,  in 
about  a  gill  of  hot  water. 

The  ethereal  tincture  of  conium  is  made  by  keeping  a  dram  of 
powdered  conium  in  one  ounce  of  sulphuric  ether  a  week. 

The  above  inhalant  is  used  in  the  tubercular  forms  of  consump- 
tion, particularly  that  of  the  scrofulous  kind,  and  in  mauy  cases  of 
bronchitis. 


Expectorant   Inhalant.  —  Take   pleurisy   root,   half   an 
squill,  one  ounce ;  ipecac,  two  drams ;  black  cohosh,  two 
queen's  root,  one  ounce  and  a  half;  American  hellebore,  two  drams; 
diluted  alcohol,  one  pint.    Grind  the  roots,  etc.,  and  add  the  alcohol. 


ounce ; 
ounces ; 


244 


DISEASES   OF  THE   CHEST. 


Let  the  whole  stand  one  week,  shaking  or  stirring  daily.  Draw  off 
and  filter  through  paper.  Two  teaspoonfuls  make  a  dose,  to  be  in- 
haled same  as  preceding. 

This  is  to  be  used  when  the  cough  is  hard  and  dry,  and  the  expec- 
toration difficult.  It  makes  the  raising  easy,  lessening  the  soreness 
of  the  chest,  and  the  harshness  of  the  cough. 

Soothing,  Febrifuge  Inhalant.  —  Take  belladonna  leaves,  half  an 
ounce ;  black  cohosh,  two  ounces ;  American  hellebore,  half  an  ounce ; 
poke-root,  two  drams ;  aconite  root,  one  ounce ;  diluted  alcohol,  one 
pint.  Grind  the  roots,  etc.,  add  the  alcohol.  Let  the  whole  stand 
one  week,  stirring  daily.  Pour  off  and  filter  through  paper.  Dose, 
one  to  two  teaspoonfuls,  to  be  inhaled  as  the  preceding. 

This  is  excellent  in  all  cases  where  the  skin  is  hot,  the  pulse 
quick,  the  tongue  and  mouth  parched,  the  chest  sore,  and  the  system 
suffering  during  the  whole  or  a  part  of  each  day,  from  a  general 
feverish  condition.     It  is  proper  in  all  the  forms  of  chest  disease. 

Astringent  Inhalant.  —  Take  of  wild  indigo,  one  ounce ;  catechu, 
half  an  ounce ;  Peruvian  bark,  one  ounce ;  golden  seal,  one  ounce ; 
diluted  alcohol,  one  pint.  Mix,  and  let  the  whole  stand  one  week, 
stirring  daily.  Drain  off,  and  filter  through  paper.  Add  two  di-ams 
of  creosote.     One  to  two  teaspoonfuls  to  be  inhaled  as  preceding. 

This  is  to  be  used  when  the  expectoration  is  profuse  and  easy,  un- 
attended by  fever,  either  in  the  latter  stages  of  chronic  bronchitis, 
when  the  mucous  membrane  of  the  tubes  is  in  a  relaxed  condition, 
or,  in  the  third  stage  of  tubercular  disease,  for  the  purpose  of  con- 
stringing,  cleansing,  strengthening,  and  healing. 

Antiseptic  Inhalant.  —  Take  wild  indigo,  one  ounce ;  belladonna 
leaves,  half  an  ounce ;  diluted  alcohol,  one  pint.  Mix,  and  let  the 
whole  stand  one  week.  Pour  off,  and  filter  through  paper.  Then 
add  solution  of  chloride  of  soda  two  ounces.  Dose,  one  to  two  tea- 
spoonfuls, to  be  inhaled  as  the  preceding. 

This  is  used  in  cases  of  gangrene  of  the  lungs,,  generally  distin- 
guished by  considerable  expectoration  having  a  very  fetid  smell. 

Anti-Hemorrhagic  Inhalant.  —  Take  witch-hazel  bark,  two 
ounces ;  black  cohosh,  four  ounces.  Grind,  and  add  one  pint  of 
diluted  alcohol.  Let  the  mixture  stand  one  week,  stirring  daily. 
Pour  off,  and  filter  through  paper.  Add  to  this  two  drams  of  creo- 
sote.    Dose,  one  to  three  ieaspoonfuls,  to  be  inhaled  as  preceding. 

This  is  an  excellent  remedy  for  bleeding  from  the  lungs.  When 
there  is  a  tendency  to  bleed,  it  should  be  used  for  a  long  time.  It 
may  frequently  take  the  place  of  No.  4,  as  an  astringent  inhalant. 

For  immediate  relief  give  strong  solution  of  salt  water. 

Object  of  Inhalants.  —  Being  vaporized  and  inhaled,  these  articles 
enter  every  air-cell  throughout  the  lungs.  Their  object  is  to  soothe 
and  mollify  inflamed  mucous  surfaces,  to  reduce  enlarged  bronchial 


■>inn*i<iimiiijnii(,  M 


riSEASES  OF  THE  0HB8T. 


24r 


.     Draw  off 

le,  to  be  in- 

i  the  expec- 
ihe  soreness 

ves,  half  an 
[f  an  ounce; 
alcohol,  one 
^•hole  stand 
per.     Dose, 

b,  the  pulse 
[  the  system 
a  a  general 
disease. 

36 ;  catechu, 
one  ounce; 
I  one  week, 
[  two  dmms 
eceding. 
id  easy,  un- 
bronchitis, 
I  condition, 
lose  of  con- 
belladonna 
md  let  the 
per.  Then 
to  two  tea- 

:ally  distin- 
smell. 

bark,  two 
ne  pint  of 
ring  daily, 
ns  of  creo- 
'eceding. 
TB.  When 
time.  It 
nhalant. 

ese  articles 
to  soothe 
bronchial 


glands  which  press  upon  neighl)oring  parts  and  ciiuse  bleeding,  to 
stimulate  the  absorbents  to  take  up  and  remove  tubercles,  to  dissolve 
tubercles  out  of  the  pulmonary  tissue,  to  cause  ulcerous  cavities  to 
expel  their  mattery  contents,  and  to  stimulate  their  sides  to  take  on 
a  healing  process.  They  should  be  used  from  three  to  six  times  a 
day,  the  inhalation  continuing  from  ten  to  fifteen  minutes. 

Other  Inhalants.  —  Great  numbers  of  other  articles  have  been 
used,  which  I  have  not  space  to  describe.  I  will  mention,  however, 
that  the  following  are  sometimes  employed  with  advantage  :  — 

For  an  Expectorant  Inhalant,  take  alcohol,  four  ounces ;  tincture 
of  camphor,  half  an  ounce ;  tincture  of  tolu,  two  drams ;  naphtha, 
one  dram ;  benzoic  acid,  thirty  grains ;  oil  of  bitter  almonds,  four 
drops.     Mix. 

For  an  Anodyne  Inhalant,  take  alcohol,  four  ounces ;  naphtha,  one 
dram ;  benzoic  acid,  thirty  grains ;  chloroform,  twenty-five  drops ; 
tincture  of  henbane,  half  an  ounce.     Mix. 

For  an  Astringent  Inhalant,  take  alcohol,  four  ounces ;  naphtha, 
one  dram ;  benzoic  acid,  thirty  grains ;  chloroform,  one  dram ;  tannin, 
eight  grains.     Mix. 

Mode  of  Inhaling.  —  For  inhaling  these,  a  sponge  is  fitted  into  a 
glass  cup,  to  which  a  flexible  tube  is  attached.  A  small  quantity  of 
the  mixture  is  poured  upon  the  sponge,  and  the  vapor  arising  is 
drawn  into  the  lungs  through  the  tube. 

To  the  expectorant  inhalant  may  be  added,  occasionally,  half  a 
dram  of  nitric  acid. 

These  latter  formulas  are  the  principal  ones  used  by  those  who 
practice  what  is  called  cold  inhalation. 

A  very  common  mode  of  inhaling  volatile  remedies  is  by  saturat- 
ing a  little  cotton,  contained  in  a  wire  basket,  with  the  desired  oil  or 
fluid,  and  placing  it  over  the  mouth  and  nose.  It  is  to  be  worn 
throughout  the  day.  Oil  of  peppermint,  creosote,  menthol,  oil  of 
eucal3rptus,  etc.,  etc.,  are  among  the  more  common  remedies  thus 
used. 

A  good  inhaler  can  be  bought  of  any  dealer  in  surgical  instruments. 

Constitutional  Treatment.  —  The  rapid  breathing  in  consump- 
tion creates  too  much  oxydation  of  the  blood,  —  so  much,  that  the 
muscles,  especially  the  heart,  are  usually  of  a  bright  red.  To  prevent 
the  patient  from  being  literally  burned  up  by  oxygen,  the  blood 
must  be  de-oxydated  as  fast  as  possible. 

While  there  is  too  much  of  oxygen,  there  is,  at  the  same  time,  a 
deficiency  of  carbon.  Hence  the  cold  hands  and  feet,  and  the  gen- 
eral inability  to  bear  frosty  weather.  The  little  nutritive  arteries,  in 
these  thin-blooded  persons,  stand  shivering  and  torpid  with  cold,  un- 
able to  perform  their  allotte.1  function  of  nutrition.  There  is  not 
fire  enough,  and  fuel  must  be  had  in  the  form  of  carbon.  Hence  one 
of  the  advantages  of  cod-liver  oil.     This  oil,  too,  as  carbon,  devoui-s 


246 


DISEASES   OF    THE   CHEST. 


the  oxygen  of  the  blood,  and  prevents  its  destroying  the  patient. 
Phis  idea  also  explains  the  fact  mentioned  by  Beniiet  and  others, 
that  in  their  post-mortems  they  found  the  evidences  of  healed  ulcei-s 
in  numerous  persons  who  had  been  spirit-drinkers  while  living.  Ami 
Liebig  helps  the  explanation  by  saying  that  alcohol,  taken  into  the 
system,  circulates  in  a  free  state  in  the  blood,  and  devours  its  oxygen. 
To  which  I  beg  to  add,  that  the  malaria  of  intermittent  and  bilious 
fever  districts,  has  been  pretty  satisfactorily  proved  to  be  an  instable 
organic  body,  consisting  of  sulphur,  carbon,  and  hydrogen,  all  of 
which  have  an  affinity  for  oxygen,  and  devour  it  in  the  system. 
Consumption  is  not  found  in  such  districts 

As  I  am  here  treating  of  the  chemical  effects  of  remedies  (and  to 
this  test  most  remedies  must  finally  come),  I  will  mention  that  tar- 
trate of  antimony  and  potassa  arrests  the  circulation  in  the  pulmonary 
arteries,  —  which  fact  gives  a  complete  and  luminous  view  of  its 
power  to  prevent  oxidation.  But  I  am  obliged  to  detract  from  its 
merits,  by  stating  that  it  also  retards  the  circulation  in  the  capillaries 
of  the  system  generally,  and  so  hinders  c?e-oxidation. 

Phosphorlis.  —  There  is  an  article  which  has  more  recently  pre- 
sented itself  to  the  notice  of  the  profession,  to  which  I  wish  to  invite 
special  attention.  I  refer  to  phosphorus.  This  agent,  for  a  time, 
challenged  our  notice  in  the  shape  of  phosphate  of  lime  ;  but  we  could 
never  feel  sure  that  this  article  was  dissolved  in  the  fluids  of  the 
body.  We  now  use,  and  with  far  more  marked  effect,  the  hypo- 
phosphites  of  lime,  soda,  potash,  and  iron.  These  are  used  in  tlie 
form  of  the  syrup  of  the  hypophosphites.  The  dose  is  a  teaspoonful 
before  each  meal.  The  effect  unon  tubercular  disease  is  immediate 
and  gratifying. 

Need  of  Phosphorus.  —  Cerebric  acid  contains  nitrogen  and  phos- 
phorus, and  is  t'.ie  peculiar  component  of  the  brain  and  nervous  sys- 
tem. By  combustion  and  the  changes  of  oxidation  in  the  brain,  the 
phosphorus  of  cerebric  acid  is  converted  into  phosphoric  acid ;  so  that 
every  act  of  the  brain  produces  phosphoric  acid.  How  rapid,  then, 
must  be  the  consumption  of  the  phosphoric  element  of  the  cerebric 
acid,  in  that  highly  active  p,nd  excitable  state  of  the  nervous  system 
which  I  have  described  as  peculiar  to  consumption.  And  how  neces- 
sary, in  order  to  save  the  brain  from  destruction,  to  meet  this  increased 
demand  for  phosphorus,  by  introducing  it  into  the  system. 

Mulder  regards  the  fibrin  of  the  blood  as  the  carrier  of  oxygen;  and 
by  this  oxidation,  the  fibrin  becomes  converted  into  the  binoxide  r.nd 
trioxide  of  protein,  —  its  phosphorus  and  sulphur  (for  it  ccitains 
both)  being  converted  into  phosphoric  and  sulphuric  acids.  Adding 
phosphorus  and  sulphur,  therefore,  as  medicinal  agents,  would  seem 
to  be  the  proper  way  to  supply  the  fibrin  with  materials  destructive 
of  its  freight  of  oxygen. 

It  is  well  known  that  the  salts  of  phosphoric  acid  are  essential  for 


DISEASES  OF   THE   CHEST. 


247 


the  patient. 
t  and  othci's, 
healed  ulcers 
living.  And 
ken  into  the 
rs  its  oxygen, 
t  and  hilioiis 
)e  an  instable 
rogen,  all  of 
I  the  system. 

edies  (and  to 
bion  that  tar- 
he  pulmonary 
3  view  of  its 
ract  from  its 
the  capillaries 

recently  pre- 
wish  to  invite 
t,  for  a  time, 

but  we  could 

fluids  of  the 
ct,  the  hypo- 
!  used  in  the 
a  teaspoonful 

is  immediate 


jen  and  phos- 

nervous  sys- 
the  brain,  the 

acid ;  so  that 
V  rapid,  then, 

the  cerebric 
rvous  system 

d  how  neces- 
this  increased 
3m. 

oxygen;  and 
biuoxide  r.nd 
)r  it  ccatains 

ds.     Adding 

would  seem 
s  destructive 

essential  for 


the  formation  of  azotic  compounds,  —  conii«)und8  wlii(^h  are  neces- 
sary to  sustain  animal  life.  It  should  be  reiuumbcrcd,  too,  as  collat- 
erally illustrating  this  fact,  that  the  tribasic  phosphates  of  potash,  soda, 
lime,  and  magnesia,  j)lay  an  important  part  in  the  growth  and  perfec- 
tion of  plants.  They  are  always  found  in  the  seeds  of  the  cerelia,  and 
no  mature  grains  are  produced  where  phosphates  are  absent  from  the 
soil.  For  the  production  of  abundant  grain-crops,  it  is  necessary 
that  these  salts  should  exist  in  the  soil,  or  be  applied  to  it  in  manures. 

It  is  known,  moreover,  that  in  all  chronic  diseases  distinguished  by 
wasting  of  tlie  tissues,  a  much  larger  quantity  of  phosphates  is  ex- 
creted by  the  kidneys  than  in  the  normal  state.  Hence  there  is  no 
healthful  growth ;  and  the  human  organism,  like  the  soil,  exhausted 
of  its  phosphates  by  successive  croppings,  brings  nothing  to  perfec- 
tion, and  needs  to  have  its  drained  salts  re-supplied. 

I  cannot  but  call  attention  here  to  the  inorganic  substances  found 
in  healthy  human  blood.  According  to  very  careful  analyses,  by 
Schmidt : 


1000  parts  of  blood-corpuscles,  contain  : 

Chlorine 1.686 

Sulphuric  Aeki 0.066 

Phosphoric  Add 1.134 

Potassium 3.328 

Sodium 1.052 

Oxygen 0.667 

Phosphate  of  Lime 0.114 

Phosphate  of  Magnesia  ....  0.073 


1000  parts  of  liquor  sanguinis  (serum 
and  fibrin),  contain : 

Chlorine 3.664 

SulhuricAcld 0.115 

Phosphoric  Acid 0.191 

Potassium 0.323 

Sodium 3.341 

Oxygen 0.403 

Piiosphate  of  Llrao 0.311 

Phosphate  of  Magnesia  ....  0.222 


Iron  is  omitted.  Now,  I  venture  the  prediction,  that  out  of  these 
figures,  mainly,  in  connection  with  those  which  represent  the  consti- 
tuents of  the  saliva,  the  bile,  the  gastric  juice,  the  pancreatic  secretion, 
and  the  organic  compounds  of  the  blood  and  tissues,  are  to  be  evolved 
within  a  few  years  a  correct  and  partially  demonstrative  system  of 
medication.  In  consumption,  all  the  inorganic  bodies  represented  by 
the  above  figures,  with  the  exception  of  oxygen,  are  deficient  in  quan- 
tity. By  reflecting  upon  the  proportions  of  these  several  bodies,  par- 
ticularly upon  the  large  amount  of  clilorine  and  soda  in  the  plasma, 
and  of  potassium  in  the  corpuscles,  the  mind  can  hardly  fail  to  obtain 
useful  hints.  I  have  not  hesitated  to  make  one  of  these  hints  the 
ground  of  a  very  free  use  of  alkalies,  —  particularly  in  the  form  of 
bathing. 

Sugar  of  Milk.  — There  is  one  other  medicinal  article  which  I  deem 
worthy  to  be  mad  prominent,  and  to  be  placed  side  by  side  with  cod 
liver  oil  and  the  hypo-phosphites.  I  refer  to  sugar  of  milk.  It  belongs 
to  that  class  of  non-nitrogenized  articles  which  Liebig  has  denomi- 
nated supporters  of  respiration.  Its  great  affinity  for  oxygen  is  well 
worthy  to  be  taken  into  the  account,  in  considering  its  value  in  con- 
sumption. So  great  is  this  attraction,  that,  with  ammonia  and  other 
alkalies,  it  has  the  power  of  reducing  some  of  the  metallic  oxides. 


248 


DISEASES   OP   THE   CHEST. 


When  taken  into  the  stomach,  it  is  rapidly  alworbed  into  the  blood, 
which,  being  an  alkaline  fluid,  augments  its  great  de-oxidating  power 
to  a  considerable  degree.  It  unites  rapidly  with  oxygen  after  enter- 
ing the  blood,  forming  carbonic  acid  and  water.  A  part  of  it,  how- 
ever, does  not  enter  the  blood  in  an  uncompounded  state,  but  is 
changed  in  the  stomach  into  lactic  acid ;  and  this,  in  the  blood,  be- 
comes an  alkaline  lactiite.  But  the  portion  thus  changed  appears 
also  very  useful ;  for  Lehmann  says :  "  We  know  of  no  substance 
which  could  better  act  in  the  blood  as  food  for  the  respiration,  than 
the  alkaline  lact^ates." 

Corroborative  of  these  views  is  the  fact  that  all  those  kinds  of 
milk,  such  as  goat's,  ass's,  etc.,  which  contain  the  largest  amount  of 
sugar  of  milk,  have  at  different  times,  and  in  various  countries,  ol>- 
tained  a  reputation  for  curing  consumption.  Goat's  whey,  in  which 
this  article  abounds,  and  from  which  it  is  largely  manufactured,  has 
been  celebrated  for  its  virtues  in  this  line.  Ancel  speaks  of  it  as  an 
excellent  remedy ;  and  Pereira  says,  "  Sugar  of  milk,  in  consumptive 
cases  and  chronic 'diseases  of  the  digestive  organs,  is  a  most  valuable 
aliment." 

One  of  the  best  forms  of  taking  sugar  of  milk  is  that  of  a  gruel, 
which  is  quite  palatable,  and  may  be  freely  eaten  by  consumptive 
persons. 

Creosote,  Quaicol,  etc.  —  Modern  researches  having  proved  that 
consumption,  as  well  as  many  throat  and  other  diseases  are  propa- 
gated by  germs  or  bacilli,  as  explained  on  page  239,  medical  investi- 
gators have  for  a  long  time  been  seeking  some  agent  that  would 
destroy  these  germs  without  at  the  same  time  injuriously  affecting 
the  human  system.  A  few  years  ago  Dr.  Robert  Koch,  a  celebrated 
German  scientist,  who  had  long  been  investigating  the  consumption, 
cholera,  and  other  microbes,  thought  he  had  discovered  a  lymph  that 
would  destroy  or  at  least  counteract  the  consumption  bacillus ;  but 
unfortunately  it  proved  a  failure.  Creosote,  carbolic  acid,  guaicol 
and  similar  drugs  kill  the  germ  when  outside  the  body,  and  for  this 
reason  most  therapeutists  of  to-day  use  these  remedies  in  as  large  a 
quantity,  and  for  as  long  a  time  as  tho  system  will  tolerate.  At  all 
events,  whatever  may  be  the  outcome  of  thecustom  at  present  in 
vogue,  creosote  certainly  arrests  the  rapid  proliferation  of  germ-life 
in  the  lungs,  improves  the  appetite  and  digestion,  lowers  the  temper- 
ature, and  apparently  helps  the  patient.  The  only  offset  to  the  use 
of  this  class  of  remedies  lies  in  the  fact  that  one  cannot  thoroughly 
disinfect  the  blood  sufficiently  to  kill  these  germs  completely.  Creo- 
sote made  from  beechwood,  taken  in  three-drop  doses  with  a  wine- 
glass of  milk,  after  food,  three  times  a  day,  is  the  usual  form  of 
administration.  This  dose  should  gradually  be  increased  till  ten  and 
even  twenty  drops  are  taken  at  a  time.  The  carbonate  of  creosote  is 
a  more  elegant  and  perhaps  more  effective  form  of  the  drug.  This 
medicine  may  also  be  procured  in  the  form  of  capsules  .and  pills. 


■-~-i»<B«a>i  iir«Mist'jtaitaw'< 


:he  blood, 
ng  power 
fter  entei- 
f  it,  how- 
te,  but  is 
blood,  be- 
d  appeal's 
substance 
tiou,  than 

I  kinds  of 
imount  of 
ntries,  ol)- 
,  in  which 
tured,  has 
)f  it  as  an 
isumptive 
t  valuable 

f  a  gruel, 
isumptive 

oved  that 
are  propa- 
al  investi- 
hat  would 
k  affecting 
celebrated 
sumption, 
onph  that 
lUus;  but 
d,  guaicol 
d  for  this 
IS  large  a 
.     At  all 
resent  in 
germ-life 
e  temper- 
,0  the  use 
loroughly 
y.    Creo- 
h  a  wine- 
form  of 
I  ten  and 
reosote  is 
g.     This 
pills. 


DISEASES   OF   THE   CHEST. 


249 


By  Dr.  Cyrus  Edison's  recently  discovered  product  &f  carbolic 
acid,  iusepsin,  it  is  claimed  that  seventy  per  cent  of  consumptive 
oases  can  be  cured.  It  can  only  be  administered  as  a  hypodermic 
injection,  however,  at  the  hands  of  an  experienced  practitioner. 

The  Coug^h. — The  best  article  I  have  ever  used  for  this  is  the 
"Pulmonic  Cherry  Cordial."  I  was  five  years  in  compounding  this 
article  to  suit  me,  and  I  believe  it  to  be  the  very  best  cough  prepa- 
ration ever  made.     Dose,  from  one  to  two  teaspoonfuls. 

Pulmonic  Cherry  Cordial. — Wild-cherry  bark,  ground,  10  pounds 
ipecac  root,  20  ounces ;  bloodroot,  24  ounces ;  squill  root,  bruised,  12 
ounces ;  pulverized  liquorice  root,  5  ounces ;  cochineal,  bruised,  2 
ounces  ;  anise  seed,  32  ounces ;  fennel  seed,  8  ounces ;  orange  peel, 
16  ounces  ;  acetate  of  morphine,  12  drams  ;  alcohol,  8  gallons  ;  water, 
8  gallons ;  pulverized  white  sugar,  40  pounds ;  sulphuric  acid,  1 
ounce. 

Directions  for  making.  —  Grind  all  the  articles  to  a  coarse  powder 
except  those  directed  to  be  bruised  or  pulverized,  and  put  them  all 
to  the  alcohol  except  the  wild-cheriy  bark,  the  water,  the  sugar,  and 
the  sulphuric  acid.  Let  them  stand  one  week,  shaking  or  stirring 
thorouglily  twice  a  day.  Then,  having  kept  the  wild-cheny  bark  two 
days  in  a  covered  vessel,  with  water  enough  ujjon  it  to  wet  it  through, 
place  it  in  a  percolator,  and  run  eight  gallons  of  water  through  it. 
Add  this  to  the  alcohol  and  other  ingredients.  Let  the  whole  stand 
tliree  days  longer,  stirring  as  before,  twice  a  day.  Draw  off,  and  fil- 
ter through  paper.  Now  add  the  sugar,  and  lastly  the  sulphuric  acid. 
The  acid  is  intended  mainly  to  improve  the  color,  by  acting  chemi- 
cally upon  the  cochineal.  The  color  is  a  fine  cherry  red,  tinged  with 
orange. 

I  have  given  the  directions  for  making  sixteen  gallons  —  this  being 
the  smallest  quantity  in  which  I  make  it.  Any  person  can  easily 
make  the  calculation  for  reducing  the  quantity.  The  assertion  pre- 
viously made  that  tliis  is  the  "  best  cough  preparation  ever  made,"  I 
see  no  cause  to  modify  in  the  smallest  degree.  Were  it  kept  in 
every  apothecary  shop,  and  were  physicians  to  prescribe  in  pul- 
monary complaints,  adding  a  little  syrup  of  squills  or  wine  of  ipecac 
when  a  more  expectorant  effect  is  wanted,  or  a  little  morphine  if 
greater  narcotism  is  sought,  it  would  save  them  much  trouble  in  com- 
pounding cough  syrups,  and  give  them  much  more  satisfactory  re- 
sults. I  have  compared  its  effect,  again  and  again,  with  the  best 
other  preparations  in  use,  and  I  pledge  my  word  that  it  will  succeed 
in  twice  as  many  cases  as  any  other  compound  that  may  be  chosen. 
Let  physicians  try  it;  and  I  will  be  responsible  for  ever  hair's 
breadth  in  which  they  find  this  proportion  of  successful  results 
abridged. 

When  a  more  quieting  effect  is  needed,  a  little  morphine  may  be 
added  to  this  preparation  ;  if  a  more  expectorant  influence  is  required, 
add  a  few  drops  of  the  tincture  of  veratrum  viride.     For  the  great 


MM 

mm 


■\  ■'» 


■  —  ""■>»" 


250 


DISEASES   OF  THE  CHEST. 


majority  of  cases,  it  will  l)e  found  to  be  right  without  any  addition. 
When  this  is  notathand,  my  of  the  preparations  (108),  (112),  (100), 
(113),  (110),  etc.,  may  be  used.  Another  good  preparation  is  Dr. 
King's  consumption  cure. 

Night  Sweats.  —  The  very  best  preparation  for  these  sweats  ia  a 
compound  of  the  oxide  of  zinc,  one  dram ;  extmct  of  conium,  half  a 
dram ;  to  be  made  into  twenty  pills,  of  which  one  or  two  are  to  be 
taken  every  night.  The  sponge  bath  also  does  much  to  check  these 
sweats,  and  vinegar  baths  (369).  Atropia,  ^U  of  a  grain  on  retiring, 
and  especially  Agaricin,  ^  grain,  will  cause  the  sweats  to  stop  abso- 
lutely. 

Diarrhoea.  —  This  is  a  most  exhausting  symptom  in  the  latter 
stages  of  consumption.  The  only  remedy  which  has  much  effect  in 
controlling  it  is  the  iris-nitrate  of  bismuth.  This  should  be  given  in 
doses  of  thirty  grains  immediately  after,  or  at  the  time  of  each  meal. 
These  doses  are  much  larger  than  used  to  be  given ;  but  they  will 
do  no  harm.     Given  to  tliis  extent,  I  find  the  bismuth  very  effectual. 

Iron.—  This  preparation,  in  some  of  its  forms  (316),  (73),  (159), 
(102),  is  almost  always  needed  in  consumption.  If  the  scrofulous 
habit  be  strongly  marked,  give  syrup  of  iodide  of  iron,  in  thirty-drop 
doses,  three  times  a  day.  It  should  be  taken  in  a  glass  of  water.  To 
the  feeble  administer  Gude's  pepto-mangan  in  teaspoonful  doses  three 
or  four  times  daily.  This  is  one  of  the  simplest  and  most  effica- 
cious forms  of  iron  we  have. 

External  Irritants These  are  needed  where  there  is  much  in- 
flammation and  soreness  of  the  chest.  Blisters  should  very  seldom 
be  used.  Croton  oil,  from  two  to  half  a  dozen  drops,  rubbed  over 
the  sore  part,  generally  answers  very  well.  Sometimes  the  mustard 
paste,  applied  to  the  extent  of  producing  redness,  two  or  three  times 
a  week,  is  sufficient.  Nitric  acid,  reduced  with  water  to  a  strength 
a  little  above  the  strongest  vinegar,  answers  a  good  purpose  for 
keeping  up  an  irritation. 

Atmospheric  Inhaiation.-- -It  has  been  said  by  Laennec  and  others, 
that  asthma  has  sometimes  the  effect  of  arresting  tubercular  consump 
tion.  Dr.  Ramadge  thought  this  was  effected  by  an  expansion  of 
the  vesicular  structure  of  the  lungs  ;  and  he  reasoned  that  the  same 
expansion,  by  mechanical  means,  would  secure  a  similar  end.  To  ef- 
fect this,  he  made  his  patients  take  long  breaths  through  a  tube  con- 
structed for  the  purpose. 

It  is  manifest  that  the  philosophy  of  atmospheric  inhalation  was 
not  understood  by  Dr.  Ramadge,  nor  has  it  been  by  any  of  his  fol- 
lowers in  this  country. 

Rokitansky  thinks  the  tubercular  habit  depends  upon  the  excess 
of  fibrin  in  the  blood ;  and  says  that  the  reason  of  consumption  being 
arrested  by  pregnancy  is,  that  this  condition  offers  a  mechanical  ob- 


•  •TmriiiiBHJSMMiSWi'''''''' 


'  I 


IHSEASKrt   OK   THK   CHEST. 


261 


ly  addition. 
I2),(10!t), 
ition  is  Dr. 


sweats  is  a 
lium,  half  a 
ro  are  to  Ihj 
check  these 

on  retiring, 
)  stop  alwo- 

a  the  latter 
ich  effect  in 
be  given  in 
f  each  meal, 
ut  they  will 
ry  effectual. 

:73),  (159), 
B  scrofulous 

thirty-drop 
f  water.  To 
I  doses  three 

most  effica- 

is  much  in- 
very  seldom 
rubbed  over 
the  mustard 
:  three  times 
}  a  strength 
purpose  for 

c  and  others, 
lar  consump 
jxpansion  of 
lat  the  same 
end.  Toef- 
1  a  tube  con- 
halation  was 
ly  of  his  fol- 

a  the  excess 
nption  being 
jchanical  ob- 


stacle to  the  transmission  of  blood  tlu-ough  the  lungs,  —  thus  pre- 
venting its  excessive  oxidation,  ai'd  keeping  it  in  a  venous  state. 
This  destroys  the  fibrinous  condition,  on  which  he  thinks  tuberculosis 
depends. 

Now  this  ift  precisely  what  is  done  by  atmospheric  inhalation.  The 
trachea  divides,  on  its  entrance  into  the  lungs,  into  two  branches, 
which  again  divide  ana  subdivide  until  the  tubes  become  smaller 
than  can  be  seen,  each  terminating  in  a  minute  air-cell.  Over  this 
entire  surface  the  air  is  intended  to  be  brought  into  communication 
with  the  blood  for  the  purjjose  of  oxidating  it.  By  forcible  inhala- 
tion, the  air-vesicles  are  inflated  to  the  extent  of  their  capacity,  by 
which  means  the  extreme  branches  of  the  pulmonary  arteries  are  so 
flattened  between  these  extended  cells,  as  to  be  able  to  convey  but  a 
small  amount  of  blood,  and  but  little  is  oxidated.  This  furnishes  a 
mechanical  obstruction  to  the  transmission  of  the  blood,  and  secures 
the  defibrination  of  which  Rokitansky  speaks. 

This  is  my  view  of  the  philosophy  of  atmospheric  inhalation.  The 
benefit  results,  not  from  a  larger  amount  of  oxidation,  as  is  generally 
supposed,  but  from  a  smaller.  Asthma  does  the  same  thing  by  pro- 
ducing spasmodic  contraction  of  the  extreme  bronchial  tubes,  and 
preventing  air  fro.n  entering  the  cells. 

The  same  end  is  gained  in  part  by  certain  kinds  of  employment,  as 
glass-blowing,  playing  upon  wind  instru  .lents,  and  the  like.  Writers 
of  distinction  mention  cases  of  recovery  from  incipient  consumption 
by  a  vigorous  use  of  the  lungs  in  singing.  Dentists  subject  their 
lungs  to  a  similar  process  of  expansion  in  the  use  of  the  blow-pipe ; 
the  writer  has  known  several  instances  in  that  profession,  in  wldch 
recoveries  have  taken  place. 

The  Conclusion  to  which  I  come  is,  that  atmospheric  inhalation 
may  be  used  with  great  advantage  in  some  ciises,  but  should  never 
be  resorted  to.  except  under  the  direction  of  a  competent  physician. 
In  a  congested  state  of  the  lungs,  with  hsemorrhagic  tendencies,  or 
with  inflammation  and  soreness,  it  is  well  fitted  to  produce  fatal 
bleeding  and  is  of  course  dangerous. 

External  Use  of  Water. —  As  a  relaxation  from  severe  exertions, 
the  ancients  had  frequent  recourse  to  bathing.  Those  who  contended 
in  the  race,  throwing  the  javelin,  and  wrestling,  at  Rome,  plunged 
into  the  Tiber  while  warm  and  panting  with  their  efforts.  That  this 
promoted  prowess  and  physical  endurance,  none  can  doubt. 

Louis,  the  great  French  authority  on  pulmonary  diseases,  lays 
down  several  rules  to  be  observed  by  consumptive  patients,  and  par- 
ticularly mentions  cold  bathing. 

Few  things  give  tone  to  the  capillaries  of  the  skin  like  cold  water, 
systematically  applied.  It  rallies  the  powers  of  the  constitution,  and 
improves  assimilation.  And  by  it  another  object  is  gained  of  scarcely 
less  importance,  —  that  of  gfuarding  the  system  against  taking  cold. 


Mil 


fc:JiKUIii^'^^- 


^^t£Uy,^'t^ 


:?"fSm:.iZ^f^:^:'W^;gSl::rj 


352 


DISEASES  or   THE  CHEST. 


Those  in  the  daily  habit  of  applying  cold  water  to  the  whole  perann 
seldom  suffer  from  colds  ajul  catarrhs ;  they  generally  l)ecome  har- 
dened so  as  to  endure  the  assaults  ol  the  elements. 

Consumptive  persons  should  generally  use  the  sponge  bath,  with 
cold  water,  if  it  can  be  endured,  otherwise  the  tepid  bath,  to  be  fol- 
lowed, in  all  cases  with  brisli  rubbing,  with  a  coai-se  towel.  If  a  sense 
of  chilliness  and  discomfort  fol'ows  tlie  bath,  a  large  poition  of  the 
water  must  be  squeezed  from  the  sponge,  so  as  to  use  but  very  little, 
and  the  washing  must  be  speedy,  and  the  rubbing  more  lively  than 
usual,  —  beginning  with  tepid  water,  and  gradually  lowering  the 
temperature  till  it  can  be  borne  cold.  A  large  teaspoonful  of  salera- 
tus  to  each  quart  of  water  should  be  used. 

Diet. 

The  diet,  like  all  other  parts  of  the  treutment,  must  have  reference 
to  the  present  condition  of  the  patient.  If  the  disease  take  the  bron- 
chial form,  and  rapid  breathing,  and  other  conditions  calculated  to 
carry  fat  out  of  the  system  have  not  yet  supervened  ;  or  if  the  pa- 
tient have  thii-st  and  hectic,  the  diet  must  be  spare  and  simple,  — 
consisting  chiefly  of  milk  and  farinaceous  sulwtances. 

But  in  all  cases  where  the  disease  is  tubercular,  or,  being  bronchial, 
has  reached  the  stage  of  emaciation,  the  very  earliest  moment  at 
which  the  fever  can  be  subdued  should  be  improved  to  build  up  the 
patient  with  a  generous  diet.  I  have  seen  cases  where  the  stuffing 
sometimes  resorted  to  for  fattening  turkeys  for  Thanksgiving  would 
seem  to  be  almost  justifiable.  A  good  rule  is  to  give  the  most  gener- 
ous diet  that  can  be  taken  without  disturbing  the  stomach,  or  increas- 
ing the  feverish  symptoms.  Animal  food  with  a  good  quantity  of 
salt  should  be  f i  eely  taken.  Pat  meats,  if  well  received  by  the  stom- 
ach (and  they  generally  are  if  taken  cold),  are  particularly  useful. 
The  same  is  true  of  sweet  butter  and  cream. 

Out-Door  Exercise.—  Without  exercise,  as  a  general  thing,  the 
consumptive  patient  will  die.  Exercise  involves  muscular  exertion, 
which  is  attended  by  the  tension,  compression,  and  greater  compact- 
ness of  the  muscles  used.  This  compression  of  the  muscles  within 
the  sheaths  (fasciae)  which  enclose  them  sends  out  their  blood,  and 
pushes  it  forward  towards  the  surface.  Reaching  the  extremities  of 
the  arteries,  the  blood  passes  through  capillary  tubes,  almost  incon- 
ceivably fine,  into  the  capillary  veins  of  similar  fineness,  whence  it 
flows  through  larger  and  larger  veins  back  to  the  heart.  At  the  mo- 
ment of  its  passage  from  the  capillary  arteries  to  the  capillary  veins, 
it  ceases  to  be  red  or  arterial,  and  becomes  purple  or  venous  blood. 
The  oxygen  in  the  arterial  and  the  carbon  in  the  venous  blood  unite, 
forming  a  literal  combustion,  just  such  as  we  produce  in  our  stoves 
and  grates  by  bringing  together  the  carbon  of  the  wood  and  the  oxy- 
gen of  the  atmosphere.     By  this  combustion  our  bodies  are  warmed. 


I 


olo  person 
come  hiir- 

batli,  with 
to  be  fol- 

If  a  HCllHti 

ion  of  tlie 
very  little, 
ively  than 
ering  the 
I  of  salera- 


)  reference 
!  the  bron- 
3ulated  to 
if  the  pa- 
simple,  — 

bronchial, 
loment  at 
ild  up  the 
le  stuffing 
ing  would 
lost  gener- 
or  increas- 
uantity  of 
the  stom- 
■ly  useful. 

hing,  the 
exertion, 
corapact- 
es  within 
)lood,  and 
emities  of 
58 1  incon- 
w. hence  it 
t  the  mo- 
ary  veins, 
us  blood. 
)0d  unite, 
ur  stoves 
I  the  oxy- 
warmed, 


DI8KASK8   OK   THE   ClIKHT. 


263 


and  the  little  secreting,  exhalant,  and  other  vessels,  are  raised  to  a 
teniperaturo  that  enables  them  to  work. 

Every  muscular  contraction  and  compression  helps  push  along  the 
venous  blood  in  larger  quantities  to  she  right  auricle  of  the  heart, 
which,  receiving  a  fuller  supply  of  its  natural  stimulus,  contracts  more 
energetically,  forcing  the  fluid  into  the  right  ventricl'^.  From  thence 
it  is  expelled  with  increased  energy  likewise  along  its  only  pathway, 
the  pulmonary  artery,  into  the  lungs.  Rushing  in  here  in  greater 
volume  than  natural,  a  demand  is  made  for  deeper  inspirations  of 
air  to  vitalize  and  fit  it  for  its  descent  by  the  pulmonary  vein,  to  the 
left  auricle.  Coming  here  also  as  the  natural  stimulus,  in  larger 
quantities  than  usual,  it  gives  increased  energy  to  its  own  j)ropulsion 
into  the  loft  ventricle,  from  whence  it  is  driven  out  through  the  arte- 
ries to  all  parts  of  the  system,  by  the  powerful  strokes  of  that  strong 
muscle. 

Thus  it  goes  its  round,  u"ged  on  by  exercise,  parting  with  its  oxy- 
gen more  and  more  freely  in  the  capillaries,  giving  more  activity  to 
the  vessels  of  th^  skin  and  other  tissues,  increasing  the  depth  and 
strength  of  breathing  by  carrying  more  venous  blood  to  the  lungs ; 
improving  the  digestion,  carrying  a  better  elaborated  pabulum  to  the 
nutrient  arteries,  and  causing  them  to  work  it  up  more  diligently  in 
renewing  the  tissues. 

Nor  is  this  all.  Every  wrench  of  a  muscle  forces  some  old,  worn- 
out  particles  from  their  places,  tallowing  none  to  remain  except  such 
ii8  are  firm,  and  able  to  bear  the  brunt  of  exertion.  The  flesh  of  those 
who  exercise  much  becomes  hard  and  enduring. 

I  say  then  to  the  consumptive,  if  you  would  live  and  not  die,  exer- 
cise, exercise,  exercise.  It  is  the  first,  second,  and  third  thing.  If 
you  ask  for  the  modes  of  exercise,  I  say  take  it  on  foot,  out  of  doors, 
every  day,  to  the  extent  of  a  small  amoui.  of  fatigue.  Don't  be 
frightened  by  a  single  cloud,  or  even  by  a  cohort  of  them.  You  have 
as  good  a  right  to  be  out  as  the  clouds ;  and  they  will  not  look  more 
angry,  but  rather  more  agreeable  from  finding  you  abroad  in  their 
company.  The  elements  of  rature  are  at  war  with  organic  life. 
Against  them  the  vital  principle  has  to  maintain  a  perpetual  struggle ; 
and  he  who  loses  the  power  to  meet  and  gain  the  victory  over  them 
by  out-door  exercise,  is  beginning  to  die. 

Go  abroad,  therefore,  often.  Try  it  again  and  again.  Extend 
your  walk  a  little  every  day.  Stretch  it  out  to  the  distant  fields. 
Gather  flowers  from  the  top  of  the  hills  and  from  the  bosom  of  the 
valleys,  and  bring  them  home  as  trophies  of  your  victory. 

If  not  able  to  begin  with  walking,  ride  as  often  as  possible  in  a 
carriage.  The  jolting  of  a  "ehicle  will  jog  the  blood  along  much 
better  than  no  exercise. 

Horseback  riding  is  still  bet*  It  combines.,  in  some  measure, 
the  passive  exercise  of  carriage  iding,  with  the  active  exertion  of 
walking  on  foot. 


264 


DISEASES   OF  THE  CHEST. 


Numerous  other  modes  of  exercise  may  be  resorted  to  with  advan- 
tage. Dumb-bells,  adapted  in  size  to  the  strength  of  the  patient, 
and  used  with  caution,  are  highly  serviceable.  The  battledoor,  the 
footb  ill,  bicycle  riding,  pitching  quoits,  and  the  athletic  sports  of  the 
gymniisium,  all  have  their  appropriate  place.  The  greater  the  variety 
the  bettei",  as  by  it  all  parts  of  the  system  are  brought  into  play,  and 
both  the  mind  and  the  muscles  ;;3t  the  change  which  they  need. 

It  is  hard  to  impress  patients  with  the  importance  of  this  subject. 
Say  what  you  will,  they  somehow  or  other  get  the  idea  that  a  mod- 
erate amount  ci:  'ixercise,  taken  when  they  feel  like  it,  is  all  that  is 
required.  Fatal  mistake  1  Whatever  the  physician  may  do,  the  pa- 
tient has  a  great  deal  to  do  for  himself.  He  must  strive  to  develop 
Ids  physical  powers  to  the  utmost.  He  must  train  himself  as  runners 
and  fighters  do  when  preparing  for  their  surprising  feats ;  for  he  is 
running  against  the  swiftest  disease  (or  the  surest  winner)  of  our  cli- 
mate, and  fighting  with  the  elements. 

If  he  regards  life  as  not  worth  this  exertion,  of  course  he  will  not 
make  it ;  but  I  beg  him  to  consider  that  without  it  recovery  will  be 
uncertain,  and  in  many  cases,  impossible.  Do  as  I  have  directed,  and 
if  your  medical  attendant  is  skilful,  the  current  of  health  will,  in 
many  cases,  begin  to  flow  back  to  you.  Life  will  renew  to  jou  its 
policy  of  insurance,  and  multiply  your  days. 

Travelling: —  Consumptive  patients  have  generally  been  sent  to  a 
southern  climate.  But  where  the  case  involves  dyspepsia  and  affec- 
tions of  the  liver,  low  latitudes  are  generally  unfriendly.  Liver  com- 
plaints are  the  bane  of  a  southern  climate,  and  a  sallow  complexion  is 
the  inheritance  of  a  southerner. 

Tubercular  persons,  chilled  by  our  northern  climate,  are  sometimes 
temporarily  relieved  by  the  warmer  atmosphere  of  the  south.  But 
the  relief  is  only  temporary ;  for,  having  lost  the  powSr,  as  they  im- 
agine, to  bear  the  frowns  of  our  northern  sky,  they  are  dying,  and 
will  die  anywhere  unless  they  recover  this  power.  And  the  way  to 
retrieve  a  lost  advantage  over  an  enemy,  is,  not  to  retreat  to  a  point 
where  recovery  will  be  harder,  but  to  meet  him  at  once.  If  the  con- 
stitution cannot  bear  up  against  an  enemy  under  the  bracing  of  a 
northern  atmosphere,  it  will  be  still  harder  to  do  so  under  the  wilting 
of  a  southern. 

After  all,  the  objects  aimed  at  should  be  change  and  travelling. 
The  exercise  involved,  the  constant  exertion  required  in  getting  from 
place  to  place,  the  agreeable  sensations  produced  by  the  motion  of 
cars  and  steamboats,  the  ever  varying  change  of  sights  and  sounds, 
and  the  constantly  increasing  stock  of  one's  ideas  of  men  and  things, 
—  these  are  what  rally  the  constitution,  and  open  anew  the  springs 
of  life. 

Especially  should  all  journeys  for  health  be  taken,  if  possible,  with 
an  object  in  view.  Let  the  consumptive  start  with  the  view  of  see- 
ing the  cave  of  Kentucky,  the  prairies  of  the  West,  tlie  great  lakes 


1  advan- 
patient, 
loor,  the 
ts  of  the 
3  variety 
(lay,  and 
jed. 

subject, 
a  mod- 
[  that  is 
I,  the  pa- 
develop 
I  runners 
'or  he  is 
i  our  cli- 

will  not 
y  will  be 
cted,  and 
\  will,  in 
I  _j'ou  its 

sent  to  a 
md  affec- 
iver  com- 
plexion is 

ametimes 
th.     But 
they  im- 
ying,  and 
le  way  to 
,0  a  point 
the  con- 
ing of  a 
le  wilting 

ravelling. 
ting  from 
aotion  of 
I  sounds, 
id  things, 
springs 

ible,  with 
w  of  see- 
eat  lakes 


DISEASES  OF  THE  CHEST. 


255 


of  the  North,  the  falls  of  Niagara,  the  fortress  of  Quebec,  the  Sague- 
nay  river,  the  doctor,  who  he  has  reason  to  think  will  cure  him,  — 
anything  which  he  is  willing  to  make  exertion  to  see,  and  that  he  is 
sure  his  eyes  will  rejoice  in  beholding. 

I  have  thus  spoken  of  consumption  more  at  large  than  of  other 
complaints,  becarse  it  is  the  great  disease  of  the  world,  and  is  in- 
creasing with  the  advancement  of  civilization. 

Acute  Bronchitis. 

This  is  an  acute  inflammation  of  the  mucous  membrane  lining  the 
air-tubes  in  the  lungs.    ,  It  is  generally  quite  a  serious  disease. 

Physical  Signs.  —  The  sound  upon  percussion  is  generally  good. 
If  there  be  any  ('  illness,  it  is  commonly  in  the  lower  and  back  part 
of  the  chest.     This  occui-s  only  in  "  Capillary  Bronchitis." 

The  breathing  murmurs  are  sometimes  more,  sometimes  less  in- 
tense than  natural.     Occasionally  they  are  almost  extinct. 

In  the  early  stage,  sibilous  and  loud  rattles. 

In  the  more  advanced  stage,  mucous  rattle. 

Now  and  then  sub-crepitant  rattle  accompanies  the  inward-drawn 
breath. 

General  Symptoms.  —  The  disease  begins  with  chills  followed  by 
fever ;  tightness  across  the  chest,  difficulty  of  breathing,  hoarseness, 
loss  of  strength,  costive  bowels,  and  a  quick  and  hard  pulse.  Water 
runs  from  the  eyes  and  nostrils,  and  there  is  a  dry,  harsh,  croupy 
cough. 

After  a  few  days,  mucus  begins  to  be  raised.  This  expectoration 
gradually  becomes  more  copious,  and  is  opaque,  yellowish,  or  green- 
ish, and  occasionally  streaked  with  blood.  This  mucus  is  verj'  ropy 
and  adheres  to  the  vessel. 

There  is  more  or  less  pain  in  the  chest ;  pain  across  the  forehead, 
which  is  increased  by  coughing;  and  a  pale  and  anxious  countenance. 

In  severe  cases,  the  tightness  across  the  chest  is  extreme,  with  a 
sense  of  suffocation,  causing  the  patient  to  call  for  the  opening  of 
the  windows.  There  is  great  diificulty  of  breathing ;  a  paleness  and 
lividity  of  the  cheeks  and  lips ;  a  loud  wheezing  and  rattling  in  the 
throat,  followed  by  cold  sweat,  insensibility  and  death. 

In  children  the  disease  comes  on  like  a  common  cold,  attended  by 
a  sore  throat,  a  great  desire  to  drink,  but  a  disinclination  to  take 
food.  But  two  or  three  swallows  of  drink  can.  be  taken  at  a  time 
for  want  of  breath.  The  phlegm  is  frequently  vomited  up  spon- 
taneously. 

Observations.  —  The  loud  and  sibilous  rattles  are  produced  by 
similar  causes,  namely,  the  passage  of  air  along  tubes  whose  interior" 
is  dry  and  rough  from  inflammation,  or  whose  calibre  Is  contracted  or 
altered  in  form  by  the  swelling  of  the  membrane,  effusion  upon  its 


■»■' 

I:   V-  ■■' 


m 


DISEASES   OF   THE   CHEST. 


inner  surface  of  a  tough,  mucous  substance,  or  a  pressure  upon  its 
external  surface  of  tubercles,  swollen  glands,  aneurismal  tumors, 
etc.  The  two  sounds  differ  mainly  in  the  key  upon  'which  they  are 
pitched, —  the  sonorous,  or  low-keyed,  conihig  from  the  larger  tubes; 
the  sibilous,  or  high-keyed,  from  the  smaller,  —  just  as  the  low  notes 
of  an  organ  come  from  the  large  pipes,  and  ihe  high  notes  from  the 
small  ones. 

.  The  sibilous  rattle  has  been  compared  to  the  chirping  of  birds,  the 
squeaking  of  puppies,  the  whistling  of  air  passing  through  a  key- 
hole, etcj;  the  sonorous,  to  the  snoring  of  a  sleeping  person,  tlie 
cooing  of  doves,  and  the  sound  of  the  bass-string  of  the  violoncello 
rubbed  with  the  finger. 

Causes.  — It  is  generally  brought  on  by  a  sudden  cold,  by  changes 
of  the  weather,  and  by  inhaling  irritating  substances.  It  is  a  second- 
ary result,  too,  of  scarlet  fever,  measles,  small-pox,  hooping  cough, 
and  the  remittent  fever  of  infants. 

Treatment.  —  In  mild  cases,  give  warm  balm  or  flax-seed  tea,  hot 
lemonade,  or  other  similar  drinks,  —  at  the  same  time  soaking  the 
feet  in  hot  water,  and,  on  retiring  to  bed,  apply  bottles  of  hot  water 
to  the  feet  and  sides,  to  produce  sweating.  If  the  bowels  be  costive, 
some  gentle  physic,  as  rhubarb  and  magnesia,  or  salts  and  senna,  may 
be  taken. 

In  the  case  of  infants,  an  emetic  of  wine  of  ipecac,  or  compound 
tincture  of  lobelia,  should  be  given,  and  followed  with  slippery  elm 
and  flax-seed  tea.  The  compound  tincture  of  lobelia,  with  tincture 
of  veratrum  viride,  may  be  continued  for  a  time  as  an  expectorant. 

In  more  severe  cases,  both  of  adults  and  children,  an  active  emetic 
is  required,  —  perhaps  the  compound  powder  of  lobelia  is  as  good  as 
any.  This  must  be  followed  with  tincture  of  veratrum  viride,  in  full 
doses,  so  as  to  reduce  the  pulse  at  once,  and  keep  it  down  to  the 
natural  standard.  This  is  one  of  the  very  best  articles  in  this  com- 
plaint, and  will  generally  very  much  lessen  its  violence  and  duration. 

If  there  is  much  difficulty  of  breathing,  the  air  of  the  room  must 
be  kept  moist,  as  recommended  in  croup. 

The  room  should  also  be  kept  warm,  —  decidedly  warmer  than  in 
the  case  of  other  fevers. 

A  gentle  perspiration  should  be  kept  up  by  small  doses  of  com- 
pound tincture  of  Virginia  snake-root,  and  by  frequently  bathing  the 
surface,  or  else  by  tincture  of  veratrum. 

Mustard  should  be  applied  to  the  chest,  and  to  the  soles  of  the  feet. 

The  cough  may  be  managed  by  preparations  (104),  (106),  (110), 
freely  given. 

The  diet  should  be  confined  to  barley-water,  toast-water,  apple- 
water,  rice-water,  and. a  solution  of  gum-arabic. 


1  upon  its 
il  tumore, 
[1  they  are 
ger  tubes; 
low  notes 
from  the 

E  birds,  the 
igh  a  key- 
person,  the 
violoncello 

by  changes 
18  a  second- 
ing cough, 

eed  tea,  hot 
loaking  the 
E  hot  water 
}  be  costive, 
senna,  may 

•  compound 
slippery  elm 
ith  tincture 
ipectorant. 
ctive  emetic 

as  good  as 
iride,  in  full 

own  to  the 
this  com- 
id  duration. 

room  must 

mer  than  in 

ses  of  com- 
bathing  the 

of  the  feet. 
06),  (110), 

rater,  apple- 


mSEASES   OK   THE   CHEST. 


Chronic  Bronchitis. 


m 


This  is  an  inflammation  of  the  mucous  membrane  of  the  air-tubes, 
which  continues  a  great  length  of  time,  without  any  sudden  or  re- 
markable changes. 

Physical  Signs.  —  The  percussion-sounds  are  similar  to  those  of 
acute  bronchitis.  When  a  bronchial  tube  is  dilated,  we  sometimes 
have  dullness  around  the     '»Led  part. 

The  breathing  murmur  w  always  accompanied  by  a  mucous,  sono- 
rous, or  sibilant  rattle,  —  sometimes  by  a  subcrepitant. 

When  dilatation  of  the  tubes  exists,  the  intensity  and  duration  of 
the  sound  of  the  ingoing  breath  is  decreased,  —  of  the  outgoing 
increased. 

In  this  state  of  the  tubes,  we  also  have  cavernous  breathing,  bron- 
chophony, sometimes  pectoriloquy,  and  bronchial  or  cavernous  cough. 

General  Symptoms.  —  A  cough  is  generally  present,  which  is  in- 
creased in  wet  weather,  and  by  every  slight  cold.  This  comes  on  in 
paroxysms ;  is  generally  worse  in  the  morning ;  and  is  relieved  by 
raising  freely.  The  matter  raised  is  generally  yellowish,  but  some- 
times whitish  and  sticky;  and  in  the  latter  stages  is  thick,  and 
sometimes  very  much  like  that  of  consumption.  Indeed,  the  disease 
often  ends  in  bronchial  consumption.  • 

Remarks.  —  The  breathing  is  bronchial  or  cavernous  when  the 
dilated  portion  of  the  tube  is  empty;  if  it  contain  fluid,  the 
mucous  rattle  will  be  heard. 

Dullness  on  percussion  will  exist  if  a  dilated  tube  press  upon  the 
surrounding  portion  of  lung  so  aa  to  condense  or  make  it  solid. 

Dilatation  of  the  tubes  occurs  only  in  chronic  bronchitis  of  long 
standing.  Its  physical  signs  are  much  like  those  of  a  cavity  in  ad- 
vanced consumption.  The  examiner  may  learn  to  distingfuish  them 
by  considering  that  in  consumption,  dullness  precedes  the  cavity,  while 
in  bronchial  dilatations,  'the  cavity  precedes  dullness. 

The  dilatation  or  swelling  out  at  some  point  of  a  bronchial  tube 
is  caused  by  obstructions  to  the  passage  of  air  through  it,  —  just  as 
an  India-rubber  tube,  partially  closed  up  at  a  given  point,  will  bulge 
out  just  in  front  of  the  obstructed  place,  when  air  is  forcibly  blown 
through  it,  and  just  as  the  left  ventricle  of  the  heart  enlarges  when 
the  blood  is  obstructed  in  its  passage  through  the  aortic  valve. 

Causes.  —  It  often  occurs  as  the  result  of  acute  bronchitis,  and 
also  of  measles,  hooping-cough,  etc.  But  taking  cold,  and  damp  and 
changeable  weather,  are  more  frequently  its  causes.  It  most  often 
follows  chronic  inflammations  of  the  throat,  which,  being  neglected, 
pfradually  creep  down  the  windpipe  into  the  tubes,  and  become  very 
ol)stinate  in  their  character. 


m 


DISEASES   OF   THE   CHEST. 


Fio.  94. 


T       iment.  —  Medicinal  inhalation  is  one  of  the  best  remedies  for 

this  complaint.     The   inhaling   powder   has,  in   many  cases,  great 

efficiency.     The  dose  is  about  what  can  lie  on  a  ten-cent  piece.     It 

should  be  used  once  a  day,  in  an  instrument  represented  in  the  cut. 

This  instrument  I  had  constructed  for  my  use.     It  consists  mainly 

of  a  glass  tube  and  a  receiver,  — 
the  latter  being  something  like  a 
tube-vial,  pierced  with  fine  holes 
around  the  lower  end.  The  pow- 
der is  poured  into  the  receiver, 
which  is  placed  in  the  larger  tube, 
and  twirled  between  the  thumb  and  finger  while  inhaling. 

When  the  powder  cannot  be  easily  got  down  into  the  tubes  in  the 
lungs,  —  as  often  happens,  —  the  inhalation  of  medicated  vapor  will 
do  better.  If  the  expectoration  be  diflicult,  the  expectorant  inhalant, 
described  under  "consumption,"  should  be  used;  if  the  expectoration 
be  too  profuse  and  free,  the  astringent  inhalant  must  be  taken. 

The  cough  preparations  recommended  for  consumption,  also  (113), 
(112),  will  be  the  proper  ones  in  this  complaint. 

The  daily  alkaline  bath,  and  brisk  friction,  are  particularly  service- 
able. 

Out-door  exercise  is  almost  as  necessary  in  this  disease  as  in  con- 
sumption. 

Enlargement  oi  the  Air-Cells.  —  Emphysema. 

This  disease  consists  in  »  Tgement  of  the  air-cells,  the  oblitera- 
tion of  their  vessels,  and  the  wasting  .:f  their  walls. 

Physical  Signs.  —  Thumping  upon  the  chest  gives  a  clearer  and 
louder  sound  than  natural,  —  one  which  is  tjonpanitic,  or  drum-head 
like. 

The  murmur  of  the  ingoing  breath  is  diminished  both  in  duration 
and  intensity,  —  of  the  outgoing  breath,  it  is  increased. 

Dry,  crepitant  rattle  attends  the  ingoing  breath  only;  occasionally, 
sibilous  rattle. 

Qeneral  Symptoms.  —  Habitual  shortness  of  breath,  and  very 
great  difficulty  of  breathing,  occurring  in  paroxysms,  which  cause 
the  patient  to  rush  to  the  open  window  for  air. 

There  is  generally  a  cough,  and  the  matter  raised  is  frothy,  liquid, 
and  mucous,  or  watery. 

The  face  has  a  peculiar  dusky  color,  and  the  countenance  an  anx- 
ious, melancholy  expression.  The  nostrils  are  thick,  and  the  lower 
lip  full.  The  muscles  of  the  neck  are  large,  and  the  gait  of  the  pa- 
tient is  stooping.  The  strength  is  wasted  in  proportion  to  the  diffi- 
culty of  breathing. 

Emphysema  tends  to  produce  disease  of  the  heart,  Brighrs  (liseisc, 
and  venous  congestions  in  the  head. 


DISEASES  OF   THE   CHEST. 


259 


medies  for 
ises,  great 
piece.  It 
n  the  cut. 
8ts  mainly 
eceiver,  — 
iiig  like  a 
fine  holes 
The  pow- 
B  receiver, 
arger  tube, 

ibes  in  the 
vapor  will 
Lt  inhalant, 
pectoration 
iken. 
also  (118), 

rly  service- 
as  in  coQ- 


sema. 

le  oblitera- 

clearer  and 
drum-head 

n  duration 

casionally, 

and  very 
hich  cause 

thy,  liquid, 

ice  an  anx- 
the  lower 
of  the  pa- 

o  the  diffi- 

il's  disi'i-^i'. 


Observations. — The  tympanitic  sound  is  caused  by  the  increased 
luuount  of  air  in  the  cells. 

The  air-cells  have  lost  their  elasticity,  the  air.,  in  a  great  degree, 
remains  in  them,  —  not  passing  in  and  out,  —  hence  the  absence  of  tlic 
vesicular  nuirmur. 

The  crepitant  rattle  attends  the  ingoing  breath  oiily,  and  is  sup- 
posed to  arise  from  the  expansion  of  the  lungs  which  are  in  a  drier 
state  than  natural.  It  has  been  compared  to  the  sound  producd  by 
blowing  into  a  dried  bladder. 

Treatment. — To  whatever  extent  the  air-cells  are  destroyed,  to 
that  extent,  of  course,  the  disease  is  incurable.  It  may,  however,  be 
palliated  and  relieved  to  a  great  extent. 

Generally,  bronchitis  exists  in  connection  with  emphysema ;  and 
when  this  is  found  to  be  the  case,  the  remedies  for  that  disease  must 
be  employed.     (370)  often  is  curative. 

The  inhalation  of  tincture  of  stramonium,  in  one  or  two  teaspoon- 
ful  doses,  the  same  as  the  alterative  inhalant  is  used,  will  be  useful. 

To  be  taken  internally,  an  excellent  preparation  may  be  made  by 
uniting  one  dram  of  etheral  tincture  of  lobelia  with  two  drams  of 
tincture  of  ipecac,  and  two  ounces  of  ammoniac  mixture.  The  dose 
is  one  or  two  tablespoonfuls.  Half-grain  to  gi-ain  doses  of  extract  of 
cannabis  indica  are  excellent  to  relieve  the  difficulty  of  breathing. 

Tne  diet  must  be  very  carefully  regulated,  as  overindulgence  at  the 
table  aggravates  the  symptoms. 

Change  of  air  is  often  highly  beneficial ;  but  it  is  impossible  to 
predict  its  effect  beforehand  in  each  individual  case. 

Swelling  of  the  Lungs.  —  Hypertrophy  of  the  Lungs. 

This  can  hardl}-^  be  regarded  as  a  disease.  It  jifenertilly  takes  place 
in  but  one  lung,  and  is  the  result  of  the  inaction  of  the  other.  Thus, 
when  one  lung  is  diseased,  the  other  has  to  do  the  work  of  both  ;  and 
being  overworked,  it  enlarges,  as  the  heart  or  an  arm  does  when  very 
much  exercised. 

The  only  treatment  required  is  to  eat  sparingly,  and  exercise  Avith 
great  moderation,  so  aa  not  to  increase  the  rapidity  of  the  breathing. 

Pulmonary  Apoplexy. 

This  is  generally  the  result  of  a  disease  of  the  heart,  particularly 
of  the  mitral  valve. 

Physical  Signs.  —  Percussion  yields  a  clear  sound,  except  where 
the  en^'orgement  of  blood  is  large,  and  near  the  surface,  —  in  which 
case,  it  is  dull. 

TLe  sound  of  breathing  is  feeble  or  absent  over  a  limited  space. 


2eo 


DISEASES   OF  THE  CHEST. 


Bronchial  breathing  is  heard  in  some  places,  and  bronchophony  in 
part,  in  the  same  regions. 
Mucous  rattle  is  also  heard. 

Observations.  —  In  this  disease  the  small  air-tnbes  and  air-cells  are 
the  seat  of  bleeding ;  and  the  blood  becoming  coagulated  here,  closes 
these  vessels  against  the  entrance  of  air.  This  explains  the  feeble- 
ness or  absence  of  the  breathing  murmur. 

The  fluidity  of  blood  in  the  immediate  vicinity  gives  rise  to  the 
mucous  rattle. 

Qeneral  Symptoms. — These  are,  difficulty  of  breathing,  tightness, 
and  dull  pain  in  the  chest.  The  mucus  raised  is  tinged  or  streaked 
with  blood.  The  blood  raised  is  darkish,  and  dirty-looking.  This 
last  symptom,  the  dirty  look  of  the  blood,  is  peculiar  in  tills  disease. 

Treatment.  —  The  most  important  remedy  is  dry-cupping  upon  the 
chest.  This  will  often  arrest  the  d'sease  at  once.  Counter-irritation 
by  croton-oil  is  also  useful.  A  free  movement  of  the  bowels  by  a 
preparation  containing  croton-oil,  or  elaterium  (31),  (33),  has  an  ex- 
cellent effect. 

Air  in  the  Cliest. — Pneumothorax. 

This  disease  consists  in  the  presence  of  air  in  the  cavity  of  the 
pleura.  Generally,  there  is  also  water  in  the  pleural  sac  at  the  same 
time ;  the  water,  being  the  heavier  fluid,  occupying  the  lower  part  of 
the  cavity,  and  the  air  the  upper  part. 

Physical  Signs.  —  Tympanitic  or  drum-like  sound  over  the  upper 
part  of  the  side.  Dull  sound  over  the  lower  part.  Breathing  mur- 
mur diminished  or  suppressed.  Amphoric  1  reathing.  Metallic  tink- 
ling. 

Qeneral  Symptoms.  —  Great  oppression  of  the  chest,  and  difficulty 
of  breathing ;  generally  attended  by  palpitation  of  the  heart,  and  fre- 
quently by  severe  pain  under  the  breast-bone,  on  the  affected  side. 
The  patient  generally  has  to  remain  in  the  sitting  posture,  and  can- 
not lie  an  instant  on  the  sound  side. 

If,  on  percussion,  one  side  of  the  chest  sounds  louder  than  the 
other  and  the  breathing  murmur  is  heard  distinctly  on  the  side  which 
gives  only  a  moderate  sound,  and  is  not  heard  at  all  on  the  loud- 
sounding  side,  we  may  be  sure  it  is  a  case  of  air  in  the  chest. 

Observations.  —  The  metallic  tinkling  is  like  the  sound  produced 
by  dropping  a  pin's  head  into  a  metallic  dish,  or  like  the  distant  tink- 
ling of  a  sheep-bell,  or  the  gentle  pulling  of  the  string  of  a  violin. 

It  is  supposed  that  when  the  fluid  in  the  cavity  of  the  pleura  hap- 
pens to  be  higher  than  the  orifice,  the  air,  when  it  enters  at  each 
in-drawn  breath,  forces  its  way  up  through  the  fluid,  in  the  shape  of 


DI8EA8K8   OF   THE   CHEST. 


261 


lO 


phony 


III 


ir-cells  are 
here,  closes 
the  feeble- 

■ise  to  the 


,  tightness, 
r  streaked 
ing.  This 
lis  disease. 

g  upon  the 
r-irritation 
)wel8  by  a 
has  an  ex- 


'^ity  of  the 
t  the  same 
fer  part  of 

the  upper 
hing  mur- 
tallic  tink- 

i  difficulty 
rt,  and  fre- 
icted  side. 
!,  and  can- 

■  than  the 

side  which 

the  loud- 

JSt. 

produced 
stant  tink- 
i  violin, 
leura  hap- 
^  at  each 
B  shape  of 


bul  jlt's,  and,  bursting  at  the  surface,  gives  the  tinkling  sound.  This 
sound  is  sometimeH  produced,  too,  by  the  failing  of  drops  of  liquid 
from  the  upper  part  of  the  cavity,  upon  the  surface  of  t'^e  fluid. 

The  amphoric  breathing  is  like  the  sound  produced  by  blowing 
obliquely  into  an  empty  cask.  One  writer  says  he  heard  the  same 
sound  when  out  shooting  on  a  rough  day,  produced  by  the  wind  blow- 
ing sideways  into  the  guu-barrel. 

Treatment. —  I  would  recommend  the  use,  two  or  three  times  a 
(lay,  of  the  antiseptic  inhalant,  mentioned  under  the  head  of  con- 
sumption. 

To  this  should  be  added  dry-cupping  over  the  whole  chest,  which 
generally  gives  great  relief.     Blisters  may  also  be  used. 

Sweating  must  be  encouraged  in  the  manner  recommended  under 
acute  bronchitis. 

For  the  difficulty  of  breathing,  give  half-grain  doses  of  cannabis 
indica,  or  five-drop  doses  of  tincture  of  aconite,  or  one-sixth  of  a 
grain  doses  of  svapnia.  Extract  of  belladonna,  or  of  stramonium,  is 
I'lso  worthy  of  trial. 

Water  in  the  Chest,—  Hydrothorax. 

This  disease  consists  in  a  collection  of  water  in  the  cavity  of  the 
pleura. 

Physical  Signs. —  There  is  a  dull  sound  over  the  effusion. 

The  breathing  murmur  is  diminished,  and  gradually  disappear 
altogether  over  the  space  occupied  by  the  effusion. 

Bronchial  breathing  is  heard  in  the  same  part. 

When  the  amount  of  fluid  is  small,  egophony  is  heard  in  the  mid- 
dle regions  of  the  chest. 

Bronchophoi.y  is  heard  when  the  effusion  is  larger. 

General  Symptoms. —  Either  upon  lying  down,  or  using  active 
bodily  exercise,  the  patient  finds  his  difficulty  of  breathing  increased. 
When  in  bed,  he  lies  with  his  head  and  shoulders  raised,  which,  by 
causing  the  fluid  to  settle  at  the  bottom  of  the  cavity,  prevents,  in  a 
measure,  its  pressure  upon  the  lungs,  and  gives  him  a  little  rest. 
His  sleep  is  interrupted  by  sudden  starts  with  alarm  and  terror.  The 
pulse  is  hard,  the  thirst  great,  the  urine  scanty  and  high-colored,  and 
has  a  sediment.  After  a  time  the  feet  swell,  the  face  is  pallid  and 
livid,  and  the  countenance  expresses  anxiety  and  alarm.  There  is  a 
short,  dry  cough. 

When  the  quantity  of  fluid  in  the  chest  becomes  large,  the  patient 
cannot  lie  down  at  all,  and  only  gets  short  and  disturbed  naps  in  the 
sitting  posture. 

Of  all  the  symptoms,  the  starting  in  sleep  is  the  most  cei-tain  sign 
ot  the  disease. 


)^3i^^d&S^^M^-- 


262 


niSKASKH   OK   THE   0HE8T. 


Causes. —  In  some  rare  cases,  this  may  occur  .\n  a  primary  disease, 
—  that  is,  as  a  disease  not  dependent  U)>on  any  other  m  its  cause. 
The  greater  numlwr  of  cases,  however,  arc  secondary.  They  arise 
from  organic  disease  of  the  heart,  or  liver,  or  stomach.  Inflammation 
of  the  pleura  is  a  very  frequent  cause. 

A  plethoric,  or  full  state  of  the  systen.,  predisposes  to  this  com- 
plaint,—  particularly  in  those  persons  who  indulge  freely  at  the 
table. 

It  may  arise,  too,  from  the  striking  in  of  skin  eruptions  ;  from  the 
free  use  of  liquors ;  and  from  frequent  excessive  bleedings  or  purg- 
ings. 

Treatment. —  Dry-cupping  is  a  valuable  remedy,  and  should  al- 
ways be  practised. 

The  chest  should  be  painted  with  the  tincture  of  iodine,  and  a 
good  degree  of  substantial  soreness  be  kept  up. 

The  internal  remedies  are  purges  (31),  (14),  (30),  and  diuretics 
(123),  (129),  (130),  (131)  when  the  patient  is  not  very  weak. 

The  iodide  of  potassium,  in  doses  of  five  or  six  grains,  once  in 
three  or  four  hours,  is  an  excellent  remedy.  The  following  is  a  good 
form  of  taking  it:  iodide  of  potassium,  one  ounce ;  fluid  extract  of 
pipsissewa,  two  ounces ;  water,  half  a  pint.     Dose,  one  teaspoonful. 

The  skin  should  be  bathed  and  rubbed  daily,  three  or  four  times, 
with  much  friction.  Tapping  the  chest  should  be  done  when  the 
fluid  persists  any  length  of  time,  otherwise  a  simple  hydrothorax  may 
become  a  doubly  serious  empyema  or  pus  in  the  chest. 

Pleurisy. — Pleuritis. 

Pleurisy,  or  pleurisy  fever,  as  it  is  sometimes  called,  is  an  in- 
flammation of  the  pleura,  or  the  membrane  which  lines  the  chest, 
and,  at  the  same  time,  is  folded  back  so  as  to  cover  the  outer  surface 
of  the  lungs. 

The  pleura,  as  is  elsewhere  explained,  is  a  short  sac  or  bag,  whose 
inner  sides  are  kept  moist,  so  that  they  may  slide  easily  upon  each 
other  as  they  are  moved  by  the  alternate  contractions  and  expansions 
of  the  lungs  in  the  act  of  breathing,  and  whose  outer  sides  are  made 
to  grow,  —  one  to  the  inside  of  the  chest,  and  the  other  to  the  out- 
side of  the  lungs. 

Pleurisy  and  lung-fever,  then,  must  be  kindred  diseases,  and  exist, 
more  or  less,  together.  In  truth  there  is  almost  always  some  affec- 
tion of  the  pleura  in  lung-fever,  and  some  affection  of  the  lungs  in 
pleurisy.  The  pain  in  Iqng-fever  is  owing  to  some  inflammation  of 
the  pleura ;  and  the  appearance  of  the  rusty-colored  phlegm  in  pleu- 
risy indicates  that  the  lungs  have  been  reached  by  the  inflammation 
of  the  membrane  which  covers  them. 

Physical  Signs Flatness  on  percussion,  at  the  lower  part  of  the 

chest,  which  ascends  as  the  effusion  of  water  increases. 


II 


.  tf.iiii«  iiMimtrntin^ummmimmimmimm 


D18EAnE8   OK  THR    CHEST. 


263 


ly  (lisoiiHp, 

itH  cause. 

I'hey  iiiise 

lamination 

this  coni- 
\y  at   the 

from  the 
1  or  purg- 

should  al- 
ine, and  a 

i  diuretics 
lyeak. 
LS,  once  in 
;  is  a  good 
extract  of 
aspoonful. 
our  times, 
when  the 
liorax  may 


is  an  in- 
the  chest, 
«r  surface 

ag,  whose 
3on  each 

xpansions 
are  made 
the  out- 

and  exist, 
)me  affec- 
lungs  in 
mation  of 
a  in  pleu- 
immation 

art  of  the 


If  the  efftised  fluid  is  not  great,  tliere  is  puerile  hreathing  at  the 
top  of  the  lung. 

Friction  sound  is  heard  occasionally  in  first  stage  of  disease. 

Ego])hony  is  heard  when  the  amount  of  fluid  in  the  pl*)UiU  is 
small. 

As  the  amount  of  water  increases,  bronchophony  appears. 

General  Symptoms.  ■ —  This  disease  is  most  frequently  introduced 
by  shiverinffs,  which  are  soon  succeeded  by  high  fever,  with  a  pecu- 
liarly hard,  resisting  pulse;  sharp,  stabbinff  pain  in  the  side, — gener- 
ally just  below  the  ni[)ple,  but  sometimes  extending  to  the  shoulder, 
arm-pit,  and  back  ;  hurried  and  intelrupted  breathing ;  and  a  short, 
dry  cough. 

The  pain  is  greatly  aggravated  by  motion,  coughing,  or  an  attempt 
to  take  a  long  breath.  It  holds  the  patient  under  constant  and 
powerful  restraint.  We  find  him  lying  upon  his  back,  or  his  well 
side;  his  countenance  full  of  anxiety,  —  fearing  to  move,  cough,  or 
even  breathe  needlessly ;  and  often  crying  out  fro»n  the  keen  torture 
these  necessary  acts  inflict  in  spite  of  all  his  caution. 

At  a  more  advanced  stage,  when  the  tenderness  has  somewhat 
abated,  he  will  prefei  to  lie  on  the  diseased  side,  as  this  leaves  the 
healthy  lung  more  o  c  liberty. 

Observations.  —  The  first  effect  of  the  inflammation  of  the  pleura 
is  to  dry  up  the  moisture  with.which  its  inner  surfaces  are  lubricated, 
or  made  smooth  and  slippery.  As  a  consequence,  these  surfaces  be- 
come rough,  and  rub  harshly  upon  each  other,  and  produce  a  sound, 
in  the  early  stages  of  pleurisy,  like  that  of  rubbing  two  pieces  of  wet 
leather  together.  It  may  be  imitated  by  rubbing  the  finger  back  and 
forth  upon  a  table.  It  is  sometimes  a  creaking  noise,  like  that  of 
new  shoes. 

As  the  disease  advances  an  important  change  takes  place  in  the 
state  of  things.  Instead  of  an  unnatural  dryness,  a  watery  fluid  is 
poured  out  copiously  from  the  inflamed  surfaces  of  the  pleural  sac. 
This  is  called  the  period  of  effusion.  This  generally,  though  not  al- 
ways;, relieves  the  pain.  But,  by  compressing  the  lung,  causes  dan- 
gerous difficcl'cy  of  breathing. 

The  air-cells  are  compressed  by  the  effused  fluid,  and  are  not 
penetrated  by  air.     Hence  the  al)sence  of  the  breathing  murmur. 

The  pouring  out  of  water  between  the  layers  of  the  pleura,  com- 
presses the  lung,  and  removes  it  from  the  walls  of  the  chest.  Hence 
the  dullness  or  deadness  of  sound  upon  percussion. 

When  listening  with  the  stethoscope,  the  voice  of  the  patient 
sounds  feeble  and  interrupted,  like  the  bleating  of  a  goat,  and  is 
hence  termed,  egophony,  or  goat-voice. 

This  peculiar  voice  is  heard  only  when  the  effusion  of  water  has 
been  moderate  in  quantity,  and  only  a  thin  layer  of  liquid  lies  be- 
tween the  ribs  and  lung.     It  is  caused  by  the  voice  passing  over  this 


264 


DISEASRS   OK   THE   CHEST. 


thin  layer,  which  is  thereby  thrown  into  vihratiom,  or  wav}',  quivering 
motions.  When  thus  agitated,  the  fluid  reacts  upon  the  voice, 
making  it  sharp  and  tremulous. 

When  the  effusion  has  become  large,  these  effects  cease ;  but  an- 
other sign  then  shows  itself,  and  distinguishes  pleurisy  from  the 
healthy  state,  and  likewise  from  the  solid,  hepatized  state  of  the 
lung  in  lung-fever.     It  may  be  discovered  thus  : 

If  the  hand  be  laid  flat  upon  the  chest  of  a  healthy  person,  while 
he  is  speaking,  a  vibration  or  thrill  will  be  left.  If,  in  like  manner, 
the  hand  be  laid  upon  the  chest  of  a  person  having  lung-fever,  with 
hepatized  lung,  this  thrill  will  be  found  still  more  perceptible.  But 
when  the  hand  is  placed  over  the  place  of  watery  effusion  on  the 
chest  of  a  person  having  pleurisy,  there  will  be  discovered,  when  the 
person  speaks,  no  thrill  whatever.  The  absence  of  this  thrill,  then,  is 
one  of  the  very  best  signs  of  pleurisy  with  effusion. 

Persons  recover  from  pleurisy  sometimes  very  rapidly,  before  effu- 
sion has  taken  place.  It  is  then  said  they  have  had  an  attack  of  dry 
pleurisy.  When  liquid  has  been  poured  out,  even  in  considerable 
quantity,  it  is  sometimes  reabsorbed,  and  the  patient  recovers  per- 
fectly. In  other  instances,  it  compresses  the  lungs,  interferes  seri- 
ously with  breathing,  reduces  his  strength,  and  he  sinks  rapidly. 

Treatment.  —  Pleurisy  has  been  divided  for  description  and  treat- 
ment into  three  stages,  following  the  natural  events  of  the  inflamma- 
tion. The  first  stage  comprises  the  period  from  the  first  onset  to  the 
time  when  effusion  commences.  The  second  stage,  or  stage  of  effu- 
sion, extends  to  the  time  when  the  liquid  begins  to  diminish ;  and 
the  third  stage  consists  of  the  period  occupied  by  the  absorption  of 
the  liquid. 

Should  the  quantity  remain  stationary  or  diminish  very  slowly 
after  the  lapse  of  two  or  thi-ee  weeks,  the  disease  becomes  chronic. 

The  indication  for  treatment  during  the  first  stage  is  to  arrest  the 
progress  (  f  the  disease,  to  diminish  its  intensity,  to  limit  the  amount 
of  morbid  products,  and  to  relieve  suffering. 

If  the  patient  is  robust,  has  a  hard,  frequent  pulse,  accompanied 
with  extreme  pain  and  fever,  blood-letting  is  indicated.  The  abstmc- 
tion  of  ten  to  fifteen  ounces  of  blood  will  give  great  relief  and 
diminish  the  intensity  of  the  attack ;  but  if  the  patient  is  not  seen 
early,  and  is  of  a  feeble  constitution,  some  other  measures  should  be 
substituted  for  it.  The  mass  of  blood  may  be  lessened  by  saline 
cathartics,  such  as  the  sulphate  of  magnesia,  or  the  bitartrate  of 
potash  in  combination  with  jalap. 

The  effect  of  a  full  dose  of  Epsom  salts  is  equal  to  the  abstraction 
of  a  pint  of  blood  from  the  system.  Depletion  is  obtained  this  way 
without  the  impoverishment  of  the  blood. 

The  frequency  and  force  of  the  heart's  action  may  also  be  affected 
by  the  nauseant  sedatives,  such  as  tartarized  antimony  and  ipecacu- 
aixha,  and  by  the  direct  sedatives,  such  as  the  tincture  of  aconite  and 


M8EA8KB   OP   THR   CHEST. 


265 


iivering 
I  voice, 

but  aii- 

•oin  lilt! 

of  the 

Q,  while 
manner, 
er,  witli 
e.  But 
on  the 
irhen  the 
,  then,  18 

ore  effu- 
ik  of  dry 
siderable 
vers  per- 
eres  seri- 
idly. 

md  treat- 
nflamnia- 
»et  to  the 
B  of  effu- 
liHh;  and 
rption  of 

•y  slowly 
ihronic. 
irrest  the 
amount 

>mpanied 

absti-ac- 

[elief  and 

not  seen 

[hould  be 

by  saline 

irtrate  of 

3tra.ction 
this  way 

affected 
ipecacu- 
lonite  and 


nf  veratrum  viride;  therefore,  if  blood-letting  is  contra-indicated,  the 
tinit  thing  U)  be  done  is  to  give  the  sulphate  of  magnesia,  and  follow 
it  with  some  diaphoretic  like  (130),  to  alleviate  the  painful  stitch  in 
the  side  "nd  to  tmnquillize  the  system. 

It  is  well  to  administer  salicylate  of  soda  in  10-grain  doses  every 
three  hours  till  a  little  ringing  is  heard  in  the  eai-s,  then  once  in  four 
hours.  This  drug  increases  the  action  of  the  skin  anil  kidneys  and 
overcomes  the  rheumatic  element  present  in  most  if  not  all  pleurisies. 
The  diet  should  be  dry,  all  liquids  Iwing  excluded,  that  the  abstrac- 
tion of  water  from  the  chest  may  be  favored. 

Nothing  gives  so  much  and  such  immediate  relief  to  pain  as  a 
subcutaneous  injection  of  morphine.  Aconite  also  is  a  valuable 
sedative  in  this  stage.  It  may  be  given  in  half  or  whole-drop  doses 
every  fifteen  minutes  for  two  hours ;  then  afterwards  a  drop,  to  be 
repeated  hourly  till  some  impression  is  made  upon  the  heart's  action. 
Smaller  doses  are  to  be  given  if  the  pulse  becomes  feeble. 

In  the  second  stage,  if  the  acute  symptoms  have  yielded  to  treat- 
ment, as  they  usually  do,  the  object  of  treatment  is  to  promote  the 
absorption  of  the  fluid.  This  is  done  by  the  judicious  use  of  saline 
cathartics  and  by  diuretics,  for  the  Iwwels  and  the  kidneys  are  the 
natural  pumps  of  the  system. 

The  application  of  counter-irritants  is  also  of  use  for  this  purpose, 
such  as  the  tincture  of  iodine,  and  small  blisters,  which  are  to  be 
allowed  to  remain  on  till  vesication,  and  then  the  blister  is  to  be 
dried  up  and  a  new  one  applied.  If  at  any  time  during  this  stage 
the  effusion  is  rapid  and  excessive,  so  as  to  endanger  life,  it  is  to 
be  drawn  off  by  puncturing  the  chest  between  the  fifth  and  sixth 
ribs  on  the  side  with  a  small  trocar,  and  the  fluid  is  to  be  drawn  off 
by  suction. 

Convalescence  commences  when  the  liquid  begins  to  be  absorbed ; 
and  active  medication  should  then  cease,  and  that  course  should  be 
pursued  which  will  lead  to  the  restoration  of  the  general  health. 
This  is  done  by  tonics,  a  nutritious  diet,  and  other  hygienic  means. 
If  the  effusion  ceases  to  be  absorbed  or  the  process  takes  place  very 
slowly,  then  that  state  of  things  exists  which  is  called  chronic  pleu- 
risy. Then  the  main  objects  of  treatment  are  to  effect  the  removal 
of  the  fluid,  and  to  develop  and  sustain  the  powers  of  the  sjrstem. 
Under  these  circumstances,  it  is  better  to  discontinue  remedies  which 
act  upon  the  bowels  and  kidneys,  at  least  for  a  time,  and  try  general 
treatment.  This  consists  of  tonics,  stimulants,  and  general  exercise 
in  the  open  air,  and  with  this  the  surgical  removal  of  the  fluids  from 
the  cavity  of  the  chest. 

The  operation  is  now  so  much  improved,  and  is  so  safe  and  simple 
and  attended  with  so  little  pain,  that  it  has  become  an  every-day 
practice,  and  an  operation  which  was  only  resorted  to  as  an  extreme 
measure  to  save  life,  is  now  admissible  whenever  the  pleural  cavity 
remains  filled  with  liquid,  after  only  a  brief  trial  of  the  remedies 
assigned  to  promote  absorption.  - 


:-\" 


266 


DIHRAHKH   OK   THK  CHR8T. 


Lung  Fever.  —  Pneumonia. 

This  diHeoHe,  by  common  uoago,  has  beon  called  a  fever ;  but  by 
physicians  it  is  reckoned  as  one  of  the  infiammationt.  It  is  inflamma- 
tion of  thti  lungn  or  liijhU ;  and  whatever  fever  there  may  be  results 
entirely  from  this  local  inflammation. 

Signs  and  Symptoms.  —  A  patient  suffering  with  lung  fever  is 
generally  found  lying  upon  his  back,  with  some  pain  in  the  side ; 
more  or  less  difficulty  of  breathing ;  a  cough,  at  first  dry,  but  soon 
accompar.ied  by  raising  a  thick,  sticky,  rusty-colored  matter,  composed 
of  a  mixture  of  phlegm  and  blood.  As  the  disease  increases  in 
severity,  this  matter  will  become  more  sticky  and  tenacious,  so  that 
it  will  adhere  to  a  spit  cup  turned  upside  down.  There  will  be  more 
difficulty  of  breathing,  greater  prostration,  and  perhaps  some  delirium. 

For  the  purpose  of  more  clearly  describing  this  complaint,  it  is 
found  convenient  to  divide  it  into  three  stages,  or  degrees  of  progress. 

First  Stage.  —  This  is  called  the  stage  of  engorgement.  The  lungs 
during  this  stivge  are  engorged  or  crowded  with  blood.  If  we  could 
inspect  them,  we  should  find  the  inflamed  portion  redder,  thinker,  and 
heavier  than  usual.  We  should  find  them  weaker,  that  is,  more 
easily  torn  than  in  the  natural  state ;  with  less  air  in  them,  and  con- 
sequently crackling  less  upon  pre.«jure,  —  yet  not  entirely  destitute 
of  air  and  crackling,  and  not  so  heavy  as  to  sink  in  water.  Rapping 
upon  the  chest  at  tliis  period  gives  out  a  flatter,  duller,  or  less  hollow 
sound  than  usual.  On  applying  the  stethoscope,  we  hear  less  of  the 
natural  rustling  sound  of  health ;  and,  either  mingling  with,  or  over- 
coming it,  we  hear  a  minute  crackling  sound,  as  the  air  passes  in  and 
out  in  breathing. 

This  crackling  has  been  compared  to  that  produced  by  fine  salt 
tluown  upon  red-hot  coals ;  or  by  that  of  rubbing  a  lock  of  fine  hair 
between  the  thumb  and  finger  near  the  ear.  It  is  caused  by  small 
bubbles  of  air  being  forced  along  the  moist  and  sticky  sides  of  the 
small  tubes  and  air-cells.  It  is  heard  only  while  the  breath  is  being 
drawn  in. 

Second  Stage.  —  If  the  inflammation  advances  to  the  second  stage, 
the  swelling  of  the  diseased  lung  increases  so  as  to  force  out  the  air 
entirely,  and  it  becomes  solid,  and  wholly  useless  for  the  purpose  of 
breathing.  In  solidity  and  general  appearance,  it  resembles  a  piece 
of  liver.  Hence  it  is  said  to  be  hepatized,  or  liverized ;  and  this  is 
called  the  stage  of  hepatization. 

I  As  the  lung  grows  more  solid,  its  vitality  and  strength  diminish ; 
it  is  not  near  as  strong  as  a  piece  of  healthy  liver,  though  it  looks 
like  it ;  it  is  soft  and  easily  broken ;  indeed  it  seems  to  be  in  a  state 
of  commencing  decay  or  rottenness.  Hen  je  some  writers,  in  order 
to  be  more  precisely  correct,  call  this  the  stage  of  red  softening. 


frrrwapitti-.—je^.;^ 


■-s^-fsssmmm^ms^^sn^'- 


DIBBABr,S  OF   TIIR  OIIEBT. 


267 


;  but  by 
nflamtna- 
te  resiulUi 

fever  is 
the  Hide ; 
but  soon 
!omp08ed 
reiVHes  in 
I,  HO  that 
i  be  more 
delirium, 
lint,  it  Ls 
progress. 

rhe  lungs 

we  could 

taker,  and 

is,  more 

,  and  con- 

dec'citute 

Rapping 

iss  hollow 

ess  of  the 

or  over- 

les  in  and 

fine  salt 
fine  hair 
by  small 
es  of  the 
is  being 

>nd  stage, 
at  the  air 
irpose  of 
!S  a  piece 
this  is 

iminish ; 

it  looks 

n  a  state 

in  order 

ling. 


With  incrcouefl  solidity,  there  is  of  course  inoreasod  dnllneM  on 
porcuHsion.  When  the  stethoscope  is  applied  to  the  (;hest,  we  hoar 
no  sound  of  air  paHsing  into  and  out  of  the  diseased  lung;  no  natural 
rustling,  or  minute  crackling;  but  in  their  stead,  we  have  a  kind  of 
whistling,  produced  by  tlie  air  passing  back  and  forth  in  the  wind- 
pipe and  ita  branches,  but  finding  no  entrance  into  the  solidified  air- 
cells.  The  breathing  sometimes  sounds  like  a  sort  of  puff,  —  owing 
to  the  column  of  air  rebounding  when  refused  admission  to  the 
closed-up  cells. 

The  general  symptoms  now  increase  in  severity.  There  is  greater 
difficulty  of  bFeathing ;  the  phlegm  is  more  gluey ;  perhaps  some 
delirium  phows  itself ;  and  the  patient  grows  weaker. 

Third  S  to  *e.  —  At  this  period,  the  lung  changes  from  red  hepa- 
tization or  red  toftening  to  gray  hepatization  or  gray  softening,  and 
matter  is  now  found  diffused  through  its  whole  substance.  The 
percussion  sounds  are  much  the  same  as  in  the  second  stage.  On 
listening,  wc  hear  more  of  the  rattling  sound  produced  by  disturbed 
phlegm.  The  matter  raised  is  thinner,  —  more  like  liquid ;  and 
looks  like  prune-juice.  The  symptoms  generally  indicate  that  the 
patient  is  sinking.  Patients  may  recover  from  the  first  and  second 
stages,  but  rarely  from  the  third. 

Treatment.  —  Pneumonitis  has  been  divided  into  three  stages, 
corresponding  to  tlie  inflammatory  events  of  the  disease:  the  first 
stage  is  that  of  active  congestion,  the  second,  that  of  solidification, 
and  the  tliird,  that  of  t  lution.  The  duration  of  the  first  stage  is 
from  twenty-four  to  forty-eight  hours,  of  the  second  from  two  to 
four  days,  and  the  stage  of  resolution  lasts  from  eight  to  ten  days. 
Different  cases  vary,  however,  in  these  times.  These  different  stages 
furnish  different  remedial  indications. 

The  objects  of  treatment  in  the  fii-st  stage  are  to  arrest  the  disease, 
to  lessen  its  intensity,  to  relieve  pain,  and  to  promote  toleration  of 
the  disease. 

When  high  fever,  a  hard  pulse,  and  extreme  pain  are  present  in  a 
robust  constitution,  the  abstraction  of  blood  from  the  arm  is  indi- 
cated. These  cases  are  not  frequent,  for  lung  fever  mostly  occurs 
in  patients  with  feeble  constitutions,  but  when  practised  in  the 
proper  cases,  the  relief  to  pain  and  embarrassment  of  breatldng  is 
often  immediate  and  marked.  In  those  cases  where  blood-letting  is 
contra-indicated,  the  same  end  can  be  secured,  but  more  slowly,  by 
saline  cathartics  and  sedative  remedies.  After  saline  purgation,  if 
the  skin  is  hot  and  the  pulse  is  frequent,  tartar  emetic  may  be  given 
in  small  doses  as  a  nauseant  sedative ;  but  it  must  not  be  carried  to 
the  extent  of  distressing  nausea.  After  this  follows  the  use  of  vas- 
cular sedatives,  such  as  the  tincture  of  aconite  and  the  tincture  of 
veratrum  viride,  if  not  contra-indicated  by  the  feebleness  of  the 
patient  with  a  tendency  to  depression. 


268 


DISEAS7.S  OF   THE   CHEST. 


•  Sometimes  the  sulphate  of  quinine,  in  a  full  dose  of  from  twenty 
to  twenty-five  grains  at  the  onset,  or  within  eight  or  ten  hours,  will 
arrest  the  disease.  It  may  be  well  to  try  it,  as  it  can  be  administered 
with  perfect  safety.  Opium  is  of  great  importance  also,  to  relieve 
pain  and  tranquillize  the  system. 

Cold  or  wai^n  applications  to  the  chest  may  be  used  according  to 
the  preferences  of  the  patient.  Warm  applications  act  as  revulsents ; 
the  cold  diminishes  the  determination  of  blood  to  the  part,  and  re- 
lieves the  pain  by  obtunding  sensibility.  Counter-irritants  are  not 
advisable  in  that  stage. 

The  treatment  of  the  second  stage  aims  at  the  promotion  of  reso- 
lution of  the  inflammation,  the  palliation  of  the  symptoms,  and  the 
maintenance  of  the  powers  of  Hfe. 

The  tinctures  of  veratrum  viride  and  aconite  may  be  continued  in 
this  stage,  if  there  is  considemble  fever  and  there  is  no  tendency  to 
asthenia ;  but  the  leading  measure  is  to  support  the  system. 

The  rational  use  of  veratrum  viride,  than  which  there  is  no  better 
drug  in  Pneumonia,  consists  in  giving  five-drop  doses  hourly  till  the 
pulse  reaches  jixty  per  mii  .ute,  then  just  often  enough  to  keep  the 
pulse  in  that  neighborhood. 

This  course  embraces  the  use  of  tonics,  stimulants,  and  nutritious 
diet.  The  use  of  alcohols  is  necessary  in  most  cases,  and  sometimes 
very  freely.  The  diet  should  consist  of  milk,  farinaceous  substances, 
and  animal  broths.  Quinine  in  tonic  doses  is  the  best  remedy  in 
this  stage. 

The  preparations  of  opium  are  very  useful,  and  only  contra-indi- 
cated by  the  accumulation  of  mucus  in  the  bronchial  tubes. 

Digitalis  is  useful  in  five  to  ten  grain  doses  three  or  four  times  a 
day,  when  it  is  necessary  to  increase  the  heart's  action. 

The  carbonat"  of  ammonia  is  necessary  in  cases  of  extreme  pros- 
tration. 

The  external  application  of  the  tincture  of  iodine  is  the  best 
counter-irritant  in  this  stage. 

During  the  third  stage,  all  those  hygienic  measures  which  improve 
the  general  health  are  to  be  pursued. 

Typhoid  Lung  Fever.  —  Typhoid  Pneumonia. 

This  is  an  inflammation  of  the  lungs,  differing  from  the  preceding 
only  in  the  character  of  the  fever  attending  it,  which  is  of  a  low, 
typhoid  character.  The  disease,  like  typhoid  fever,  is  characterized 
by  great  debility  and  prostration. 

Symptoms.  —  These  are  a  combinat-.on  of  the  symptoms  of  pneu- 
monia and  of  typhoid  fever.  The  disease  begins  mth  great  weari- 
ness, lassitude,  dizziness,  pain  in  the  head,  back,  and  limbs.  Soon 
there  is  much  difficulty  of  breathing,  tightness  across  the  chest,  with 
a  dry,  short,  hacking  cough. 


Hmt  aHJMMMMIIfcMMWBMi^W 


DISEASES  OF   THE   CHEST. 


269 


As  the  disease  advances,  the  active  syniptoms  pass  away ;  there  is 
a  dull  pain  across  the  chest ;  drowsiness  is  very  apt  to  come  on,  with 
the  various  symptoms  of  sinking  peculiar  to  typhoid  fever.  The 
skin  is  harsh  end  dry,  the  temperature  uneven,  the  tip  and  edge  of 
the  tongue  red,  and  the  middle  covered  with  ,i  yellow  or  brown  fur. 
The  bowels  are  tender,  swollen,  and  drum-head  like ;  while  there  is 
often  a  diarrhoja,  —  the  discharges  having  a  dirty-yellow  color. 

Treatment.  —  This  should  be  like  the  treatment  of  pneumonia 
and  typhoid  fever  united. 

Great  care  must  be  taken  not  to  use  reduc'  remedies.  While 
active  'rging  must  not  be  used,  yet,  if  there  i*re  symptoms  of  an 
inactive  state  of  the  bowels,  podophyllin  and  leptandrin  (34),  (39), 
may  be  employed  with  advantage. 

When  there  are  symptoms  of  great  depression,  use  tonics  (46), 
(48),  (50),  (63),  (60),  (64),  (67),  (73),  taking  care  to  keep  the 
cough  loose  by  flaxseed,  slippery  elm,  and  marshmallow  tea,  and  by 
some  external  irritant. 


f  pneu- 

it  weari- 

Soon 

st,  with 


Broncho-Pneumonia. 

This  is  an  infectious  inflammation,  characterized  by  an  exudation 
from  the  blood-vessels,  the  formation  of  new  connective  tissue,  and 
the  growth  of  bacteria.  The  disease  involves  the  walls  of  the  bronchi 
and  the  air-spaces  surrounding  t"he  inflamed  tubes.  It  is  frequently 
called  capillary  bronchitis  and  catarrhal  pneumonia.  It  is  the  ordi- 
nary pneumonia  of  children,  and  is  frequently  seen  in  young  people. 

It  comes  on  primarily,  but  is  often  secondary  to  measles,  whooping- 
cough,  etc. 

Symptoms.  —  In  the  very  young,  the  only  symptoms  are  fever, 
prostration,  and  rapid  breathing.  There  is  no  cough,  no  physical 
signs,  but  the  disease  is,  almost  ^  ways,  fatal  within  a  few  da,y%^  time. 

There  is  a  great  difference  in  the  invasion  of  the  disease  in  dif- 
ferent cases,  the  severer  cases  being  ushered  in  by  one  or  more  con- 
vulsions, by  rapid  rise  of  temperature,  vomiting,  difficulty  in  breathing, 
and  delirium;  the  milder  cases  beginning  with  lower  temperature, 
moderate  prostration  and  shortness  of  breath. 

The  height  of  the  temperature  is,  as  a  rule,  in  proportion  to  the 
severity  of  the  disease.  Temperatures  of  106°  and  over  are  usually 
fatal.  The  pulse  reaches  160  to  170  in  adults,  and  even  higher  in 
children,  —  so  high,  in  fact,  that  it  cannot  be  taken.  The  respiration 
varies  from  40  to  80.  Sleeplessness,  restlessness,  and  even  delirium 
are  frequently  present.  The  face  is  flushed,  the  tongue  coated,  and 
oftentimes  diarrhoea  and  vomiting  occur.  Cough  is  usually  present, 
and  in  the  ynng  the  sputum  is  swallowed.  The  urine  is  frequently 
albuminoua  and  contains  casts. 

Between  the  second  and  fifth  days  the  signs  of  consolidatioD  and 


270 


DISEASES   OF  THE   CHEST. 


pleurisy  appear,  i.  e.,  dullness  on  percussion,  bronchial  breathing  and 
bronchophony  with  crepitant  rattles. 

The  duration  of  the  disease  in  children  varies :  of  the  fatal  cases 
the  majority  die  within  the  first  fortnight.  The  cases  which  recover 
vary  from  one  to  chree  weeks,  though  many  persist  for  six  and  eight 
weeks.  The  softening  and  absorption  whicii  occurs  in  all  pneumo- 
nias that  recover  occupy  a  much  longer  period  in  broncho-pneumo- 
nia than  in  lobar  pneumonia. 

Many  cases  of  broncho-pneumonia  are  complicated  by  cerebral 
svmptoms  of  convulsions,  delirium,  stupor,  vomiting,  etc.,  even  before 
any  marked  lesions  in  the  lungs  appear;  as  these  subside  the  lung 
symptoms  appear.  Many  cases  are  protracted  for  a  long  time,  and 
though  they  may  terminate  favorably  at  last,  yet  they  are  apt  to  run 
into  a  chronic  hardening  of  the  lung  \>aich  lasts  for  jears;  or  they 
recover  with  a  permanent  consolidation  of  the  lung.  Some  die  of 
exhaustion. 

Treatment.  —  The  use  of  hot  fomentations  and  poultices  over  the 
chest  and  the  administration  of  small  doses  of  ipecac  and  aconite  at 
short  intervals  soothe  the  bronchitis  and  pain. 

For  the  cerebral  symptoms,  phenacetin  and  the  bromides  are  very 
useful.  Aconite  and  digitalis  are  usually  employed  when  the  pneu- 
monia stage  comes  on.  As  a  rule  stimulants  are  not  required  in 
children,  in  whom  the  disease  most  frequently  occurs. 

In  convaleaence,  iron,  q  "nine,  cod-liver  oil,  oxygen  and  a  change 
of  air  apj  to  be  recommenaod. 

Other  Forms  of  Lung  Inflammation. 

Op  the  various  other  forms  of  lung  inflammation  which  occur, 
mention  may  be  made  of  pneumonia  dependent  on  Heart  Disease ; 
Interstitial  Pneumonia,  or  the  formation  of  new  connective  tissue 
and  obliteration  of  the  air-spaces ;  1  abercular  Pneumonia,  which  is 
caused  by  the  presence  of  tubercle  bacilli ;  Acute  and  Chronic  Mi- 
liary Tuberculosis,  characterized  by  the  presence  of  numerous  minute 
nodules  called  miliary  tubercles ;  Acute  and  Chronic  Tubercular 
Consumption^  Gangrene  of  the  Lung,  where  a  portion  of  the  lung 
has  lost  its  vitality  and  the  germs  of  putrefaction  have  entered. 


Asthma. 

Asthma  may  be  defined  to  be  great  difficulty  of  drawing  in  the 
breath,  —  coming  on  suddenly,  sometimes  gradually, -— accompanied 
with  a  sense  of  extreme  suffocation,  and  a  desire  for  fresh  air ;  con- 
tinuing for  a  longer  or  shorter  period,  and  then  passing  away,  and 
leaving  the  patient  a  period  of  comparatively  easy  respiration. 

Symptoms.  —  There  are  sometimes  no  premonitory  symptoms, 
the  attack  coming  on  suddenly,  and  without  warnings  but  more  fre- 


DISEASES   OF  THE  CHEST. 


271 


ling  and 

»1  cases 
recover 
ad  eight 
pneumo- 
pneumo- 

cerebral 
n  before 
;he  lung 
ime,  and 
)t  to  run 

or  they 
e  die  of 

over  the 
conite  at 

are  very 
he  pneu- 
[uired  in 

i  change 


ih  occur, 
Disease ; 

e  tissue 
[which  is 
Ionic  Mi- 
minute 

bercular 

;he  lung 

■ed. 


in  the 

ipanied 

|iir;  con- 

(ray,  and 


iptoms, 
Lore  fre- 


quently there  are,  for  some  days  before  the  onset,  loss  of  appetite, 
flatulence,  belching  of  wind,  irritability,  languor,  chilliness,  oppres- 
sion, and  drowsiness.  The  hard  breathing  generally  makes  its 
appearance  in  the  night,  —  quite  often  at  three  or  four  o'clock  in 
the  morning,  when  the  nervous  system  is  at  its  lowest  ebb.  There 
is  first  a  sense  of  tightness,  or  stricture,  across  the  chest,  which 
seems  to  expand  with  difficulty.  The  patient  can  no  longer  remain 
lying  down ;  he  rises  up,  draws  up  his  kn<>.es,  and,  leaning  forward, 
puts  his  elbows  upon  them,  and  his  head  upon  his  hands,  and  then 
struggles  hard  to  di-aw  in  his  ^-"ath ;  which,  passing  in  slowly  and 
laboriously,  produces  a  loud  jzing  sound.  Sometimes  he  feels 
that  he  must  have  fresh  air,  a.,  rushing  to  a  window,  puts  his  head 
far  out,  to  catch  a  stirring  breeze.  The  hands  and  feet  are  cold,  the 
face  haggard  and  distressed,  —  sometimes  a  little  red  and  swollen, 
but  more  generally  pale  and  shrunk,  —  the  body  wet  with  perspira- 
tion, the  pulse  irregular,  feeble,  and  small,  though  sometimes  not 
disturbed.  These  symptoms  continue  for  some  hours,  more  or  less, 
when  the  breathing  becomes  more  easy,  and  there  is  a  little  phlegm 
raised,  sometimes  considerable.  This  cessation  of  difficult  breathing 
may  be  complete,  or  only  partial ;  and  lasts  for  a  longer  or  shorter 
period,  when  the  attack  again  recurs. 

Causes.  —  It  is  well  known  that  Asthma  has  its  cause  mainly  in 
the  nervous  system.  The  air-tubes  are  encircled  with  a  series  of 
little  bundles  of  fibres,  which  are,  in  fact,  muscles,  and  like  all  other 
muscles  have  the  power  of  contracting  or  shortening  themselves. 
These  muscles,  too,  like  all  others,  have  nerves  distributed  to 
them ;  and  when  these  nerves  become  diseased  or  irritable,  they  will 
become  disturbed  on  certain  occasions,  and  cause  these  small,  circu- 
lar puckering  strings  to  contract  and  close  up,  the  air-tubes  near 
their  terminations,  very  much  as  the  puckerihg-string  closes  the 
mouth  of  the  work-bag,  so  that  very  little  air  can  pass  into  the  air- 
cells,  and  that  little  with  great  difficulty  and  slowness.  When  these 
contractions  take  place,  and  the  air  is  thus  shut  off,  the  result  is  a  fit  of 
asthma.  This  disease  may  be  brought  on  by  any  of  those  states  of 
the  atmosphere  which  disturb  or  irritate  the  bronchial  surfaces,  or  by 
any  of  the  numerous  causes  which  mysteriously  unbalance  the 
nervous  system.  A  fit  may  be  brought  on  by  whatever  disturbs  the 
mind. 

Treatment.  —  The  disease  has  been  regarded  as  extremely  diffi- 
cult of  cure.  There  are  certain  remedies,  however,  which  have  a 
remarkable  control  over  it,  and,  if  skilfully  used,  will  frequently 
bring  it  to  a  complete  termination,  and,  even  in  the  worst  cases,  to  a 
state  of  very  great  mitigation  and  improvement. 

Inhalation.  —  The  most  important  and  certain  remedy  is  the  use 
of  the  Alterative  Inhalant,  described  on  page  243.  1!  have  with  this 
article  alone  effected  some  surprising  cures ;  yet  it  is  well  to  combine 


272 


DISEASES  OF  THE   CHEST. 


other  treatment  with  it.  I  have  had  several  cases  of  a  most  distress- 
ing character,  —  the  attacks  continuing  night  and  day,  —  in  which 
the  inhalation,  judiciously  administered,  has  caused  the  disappearance 
of  the  complaint  within  twenty-four  hours,  and  in  which  no  return  of 
suffering  has  occurred  for  several  weeks,  and  then  only  in  a  modified 
form.     This  remedy  should  be  used  four  or  five  times  a  day. 

Iodide  of  potassium  is  a  most  valuable  internal  remedy  in  this 
complaint;  indeed,  in  a  certain  sense,  it  is  silniost  a  specific.  It 
should  be  used  (prescriptions  101,  138,  140,  151)  at  the  same  time 
with  the  inhalation.  The  following  preparation  is  a  very  good 
remedy  for  this  disease :  Ethereal  tincture  of  lobelia,  two  ounces ; 
tincture  of  asafoetida,  one  ounce;  grindelia,  one  ounce;  iodide  of 
potassium,  two  ounces;  simple  syrup,  four  ounces.  Mix.  Dose, 
from  a  teaspoonful  to  a  tablespoonful,  every  hour  or  two. 

Several  other  remedies  are  used  for  asthma,  with  more  or  less 
success,  such  as  electro-magnetism,  smoking  stramonium  leaves, 
burning  paper  dipped  in  a  strong  solution  of  nitrate  of  potash,  and 
inhaling  the  smoke,  etc.,  —  but  none  of  these  have  as  much  value  as 
the  tTTo  remedies  first  named. 

In  as  grave  a  complaint  as  a  severe  case  of  asthma,  it  is  always 
well  to  seek  the  aid  of  a  physician. 

Hay-Asthma.  —  Hay-Fever. 

This  is  a  very  troublesome  complaint,  which  seems  to  combine 
the  peculiarities  both  of  asthma  and  of  influenza.  Fortunately,  it 
ftttacks  but  few  persons,  and  those  only  at  particular  seasons  of  the 
year,  —  namely,  while  hay  is  in  blossom,  and  during  hay-making. 

Symptoms.  —  These  are  a  combination  of  the  symptoms  of  the 
two  diseases  above  named.  There  is  great  irritation  of  the  eyes, 
with  sneezing,  and  a  free  discharge  from  the  nose.  There  is 
tightness  across  the  chest,  diflSculty  of  breathing,  and  a  pricking 
sensation  in  the  throat  These  symptoms  often  appear  in  great 
severity,  making  the  complaint  a  really  distressing  one. 

Cause.  —  This  disorder  appears  to  have  but  one  cause,  —  namely, 
some  sort  of  emanations  from  the  grasses,  flowers,  etc.,  while  in 
blossom ;  which  emanations  come  in  contact  with  the  mucous  lining 
of  the  eyes,  nose,  and  throat,  producing  very  great  and  teasing  irri- 
tation. 

Treatment.  —  One  of  the  best  remedies  for  this  troublesome  com- 
plaint is  to  avoid  the  cause,  by  removing,  during  the  flowering  and 
haying  seasor,  to  some  large  city,  or,  still  better,  close  down  to  the 
seashore,  where  flowers  and  hay  do  not  grow. 

Of  medicines,  the  tincture  of  lobelia,  taken  in  moderate  doses,  is 
a  very  good  remedy.  Quinine  and  iron,  given  in  combination  (75), 
are  valuable  preparations.     Strychnine  and  nux  vomica,  in  connec- 


W;^Si,^I^S!iS. 


lost  distress- 
—  in  which 
sappearaiice 
110  return  of 
1  a  modified 
day. 

ledy  in  this 
speoific.  It 
I  same  time 
very  good 
wo  ounces; 
i;  iodide  of 
Aix.    Dose, 

lore  or  less 
um  leaves, 
potash,  and 
oh  value  aa 

t  is  always 


to  combine 
•tunately,  it 
sons  of  the 
making. 

oms  of  the 
i  the  eyes. 
There  is 
a  pricking 
.r  in  gre&t 

—  namely, 
1.,  while  in 
sous  lining 
easing  irri- 

esome  com- 
R'ering  and 
)wn  to  the 

be  doses,  is 
ation  (75), 
in  connec- 


DISEA8E8  OF  THE  CHEST.  273 

t       V^  .'l'.'"  "'"^  "^'°  ^  '^Wed  in  one  of  thesf  solutions,  and 

hung  about  the  apartments  of  the  house.     The  hands  and  face  may 

likewise  be  washed,  once  or  twice  a  day,  in  a  weak  solution.  ^ 

Ihe  oxide  of  zinc  and  the  extract  of  nux  vomica,  made  into  pills, 

ornTtT   '^''  ""'  '"  \^^^  "  ^"^  °^  '^'  extract  to  each  pill,Cd 
one  pill  taken  morning  and  evening,  should  not  be  forgotten 

m.?oi!^     '"T""'  ^T^^  ^y  "^^^'^^  °^  ''  «^"^«1'«  hair  brush  on  the 

aTd'^m-^igr  t^lt^  ^°^^'  '-  ^-  "-^  '^  «^-^  ^  P— y^- 

rpJif;/°"T'i!^  formula  is  the  most  efficacious  of  this  class  of 
reraediBs  and  should  be  painted  onto  the  nasal  mucous  membrane  as 
high  HP  as  possible ;  its  use  maybe  repeated  several  times  till  the 
membrane  becomes  numb. 

Cocaine 19 

Antifebrin ok  5!* 

Alcohol   ...  i^f- 

Simple  Elixir    ...!.' '       tZ' 

Mix  and  shake  before  using. 


.W.|!l»^*,.^Jn^^■* 


HEART  DISEASES. 


Life  rests  upon  a  tripod,  —  the  brain,  the  lungs,  and  the  heart. 
These  are  equally  important  to  its  we'1-being  and  continuance. 

In  substance,  tbe  human  heart  is  a  bundle  of  muscles,  so  put  to- 
gether as  to  bear  the  greatest  possible  amount  of  work.  In  size, 
shape,  and  look,  it  is  much  like  the  heart  of  the  hog.  I  wish  it 
never  had  a  likeness  to  it  in  its  moral  nature. 

The  heart  is  enclosed  in  a  case  or  sac,  called  the  pericardium.  It 
lies  between  the  two  lungs,  a  little  to  the  left  side  of  the  chest.  Its 
point  is  under  the  sixth  rib  on  the  left  Ride,  and  its  lower  surface 
rests  on  the  diaphragm,  —  a  horizontal  partition  between  the  chest 
and  belly. 

The  heart  is  double.  It  has  four  cavities,  —  two  for  receiving  the 
blood,  which  are  called  auricles,  and  two  for  driving  it  out,  called 
ventricles. 

The  venous,  or  dark  blood,  is  brought  from  all  parts  below,  and 
emptied  into  the  right  auricle  through  the  ascending  vena  cava,  and 
from  all  parts  from  above,  and  pour  into  the  same  cavity  through 
the  descending  vena  cava.  From  this  it  passes  into  the  right  ventri- 
cle, which  contracts,  and  forces  it  through  the  pulmonary  artery  into 
the  lungs,  where  it  becomes  red,  and  passes  into  the  left  auricle 
through  the  pulmonary  vein,  thence  into  the  left  ventricle,  which 
contracts,  and  throws  it  out  through  the  great  aorta  to  all  parts  of 
the  body.  Fig.  95  gives  a  good  idea  of  Ijie  circulation  through  the 
heart  and  lungs. 

The  heart  is  divided  into  two  sides,  which  are  separated  from  each 
other  by  a  muscular  partition,  —  each  side  having  an  auricle  and  a 
ventricle. 

The  auricles  have  comparatively  thin  walls,  as  they  are  only  used 
for  reservoirs.  The  walls  of  the  ventricles  are  much  thicker,  being 
used,  —  particularly  that  of  the  left  side,  —  for  forcing  the  blood 
over  a  large  surface. 

Between  the  auricle  and  ventricle  on  the  right  side,  are  three  folds 
of  triangular  membrane,  called  the  tricuspid  valves.  Between  the 
auricle  and  ventricle  on  the  left  side,  are  three  valves,  called  mitral. 

At  the  beginning  of  the  pulmonary  artery,  and  the  aorta,  are  three 
half-moon  shaped  folds  of  membrane,  called  semilunar  valves. 

274 


1 


ltiiiai»ftii)iiMiwiiwiiiwu»«Mi8ia»teBHia 


BBWiis^tsr!; 


HEART  DISEASES. 


276 


The  office  of  all  these  valves  is,  to  close  after  the  blood  has  gone 
through,  and  prevent  its  flowing  back  while  the  cavity  is  being  again 
filled.     They  do  the  same  duty,  in  fact,  as  the  valves  of  a  pump. 

Through  this  heart,  thus  constructed,  all  the  blood  in  the  body, — 
about  twenty-eight  pounds,  —  passes  once  in  about  one  minute  and  a 
half.  This  is  rapid  work ;  and  when  we  consider  that  the  heart 
works  in  this  way  through  the  whole  life,  resting  not,  day  or  night, 
we  cannot  wonder  that  it  gets  out  of  order. 


the  heart, 
lance. 

so  put  to- 

t.     In  size, 

I  wish  it 


^m&^^ 


irdium.    It 

chest.    Its 

wer  surface 

n  the  chest 

eceiving  the 
;  out,  called 

below,  and 

la  cava,  and 

ity  through 

right  ventri- 

artery  into 

left  auricle 

ricle,  which 

all  parts  of 

;hrough  the 

Id  from  each 
iricle  and  a 

16  only  used 

jicker,  being 

the  blood 

le  three  folds 
between  the 

ailed  mitral, 
fta,  are  three 

tves. 


12 


FlO.  96.; 

The  whole  heart  is  seldom  affectefi.  The  left  side  is  more  liable 
to  disease  than  the  right. 

Impulse  of  the  Heart. 

The  ear,  when  placed  over  the  heart,  feels,  at  each  beat,  a  slight 
shock.  This  is  felt  at  the  same  time  the  first  sound  is  heard.  This 
impulse  is  caused  by  the  apex  or  point  of  the  heart  being  thrown  up 
against  the  ribs  by  the  contraction  of  the  ventricles.  It  is  felt  best 
between  the  cartilages  of  the  fifth  and  sixth  ribs  on  the  left  side. 

The  Sounds  of  the  Heart. 

On  appljring  the  ear  to  the  chest  just  over  the  heart,  two  sounds 
are  heard.  The  first  one  is  dull  and  slightly  prolonged ;  the  second 
is  a  shorter  and  smarter  sound,  having  a  sort  of  clack.  These  occur 
in  pretty  rapid  succession,  and  then  comes  a  brief  interval.  And  this 
round  of  action,  first  a  long  and  dull  sound,  then  a  short  and  smart 
one,  and  then  an  interval,  —  called  the  heart's  rhythm,  —  is  repeated 
continually.    If  the  space  of  time  occupied  by  the  rhythm  be  divided 


276 


HRART   DISKA8EB. 


into  five  parts,  the  first  sound  will  take  about  two  parts,  the  second 
one,  and  the  interval  of  repose,  the  remaining  two,  The  first  sound 
is  heard  about  the  time  of  the  contraction  of  the  ventricles,  and  Ik 
therefore  called  the  8i/»tolic  sound ;  the  second  is  synchronous  with 
the  opening  of  the  ventricles,  and  is  called  the  diantolic  sound.  The 
syllables  too-to  —  too-to,  very  fairly  represent  the  two  sounds  of  the 
heart.  These  sounds  are  heard  over  the  largest  space  in  lean 
persons. 

Percussion  Sounds. 

If  the  ends  of  the  fingers  be  struck  upon  the  cheat  over  the  heart, 
a  dull  sound  will  be  heard  over  a  space  from  one  and  a  half  to  two 
inches  square,  —  beginning  at  the  fourth  rib  on  the  left  side,  and  ex- 
tending down  nearly  to  the  sixth.  The  dullness  is  diminished  by 
lying  upon  the  back,  and  increased  by  leaning  forward,  and  by  taking 
a  full  breath.  The  deadness  of  sound  is  caused  by  the  heart  being 
a  partially  solid  body.  The  lungs  which  surround  it  yield  a  clear 
sound. 

If  a  solid  substance,  as  large  as  the  heart,  were  placed  on  the  in- 
side of  a  drum,  against  the  head,  only  a  dead  sound  would  be  ob- 
tained by  striking  on  that  spot ;  everywhere  else,  the  sound  would 
be  louder.    • 

Altered  Sounds  of  the  Heart. 

These  sounds  are  changed  by  disease  in  a  variety  of  ways,  both  as 
to  their  character  and  duration.  One  or  both  sounds  may  be  turned 
into  a  noise  like  the  blowing  of  a  pair  of  bellows.  This  is  called  the 
bellows  sound.  When  this  sound  is  very  harsh,  it  may  become  like 
the  noise  of  a  rasp,  or  file,  or  saw.  These  altered  sounds  are  all  pro- 
duced by  an  altered  condition  of  the  valvular  passages  throucrh 
which  the  blood  passes.  If  you  build  an  aqueduct  of  equal  dim^;.;- 
sions  tliroughout,  and  smooth  on  the  inside,  you  may  send  a  certain 
volume  of  water  through,  at  a  given  speed,  without  noise.  But  if 
you  make  sudden  contractions  in  the  aqueduct,  or  allow  large  stones 
to  project  into  it,  and  then  attempt  tc  send  through  the  same  body 
of  water,  at  the  same  rate  of  speed,  you  will  hear  all  sorts  of  noises. 

Enlargement  or  Hypertrophy  of  the  Ventricles. 

This  is  simply  a  thickening,  or  an  increase  of  bulk,  in  the  walls 
of  the  ventricles.  The  muscles  composing  the  walls  of  one  or  both 
of  these  cavities  grow  thick  and  large. 

Physical  Signs.  —  Impulse  stronger  than  natural.  When  consid- 
erable, it  is  accompanied  with  a  lifting  and  heaving  of  the  parts. 
Dull  sound  on  percussion  over  a  larger  space.  First  sound  of  heart 
prolonged;  second  sound  feeble.  The  interval  of  silence,  shorter 
than  natural.    In  bad  cases,  the  second  sound  is  nearly  extinguished. 


^m^ 


^^^ 


--^^^^' 


HBART   DISEASES. 


277 


he  secoml 
iret  sound 
les,  and  is 
incus  with 
und.  Tlic 
ids  of  the 
B   in   lean 


■  the  heart, 
ilf  to  two 
de,  and  ex- 
inished  by 
.  by  taking 
eart  being 
Id  a  clear 

on  the  in- 
ald  be  ob- 
iind  would 


lys,  both  as 

be  turned 

called  the 

icome  like 

ire  all  pvo- 

throuerh 

lal  dinivii- 

a  certain 

But  if 

rge  stones 

ame  body 

of  noises. 

Tides. 

the  walls 
ae  or  both 

en  consid- 
the  parts, 
of  heart 
e,  shorter 
inguished. 


Qeneral  Symptoms.  —  Hypertrophy  of  left  ventricle  gives  a  strong, 
prolonged,  and  tense  pulse.  I'alpitation  more  constant  than  in  any 
other  disease  of  the  heart.  In  advanced  stivges,  the  patient  is  easily 
out  of  breath.  There  is  a  rush  of  blood  to  the  head  on  making  exer- 
tion or  stooping,  with  more  or  less  throbbing  and  lancinating  head- 
aches, which  are  aggravated  by  suddenly  lying  down  or  rising  up. 
There  are  vertigo,  ringing  in  the  ears,  sparks  of  light  and  other  illu- 
sions before  the  eyes  ;  also  a  purplish,  violet  or  livid  color  upon  the 
cheeks,  nose,  and  lips.  In  many  cases  there  is  a  dull,  severe  aching 
pain  in  the  region  of  the  heart,  and  extending  towards  the  shoulder 
and  the  inside  of  the  arm. 

When  the  riffht  ventricle  is  enlarged,  there  is  a  swelling  of  the  ex- 
ternal jugular  veins. 

Ca'ises.  —  The  walls  of  the  heart  are  thickened  by  overwork,  in  the 
same  way  that  the  blacksmith's  arm  is  made  muscular  and  large.  All 
muscles  gi'ow  in  the  same  way.  More  action  sends  more  blood  to 
them,  and  this  causes  an  increase  of  nutrition. 

Whatever  interposes  an  obstacle  to  the  passage  of  the  blood  through 
tlie  valviilar  openings,  will  cause  the  ventricles  which  force  it  through 
to  work  harder.  Hence,  obstructions  in  the  semilunar  valves  cause 
hypertrophy  of  the  ventricles. 

Any  excitement  of  the  mind,  or  any  great  exertion,  which  causes 
the  heart  to  beat  harder  and  faater^  if  it  be  often  repeated,  will  induce 
a  thickening  of  the  ventricles. 

Treatment.  —  First,  remove,  as  far  as  possible,  all  causes  of  excite- 
ment which  produce  palpitation.  If  the  head  is  much  affected,  apply 
wet  cups  to  the  back  of  the  neck.  The  same  may  be  applied  over 
the  heart.  This  will  generally  improve  the  symptoms  at  once.  A 
blister  placed  over  the  heart  will  likewise  make  a  favorable  impres- 
sion. 

The  meals  should  be  taken  at  regular  intervals,  and  should  be  very 
light  The  food  should  be  plain  and  simple,  and  composed  much 
more  of  vegetable  than  of  animal  food.  In  fact,  the  diet  should  be 
80  spare  as  slightly  to  reduce  the  strength. 

The  patient  should  be  careful  never  to  take  violent  exercise,  or, 
indeed  to  be  in  a  hurry  about  anything.  In  bad  cases,  walking  up 
hill,  or  against  a  strong  wind,  is  often  out  of  the  question,  and  must 
in  any  case  be  attempted  with  great  caution.  Staircases  are  to  be 
shunned  as  enemies.  An  attempt  to  run,  even  to  avoid  being  left  by 
the  cars,  might,  in  some  cases,  prove  immediately  fatal.  Carriage- 
riding  is  not  objectionable. 

The  passions  must  be  held  in  the  most  thorough  subjection.  Ex- 
citements of  all  sorts  are  dangerous,  and  must  be  avoided. 

For  the  first  week  or  two  of  treatment,  active  purgatives  will  be 
useful.  For  this  purpose,  epsom  salts  and  senna  will  answer  a  good 
purpose,  and  should  be  used  so  as  to  procure  two  or  three  watery 
stools  a  day. 


278 


HEART   DIHRASKS. 


Ill  addition  to  this,  Homo  sedative  to  lesson  the  force  of  the  heart's 
action  is  genemlly  needed,  especially  when  there  is  consideraltle 
palpitation.  For  this  purpose,  tincture  of  black  cohosh, and  tiiuturc 
of  scuUcap,  or  the  former  with  tincture  of  digitalis  (285),  (9-4),  arc 
quite  useful.  Three  to  ten  drops  of  tincture  of  the  American  hel'  j- 
bore  (venitruni  viride)  will  reduce  tlie  action  of  the  heart  perhaps 
more  effectually  than  any  other  inodicine,  for  a.  few  days  or  weeks. 

Dilatation  of  the  Ventricles. 

The  several  cavities  of  the  heart  hold  about  one  and  a  half  ounces 
each.  Dilatation  is  simply  an  enlaryement  of  these  cavities,  so  that 
they  will  hold  more.  And  this  increase  in  the  size  of  the  cavity  in 
simple  dilatation  is  generally  at  the  cost  of  the  walls,  which  are  made 
thinner  and  weaker,  — just  as  the  walls  of  a  bladder  are  made  thinner 
by  blowing  into  it  and  increasing  ita  internal  dimensions. 

Physical  Signs.  —  Impulse  more  abrupt,  and  less  marked  than  natr 
ural.  Dull  sound  on  percussion  commensurate  in  extent  with  the 
dilatation.  The  first  l)eat  of  the  heart,  clearer,  louder,  and  shorter 
tiian  natural,  and  more  nearly  resembling  the  second. 

Qeneral  Symptoms.  —  Difficulty  of  breathing;  terrific  dreams; 
starting  from  sleep ;  swelling  of  the  feet  and  legs ;  purple,  violet,  or 
blue  color  of  the  cheeks,  nose,  lips,  and  especially  around  the  eyes ; 
feeble  and  oppressed  palpitation  ;  various  disturbances  in  the  head ; 
bleeding  from  the  nose,  stomach,  bowels,  and  womb ;  and  frequently 
eiUargement  of  the  liver. 

Explanations. — The  first  sound  of  the  heart  is  short  and  not  well 
marked,  in  consequence  of  the  muscular  walls  of  the  ventricles  in 
this  disease  being  thin  and  in  a  weakened  condition,  so  that  every 
stroke  they  make  is  short,  quick,  and  spasmodic,  instead  of  stron^ 
and  lifting,  as  in  hypertrophy.  For  the  same  reason,  the  impulse  is 
a  brief  blow  dealt  the  walls  of  the  chest,  which  gives  a  slight  shock, 
but  has  not  power  enough  to  lift  the  chest  up.  The  blow  is  quick, 
because  the  muscle  is  thin  and  can  contrect  quicker  than  a  thick  one. 

Dilatation,  by  thinning  the  walls  of  the  cavities,  enfeebles  the  heart, 
and  shows  us  an  obstructed  circulation.  Accordingly  the  blood  is 
not  transmitted  by  the  left  ventricle,  and  being  retained  in  the  lungs, 
it  causes  a  crowded  state  of  the  vessels,  and  difficulty  of  breathing ; 
also  congestion  of  the  brain,  with  terrific  dreams,  etc.  And. this  en- 
gorgement of  the  lungs,  being  propagated  backwards  to  the  right 
heart,  great  vein  j,  and  all  their  ramifications,  produces  dropsy  of  the 
feet  and  legs,  discoloration  of  the  face,  passive  hemorrhages,  and  con- 
gfestion  of  the  brain,  liver  and  membranes.  Fig.  95  gfives  an  idea  of 
how  all  this  happens. 

Treatment. — As  in  many  other  diseases,  search  out  the  causes,  and 
remove  them.     If  it  be  obs^uction  of  the  circulation  in  the  lungs  by 


HEART    DISEASES. 


279 


the  heart's 
iiHidemUe 
id  tiiK.tuie 
,  (94),  aro 
icim  hel'a- 
rt  peilmpn 
r  weeks. 


lalf  ounces 
as,  8o  that 
)  cavity  in 
1  are  made 
.de  thinner 

d  than  nat- 
t  with  the 
,nd  shorter 

c  dreams; 
,  violet,  or 
the  eyes; 
the  head; 
frequently 

d  not  well 
ntricles  in 
that  every 

of  strong 
impulse  is 
ght  shock, 
V  is  quick, 

thick  one. 

the  heart, 
3  blood  is 

the  lungs, 

jreathing ; 

id. this  en- 
the  righi 

jsy  of  the 
and  con- 

an  idea  of 


auses,  and 
lungs  by 


bronchitis  or  other  complaint,  that  needs  tho  first  attention.  If  it  Im- 
caused  by  violent  exercise,  by  sti-ong  enrntions  of  the  mind  habitually 
indulged,  or  by  drunkenness,  or  any  other  irregularity  of  lift),  these 
iiabita  must  be  corrected  without  delay. 

If  it  be  caused  by  organic  disease  of  the  valves  of  the  heart,  relief 
cannot  be  so  readily  obtained ;  but  even  in  these  cases,  it  is  to  be 
sought  and  expected. 

The  circulation  is  to  be  kept  as  tranquil  as  possible  by  a  strictly 
([uiet  and  orderly  life,  and  a  plain,  moderate,  unstimulating  diet.  In 
this  disease,  however,  it  should  be  more  nutritious,  and  composed  to 
a  larger  extent  of  meats,  than  in  hypertrophy. 

In  some  cases  the  general  health  and  tone  of  the  system  will  need 
to  be  improved  by  bitters  (60),  (67),  (64),  (69),  (79),  mineral  acids 
(60),  iron  (269),  (61),  and  aromatics  (115).  The  compound  mix- 
ture of  iron  is  a  good  preparation  when  this  mineral  is  called  for  by 
a  low  state  of  the  blood. 

The  stomach  should  be  kept  in  the  best  possible  condition,  as  a 
very  small  disturbance  of  it,  even  from  acidity,  will  set  the  heart  to 
l)eating  very  violently. 

If  hysterical  symptoms  are  present,  tho  compound  galbanum  pill, 
and  valerian  (97),  and  other  nervines  will  be  called  for. 

In  attacks  of  great  difficulty  in  breathing,  immerse  all  the  extremi- 
ties in  warm  water,  and  throw  a  blanket  around  the  patient  to  pro- 
mote sweating,  —  at  the  same  time  admitting  fresh  air  to  satisfy  the 
desire  for  breath.  Give  a  draught,  composed  of  ether,  camphor, 
ammonia,  etc.  (1S5).  This  may  be  repeated  two  or  three  times,  at 
intervals  of  Iialf  an  hour,  or  an  hour,  according  to  the  urgency  of  the 
case. 

Hypertrophy  with  Slight  Dilatation. 

This  is  one  of  the  most  common  complications  of  heart  disease. 
It  consists  both  in  a  thickening  of  t  le  walls  of  the  he-.rt,  and  an  en- 
largement of  the  cavities,  —  the  f '.rmer  being  more  marked  than  the 
latter. 

Physical  Signs. — Both  sounds  are  louder  than  in  any  other  dis- 
ease of  the  heart,  and  are  heard  sometimes  over  the  whole  chest. 
The  impulse  is  strong  and  heaving,  with  an  abrupt  back-stroke.  In 
bad  cases,  the  whole  person,  and  even  the  bed,  is  shaken  by  it.  The 
dull  sound  on  percussion  covers  a  large  space. 

General  Symptoms.  —  The  same  as  those  of  the  two  diseases  of 
which  it  is  composed,  slightly  modified  by  the  action  of  each  upon 
the  other. 

Dilatation  with  Slight  Hypertrophy. 

This  is  an  enlargement  of  the  cavities  of  tne  heart,  with  a  slight 
thickening  of  its  walls ;  the  dilatation  being  the  predominant  disease, 
or  greater  than  hypertrophy. 


280 


HIART  DIBRA8ES. 


Physical  Slffns<  —  PorcuBHion  giveH  a  dull  Hound  in  the  region  nf 
the  heart,  in  proportion  to  it«  nize.  The  first  l)eat  reHemblcr,  the  sec- 
ond.    The  Houond  Ixsat  is  loiidor  than  natural. 

The  impulHe  i8  a  short,  quick  stroke,  which  contrasts  strongly  with 
the  slower  and  heavior  one  of  hypertrophy  and  dilat^ition. 

The  general  Hynijjtoms  and  the  treatment  are  a  modification  of 
those  of  the  two  disease  united  in  it.  It  is,  however,  to  be  kept  in 
mind  that  the  dilatation  takes  the  lead ;  and,  furnishing  the  predomi- 
nant symptoms,  is  specially  to  l)e  regarded  in  the  treatment. 

Aneurismal  Tumors  of  the  Heart. 

When,  from  some  obstruction  in  the  valves,  the  blood  cannot  easily 
pass  out  of  an  auricle  or  a  ventricle,  its  inner  walls  may  become 
unable  to  bear  the  distending  force,  and  giving  way,  let  the  blood 
through  against  the  outer  coats,  which  stretch,  and  swell  out  into  the 
shape  of  a  tumor,  —  the  inside  of  the  tumor  becoming  a  regular  sac. 
Such  a  state  of  things  constitutes  an  aneurism  of  the  heart.  Of 
course  it  is  a  very  grave  disease. 

Softening  rf  the  Heart. 

In  this  disease  the  substance  of  the  heart  becomes  soft,  and  easily 
broken.     It  is  genemlly  the  result  of  some  form  of  inflammation. 

Physical  Signs.  —  The  contractions  of  the  heart  being  weakened 
by  softening,  the  impulse  is  reduced  in  force,  and  both  beats  are 
weaker,  and  often  they  are  intermittent.  The  first  beat  becomes 
short  and  flapping,  like  the  second. 

Qeneral  Symptoms. — A  quick,  feeble,  small,  and  faltering  pulse, 
great  anxiety,  and  a  disposition  to  faint.  General  languor ;  a  sallow, 
bloodless,  withered  complexion,  with  a  purple,  livid  tint  of  the  lips 
and  cheeks,  and  frequently,  general  dropsy,  from  the  inability  of  the 
heart  to  propel  its  contents. 

Treatment.  —  When  accompanied  by  acute  inflammation,  softening 
is  to  be  treated  on  the  same  principles  as  inflammation  of  the  heart- 
case. 

If  it  be  a  result  of  chronic  inflammation,  it  calls  for  iron,  bitters, 
nutritious  animal  food,  and  good  air. 

Induration  of  the  Heart. 

The  muscular  substance  of  the  heart  sometimes  undergoes  a  hard- 
ening process.  It  is  occasionally  so  much  hardened  as  to  sound, 
when  struck,  like  a  hollow  horn  vessel.     The  disease  is  rare. 

It  increases  the  heart's  impulse,  like  hypertrophy ;  and  it  requires 
about  the  same  treatment  as  that  disease. 


i!c4*!:'.\V.av 


HBART  DI8EA8IS. 


28t 


region  of 
:5  the  sec- 

mgly  witli 

ication  of 
le  kept  in 
3  predomi- 
t. 


mot  easily 
ly  become 
the  blood 
it  into  the 
jgular  sac. 
leart.     Of 


and  easily 
oatioD. 

weakened 

beats  are 

:  becomes 

ing  pulse, 
a  sallow, 

if  the  lips 
ty  of  the 


Hoftening 
16  heart- 

n,  bitters. 


38  a  hard- 
to  sound, 

3. 

;  requires 


Fatty  Degeneration  of  the  Heart. 

The  heart  HometinicH  Iwconies  overloaded  with  fiit,  which  in  depos- 
ited between  the  hearUcuse  and  the  mu8(;iihtr  Huljotiince,  —  covering 
the  organ  all  over  externally,  and  in  some  cases  penetrating  to  some 
depth  into  its  sulmtance.  The  muscular  walls  themselves  become 
thin  and  flabby. 

Symptom*.  —  The  sounds  of  the  heart  are  diminished,  —  especially 
the  first.  The  pulse  is  irregular.  Pain,  and  a  feeling  of  oppression 
in  the  region  of  the  heart,  with  general  signs  of  retarded  circulation, 
such  as  congestion  of  the  bnvin  and  liver.  There  is  occasiouall}  "d- 
diness,  loss  of  meuiory,  and  i  iilpitation. 

Treatment.  —  Exercise,  mental  excitement,  and  stimulating  drinks 
must  be  avoided ;  and  the  patient  must  live  for  one  or  two  yeare  on 
a  very  light  diet,  takiug  but  very  little  auimal  food. 

Bony  and  Cartilaginous  Productions  in  the  Heart. 

Tfiese  productions  in  the  heart  are  fortunately  rare.  Yet  they 
occur;  and  the  point  of  the  heart,  in  its  whole  thickness,  is  some- 
times changed  to  cartilage.  The  ventricles  are  sometimes  so  ossified 
as  to  resemble  the  bones  of  the  head. 

The  symptoms  of  these  degenerations  are .  obscure ;  and  as  such 
cases  are  not  curable,  it  is  ol  less  consequence  that  we  should  Ikj  able 
to  know  their  precise  nature  during  the  life  of  the  patient.  The 
treatment  can  only  afford  temporary  rel'  ',  and  should  be  such  us  is 
prescribed  in  other  heart-diseases  with  similar  symptoms. 

Shrinking  of  the  Heart. — Atrophy. 

The  heart,  liko  any  other  muscle,  is  liable  to  defective  nutrition, 
and  in  consequence  of  it  may  become  Rmall.  It  shrinks,  in  some 
cases,  to  the  size  of  an  infant's  heart. 

The  complaint  is  generally  caused  by  whatever  reduces  the  general 
flesh,  as  consumption,  diabetes,  chronic  dysentery,  cancer,  and  exces- 
sive loss  of  blood. 

It  can  hardly  be  called  a  disease.  Persons  who  have  it  are  less 
subject  to  inflammatory  diseases  than  others,  though  they  faint  from 
slight  causes,  &n<}  have  nervous  affections. 

Treatment.  —  If  its  causes  can  be  discovered,  treait  them;  if  not 
the  treatment  should  be  the  same  as  for  dilatation. 

Acute  Inflammation  of  the  Heart-Case. — Pericarditis. 

The  pericardium,  or  heart-case,  is  a  membranous  sac,  in  which 
the  heart  is  contained.     It  is  composed  of  two  layers.     The  outside 


••■    , 


282 


HEART   DISEASES. 


m 


m 


one  is  fibrotis,  dense  and  white  ;  the  inside  one  is  serous.  The  serous 
liiyer  forms  the  lining  of  the  fibrous  one,  and  then  is  reflected  over 
the  heart  and  the  roots  of  the  large  blood-vessels. 

When  the  pericardium  becomes  acutely  inflamed,  it  thi-ows  out 
both  lymph  and  serum  or  water.  The  lymph  often  causes  the  two 
layers  of  the  sac  to  grow  together. 

Physical  Signs.  — The  impulse  is  strong  when  the  effusion  of  water 
is  small,  —  feeble  and  unequal  when  it  is  large.  Percussion  yields  a 
dull  sound  in  proportion  to  the  amount  of  fluid  in  the  sac. 

When  listening  with  the  stethoscope,  a  rough  noise  is  heard,  resem- 
bling either  the  rasping  of  wood,  the  grating  of  a  nutmeg,  the  rustling 
of  silk,  or  the  crackling- of  parchment.  Sometimes  it  is  softer,  like 
the  blowing  of  a  pair  of  bellows.  Occasionally  it  resembles  the 
creaking  of  a  new  shoe-sole,  or  has  a  low  creaking,  like  the  tearing 
of  linen  cloth. 

When  there  is  effusion,  the  ordinary  beats  of  the  heart  sound  dull 
and  distant. 

General  Symptoms.  —  Acute  inflammatory  fever,  generally  pre- 
ceded by  chills,  with  pungent  pain  in  the  region  of  the  heart,  shooting 
to  the  left  shoulder-blade,  shoulder,  and  up:  -^r  arm. 

Pain  increased  by  taking  a  full  breath,  by  stretching  the  left  side, 
by  percussion,  and  by  pressure  between  the  ribs  over  the  heart. 
Sometimes  the  pain  is  in  the  epigastrium,  or  left  hypochondrium. 
Inability  to  lie  on  the  left  side. 

Explanation.  —  The  noises  mentioned  above  are  produced  by  the 
rubbing  together  of  opposite  surfaces  of  the  heart-case,  made  rough 
by  the  exudation  of  lymph.  The  rasping  is  supposed  to  be  caused 
by  firm  and  rugged  lymph ;  th«  rustling  and  creaking,  by  soft  and  wet 
lymph;  the  bellows  muiinur,  by  soft  and  dry  lymph;  the  creaking, 
croaking,  and  crackling,  by  drg,  tough  lymph.  These  sounds  may  all 
be  imitated  by  rubbing  a  damp  finger  upon  the  back  of  the  band, 
while  listening  with  the  stethoscope  applied  to  the  palm. 

Chronic  Inflammation  of  the  Heart-Case. 

When  acute  pericarditis  runs  for  more  than  ten  days  or  a  fortnight, 
it  becomes  chronic.  It  is  chronic  from  the  beginning,  when  it  runs  a 
slow,  insidious  course,  without  marked  or  violent  symptoms. 

The  symptoms  are  much  the  same  in  kind  with  those  of  the. acute 
form,  only  less  in  degree.  This  low  grade  of  the  sjmaptoms  of  the 
disease  renders  it  more  obscure  than  the  acute. 

Treatment. — In  the  acute  form  of  the  disease,  apply  wet  cups 
over  the  region  of  the  heart,  or  apply  from  a  dozen  to  forty  leeches 
to  the  same  parts. 

At  the  same  time,  move  the  bowels  freely  by  an  injection  (247), 
or  by  a  purgative  pill  (31). 


HEART  DISEASES. 


283 


The  strength  and  amount  of  the  remedies  employed  in  each  case 
must  be  in  proportion  to  the  vigor  of  the  patient's  constitution. 

It  is  of  great  importance  that  the  treatment  should  be  active  and 
prompt,  and  that  the  disease  should  be  broken  down  early. 

Diluent,  cooling  drinks  (112),  (129),  (298),  (299),  should  be  al- 
lowed as  freely  as  the  patient  desires,  in  order  to  dilute  the  blood, 
and  render  it  less  stimulating  to  the  heart. 

At  the  same  time,  five  to  fifteen-drop  doses  of  tincture  of  veratrum 
viride  should  be  given  every  hour,  to  bring  down  the  action  of  the 
heart.  Ten-drop  doses  of  tincture  of  digitalis  every  four  hours  are 
good. 

Let  the  diet  be  wholly  of  barley-water,  thin  gruel,  weak  tea,  or 
arrow-root. 

During  recovery,  the  diet  must  be  spare,  and  the  greatest  tranquil- 
lity of  mind  and  body  be  preserved. 

In  the  treatment  of  chronic  cases,  when  the  cavity  appears  to  con- 
tain fluid,  counter-irritation  is  suitable.  Blisters,  croton-oil,  the  com- 
pound tar-plaster,  and  especially  the  tincture  of  iodine.  The  diet 
may  be  a  little  more  nutritious  than  in  the  acute  form  of  the  disease, 
—  embracing  light  animal  food  and  broths. 


(247), 


Inflammation  of  the  Heart.  —  Carditis. 

This  is  an  infl>  mmation  of  the  muscular  substance  of  the  heart. 
When  existing  alone,  it  is  a  very  rare  disease.  Being  mixed  up  with 
other  forms  of  heart  disease,  it  does  not  require  any  separate  account 
of  ite  symptoms  or  treatment. 

Acute  Inflammation  of  the  Lining  of  the  Heart. 

Bhdocarditis. 

The  heart  is  one  of  the  citadels  of  life.  Disease  attacks  it  on  all 
sides.  In  this  complaint,  it  has  entered  the  fort  and  taken  possession. 
The  inflammation  is  on  the  lining  membrane. 

Physical  Signs.  —  The  impulse  is  violent,  abrupt  and  regular,  as 
long  as  the  circulation  through  the  heart  is  free,  but  when  this  is  im- 
peded, it  is  at  first  a  confused  tumult  (which  generally  happens  when 
a  fort  is  first  taken),  and  gradually  sinks  to  a  feeble  flutter. 

The  dull  sound  upon  percussion  covers  a  space  of  from  three  to 
seven  square  inches. 

The  beats  of  the  heart  are  generally  accompanied  or  marked  by  a 
bellows  murmur,  the  loudness  of  which  depends  on  the  strength 
of  the  heart's  action. 

General  Symptoms.  —  Inflammatory  fever.  The  action  of  the 
heart  being  generally  violent  and  abrupt,  the  pulse  corresponds  with 
it,  and  is  strong,  full  and  hard. 


284 


HEART  DISEASES. 


Explanation. — The  bellows  sound  is  supposed  to  depend  on  the 
inflamed  and  swollen  condition  of  the  valves. 

The  dullness  on  percussion  will  be  slight  when  the  circulation 
through  the  heart  is  free ;  —  more  distinct  and  marked  when  it  is 
obstructed. 

Dr.  Hope  says  the  disease  may  be  anticipated,  if  a  person  be  »M(/- 
denly  attacked  with  these  three  signs :  namely,  fever,  violent  action 
of  the  heart,  and  a  murmur  which  did  not  exist  before. 

This  disease,  like  inflammation  of  the  hearlrcase,  is  often  produced 
by,  and  is  intimately  connected  with,  acute  rheumatism,  and  is  then 
to  be  treated  on  same  principles  as  rheumatic  disorders. 

Chronic  Inflammation  of  the  Heart's  Lining:. 

Physical  Signs. — The  impulse  more  perceptible  and  diffused  than 
natural. 

The  dull  sound  upon  percussion  covers  a  .space  of  from  four  to 
eight  square  inches. 

There  is  a  sawing,  rasping,  or  filing  sound.  This  sound  may  cover 
one  or  both  beats  of  the  heart.  Sometimes  these  unnatural  sounds 
are  double ;  in  which  case,  the  first  is  caused  by  an  obstruction  to  the 
natural  flow  of  the  blood  forward ;  the  second,  by  the  regurgitation 
or  retrograde  flow  of  the  blood  from  some  defect  in  the  valve,  —  just 
as  a  pump-valve  may  get  out  of  order,  and  allow  the  water  which 
has  gone  through  to  flow  back. 

Explanation. — A  variety  of  organic  changes  occur  in  the  valves, 
which  give  rise  to  the  murmurs.  Inflammation  of  the  lining  mem- 
brane of  the  heart  reaches  the  valves,  causing  puckering,  thickening, 
vegetative,  cartilaginous,  bony  and  ft,t-like  degenerations,  which  oh- 
ttruet  the  blood  in  its  onward  flow,  or  prevent  a  closure  of  the  valves, 
and  allow  it  to  flow  back ;  the  former  causing  the  first  sound,  the 
latter  the  second.  If  the  unnatural  noise  be  synchronous  with  the 
first  beat  of  the  heart,  it  implies  disease  in  either  set  of  the  semilunar 
valyes,  or  an  impossibility  of  closing  the  auriculo-ventricular  open- 
ings ;  if  it  accompany  the  second  beat,  it  signifies  that  either  set  of 
the  semilunar  valves  may  be  open. 

A  murmur  attending  the  first  beat  of  the  heait  must  be  caused  by 
a  current  of  blood  from  a  ventricle ;  one  attending  a  second  sound, 
by  a  like  necessity,  is  produced  by  a  current  into  a  ventricle.  • 

Treatment. — The  same  as  that  for  pericarditis.  It  should  be 
equally  prompt  and  vigorous.  It  must  not  be  forgotten  that  this  dis- 
ease leads  to  various  organic  diseases  of  the  valves  of  a  very  grave 
character,  and  that  such  mischiefs  can  only  be  escaped  by  cutting  the 
disease  short  in  the  very  beg^inning. 


HEART  DISEASES. 


285 


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Disease  of  the  Semilunar  Valves. 

The  inflammation  of  the  lining  of  the  heart  makes  sad  work  with 
the  valves.  The  semilunars  are  subject  to  various  changes  in  their 
structure. 

Physical  Signs.  —  Obstructive  Murmur. — In  disease  of  the  semi- 
lunars, the  firat  beat  of  the  heart  is  accompanied  or  obscured  either 
by  the  bellows  murmur,  or  a  sawing,  rasping,  or  filing  sound.  The 
unnatural  murmur,  whatever  it  is,  appears  superficial  or  near.  The 
second  beat  is  natural. 

When  the  opening  into  the  aorta  is  contracted,  or  in  any  way  ob- 
structed by  unhealthy  growths,  so  that  the  blood  is  subjected  to  more 
than  a  natural  degree  of  friction  in  passing,  this  sound  will  be  heard. 
It  is  called  obstructive,  because  it  arises  from  the  obstruction  of  the 
blood  in  its  forward  course. 

Regurgitant  Murmurs. —  First  beat  of  heart  natural.  Second 
beat  accompanied  or  replaced  by  bellows  murmur.  There  is  some- 
times a  musical  murmur. 

Explanation.  —  The  regurgitant  murmurs  arise  from  the  valves 
being  too  small,  or  defective  in  some  way,  and  allowing  the  blood  to 
flow  back  through  the  orifice. 

This  murmur  is  loudest  opposite  the  semilunar  valves,  and  is  more 
audible  above  these  valves  than  below  them. 

When  the  aortic  valves  are  contracted  or  shortened,  and  the  open- 
ings are  not  guarded  by  them,  so  as  to  prevent  the  backward  passage 
of  the  blood,  there  is  a  double  bell  vs  murmur,  —  one  when  it  is 
driven  through  the  orifice,  and  another  when  it  flows  back. 

Disease  of  the  Mitral  Valves. 

Physical  Signs. — Obstructive  Murmur. —  First  beat  of  heart 
natural.     Second  beat  accompanied  or  replaced  by  bellows  murmiir. 

Regurgitant  Murmurs. — The  first  beat  of  the  heart  accompanied 
by  a  ioud  and  rough  bellows  murmur.  This  sound  is  like  sawing  or 
filing.  It  is  loudest  above  or  below  the  nipple,  between  the  fourth 
and  seventh  ribs.  There  is  occasionally  a  musical  murmur.  The 
second  beat  of  the  heart  is  natural.  Sometimes  there  is  a  purring 
tremor. 

General  Symptoms  of  Valvular  Disease. — Cough,  in  many  cases 
with  watery  expectoration ;  difficulty  of  breathing ;  frightful  dreams 
and  starting  from  sleep ;  congestion  of  the  lungs ;  expectoration 
stained  with  dark  and  grumous  blood ;  swelling  of  the  jugular  veins  ; 
a  livid  look  of  the  face ;  a  feeling  as  if  a  cord  were  tied  tight  around 
the  lower  part  of  the  chest ;  general  dropsy,  of  the  legs  and  feet  in 


286 


HEART   DISEASES. 


particular;  passive  hemorrhages  from  the  mucous  membranes;  en- 
gorgement of  the  liver  and  spleen ;  congestion  of  the  brain,  with  feel- 
ings of  oppression.     When  the  mitral  valve  is  contracted,  admitting 
regurgitation,  the  pulse  is  small,  weak,  irregular  and  intermittent. 
These  are  the  worst  symptoms  of  an  advanced  stage. 

Explanations.  — The  examiner  will  distinguish  the  various  sounds 
thus: 

The  murmurs  generated  at  the  origin  of  the  arteries  spread  their 
sonorous  currents  upwards  along  these  arteries' 

Those  produced  in  the  auriciilar  orifices  will  be  conducted  into  the 
auricles,  and  propagated  downwards  towards  the  apex  of  the  heart. 

Which  Set  of  Valves.  —  To  learn  in  which  set  of  valves  it  origi- 
nates, therefore,  find  its  seat,  and  trace  its  direction. 

Finding  the  murmur  to  be  in  the  aortic  orifice,  it  is  then  known  to 
be  obstructive,  if  the  first  sound  is  morbid,  and  the  second  sound  natu- 
ral ;  and  regurgitant,  if  the  first  sound  is  natural,  and  the  second  sound 
morbid. 

But  if  the  murmur  be  in  the  mitral  orifice,  it  is  obstructive  when  the 
first  beat  of  the  heart  is  natural,  and  the  second  beat  morbid ;  and  re- 
gurgitant when  the  first  beat  is  morbid  and  the  second  beat  natural. 

The  Pitch  or  Key  of  a  murmur  depends  on  the  distance  of  its  seat 
from  the  ear  of  the  listener,  — nearness  giving  a  high,  and  distance  a 
low  key.  Thus,  a  murmur  seated  in  the  orifice  of  the  pulmonaiy 
artery,  being  nearer  the  surface,  has  a  higher  pitch  than  any  other. 
It  is  on  about  the  same  key  with  a  whispered  «,  —  sometimes  a  little 
lower,  and  depending  somewhat  on  the  strength  of  the  current  of 
blood,  a  strong  current  elevating,  and  a  weak  current  depressing  the 
tone. 

The  mitral  orifice  is  situated  opposite  the  junction  of  the  cartilage 
of  the  third  rib  with  the  left  side  of  the  breast-bone.  The  aortic 
orifice  is  about  half  an  inch  to  the  right  of  this,  and  the  same  dis- 
tance lower.  It  is  known  by  the  key  being  lower,  —  about  like  a 
whispered  r,  which  is  the  ordinary  type  of  thr  .awing  sound. 

Murmurs  from  pulmonic  and  aortic  regurgitations  are  about  two 
tones  lower,  in  consequence  of  the  currents  of  the  blood  being  weaker. 
They  are  like  whispering  awe  by  inspiration  and  if  the  click  of  the 
valve  be  heard,  the  sound  will  be  changed  to  paw. 

Murmurs  in  the  mitral  valve,  being  more  deeply  seated,  are  about 
four  tones  lower,  and  are  like  a  whispered  who. 

The  tricuspid  murmurs  are  higher  than  the  mitral,  because  nearer 
the  surface. 

The  musical  murmur  has  been  compared  to  whistling,  the  cooing 
of  a  dove,  and  the  mewing  of  a  kitten.  It  generally  results  from  re- 
gurgitation. 

The  purring  tremor  is  caused,  generally,  by  regurgitation  through 
the  mitral  valve. 


MMI 


mm 


HEAKT   DISEASES. 


->   287 


anes ;  en- 
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through 


Other  Symptoms  Explained.  — The  difficulty  of  breathing,  fright- 
ful dieama,  congestion  of  the  lungs,  hemorrhages,  engorgements,  etc., 
mentioned  above,  all  proceed  from  such  valvular  stiffenings,  pucker- 
ings,  ossifications,  enlargements,  and  contractions,  as  occasion  a  decid- 
edly obstructed  circulation. 

The  small,  weak,  irregular,  and  interrupted  pulse,  is  caused  by  con- 
traction of  the  mitral  valve,  which  occasions  an  insufficient  or  irregu- 
lar supply  of  blood  to  the  ventricle,  and  causes  the  ventricle,  by  losing 
the  resistance  of  the  valve,  to  expend  its  force  in  a  backward  as  well 
a  forward  direction,  thus  sending  but  little  blood  into  the  arteries. 

Treatment.  — The  tendency  of  valvular  disease  is  to  produce  hyper- 
trophy and  dilatation.  The  strong  and  ceaseless  efforts  of  the  ven- 
tricle to  drive  the  blood  through  an  orifice  obstructed  by  valvular 
disease,  will  of  course  make  the  walls  grow  thick,  which  is  hjrpertro- 
phy ;  and  at  the  same  time,  the  accumulation  of  blood  which  cannot 
be  driven  forward  fast  enough,  must  tend  to  swell  and  enlarge  the 
cavity,  —  which  is  dilatation. 

The  great  object  of  treatment,  therefore,  is  to  diminish  the  force 
and  activity  of  the  circulation,  — to  induce  the  heart  to  cease  striving 
to  do  what  cannot  be  done. 

To  accomplish  this,  give  sedatives  (285),  (94),  (124).  The  helle- 
bore and  cohosh  will  be  found  particularly  serviceable. 

The  tincture  of  the  American  hellebore  is  about  the  best  of 
all.  Purgatives  may  be  given  according  to  the  strength  of  the 
patient. 

When  there  is  dropsy,  and  a  scanty  secretion  of  high-colored  urine, 
diuretics,  or  medicines  to  increase  the  action  of  the  kidneys,  are  very 
important.  For  this  purpose,  digitalis  and  acetate  of  potash  (130) 
are  excellent.  Should  this  not  succeed  in  reducing  the  dropsy,  an 
active  purgative  (31)  may  accompany  it. 

Diaphoretics,  or  medicines  which  promote  perspiration,  are  also 
useful.  This  opening  of  the  skin,  however,  is  generally  brought 
about  by  the  hellebore,  etc.  (124),  (358). 

The  diet  should  be  unstimulating,  and  yet  should  be  sufficiently 
nourishing  to  prevent  the  patient  from  running  too  low.  Animal 
food  of  the  most  digestible  kind  may  be  taken  once  a  day ;  though 
there  are  many  cases  requiring  its  entire  rejection. 

The  passions  should  be  kept  in  the  most  perfect  subjection,  and 
the  life  should  be  as  tranquil  is  possible.  Nothing  must  be  done  in  a 
hurry. 

Water  in  the  Heart-Case.  —  Hydropericardium. 

This  disease  is  common  as  an  attendant  of  general  dropsy. 

Physical  5igns.  —  The  impulse  is  undulatory,  as  if  transmitted 
through  a  fluid,  and  it  is  not  always  of  the  same  strength. 

The  dullness  extends  upward  in  a  conical  form,  in  proportion  to 


288 


HEART   DISEASES. 


the  amount  of  fluid,  —  sometimes  rising  as  high  as  the  second  rib. 
The  impulse  does  not  coincide  with  the  first  beat  of  the  heart. 

General  Symptoms.  —  The  patient  has  a  sensation  of  tw-  heart 
heintj  in  afioathuf  state.  The  pulse  is  small,  frequent,  and  intermit- 
tent. 

Explanation.  —  The  reason  that  the  impulse  does  not  occur  at 
the  same  time  with  the  first  beat  of  the  heart  is,  that  the  apex  does 
not  immediately  strike  the  walls  of  the  chest,  —  some  time  being  re- 
quired to  push  it  up  through  the  fluid. 

The  l)eat8  of  the  heart  sound  more  distant  than  natural  in  conse- 
quence of  the  organ  being  pushed  away  from  the  walls  of  the  chest 
by  the  fluid. 

Palpitation.  —  Nervous  Palpitation.  — Ansmic 

Palpitation. 

There  is  a  great  deal  of  palpitation  of  the  heart  dependent  on 
dyspepsia,  hypochondria,  hysterics,  mental  agitation,  excessive  study 
with  deficient  sleep,  venereal  excesses,  and  masturbation. 

Palpitations  likewise  occur  from  what  is  called  anaemia,  or  a  low 
and  deficient  state  of  the  blood. 

Physical  Signs.  —  The  impulse  is  weak,  fluttering,  or  tumultuous, 

—  generally  increased  by  trifles. 

The  beats  of  the  heart  are  increased  in  frequency,  and  sometimes 
marked  by  intermission.  Now  and  then  they  are  accompanied  by  a 
bellows  murmur.     There  are  musical  murmurs  in  the  jugular  veins, 

—  loudest  a  little  above  the  collar-bones. 

General  Symptoms.  —  The  complexion  is  generally  pallid  and 
bloodless ;  the  li[>s  and  the  inside  of  the  mouth  partaking  of  the 
same  paleness;  the  pulse  quick,  small,  weak,  and  jerking;  and  during 
palpitation  it  sometimes  has  a  thrill.  Slight  causes  produce  breath- 
lessness  and  faintness.  A  dislike  of  animal  food,  and  a  fondness  for 
acids.  The  monthly  discharge  in  females  is  deficient,  and  the  whites 
take  its  place.  Sometimes  the  menses  are  too  profuse,  lasting  for 
several  days,  and  consisting  only  of  blood.  In  this  state  of  things 
there  is  great  feebleness  both  of  mind  and  body,  with  rushing  noises 
in  the  ears. 

Explanations.  —  The  murmurs  depend  on  a  lack  of  blood.  The 
conditions  of  their  existence  are,  thinness  of  blood,  a  swift  and  spas- 
modic circulation,  and  particularly  an  unfilled  condition  of  the  blood- 
vessels. A  brook  is  the  more  babbling  in  proportion  as  its  water  is 
more  shallow.  It  is  a  law  in  physics,  that  heaviness  of  freight  gives 
steadiness  of  motion ;  and  lightness  of  freight  gives  unsteady  motion. 
The  fireman's  hose  trembles  and  vibrates  when  only  half  full  of 
water.  In  like  manner  the  blood-vessels  are  agitated  when  imper- 
IVctly  filled. 


II 


HEART   DISEASES. 


289 


jond  rib. 
rt. 

tw.  heart 
intermitr 

occur  at 
pex  does 
being  re- 
in conse- 
the  chest 


emic 

ndent  on 
ive  study 

or  a  low 

oaultuous, 

jometimes 
nied  by  a 
liar  veins, 

)allid  and 
ng  of  the 
nd  during 
ce  breath- 
ndness  for 
the  whites 
asting  for 
of  things 
ling  noises 

ood.  The 
t  and  spas- 
the  blood- 
ts  water  is 
eight  gives 
tdy  motion, 
alf  full  of 
[ie»  imper- 


Treatment:  —  This  is  to  be  governed  altogether  by  the  cause  of 
the  trouble.  If  it  be  dyspepsia,  hypochondria,  hysterics,  etc.,  these 
several  diseases  require  their  usual  treatment ;  when  they  are  cured, 
the  palpitation  will  stop. 

But  when  it  is  caused  by  alow  state  of  the  blood,  then  give  for 
several  weeks,  iron,  the  compound  mixture,  and  (316),  (310). 

The  food  must  likewise  be  nourishing,  —  tender  meat,  beef  and 
mutton,  with  broths,  etc. 

Gentle  exercise  will  be  required,  and  much  exposure  to  a  bracing 
out-door  air. 

Neuralgia  of  the  Heart. — Mgina  Pectoris. 

This  is  a  strictly  nervous  disease.  It  begins  with  a  sensation  of 
pain  and  constriction  in  the  region  of  the  heart.  This  pain  is  accom- 
])iinied  with  more  or  less  pain  and  numbness  in  the  left  arm.  In 
females  it  is  not  uncommon  for  it  to  be  attended  by  great  sensitive- 
ness and  pain  of  the  breasts.  When  the  attack  is  violent,  the  pain 
in  the  heart  is  excruciating,  and  even  terrific.  There  is  attending 
this  a  feeling  of  great  oppression  in  the  chest,  amounting,  in  the 
worst  cases,  to  a  seiise  of  suffocation.  The  heart  palpitates  violently, 
the  brain  is  oppressed,  and  f^rinting  sometimes  occurs. 

The  disease  is  brought  on,  in  nervous  subjects,  by  over-excitement 
of  the  heart.  Walking  up  hill,  against  a  strong  wind,  may  bring  it 
(in.  If  walking  at  the  time  of  the  attack,  the  patient  is  compelled  to 
stop,  and  stand  still  till  the  pain  subsides. 

The  disease  is  often  connected  with  organic  changes  in  the  heart's 
structure,  such  as  ossifications  and  other  alterations. 

Treatment.  —  When  the  complaint  depends  on  organic  disease 
of  the  heart,  the  treatment  must  be  directed  to  the  cure  of  these 
diseases. 

To  relieve  a  severe  attack,  the  patient  should  be  instantly  placed 
in  a  quiet  position ;  wind  in  the  stomach,  if  present,  should  be  ex- 
pelled by  peppermint  or  anise  water,  or  ether,  or  (115),  or  some  other 
aromatic.  If  there  is  acidity  or  sourness  of  the  stomach,  it  must  be 
corrected  by  a  teaspoonful  of  soda  in  half  a  tumbler  of  water ;  and 
if  the  stomach  be  full  of  undigested  food,  let  the  patient  take  a  table- 
spoonful  of  ground  mustard,  stirred  up  with  a  teacupful  of  warm 
water.     This  will  cause  almost  instant  vomiting. 

These  things  being  done,  give  some  quieting  or  antispasmodic 
medicines,  or  one  of  the  following  prescriptions :  (285),  (97),  (136), 
(124).     Inhale  5  drops  of  nitrite  of  amyl  on  a  cloth  frequently. 

Greav  relief  is  often  obtained  by  sending  a  current  of  magnetism 
through  the  region  of  the  heart,  by  applying  one  pole  of  the  machine 
in  front,  and  the  other  upon  the  back. 

During  the  intervals,  the  general  health  is  to  be  improved  by  a 
wholesome,  nourishing  diet,  gentle  outrdoor  exercise,  and  a  careful 


^m^' 


290 


HBAllT  DISEASES. 


control  of  all  the  passions.     ,U  of  a  grain  of  nitro-glycerine  every 
hour,  while  in  pain,  steadies  and  slows  the  heart. 

Polypus  of  the  Heart. 

A  PORTION  of  the  fibrin  sometimes  separates  from  the  blood  in 
the  heart  and  large  vesaels,  and  becoming  more  or  less  organized, 
forms  polypuses,  which  fill  the  cavities  to  which  they  are  attached, 
and  seriously  obstruct  the  circulation. 

Physical  Signs.  — When  the  pulsations  of  the  heart,  previously 
regular,  become  suddenly  anomalous,  confused,  and  obscure,  so  that 
they  cannot  be  analyzed,  we  may  suspect  a  polypus. 

aeneral  Symptoms.  —A  sudden  and  great  aggravation  of  the  bad 
breathing,  without  any  visible  cause,  —  the  patient  being  in  agony 
from  a  sense  of  impending  suffocation,  and  tossing  about  from  side 
to  side,  struggling  for  breath.  The  pulse  small,  weak,  irregular,  in- 
termittent, and  unequal;  the  surface  and  extremities  cold;  the  face, 
livid,  — to  which  there  is  generally  added  nausea  and  vomiting. 

Treatment.  — When  the  polypus  is  once  formed,  the  case  is  hope- 
less.    The  treatment,  therefore,  can  only  be  preventive. 

The  chief  things  to  be  done  are,  to  keep  the  patient  in  a  state  .  t 
entire  tranquillity,  and  to  bring  the  circulation  to  the  surface,  by  keep- 
ing the  skin  warm,  and  excited  by  friction.  This  will  call  the  blood 
away  f.ora  the  heart  and  great  vessels,  and  lessen  the  chances  of  the 
polypus. 

Displacements  of  the  Heart. 

The  heart  may  be  misplaced  from  birth.  I  have  seen  a  case  in 
which  it  lay  upon  the  right  side,  and  had  always  been  in  that  posi- 
tion.   Its  action  was  natural. 

A  variety  of  causes  may  tend  to  push  it  out  of  its  place,  as  water 
in  the  cavity  of  the  pleura.  In  such  cases,  it  will  return  to  its  place 
when  the  water  is  drawn  off  or  absorbed. 


m''!S^,r^^':\'m^J'^^^^^IMl>^!i^LS'-&'^S!r£^ 


wsmr^ 


ne  every 


blood  in 
n'ganized, 
attaciied, 

)reviou8ly 
e,  so  that 


of  the  bad 
in  agony 
from  side 
egular,  in- 
;  the  face, 
liting. 

Be  is  hope- 

a  state  «f 
ic,  by  keep- 
.  the  blood 
ices  of  the 


•c    :! 


a  case  in 
that  posi- 

e,  as  water 
bo  its  place 


m-^ 


PI  7 


THE  INTERNAL  ORGANS  OF  THE  HUMAN  BODY. 


PI  7 


DISEASES  OP  THE  ABDOMINAL  CAVITY. 


Undkb  the  above  head  I  shall  consider  most  of  the  diseases  which 
occur  in  the  great  cavity  below  the  diaphmgm,  called  the  abdomen 
or  belly.  These  affections  are  quite  important,  and  make  up  a  con- 
Hiderable  part  of  the  ills  we  suffer  from  disease. 

Before  speaking  of  these  diseases,  however,  I  will  call  the  reader's 
attention  to  a  profile  view  of  the 
relative  position  of  the  several  or- 
gans lodged  in  this  cavity. 

In  Fig,  9G,  L  is  the  liver,  S  the 
Htomach,  C  the  colon,  R  the  rectum 
l\  the  bladder,  P  D  the  pancreas, 
and  I  the  intestines.  The  double 
lines,  folded  back  upon  each  other, 
and  surrounding  most  of  the  or- 
gans, represent  the  peritoneum^  a 
membrane  which  lines  the  g^at 
cavity  of  which  I  am  speaking. 

It  will  be  well,  too,  before  pro- 
ceeding further,  to  make  the  reader 
acquainted  witli  the  names  of  cer- 
tain regions  of  the  abdomen  which 
he  will  find  constantly  spoken  of 
in  medical  books.  I  have  not 
used  these  terms  much  in  my 
Ixjok ;  but  it  will  be  convenient 
to  be  acquainted  with  them.  Phy- 
sicians who  are  careless  in  their 
readings  are  not  always  familiar 
with  their  exact  locality. 

In  Pig.  97,  the  abdomen  is  di- 
vided into  nine  different  regions 
by  the  drawing  of  two  parallel  lines  up  and  down,  2,  2,  and  8,  8, 
and  two  lines  across,  4,  4,  and  1, 1.  This  gives  three  regions  above, 
three  in  the  middle,  and  three  below. 

In  the  upper  row,  6  is  the  epigastrium  or  epigastric  region,  in  which 
are  the  left  lobe  of  the  liver,  and  a  portion  of  the  stomach ;  6,  on  the 

291 


FlO.  96. 


r 


202 


niSFARKS   OK   TIIR    AnDOMINAI.   CAVITY. 


1 


FlO    97. 


right  side,  is  the  right  hi/poi'liondrium,  in  which  is  Um  rijjlij,  |oIh>  of  ilm 

livor ;  iiiul  f),  mi  tho  h-t't  Hidt;,  is  the  lejt 
hjipochondriumy  which  coiitniiis  tho  sphuMi, 
and  11  portion  of  this  Htomach  and  liver. 

In  the  nii(Ullo  row,  7  is  tlio  umbilical 
m/ion,  which  contains  tho  small  intestines. 
On  the  right  side,  H  is  the  rif/ht  lumlxv 
reyion,  which  holds  tho  right  kidney  and 
tho  ascending  colon ;  and  8,  on  tho  left,  is 
the  left  liimliar  re/jion,  whi(!h  contains  the 
left  kidney  and  the  descending  colon. 

In  tho  lower  row,  9  is  tho  hi/pot/agt n'tim 
or  hi/pof/astrio  rej/ion,  which  contains  h 
portion  of  the  small  intestines  and  hladdci . 
On  the  right,  10  is  the  riffht  iliac  fima, 
containing  tho  cceeiim  or  caput  coli ;  iiiul 
10,  on  the  left,  is  the  left  iliac  fossa,  con- 
taining the  sigmoid  flexure. 
And    now    I    may    as 

well  present,  in  Fig.  98, 

a  front  view  of  many  of 

the  organs,  both  in  the 

chest  and  abdomen:  1,  1, 

1,  1,  are  the  muscles  of 

the  chest ;  2,  2,  2,  2,  the 

ribs;  3,  8,  8,  the  upper,/ 

middle,  and  lower  lobes] 

of  the  right  lung;  4,  4,1 

the  lobes  of  the  left  lung;1 

6,  the  right  ventricle  of| 

the  heart;  6,  the  left  ven- 
tricle ;  7,  the  right  auricle 

of  the  heart;  8,  the  left 

auricle;  9,  the  pulmonary 

artery;  10,  the  aorta ;  11, 

the  vp       "^^'a  descendens ; 

12,  indpipe ;    18, 

.*;   14,  14,  14, 

.<3  pleura;    15,  16, 

cho  diaphragm;  16,16, 

tne  right  and  left  lobes  of 

the  liver;  17,   the  gall- 
bladder ;  18,  stomach;  26, 

the   spleen;   19,  19,  the 

duodenum ;    20,   the   as- 
cending  colon ;   24,   the 

transverse  colon ;  25,  the 

descending  colon;  22,  22,  22,  22,  the  small  intestines;  28,  23,  the 


rio.  98. 


I*. 


niBKAflFft  np   THK    AHHOMINAI,   riAVITY. 


203 


■•14. 


26 


walls  of  till)  Iwlly  turned  down;  24,  the  thorarir,  diict,  <>[)eiiing  intr) 
tho  left  Hnl)clavi>in  vein  (27). 

Acute  Inflammation  of  the  LWer.  —  I Icpai His. 

The  liver  is  the  largost  gland  in  the  l)ody.  (See  Fig.  81.)  It  lies 
in  the  right  side,  and  iit  the  top  of  the  great  ulxloniinal  cavity,  di- 
rectly under  the  midriff,  tnd  lapping  upon  the  stoniaoh.  Fig,  90 
showH  itH  relative  position.  Its  otHuu  woh  HUppcsed  to  Iw  to  take  tiiv 
superabundant  carbon  out  of  the  blood.  TIuh  carbon  it  unites  vitii 
other  elements  and  forms  bile,  the  peculiar  bitter  sul)8tance  which  is 
poured  into  the  upper  bowel,  and  greatly  aids  digestion. 

The  liver  is  liable  to  become  inflamed  from  several  causes,  such 
as  gravel-stones,  external  violence,  suppressed  secretions,  hot  climates, 
intlammation  of  the  duodenum,  etc. 

Symptoms.  —  These  are  sympathetic  fever,  with  pain,  and  a  sense 
of  tension  in  the  right  side,  inability  to  lie  on  the  left  side,  difficulty 
of  breathing,  a  dry  cough,  vomiting,  and  hiccup. 

The  pain  is  acute  and  lancinating  generally,  though  sometimes 
dull  and  tensive.  When  sharp,  it  is  like  the  stitch  of  pleurisy,  and 
it  indicates  that  the  peritoneum  which  covers  the  liver  is  inflamed. 
When  dull,  it  is  the  body  of  the  organ  which  is  suffering.  When 
the  convex  surface  of  the  liver  is  the  se.\t  of  the  disease,  the  pain  is 
apt  to  run  up  to  the  right  collar-bone,  and  to  the  top  of  the  right 
shoulder.  Breatlung,  coughing,  and  lying  on  the  left  side,  increase 
the  pain.  A  soreness  is  felt  by  pressing  over  the  liver.  The  pulse 
is  full,  hard,  and  strong,  tho  bowels  are  costive,  and  the  stools  are 
clay-colored,  owing  to  not  being  tinged  with  bile,  —  this  having 
stopped  flowing.  The  tongue  is  covered  with  a  yellow,  dark  brown, 
or  even  black  coat,  and  there  is  a  bitter  taste  in  the  mouth. 

Explanation.  —  The  bile,  secreted  by  the  liver,  is  poured  into  the 
upper  bowel,  and  gives  the  brown  or  yellow  color  to  the  contents 
of  the  bowels.  When  the  liver  is  inflamed,  it  cannot  work,  —  it  se- 
cretes little  or  no  bile,  and  the  discharges  from  the  bowels  lose  their 
color.  The  bile  is  slightly  laxative,  and  when  it  ceases  to  flow  into 
the  bowels,  they  become  bound  or  costive.  When  the  liver  does  not 
work,  the  bile  has  to  be  taken  out  of  the  blood  by  the  kidneys,  and 
the  urine  becomes  of  a  deep  yellow  color.  Much  of  it  goes  out 
through  the  skin,  too,  which  is  likewise  yellow,  and  the  sweat  be- 
comes so  yellow  as  to  stain  the  linen. 

Treatment.  —  Flax-seed  poultices  applied  over  the  liver  are  veiy 
good.  Purgatives  will  also  need  to  be  used  pretty  freely  at  iiiyt. 
Those  which  produce  watery  stools  (31),  (247),  (34),  will  be  of  the 
greatest  service. 

After  the  cups  and  purgatives  have  been  thoroughly  used,  blisters 
will  be  useful,  and  it  will  be  better  to  apply  several  in  succession, 


I 


294 


DISEASES   OF   THE    ABDOMINAL   CAVITY. 


rather  than  to  keep  the  first  one  open.  Or,  in  the  milder  cases,  ;i 
mustard  poultice  may  be  applied  over  tli  ^  whole  side,  and  even  along 
the  dpine. 

Frictions  over  the  stomach  and  liver  with  dilute  nitro-muriatic 
acid,  and  a  foot-bath  of  the  same,  will  sometimes  do  well.  The  acid 
should  be  reduced  with  water  to  about  the  strength  of  sharp  vinegar. 
Water  a  little  soured  with  this  same  acid  makes  an  excellent  drink 
for  the  patient. 

Perepiration  should  be  induced  by  the  spirit  vapor-bath,  and  kept 
up  ger  "  by  the  tincture  of  the  American  hellebore,  from  three  to 
ten  divtps  ?very  hour.  Or,  the  same  thing  may  be  done  by  prescrip- 
tions (12fi;,  (358). 

When  tb  urine  is  small  in  quantity  and  red,  ^,ive  some  diuretic, 
as  iafusioK  ^^  marshmallow-root,  pumpkin-seeds,  or  trailing  arbutus. 

The  diet  should  be  rice-water,  gruel,  and  toast-water.  While 
getting  up,  it  may  gradually  be  improved,  and  some  light  tonics 
(49),  (58),  (64)  be  added  to  it. 


Chronic  Inflammation  of  tlie  Liver. 

Hepatitis. 


Chronic 


There  are  few  chronic  diseases  for  which  the  physician  is  more 
often  consulted  than  this.  In  the  warm  climate  of  the  South,  in 
the  bilious  districts  of  the  West,  and  indeed  even  in  the  Middle  and 
Eastern  States,  it  meets  us  continually,  and  demands  our  attention. 
That  it  is  difficult  to  cure  must  be  admitted;  but  a  constant  famil- 
iarity with  chronic  diseases,  for  several  years,  has  convinced  me  that 
it  is  generally  curable. 

Symptoms A  sense  of  fulness  and   weight  in  thp  right  side 

with  some  enlargement,  and  shooting  pains  felt  in  the  same  region, 
particularly  when  it  is  pressed,  with  pains  in  one  or  both  shouldei-s, 
and  under  the  shoulder-blades ;  uncomfortable  sensations  when  lying 
on  the  left  side;  yellowness  of  the  skin,  eyes,  and  urine;  bowels 
irregular,  loose,  or  costive;  appetite  disturbed;  sometimes  a  dry, 
hacking  cough;  shortness  of  breath;  tongue  whitish,  and  brown  or 
yellow  towards  the  root ;  a  bitter  and  bad  taste  in  the  mouth  in  the 
morning.  The  urine  deposits  a  sediment  on  standing.  There  is 
generally  a  low  and  desponding  state  of  mind,  with  irritability  and 
peevishness  of  temper. 

The  skin  is  often  covered  with  yellow  spots  and  with  a  branny 
substance.  The  various  symptoms  of  dyspepsia  are  often  present. 
The  nervous  system  is  generally  much  disturbed,  and  there  is  a  dis- 
inclination to  apply  the  mind.  There  is  frequently  a  great  dread  of 
imagined  evil,  supposed  to  be  impending. 

Treatment.  —  This  does  not  require  *:o  be  as  active  as  that  for  the 
acute  form  of  the  disease. 


""steiHB 


DISEASES  OP  THE   ABDOMINAL  CAVITY. 


295 


If  there  l)e  much  tenderness  of  the  liver,  begin  with  mustai-d 
poultices,  and  the  compound  pills  of  podophyllin,  or  the  compound 
pills  of  leptandrin,  or  (36). 

I  have  abandoned  the  use  of  mercury  in  this  disease,  as  in  most 
others;  but  if  any  prefer  to  use  it,  the  blue  pill  (52)  will  be  found 
the  most  useful  form. 

The  compound  tar-plaster  placed  over  the  liver,  in  bad  cases,  is 
often  very  serviceable. 

An  alterative  (138),  (146)  will  be  found  useful. 

The  daily  alkaline  sponge-bath  must  on  no  account  be  omitted. 
Vigorous  friction  must  follow  it.  Vigorous  constitutions  will  bear 
the  shower-bath;  in  such  cases  it  may,  occasionally,  take  the  place 
of  the  sponge-bath. 

The  diet  must  be  simple,  yet  nourishing  and  wholesome,  and 
embracing  but  a  small  amount  of  fat,  as  this  is  composed  largely  of 
carbon,  and  the  liver  is  unable  to  remove  what  i^  already  in  the  blood. 

Especially  and  above  all,  out-door  exc-cide  must  be  taken  to  the 
full  amount  of  the  strength,  and  the  thoughts  be  occupied  with 
cheerful  subjects.  Let  the  hot  sun  be  avoided,  and  the  summer 
exercise  be  taken  in  the  cool  hours  of  the  day. 

The  recovery  from  this,  as  from  all  other  chronic  diseases,  must 
necessarily  be  slow. 

Congestion  of  the  Liver. 

This  is  not  strictly  a  disease,  but  the  result  of  gastro-intestinal 
disorders.  There  is  an  enlarged,  congested  liver,  with  a  sense  of 
fulness  and  weight  in  the  right  side  under  the  ribs. 

The  application  of  heat,  and  even  leeches,  to  the  side,  and  the  ad- 
ministration of  saline  laxatives,  afford  relief.  The  diet  must  be  light 
and  farinaeeous. 

Passive  Congestion  of  tlie  Liver 

Results  from  mechanical  obtruction  to  the  outflow  of  blood  from 
the  liver.  When  this  condition  has  existed  some  time,  there  is  a 
sense  of  weight  and  fullness  in  the  liver  region  when  sitting  up  or 
lying  on  the  left  side.  The  liver  is  enlarged  and  tender;  the  breath 
is  shortened,  and  pain  may  be  present,  extending  to  the  shoulder. 

Jaundice  is  usually  preseno,  but  only  to  a  slight  degree.  When 
the  heart  is  the  cause  of  the  obstruction  to  the  outflow  of  blood, 
there  is  often  present  an  associa  id  gsistro-duodenal  catarrh,  in  which 
case  loss  of  appetite,  nausea,  vomiting,  belching  of  gas,  and  pain, 
are  also  present.  In  the  later  stages  of  a  ]  rolonged  case,  ascites,  or 
dropsy  of  the  peritoneal  cavity,  is  present. 

Prognosis.  —  The  outcome  of  passive  congestion  of  the  liver  is 
usually  grave,  since  it  is  the  result  of  some  structural  disease  else- 
where, as  of  the  heart,  asthma,  chronic  pleurisy,  tumors,  etc. 


296 


DISEASKS   OF   THK    ABltOMINAL   CAVITY. 


I 


Treatment.  —  The  indications  for  treatment  are  to  strengthen  the 
lieait  wilh  digitalis,  strophanthus,  etc.,  increase  the  strength  of  tht; 
patient  with  strong,  stimulating  food,  and  to  deplete  the  portal  circu- 
lation by  vegetable  laxatives  like  podophyllin,  rhubarb,  aloes,  etc.; 
the  salines  also  furnish  an  agreeable  method  of  depletion,  as  for 
instance,  Crab-orchard  water,  Hunjadi,  etc.  It  occurs  usually  after 
middle  life,  and  is  more  common  in  women  than  men.  It  is  usually 
secondary  to  cancer  elsewhere,  as  in  the  bowels  or  stomach,  rectum 
and  womb.  The  liver  is  increased  in  size,  and  is  frequently  studded 
with  cancerous  nodules,  which  in  well-marked  cases  may  be  felt 
through  the  abdominal  wall. 

The  disease  usually  gives  rise  to  loss  of  appetite,  nausea,  vomiting, 
constipation,  emaciation  and  weakness.  Pain  over  the  liver  is  gen- 
erally present,  while  jaundice  exists  in  about  fifty  per  cent  of  cases 
Dropsy  of  the  bowels  exists  likewise  in  about  the  same  proportion  of 
cases.  Hemorrhages  from  the  nose,  stomach  and  bowels  occur  in 
the  later  stages  of  the  disease.  The  temperature  is  usually  lowef 
than  normal,  and  the  pulse  slow,  especially  if  jaundice  be  present ; 
the  urine  is  diminished  in  amount  and  high  colored.  The  disease 
progressively  advances  to  a  fatal  termination  inside  of  a  year.  No 
kuowu  treatment  is  of  avail  in  arresting  the  terrible  malady. 

Cirrhosis  of  the  Liver. 

This  is  a  disease  characterized  by  an  excessive  increase  of  the 
fibrous  tissue  in  the  liver,  whose  later  function  is  to  contract  and 
squeeze  out,  so  to  speak,  the  softer,  glandular  structure  of  the  liver 
proper,  thus  causing  its  atrophy  and  diminution  in  size.  The  dis- 
ease is  caused  mainly  by  the  introduction  into  the  portal  system  of 
some  irritant  like  alcohol.  It  is  generally  known  as  the  gin-drinker's 
liver,  but  it  does  not  result  especially  from  gin  any  more  than  from 
any  other  spirit.  It  is,  at  all  events,  essentially  a  disease  due  to  pro- 
longed though  moderate  use  of  spirits  of  one  sort  or  another,  and 
occurs  between  the  ages  of  thirty  and  sixty,  mostly  in  men. 

The  symptoms  of  this  disease  are  at  first  those  of  gastric  and  intes- 
tinal disorders  due  to  alcohol,  as  nausea,  flatulence,  constipation  and 
looseness,  etc. 

Dropsy  is  finally  the  most  pronounced  symptom  of  the  diseiise,  but 
hemorrhages  from  the  bowels  not  infrequently  occur.  The  disten- 
sion of  the  abdomen  by  dropsy  is  sometimes  enormous ;  finally  the 
feet  and  legs  become  swollen,  emaciation  and  weakness  progress,  and 
the  patient  may  finally  die  in  coma  or  convulsions.  The  disease,  when 
suffisiently  advanced  to  be  recognized,  is  incurable. 

Treatment.  — The  treatment  is  to  be  directed  toward  the  removal 
of  all  irritating  food  and  alcohol.  The  diet  should  consist  largely  of 
milk;  green  vegetables  and  fruit,  beans,  peas,  eggs,  lean  meat,  etc., 
may  be  taken  if  well  borne. 


DISEASES   OF  THE  ABDOMINAL  CAVITY. 


297 


The  stomach  and  bowels  .are  to  be  kept  in  good  condition,  th«> 
dropsy  drawn  off  or  removed  by  means  of  loose  evacuations  from  the 
bowels. 

Hydrochloric  acid  in  three-drop  doses,  well  diluted,  after  meals, 
may  be  of  service,  while  bitter  stomach-tonics  are  to  be  given  before  ' 
eatiug. 

Acute  Inflammation  of  the  Spleen.  ~  Splenitis. 

Thk  spleen  is  in  the  upper  part  of  the  belly,  on  the  left  side, 
opposite  the  liver.  It  is  subject  to  acute  inflammation,  which  is 
known  by  a  pain  just  under  the  short  ribs  on  the  left  side,  also  by 
swelling,  soreness  to  the  touch,  and  by  more  or  less  fever.  The  pain 
often  shoots  ui)  through  the  midriff  and  to  the  left  shoulder.  There 
18  a  short,  di-y  cough ;  a  feeling  of  tightness  about  the  heart ;  a  sick- 
ness at  the  stomach,  and  vomiting ;  and  a  discharge  frequently  of 
black  blood  from  the  bowels.  The  urine  is  scanty,  is  passed  with 
some  difficulty,  and  is  high-colored. 

This  disease  appears  most  frequently  in  hot  climates,  and  is  often 
connected  with  intermittent  fevers. 

Chronic  Inflammation  of  the  Spleen. 

This  prevails  most  in  fever-and-ague  districts,  and  is  a  frequent 
result  of  chills  and  fever.  It  is  generally  very  stubborn,  often  lasting 
many  years. 

Symptoms —  A  feeling  of  weight,  tightness,  and  sometimes  pain 
in  the  left  side,  the  pain  being  increased  by  pressure,  or  an  attempt 
to  lie  on  the  left  side.  The  organ  sometimes  enlarges  very  much,  so 
that  it  can  be  felt  by  the  hand.  This  enlarged  mass  passes  under 
the  common  name  of  "  ague  cake."  There  are  sometimes  numbness, 
weakness  of  the  legs,  difficulty  of  breathing,  palpitation  of  the  heart, 
inability  to  exercise  much,  otetinate  constipation,  vomiting  of  food, 
piles,  diy  skin,  tongue  coated  white  or  red,  low  spirits,  and  occasion- 
ally dropsical  affections. 

During  the  chill  in  fever  and  ague,  the  spleen  becomes  enormously 
loaded  with  blood.  Surfeited  and  stretched  in  this  way  again  and 
again,  it  is  not  strange  that  the  organ  should  become  diseased. 

Treatment.  —  This  should  be  about  the  same  as  the  treatment  for 
acute  and  chronic  inflammation  of  the  livei-. 

After  the  active  symptoms  of  inflammation  are  subdued,  the  warm 
bath  may  be  used  one  or  twice  a  week. 

In  the  chronic  form  of  the  disease,  counter-irritation  with  the 
compound  tar-plaster,  with  mustard  poultices,  croton-oil,  or  tincture 
of  iodine,  will  be  particularly  needed. 

Among  medicines,  muriate  of  ammonia  (53"),  has  a  high  reputation. 


^^"WIIM 


298 


DISEASES   OF   THE   ABDOMINAL  CAVITY. 


To  keep  the  lx)wel8  open,  [)odophyllin,  quinine,  and  mix  vomica 
(46),  liave  a  fine  effect.  Iron  may  be  given  (73)  when  the  patient 
is  bloodless  and  pale. 

Jaundice.  —  Icterus. 

The  jaundice  is  a  very  common  disease,  and  to  be  known  needs 
only  to  be  seen  ;  but  inasmuch  as  it  may  be  but  a  symptom  rather 
than  a  disease  per  se,  it  behooves  one  to  be  careful  that  some  hidden 
disorder  be  not  preying  upon  the  system.  Among  the  more  common 
affections  which  give  rise  to  jaundice  are  gastro-duodenal  catarrh, 
frequently  affecting  children,  obstruction  of  the  gall-ducts  by  thick 
bile  or  mucus,  or  by  gallnstones ;  cancer,  chronic  forms  of  liver  com- 
plaints, and  some  forms  of  blood  diseases. 

Symptoms.  —  The  most  prominent  symptoms  are,  yellowness  of 
the  skin  and  whites  of  the  eyes,  saffron-colored  urine,  and  whitish  or 
clay-colored  stools.  So  full  is  the  urine  of  bile,  that  a  piece  of  white 
linen  dropped  into  it  receives  a  bright  yellow  tinge. 

Besides  these  symptoms,  there  are  impaired  appetite,  a  loathing 
of  food,  the  sense  of  a  load  at  the  pit  of  the  stomach,  sourness  of 
stomach,  sometimes  sickness  and  vomiting,  a  bitter  taste  in  the  moutli, 
disinclination  to  move  about,  sleepiness,  a  dull  pain  in  the  right  side, 
which  is  increased  by  pressure. 

The  entire  body  of  a  person  who  has  died  of  jaundice,  including 
bones,  muscles,  and  membranes,  are  found  to  be  full  of  bile,  and  col- 
ored yellow. 

Explanation. — The  bile  flows  into  the  upper  bowel,  a  little  below 
the  stomach,  through  a  duct  or  tube  about  as  large  as  a  goose-quill. 
This  little  tube  or  vessel  receives  the  bile  from  a  smaller  tube,  called 
the  hepatic  duct,  and  from  another  which  goes  to  the  gall-bladder, 
called  the  cystic  duct. 

These  little  tubes  sometimes  get  obstructed  or  plugged  up  by 
sticky,  thickened,  or  hardened  bile,  or  by  gall-stones,  formed  in  the 
liver ;  and  the  bile,  finding  no  outlet  through  its  natural  channels,  is 
taken  up  by  the  absorbents,  distributed  over  the  system,  and  produces 
the  yellowness  we  witness.  When  these  ducts  and  the  gall-bladder 
are  filled  and  stretched  by  this  thickened  and  hardened  bile,  they  be- 
come tender  and  sore.  Hence  the  sore  feeling  in  the  side  when 
pressure  is  made. 

There  is  another  explanation  of  the  way  in  which  the  yellowness 
of  jaundice  is  produced,  and  it  mattei-s  not  whether  it  or  the  one  just 
given  be  adopted.  It  is  this :  The  bile  is  formed  by  the  blood,  and 
not  by  the  liver.  The  office  of  the  liver  is  to  draw  or  strain  off  the 
bile  from  the  blood.  And  when  this  organ  is  inflamed,  or  irets  slug- 
gish and  will  not  work,  the  blood  is  not  relieved  of  its  yellow  freight. 
The  bile  accumulates,  and  in  attempting  to  escape  through  other 
channels,  it  lodges  in  the  various  tissues,  particularly  in  the  skin. 


vomica 
patient 


n  needs 
(1  rather 

hidden 
common 

catarrh, 
by  thick 
ver  com- 

mmess  of 
hitish  or 
of  white 

loathing 
irness  of 
le  moutli, 
ight  side, 

ncluding 
,  and  col- 


,le  below 
ose-quill. 
be,  called 
l-bladder, 

id  up  by 
d  in  the 

annels,  is 
produces 
l-bladder 
they  be- 
de  when 

llowness 
one  just 
lood,  and 
off  the 
rets  slug- 
freight, 
gh  other 
skin. 


V 


DISKA8E8   OF  THE   ABDOMINAL  CAVITY. 


JM9 


Treatment.  —  An  infusion  of  thoroughwort,  drunk  freely  every 
day,  is  a  valuable  remedy.  The  inner  bark  of  the  barberry  steeped 
in  cider,  or  this  article  compounded  with  others  (286),  (287),  will 
be  found  excellent. 

The  diet  should  be  plain,  wholesome,  and  nourishing,  but  com- 
posed mostly  of  vegetable  articles,  particularly  green  vegetables  and 
berries  when  they  are  to  be  had. 

Cold  water  should  be  the  principal  drink ;  or  drink  and  medicine 
may  be  combined  in  the  shape  of  three  drops  of  murisvtic  acid,  and 
two  drops  of  nitric  acid,  dissolved  in  a  tumbler  of  water  slightly 
sweetened.  This  is  generally  a  pleasant  drink,  and  will  assist  very 
much  in  the  cure. 

The  warm  bath  once  or  twice  a  week,  and  the  alkaline  sponge-bath 
every  day,  with  smart  friction,  must  not  be  omitted. 

When  jaundice  is  caused  by  the  passage  of  gall-stones  through  the 
bile-duct,  there  is  sometimes  terrible  pain  and  suffering,  —  the  stone, 
occasionally,  being  as  large  as  a  nutmeg,  and  forcing  its  way  through 
a  quill-sized  tube.  So  great  is  the  distress  that  the  patient  sometimes 
rolls  upon  the  floor  in  agony.  To  alleviate  this  pain,  large  doses  of 
opium,  laudanum,  or  morphine,  are  required.  A  large  teaspoonful  of 
bicarbonate  of  soda  dissolved  in  a  tumblerful  of  hot  water  is  an  ex- 
cellent remedy  if  drunk  at  a  single  draught.  It  relieves  the  acidity 
of  the  stomach,  and  acts  as  a  fomentation  to  the  internal  seat  of  the 
pain.  MusUvrd  poultices,  or  warm  fomentations,  over  the  seat  of  the 
pain,  are  required.     The  warm  bath  is  excellent. 

The  acid  bath,  made  by  mixing  three  parts  of  muriatic  acid  with 
two  parts  of  nitric  acid,  and  adding  as  much  of  this  mixture  to  water 
as  will  make  it  about  as  sour  as  weak  vinegar,  is  valuable  in  jaundice. 
Only  a  quart  of  water  need  be  taken  ;  and  the  solution  should  be 
applied  with  a  sponge.  It  is  of  the  right  strength,  if  it  produce  a 
slight  tingling  of  the  skin. 

Qall-Stones. —  Biliary  Calculi. 

These  are  brownish,  ohocola  -colored  concretions  which  form 
either  in  the  gall-bladder  itself,  in  the  duct  leading  from  the  gall- 
bladder, or  in  the  common  duct  which  is  formed  by  the 
union  of  the  gall-duct  and  the  hepatic  duct  which  leads 
from  the  liver.  They  are  solid,  generally  have  bodies  of 
irregular  shape  and  size,  and  have  facets  cavised  by  the 
stones  being  impacted  ag^ainst  one  another.  Fig.  99 
shows  their  appearance.  These  concretions  are  formed 
of  inspissated  bile  and  organic  salts.  When  they  settle  into  the  ducts 
their  natural  course  is  downward  through  the  duct  into  the  bowel, 
where  they  are  naturally  carried  off  with  the  faeces.  Their  passage 
through  these  ducts  is  accompanied  often  with  extreme  pain  and 
colic,  the  pain  being  the  severest  of  any  to  which  the  system  is  sub- 
jected, and  generally  requires  an  opiate.     When  once  an  attack  of 


^ 


a. 


^ 


FlO.  99. 


800 


PI8EASKS   OF  THE    ABDOMINAI,   CAVITY. 


gall-fitones  has  occurred,  the  patient  is  liable  to  more,  as  they  seldom 
exist  singly  in  the  gall-bladder.  These  repeated  attacks  have  lieen 
the  subject  of  a  great  deal  of  thought  among  surgeons. 

Symptoms. — An  almost  constant  uneasiness  in  the  right  hypo- 
chondriac region,  with  spasms  of  pain,  coming  on  suddenly,  and  last- 
ing for  a  time  with  gi'eat  severity,  and  then  subsiding.  The  pain  is 
caused  by  a  stono  being  suddenly  forced  into  tlie  duct  and  moving 
forward  in  it,  and  it  sulfides  when  the  stone  either  stops,  or  gets 
through  the  duct.  When  the  stone  reaches  the  bowels,  it  passes  off 
with  the  stools. 

The  patient  generally  has  a  pale,  sallow  complexion,  a  small,  feeble 
pulse,  and  often  suffers  from  nausea  and  vomiting,  and  from  restless- 
ness and  hurried  breathing. 

Treatment.  —  To  reduce  the  spasm,  give  svapnia  powder  in  full 
doses,  or  chlorodine.  Also,  apply  mustard  over  the  right  hypochon- 
drium  and  stomach,  and  fellow  it  with  hot  fomentations  with  hops, 
or  use  wet  cups. 

If  the  stomach  is  irritable,  give  the  neutralizing  mixture  until  it 
moves  the  bowels.  To  relieve  the  intense  pain,  morphine  should  be 
administered,  together  with  hot  baths  and  hot  cloths  over  the  abdo- 
men. 

Sweet  oil  was  at  one  time  advocated  as  a  solvent  of  these  bodies, 
but  experience  has  not  proven  the  validity  of  the  claim.  Many 
practitioners,  however,  still  insist  that  oil  in  large  doses  hastens  the 
passage  of  the  stones. 

To  remove  the  acidity  on  which  the  foi-mation  of  these  stones  so 
often  depends,  a  neutralizing  preparation  (338)  may  be  given  for  a 
long  time,  the  diet,  in  the  mean  time,  being  well  regulated.  The 
sponge-bath  with  saleratus  and  water,  should  be  taken  daily,  followed 
by  brisk  rubbing ;  and  free  exercise  in  the  open  air  should  on  no 
account  be  omitted. 

Of  late  years  it  is  customaiy  to  treat  this  complaint  surgically, 
operating  directly  on  the  gall-bladder  by  incising  it  and  removing 
the  stones.  If  the  ducts  become  obstructed,  they  too  are  incised  and 
the  stones  dislodged,  either  by  pushing  them  down  into  the  bowel, 
or  otherwise,  as  maj'  be  most  convenient.  The  gall-bladder  is  either 
sutured  to  the  abdominal  wall,  and  a  biliary  fistula  forms,  discharg- 
ing the  bile  upon  the  abdominal  wall;  or  it  may  be  drained  off  into 
a  bottle;  or,  as  has  been  recently  advocated,  the  bladder  may  be 
sewn  up  tightly  and  replaced.  Sometimes  communication  is  estab- 
lished between  the  gall-bladder,  or  the  duct,  and  the  duoden  m,  by 
means  of  an  ingenious  device  called  "  Murphy's  Button."  This 
button,  invented  by  Dr.  Murphy  of  Chicago,  is  intended  to  di-aw  to- 
gether the  parts  to  he  connected,  retaining  them  in  that  position. 
A  fter  some  days  the  walls  slough  away,  and  the  button  passes  into 
the  bowel,  and  is  thus  removed  from  the  system.     By  this  means 


DISEASES  OF   THE   ABDOMINAL   CAVITY 


301 


jy  seldom 
lave  been 


rlit  hypo- 
,  and  last- 
le  pain  is 
1  moving 
8,  or  gets 
passes  off 

all,  feeble 
n  restless- 

er  in  full 
hypochon- 
/ith  hops, 

e  until  it 
should  be 
the  abdo- 

se  bodies, 
11.  Many 
astens  the 

I  stones  so 
iven  for  a 
bed.  The 
',  followed 
lid  on  no 

surgically, 
removing 
icised  and 
he  bowel, 
r  is  either 
discharg- 
d  off  into 
r  may  be 
I  is  ostab- 
len  m,  by 
n."  This 
3  di-aw  to- 
t  position, 
asses  into 
lis  means 


many  stubborn  cases  of  impacted  gall-stone  have  been  permanently 
cured. 

Abscess  of  the  gall-bladder,  inflammation  of  the  surrounding 
tissue,  and  even  death  are  not  infrequent  results  of  the  presence  of 
these  foreign  bodies. 

For  preventing  the  formation  of  gall-stones,  see  the  articles  on 
Biliousness,  Diet,  etc. 

Acute  Inflammation  of  the  Stomach.  —  Gastritis. 

This  is  a  rare  disease.  It  is  generally  induced  by  irritating  and 
corrosive  substances  taken  into  the  stomach.  Poisons,  as  ai-senic, 
aquafortis,  corrosive  sublimate,  and  the  like,  are  the  most  common 
causes  of  it.  Blows,  sudden  stoppage  of  sweat,  and  excessive  use  of 
ardent  spirits,  may  also  excite  it. 

Symptoms.  — It  is  marked  by  burning  pain  in  the  stomach,  thirst, 
restlessness,  anxiety,  constant  vomiting,  prostration  of  strength,  a 
quick,  hard,  and  small  pulse,  incessant  retching,  a  sunken  counte- 
nance, hiccough,  cold  hands  and  feet,  and  a  damp  skin. 

Treatment.  —  If  the  inflammation  be  excited  by  poison,  the  reme- 
dies named  under  antidotes  for  poisons  must  be  first  employed. 

The  poison  being  neutralized  or  thrown  off,  the  inflammatory  con- 
dition must  be  combatted  with  the  remedies  usual  for  such  states. 
Mustard  poultices  to  the  feet,  along  the  spine,  and  particularly  over 
the  pit  of  the  stomach,  will  be  among  the  first  things  to  be  employed, 
and  should  be  followed  by  hot  fomentations  of  stramonium  leaves  or 
hops,  —  both  the  fomentations  and  the  poultices  to  be  repeated  as 
occasion  may  require.  Dry  cupping  over  the  region  of  the  stomach 
is  useful.  Small  and  repeated  doses  of  bismuth,  or  |-grain  doses  of 
cocaine,  are  generally  very  soothing  to  the  stomach,  and  relieve  the 
terrible  vomiting. 

Drinks.  —  Cold  water,  bread-water,  rice-water,  arrow-root  gruel, 
infusion  of  slippery-elm  bark,  and  of  mai-shmallow.  These  should 
be  taken  in  very  small  qaantities,  —  say  a  teaspoonful  at  a  time, — 
about  twenty  drops  of  tincture  of  aconite-root  being  added  to  a  half 
tumblerful.  Lumps  of  ice  may  be  held  in  the  mouth,  and  occasion- 
ally swallowed. 

Injections.  —  Emetics  and  physic  are  not  proper,  but  injections 
(248),  (263),  or  simply  soap-suds,  will  be  required. 

The  remedies  must  be  pursued  until  all  tenderness  has  disappeared 
from  the  pit  of  the  stomach. 

While  the  patient  is  recovering,  great  care  must  be  taken  not  to 
overload  the  stomach  with  food.  Arrow-root,  sago,  and  milk  are 
among  the  first  articles  to  be  allowed.  After  these,  will  come  gnid- 
ually  beef-tea,  chicken-broth,  soft-boiled  eggs,  and  beef-steak,  until 
the  whole  diet  can  be  restored. 


302 


DISEASES  OP  THE  ABDOMINAL  CAVITY. 


Chronic  Inflammation  of  the  Stomach. 

This  is  a  much  more  common  disease  that  the  preceding ;  indeed 
it  is  very  common.  Though  it  does  not  put  life  in  immediate  danger, 
it  perverts  the  feelings  of  the  stomach,  and  causes  many  of  the  symp- 
toms of  indigestion.  Dyspepsia,  however,  is  a  different  complaint, 
and  not  iiecessarily  connected  with  inflammation. 

Symptoms.  —  There  is  generally  pain  in  the  stomach,  which  is  in- 
creased by  the  presence  of  food,  and  by  external  pressure.  The  pain 
is  sometimes  felt  only  during  digestion.  The  fermentation  of  tlie 
food  in  the  stomach  generates  a  gas,  which  is  frequently  belched  up. 
This  is  what  is  meant  in  common  language  by  having  "  wind  in  the 
stomach,"  and  "  belching  wind."  The  meals  are  frequently  vomited 
up ;  the  appetite  is  lickle,  sometimes  voracious,  and  again  nearly  ab- 
sent ;  the  thirst  is  likewise  variant ;  the  tongue  is  white  in  the  centre, 
and  red  at  the  sides  and  tip,  —  sometimes  smooth  and  red  all  over, 
like  a  slice  of  raw  beef.     The  urine  is  scanty  and  high-colored. 

The  disease  is  very  liable,  if  badly  managed,  to  lead  to  ulceration 
of  the  coats  of  the  stomach,  and  thence  to  a  fatal  end  ;  for  an  ulcer 
may  penetrate  the  walls  of  the  stomach,  and  let  its  contents  into  the 
abdominal  cavity,  which  would  excite  an  immediately  fatal  inflam- 
mation. 

Treatment. — If  there  be  much  tenderness,  we  may  apply  leeches 
over  the  stomach.  With  less  tenderness,  counter-irritation  will  an- 
swer,*—  as  blisters,  croton-oil,  mustard  poultices,  the  compound  tar- 
plasters,  or  dry  cups. 

The  skin  of  the  whole  surface  should  receive  special  attention. 
The  warm  or  the  cold  bath  should  be  used  often,  according  to  the 
strength  of  the  patient.  When  the  reaction  ;is  good,  a  cold  compress 
bound  upon  the  stomach  every  night,  will  do  much  to  bring  relief. 

The  diet  cannot  be  too  carefully  managed.  While  there  is  consid- 
erable tenderness,  the  nourishment  must  be  of  the  most  simple  and 
unirritating  kind,  —  consisting  of  little  more  than  the  most  bland 
nutritive  drinks ;  and  even  these  should  be  taken  in  small  quantities 
at  a  time.  Gum  arable  water,  rice-water,  barley-water,  arrow-root, 
gruel,  tea,  and  toast  without  butter,  will  be  amply  sufficient  to  keep 
soul  and  body  together,  and  will,  in  two  or  three  weeks,  generally 
starve  the  enemy  out  of  his  quarters.  After  this,  a  more  nourishing 
diet  may  gradually  be  resumed.  Many  of  the  recent  proprietary 
foods  serve  an  admirable  purpose  in  furnishing  a  large  amount  of 
nutriment  in  small  bulk,  which  is  easily  digested.  Among  these 
may  be  mentioned  proteinol,  in  teaspoonful  to  biblespoonful  doses, 
liquid  peptonoids,  malted  milk,  koumiss,  matzoon,,  etc.  These  latter 
are  milk  preparations  with  the  cooling  and  refreshing  taste  of  soda. 


DISEA8KS  OF  THE   ABDOMINAL  UAVITY. 


303 


IndSgestion.  —  Dyspepsia. 

Dyspepsia  is  a  disease  of  civilization.  Savages  know  nothing  of 
it.  It  is  the  costly  price  we  pay  for  luxuries.  All  civilized  nations 
suffer  from  it,  more  or  leas,  but  none  so  much  as  the  people  of  the 
United  States.  It  is  here,  in  the  new  world,  that  the  disease  has 
become  domesticated,  and  we,  as  a  people,  who  have  threatened  to 
monopolize  its  miseries. 

Few  disordere  inflict  upon  their  victims  greater  suffering;  yet  it  is 
not  particularly  dangerous,  and  it  is  even  loubtful  whether  it  tends 
very  much  to  shorten  life,  unless  the  lengv  .  of  life  be  judged  to  con- 
sist in  the  sum  of  happiness  enjoyed,  —  in  which  case  few  complaints 
shorten  it  more. 

Symptoms.  —  These  vary  very  much  in  different  stages  of  the  dis- 
ease, and  in  different  persons.  In  general  the  complaint  begins  with 
a  sense  of  fullness,  tightness,  and  weight  in  the  stomach,  sooner  or 
later,  after  meals,  and  a  changeable,  diminished,  or  lost  appetite. 
Cooasionally,  the  app-tite  is  craving,  and  when,  in  obedience  to  its 
promptings,  a  large  meal  is  taken,  there  is  pain  in  the  stomach,  with 
general  distress  and  nervousness,  and  sometimes  vomiting.  Flatu- 
lency and  acidity  are  common,  with  sour  and  offensive  belching  of 
wind ;  and  very  often  there  is  a  water-brash,  or  vomiting  of  a  clear, 
glairy  fluid  when  the  stomach  is  empty.  Dizziness  is  a  prominent 
symptom.  There  is  a  great  deal  of  what  patients  call  an  "  all-gone  " 
feeling  at  the  pit  of  the  stomach,  —  a  weakness  so  great  at  that  par- 
ticular spot,  that  it  is  very  hard  to  sit  up  straight.  There  is  a  bad 
taste  in  the  mouth ;  the  tongue  is  covered  with  a  whitish  fur ;  there 
is  headache,  heartburn,  palpitation  at  times,  high-colored  urine,  and 
tenderness,  now  and  then,  at  the  pit  of  the  stomach.  The  bowels 
are  generally  irregular,  sometimes  very  costive,  at  other  times  loose, 
when  portions  of  food  a^e  passed  off  undigested. 

Nervous  Complication.  —  Such  are  the  symptoms  in  a  case  of 
simple  disorder  of  the  stomach,  when  no  other  part  of  the  system  is 
materially  involved.  This  is  indigestion,  well-marked,  and  distressing 
enough ;  but  it  is  only  a  part  of  what  is  understood  by  a  case  of 
modern  dyapepna.  In  thia^  either  the  indigestion,  in  its  course,  dis- 
turbs and  involves  the  nervous  system,  or  the  nerves  become  them- 
selves disordered,  and  produce  the  indigestic  Sometimes  one  hap- 
pens, sometimes  the  other,  it  matters  not  which ;  both  are  present  — 
the  affec  :ion  of  the  stomach  and  of  the  nerves  —  in  a  case  of  thorough 
dyspepsia.  To  make  out  a  full  case,  in  its  tormenting  completeness, 
we  mast  add  to  the  above  symptoms,  great  depression  of  spirits, 
amounting  at  times  to  complete  hopelessness  and  despondency;  a 
dread  and  fear  of  some  impending  evil ;  a  lack  of  interest  in  passing 
events ;  unwillingness  to  see  company  or  to  move  about ;  an  irritable 
iind  fretful  temper ;  a  desi.e  to  talk  of  one's  troubles,  and  nothing 


m 


304 


DI8KA8KS   OK   THE   ABDOMINAL  CAVITY. 


else ;  a  sallow,  haggard,  sunken,  and  sometimes  wild  expression  of 
countenance ;  a  dry,  wrinkled,  and  harsh  skin,  with  unreireshinp 
sleep,  disturbed  by  all  sorts  of  annoyances  and  difficulties,  such  m 
shipwrecks,  falls  down  precipicps,  and  nightmare. 

The  man  who  bus  all  these  symptoms,  or  any  considerable  portion 
of  tht'in,  lias  dyspepsia,  and  is  about  as  miserable  as  if  all  the  sorrows 
of  life  were  electrical  currents,  and  were  running  through  him  con- 
tinually. 

Causes  of  Dyspepsia.  —  To  healthy  digestion,  three  conditions  are 
especially  necessary,  —  that  the  footl  should  be  well  chewed  and 
mixed  with  saliva  before  it  is  swallowed ;  that  the  stomach  should 
pour  out  and  mix  with  it  the  right  amount  of  healthy  gastric  juice ; 
and  that  it  should  be  well  churned  wliile  in  the  stomach. 

It  is  well  known  that  tiie  firat  of  these  conditions,  a  thorough  chew- 
ing of  food,  is  rare  in  this  country.  We  eat  too  fast ;  we  do  not 
masticate  our  food ;  we  bolt  it  whole. 

This  Ls  the  first  cause  of  dyspepsia,  and  it  is  tlie  fruitful  mother  of 
causes.  It  furnishes  the  occasion  for  eating  too  much ;  for  when  the 
food  is  swallowed  with  such  rapidity,  the  stomach  is  taken  by  sur- 
prise, as  it  were ;  it  cannot  secrete  gastric  juice  fast  enough  to  bo 
diffused  through  the  fast-growing  mass ;  and  the  appetite  does  not 
decline  until  a  great  deal  too  much  is  taken.  The  coats  of  the 
stomach,  lx;ing  stretched  unnaturally,  do  not  pour  out  the  gastric 
juice  at  the  right  time,  or  as  much  of  it  as  is  wanted,  and  what  there 
is,  is  altered  in  quality. 

Moreover,  the  stomach  being  overburdened,  cannot  tuni  over  and 
e'liurn  it  contents  properly. 

To  fast  eating,  we  may  add,  high-seasoned  dishes,  too  stimulating 
fur  the  stomach ;  eating  between  meals,  and  at  unseasonable  houre, 
—  particularly  at  bed-time ;  excessive  use  of  strong  drinks  and 
tobacco ;  habitually  sitting  up  late  at  night :  inactive  habits  of  body ; 
and  excessive  use  of  the  mind. 

No  causes  of  dyspepsia  are  more  active  chan  those  which  disturb 
and  fret  the  mind.  It  is  surprising  how  suddenly  any  mental  ag'ta- 
tion  will  put  an  end  to  the  appetite,  and  suspend  digestion.  And 
when  these  mental  disturbances  are  protracted,  when  care  becomes  a 
daily  and  hourly  companion,  dyspepsia  is  almost  sure  to  show  itself. 
Considering  the  numerous  causes  of  unpleasant  mental  excitement 
which  we  have  in  the  politics,  the  business,  the  ambition,  the  family 
jars,  etc.,  of  this  country,  it  is  a  wonder  that  dyspepsia  is  hot  even 
more  prevalent.     It  is  hard  for  the  sensitive  to  escape. 

These  causes  may  seem  too  simple  to  be  the  frequent  origin  of  so 
much  misery,  and  yet  whole  volumes  might  be  written  on  this  one 
subject.  One  cannot  too  forcibly  nor  too  frequently  remind  the 
reader  of  the  importance  of  these  simple  and  brief  remarks.  No 
treatment  will  avail  if  they  are  not  heeded. 


UI8RASKP   OF   THK   ADDOMINAL   CAVITY. 


806 


tBion  of 
I'reHhiiij^ 
such  aH 

I  portion 
)  sorrows 
liim  con- 

itions  are 
wed  and 
h  should 
ric  juice ; 

igh  chew- 
'^e  do  not 

mother  of 
when  the 
3n  by  8ur- 
ugh  to  Ix! 
does  not 
its  of  the 
;he  gastric 
what  there 

1  over  and 

timulating 
,ble  hours, 
rinks  and 
of  body ; 

[ch  disturb 

sntal  ag'*^a- 

;ion.     And 

becomes  a 

[how  itself. 

ixcitement 

the  family 

hot  even 

rigin  of  80 
In  this  one 
}emind  the 

larks.     No 


Urinary  DeposiU.  —  Before  speaking  of  the  treatment  of  dyspep- 
sia, it  will  bo  proper  to  take  notice  of  certain  deposits  in  the  urine, 
to  which  persons  suffering  from  this  complaint  are  liable,  and  the 
discovery  of  wliioh  will,  in  many  cases,  indicate  the  treatment. 

Many  dyspeptics  have  acid  urine,  which  is  loaded  with  cry»tah  of 
oxalate  of  lime.  These  persons  are  much  depressed  in  spirit,  and 
look  upon  the  dark  side  of  everything.  They  are  painfully  disturbed 
by  small  annoyances,  are  imtablo  in  temper,  incapable  of  exerting 
themselves,  look  with  dread  upon  tlio  future,  and  generally  have  the 
(lark  and  dingy  look  of  the  face  whioh  indicates  functional  derange- 
ment of  the  liver. 

The  most  of  these  crystals  are  octahedral  in  form,  and  in  the  field 
of  a  good  microscope  are  beautiful  objects  for  inspection.  (Figs.  100 
and  101.)  To  o'-tain  them,  take  a  portion  of  urine  passed  in  the 
morning  (urina  sanguinis},  and  let  it  stand  till  a  deposit  takes  place. 
Pour  off  the  upper  portion  of  the  urine ;  put  a  part  of  the  remainder 
in  a  watc'ij-glass,  and  gently  lieat  it  over  a  lamp.  The  heat  will 
cause  a  deposit  of  the  crystals. 


no.  100. 


Fro.  101. 


no.  103. 


The  oxalate  of  lime  is  frequently  found  in  urine,  the  crystals  hav- 
ing the  form  of  dumbells.  When  examined  by  polarized  light,  they 
appear  beautifully  colored  and  striated.     (Fig.  102.) 

The  urate  of  ammonia,  and  uric  acid  gravel,  are  likewise  found  in 
large  quantities  in  the  urine  of  many  dyspeptics.  Some  are  ex- 
hausted by  them,  and  reduced  almost  to  skeletons,  and  to  a  wretched 
state  of  health,  —  having  boils,  eruptions,  etc. 

To  find  the  urates,  put  a  little  of  the  urine  containing  the  deposit 
in  a  test-tube,  and  warm  it  gently  over  a  lamp.  If  the  deposit  readily 
dissolve,  it  is  probably  urate  of  ammonia  (Figs.  103  and  104),  and 
may  then  be  examined  under  the  microscope,  to  make  the  matter 


sure. 


To  find  uric  or  lithic  acid,  let  morning  urine  stand  until  a  solid 
deposit  has  sunk  to  the  bottom ;  then  pour  off  the  liquid,  and  place 
some  of  the  solid  portion  upon  ..  glass,  and  examine  it  with  a  micro- 
scope, and  if  this  acid  be  present,  its  peculiar  crystalline  forms 
(Fig.  105)  will  he  discovered,  either  alone,  or  mixed  with  urate  of 
ammonia. 


806 


mSRASKS  OF   THR   ABDOMINAL  CAVITY. 


In  thofle  cases  in  which  there  is  a  great  prostration  of  the  nervous 
system,  with  ii  Iokh  of  sexual  power,  ImuI  feelings  in  the  head,  perhaps 
pain  and  weakness  across  the  loin:'*,  and  a  tendency  to  consiuuption, 


rio.  108. 


FlO.  KM. 


we  may  suspect  the  presence  of  the  triple  phosphates  in  the  urine. 
Phosphorus  m  one  of  the  elements  of  the  hrain  and  nerves,  and  when 

there  is  a  constiint  drain  of  this  element 
through  the  kidneys,  the  nervous  system 
is  gradually  exhausted.  To  find  the  triple 
phosphatt^s,  put  some  morning  urine  in  a 
glaiis  vessel,  and  let  it  stand  till  a  sedi- 
ment has  gone  to  the  bottom.  Put  some 
of  the  sediment  in  a  test-tube,  and  warm 
it  gently  over  a  lamp.  If  the  warmth 
do  not  dissolve  the  deposit,  add  to  it  a 
little  acetic  acid;  if  the  deposit  dissolve  in 
the  acetic  acid,  it  probably  consists  of  earthy 
phosphates.  This  is  then  to  be  exam- 
ined under  the  microscope  to  ascertain 
whether  it  is  the  plio8{)hate  of  lime,  the 
triple  phosphate,  or  a  mixture  of  both. 

Fig.  106  shows  us  the  prismatic  crys- 
tals of  the  triple  phosphate.  In  a  few 
rare  cases,  these  are  penniform  (Fig.  107).  Fig.  108  gives  us  an- 
other specimen  of   the  crystals  of   the  triple  phosphates,  as  they 


7^  Ay^- 


FlO.  lOS. 


FlU.  106. 


FIO.  107. 


-i^,v\ 


FlO.  108. 


appear  under  the  microscope,  mixed  with  amorphous  particles  of 
phosphate  of  lime.  If  an  excess  of  ammonia  be  added  to  the  urine, 
the  crystals  become  star-like  and  foliaceous,  as  in  Fig.  109. 


mSKASES  OK   TIIF    AHPOMINAI,   CAVITY. 


307 


the  nervom 
jad,  perhaps 
^iwumption, 


I  the  urine. 
8,  and  when 
ihis  element 
/OU8  system 
lul  the  triple 
^  urine  in  a 
I  till  a  sedi- 

Put  some 
5,  and  warm 
the  warmth 
add  to  it  a 
it  dissolve  in 
Ists  of  earthy 
3  be  exam- 
to  ascertain 
of  lime,  the 
e  of  both, 
smatic  crys- 

In  a  few 
fives  us  an- 
;e8,  as  they 


lO.  108. 


particles  of 
»  the  urine, 
9. 


Treatment  of  Dyspepsia.  —  Ah  there  are  few  cnmplaintH  whicli 
(listreHH  the  i  Lient  morn  thiiii  dyspepsi..,  so  tluiro  are  few  which  jjive 
till!  physioiai.  lUore  trouble,  (it^norally  our 
art  has  failed  upon  it  t)e(;ause  too  much  ha.s 
liet'ii  required  of  us.  We  have  not  merely 
been  asked  to  euro  the  disease,  but  to  do  it 
while  the  patient  eontiuu(!s  the  indulgenec 
(if  his  appetite,  or  his  exces-sivo  application 
to  business  or  study.  It  luislMsen  ex[)ected 
of  us,  that  wii-ii  medicine  we  should  contra- 
vene the  laws  of  nature,  and  restore  health 
while  the  causes  of  the  disease  are  in  full  ac- 
tivity. 

This  complaint  is  often  brought  on  by 
not  keeping  the  l:Kiwels  open.     To  euro  it,  therefore,  one  of  the  first 
things  to  })e  done  is  to  remove  costiveness  and  regulate  the  bowels. 

One  of  the  very  best  articles  I  know  of  to  remove  constipation  is 
Mettauer's  Aperient.  I  have  placed  it  in  the  departmei  ',  of  Phar- 
macy;  it  ought  to  be  in  the  United  States  Dispensatory.  Taken 
immediately  after  meals,  in  doses  of  a  teaspoonful,  it  corrects  a(;idity 
of  the  stomach,  it  gently  opens  the  bowels,  and  when  its  action  is 
over,  will  be  found  to  have  diminished  the  costiveness,  rather  than 
increased  it,  as  most  kinds  of  physic  do.  It  is  excellent  in  the  bil- 
ious forms  of  dyspepsia, — acting  fiiiely  upon  the  liver,  —  particularly 
if  a  few  drops  of  aqua  rcgia  in  water  be  taken  before  meals,  —  the 
iiperient  being  taken  after. 

If  piles  exist,  this  mixture  will  he  objectionable  on  account  of  the 
aloes,  and  the  fluid  neutiulizing  extract  may  take  its  place.  Sweet 
tincture  of  rhubarb  and  soda  (37),  is  sometimes  preferable  to  the 
aperient. 

Several  other  preparations  (38),  (289),  (39),  (290),  will  be  found 
useful  to  remove  costiveness  and  debility  of  the  stomach. 

For  acidity,  besides  the  remedies  already  mentioned,  prepared  char- 
coal may  be  used,  in  teaspoonful  doses,  or  carbonate  of  magnesia,  or 
fluid  magnesia,  or  trisnitrate  of  bismuth.  A  good  remedy  is  pulver- 
ized gufaiacum,  rhubarb,  prepared  charcoal,  and  carbonate  of  mag- 
nesia, equal  parts;  also  (28),  (37),  (38),  (42).  If  crystals  of  oxa- 
latb  of  lime  be  found  in  the  urine,  give  a  few  drops  of  aqua  regia,  in 
water,  thrje  times  a  day. 

Hygienic  Treatment.  —  The  didt  must  be  managed  with  great  pru- 
dence. Food  must  be  taken  in  such  quantities  only  as  the  stomach 
can  digest,  however  small  that  quantity  may  be  ;  and  it  must  be  taken 
slowly,  and  well  chewed.  No  article  should  be  touched,  or  thought 
of,  which  disagrees  with  the  stomach.  Costiveness  may  frequently 
I*  entirely  removed  by  eating  no  bread  except  that  made  from  un- 
bolted wheat-flour,  commonly  called  Graham  bread  (that  made  from 
Franklin  Mills  flour),  or  by  making  one  of  the  three  daily  meals  of 


308 


DISEASES   OF  THE   ABDOMINAL  CAVITY. 


boiled  cracked  wheat,  with  milk  or  molasses.  If  the  triple  phosphates 
be  found  in  the  urine,  there  is  a  special  reason  why  the  unbolted 
flour,  or  the  cracked  wheat  should  be  used.  The  wheat-grain  abounds 
in  phosphorus,  the  largest  portion  of  which  is  in  the  bran,  and  this 
is  much  needed  when  the  kidneys  are  robbing  the  brain  of  its  phos- 
phoric element. 

Not  too  much  Brain-work. — It  is  important  that  the  brain  and 
nervous  system  should  be  relieved  of  the  burden  of  too  much  work, 
and  that  the  thoughts  should  be  turned  into  the  most  agreeable  chan- 
nels. If  the  patient  would  get  well,  the  disinclination  to  move  about 
and  see  company  must  be  resisted.  In  many  cases,  dyspeptics  are 
like  sea-sick  persons, — feeling  as  though  they  would  rather  go  over- 
board than  move.  In  such  instances,  friends  must  not  be  harsh  with 
them,  and  frown  upon  their  listlessness  as  if  it  were  a  fault ;  but 
rather  treat  them  affectionately,  and  beguile  them  out  by  all  sorts  of 
pleasing  enticements.  Exercise  must  be  had,  every  day,  and  be  con- 
nected, if  possible,  with  an  object,  so  that  it  may  be  performed  cheer- 
fully. It  is  important  to  engage  the  mind  in  the  exercise;  and  for  this 
purpose,  some  contested  game  is  very  useful,  as  playing  at  billiards, 
rolling  nine-pins,  pitching  quoits,  or,  where  the  strength  will  permit, 
playing  ball  or  riding  the  bicycle. 

Cheerfulness.  —  Nothing  does  more  to  drive  away  dyspepsia  than  a 
cheerful,  lively,  and  even  mirthful  state  of  mind.  All  the  nervous 
influences  sent  from  the  brain  to  the  stomach  should  be  of  the  most 
agreeable  kind.  Some  people  think  it  vulgar  to  laugh.  Let  such 
stand  with  long  faces  in  life's  shadows,  if  they  choose.  As  a  general 
loile,  the  best  men  and  women  laugh  the  most.  Good,  round,  hearty, 
side-shaking  laughter,  is  health  for  everybody ;  for  the  dyspeptic,  it 
is  life. 

Dyspeptics  who  have  a  taste  for  it,  and  can  endure  the  expense, 
should  travel.  A  voyage  to  Europe,  and  a  year  spent  in  seeing  the 
wonders  of  the  old  world,  will  generally  cure  the  most  stubborn  case 
of  indigestion.  This,  however,  depends  upon  circumstances.  For 
those  having  the  finer  organizations  and  the  higher  natures,  extensive 
travelling  is  sometimes  indispensable.  The  narrow  circle  of  thoughts, 
associations  and  things  in  tho:r  own  neighborhood,  do  not  fill  the 
compass  of  their  wants ;  their  many-sided  faculties  need  to  be  drawn 
on  by  the  large  variety  to  be  found  only  in  travel.  Their  large  and 
impressible  natures  want  to  be  filled  full  in  order  to  drive  outdisease, 
and  it  takes  a  world,  or  a  considerable  part  of  it,  to  fill  them.  The 
dyspepsia  of  such  natures  is  not  comprehended  by  the  multitude,  and 
even  physicians  are  often  amazed  that  their  narrow  prescriptions  do 
not  reach  it. 

Heartburn.  —  Cardialgia. 

This  is  a  gnawing  and  burning  pain  in  the  stomach,  attended  by 
disturbed  appetite.     It  is  generally  caused  by  great  acidity  of  the 


~ 


DISEASES  OP  THE   ABDOMINAL   CAVITY. 


309 


)ho8phates 

unbolted 

n  abounds 

I,  and  this 

its  phos- 

brain  and 
uch  work, 
lable  chan- 
love  about 
eptics  are 
r  go  over- 
harsh  with 
fault;  but 
dl  sorts  of 
nd  be  con- 
ned cheer- 
nd  for  this 
b  billiards, 
ill  permit, 

)sia  than  a 

e  nervous 

the  most 

Let  such 

a  general 

id,  hearty, 

speptic,  it 

!  expense, 

seeing  the 

aborn  case 

ices.     For 

extensive 

thoughts, 

ot  fill  the 

be  drawn 

large  and 

ut  disease, 

em.     The 

itude,  and 

iptions  do 


bended  by 
ity  of  the 


stomach,  and  is  a  symptom  of  dyspepsia,  and  often  afliicts  pregnant 
women.  Whenever  too  much  food  is  taken,  it  is  liable  to  ferment, 
and  become  extremely  sour,  —  causing  heartburn.  In  such  cases, 
vomiting  often  occurs  ;  and  what  is  thrown  up  is  sour,  and  some- 
times bitter. 

Treatment.  —  Immediate  temporary  relief  may  be  obtained  by 
swallowing  a  teaspoonful  of  soda,  magnesia,  or  chalk,  in  a  tumbler  of 
cold  or  warm  water.  Fluid  magnesia,  or  lime-water,  will  answer  the 
same  purpose.  If  there  is  wind  in  the  stomach,  as  well  as  acidity,  a 
teaspoonful  of  the  aromatic  spirit  of  ammonia,  or  (135),  will  often 
still  the  uneasiness  in  a  moment. 

To  cure  the  complaint,  the  stomach  must  be  strer  Jiened  by  the 
remedies  directed  for  dyspepsia. 

Spasm  or  Cramp  in  the  Stomach. —  Gastrodynia. 

Though  generally  of  shorter  duration,  this  is  more  violent  than 
heartburn.  It  is  attended  by  a  sense  of  fullness,  by  anxiety,  and  by 
great  restlessness.  In  females,  hysterical  symptoms  are  often  coupled 
with  it.  Great  quantities  of  air  or  gas  are  generally  expelled,  and 
the  pain  shoots  through  to  the  back  and  shoulders. 

Treatment.  —  A  strong  purg^ative  injection  (248)  will  often  bring 
immediate  relief.  The  sweet  tincture  of  rhubarb  and  soda  (37),  with 
a  few  drops  of  tincture  of  cayenne  mixed  with  it,  will  often  bring 
speedy  relief.  So  will  a  mustard  poultice  laid  upon  the  stomach. 
The  mustard  poultice  is  a  remedy  of  great  excellence,  in  many  cases. 
It  deserves  to  be  called  the  poor  man's  friend. 

Water-Brash.  —  Pyrosis. 

This  consists  in  a  discharge  from  the  stomach,  generally  in  the 
morning,  of  a  thin,  glairy,  watery  fluid,  sometimes  insipid,  at  other 
times  sweetish,  and  at  still  others  sour.  A  burning  heat  or  pain  in 
the  stomach  attends,  and  seems  to  be  the  immediate  cause  of  the 
discharge.  The  discharge  appears  to  be  the  natural  mucus  of  the 
stomach,  which  is  poured  out  in  large  quantities  in  consequence  of  a 
kind  of  catarrh  of  its  mucous  lining.  The  amount  thrown  up  varies 
from  a  spoonful  to  a  pint  or  more. 

The  complaint  is  caused  by  a  poor,  innutritious  diet,  or  by  what- 
ever causes  the  blood  to  become  thin  and  watery. 

Treatment. — Ten  or  fifteen  drops  of  water  of  ammonia,  in  half  a 
tumbler  of  water,  will  quiet  tlie  distress,  and  check  the  discharge. 
The  most  effectual  remedy  I  am  acquainted  with  for  breaking  up  the 
discharge,  is  the  trisnitrate  of  bismuth,  taken  at  meal-times,  in  from 
twenty  to  thirty-grain  doses,  three  times  a  day.  The  compound  pow- 
der of  kino  is  a  valuable  remedy.  The  compound  tincture  of  senna 
and  the  tincture  of  balsaiu  ^i  tolu,  in  equal  parts,  and  administered 


310 


DISKASES   OF  THE   ABDOMINAL  CAVITY. 


in  tablespoonful  doses,  are  sometimes  useful.     The  tincture  of  nux 
vomica  is  a  good  remedy. 

To  restore  the  blood,  some  of  the  various  preparations  of  iron  (74), 
(80),  (78),  (316),  will  be  required. 

The  diet  should  consist  of  easily-digested,  nutritious  food, 
soupsv  broths,  fresh  meat,  and  unbolted  wheat-bread. 


aa 


Vomiting*. 

This  occurs  under  a  great  variety  of  circumstances.  It  may  be 
induced  by  acidity  of  the  stomach,  by  irritability  of  the  stomach,  by 
distress  of  mind,  by  injury  of  the  brain,  by  offensive  odors,  and  by  all 
organic  diseases  of  the  stomach. 

Treatment.  —  Generally,  it  is  cured  by  treating  the  disease  which 
induces  it.  But  in  many  cases  it  persists  very  obstinately,  and  may 
become  the  chief  thing  to  be  attended  to.  In  such  cases,  it  may  re- 
quire a  careful  investigation  of  the  cause  to  check  it.  But  generally 
some  aromatic,  as  ginger,  spearmint,  peppermint,  or  spice-tea,  will 
put  an  end  to  it.  Some  cordial  or  stimulant,  as  brandy,  champagne, 
tincture  of  ginger,  paregoric,  elixir  solutis,  or  cherry  brandy,  will 
answer  well.  Strong  coffee,  without  sugar  or  milk,  will,  in  some 
cases,  act  like  a  charm.  If  it  is  dependent  on  acidity,  the  remedies 
are  given  under  "  dyspepsia."  If  caused  by  irritixbility  of  stomach, 
a  pill  of  extract  of  belladonna  and  ipecac  (339)  will  do  well. 

While  vomiting,  the  patient  should  lie  still  in  bed,  and  in  bad 
cases,  a  mustard  poultice  should  be  placed  upon  the  stomach. 

The  vomiting  of  children  may  sometimes  be  stopped  by  wetting  a 
piece  of  cloth  with  laudanum,  and  laying  it  upon  the  "t  of  the 
stomach. 

Seasickness. 

This  is  the  great  terror  of  persons  who,  for  the  first  time,  croRs  the 
ocean.  •  It  is  said  that  dark-complexioned  persons  suffer  more  from 
it  than  other;. 

If  it  cannot  be  entirely  prevented,  it  may  be  mitigated  by  lying 
flat  upon  the  back.  To  lie  on  deck,  in  the  open  air,  is  much  better 
than  lying  in  the  close  air  of  tie  cabin  or  stateroom.  A  wineglass 
of  brandy,  or  iced  champagne,  sipped  now  and  then,  will  relieve  the 
sickness  very  much.  For  a  child,  it  is  sometimes  sufficient  to  wet  a 
cloth  with  mustard,  and  lay  it  upon  i\e  pit  of  the  stomach.  Creo- 
sote, one  drop  at  a  dose,  made  into  a  p;!1  h  excellent.  Ten  drops 
of  hartshorn,  in  half  a  tumbler  of  water,  is  good  for  some.  But  the 
best  known  i-emedy  is  chloroform,  taken  in  doses  of  from  forty  to 
eighty  drops,  suspended  in  water  by  means  of  a  little  gum-arabic. 
Bromide  of  soda  in  large  doses,  daily,  prevents  it,  or  bromo-caffein 
when  it  first  comes  on.  Cocaine  in  one-eighth  grain  doses  every 
twenty  minutes  is  usually  very  helpful.     A  spinal  ice-bag  placed 


n^-^j-wiwf^n^'iyw 


mnm^mimmmm 


DISEASES   OF   THE   ABDOMINAL   CAVITY. 


311 


opposite  the  stomach  while  the  sufferer  lies  upon  the  back  will  do 
more  toward  curing  sea-sickness  than  any  other  single  remedy. 
These  bags  are  about  eight  inches  long,  made  of  thin  rubber,  and  are 
to  be  filled  with  small  pieces  of  cracked  ice.  When  the  ice  melts 
refill  the  bag. 

Milk  Sickness. 

This  disease  prevails  in  the  West,  chiefly  in  the  neighborhood  of 
level,  heavily-timbered,  rather  wet  oak-land. 

The  cattle,  horses,  and  sheep,  which  range  in  this  land,  are  fre- 
quently attacked  by  a  disease  which  the  people  call  the  trembles.  It 
is  supposed  to  be  produced  by  eating  some  plant  growing  upon  those 
lands,  88  cattle  which  feed  in  the  neighboring  regions  are  free  from 
it  until  they  find  their  way  into  these  low  grounds.  It  has  been  sug- 
gested that  the  offending  plant  may  be  the  poison  ivy  (rhus  toxicoden- 
dron) .  Be  this  as  it  may,  the  calves,  soon  after  sucking  cows  which 
have  run  in  these  grounds,  are  seized  with  trembling,  and  frequently 
die  of  the  disease.  Dogs  which  lap  the  milk  are  affected  in  a  similar 
manner.  Children  drinking  it  leave  the  table  and  vomit.  Upon 
grown  persons  the  effects  are  more  severe,  but  not  so  sudden.  The 
eating  of  the  beef,  mutton,  or  veal,  of  affected  animals,  brings  on  the 
same  disease. 

Symptoms. — The  disease  sets 'in  with  sickness  at  the  stomach, 
which  is  preceded  by  general  debility,  more  particularly  of  the  legs. 
There  is  nausea,  vomiting,  and  the  breath  is  so  offensive  and  peculiar 
that  those  acquainted  with  the  complaint  immediately  recognize  it 
from  this  smell. 

These  existing  for  weeks,  constitute,  in  some  cases,  the  whole  of 
the  symptoms.  In  other  cases  they  are  more  severe,  being  attended 
by  chills  and  flushes,  great  oppression  about  the  heart,  anxiety,  deep 
breathing,  heat  in  the  stomach  compared  to  fire  and  boiling  water, 
violent  retching  and  vomiting,  alarming  beatings  of  the  heart,  and 
throbbings  of  the  large  vessels,  and  cold  extremities,  —  producing, 
all  together,  extreme  distress. 

In  most  cases,  the  vomiting  returns  eVery  hour  or  two,  attended 
by  great  burning  at  the  pit  of  the  stomach,  the  substance  thrown  up 
having  a  peculiar  bluish-green  color,  and  a  sour  smell.  As  soon  as 
this  discharge  takes  place,  the  patient  falls  back  upon  the  pillow,  and 
lies  easy  until  another  turn  comes  round.  .  The  tongue  is  covered 
with  a  whitish  coat,  the  bowels  are  obstinately  costive,  and  the  pulse 
is  small  and  quick. 

Treatment.  —  It  is  believed  that  the  neutralizing  mixture,  given 
in  tablespoonful  doses  every  time  the  nausea  and  burning  ciensation 
are  felt,  is  the  most  effectual  remedy  yet  used.  It  relieves  the 
acidity,  and  seems  well  adapted  to  allay  the  irritation.  Some  anti- 
bilious  physic  (40)  to  move  the  bowels  should  also  be  given. 


MillJi 


HMMMHBt^. 


312 


DISEASES  OP  THE  CHEST. 


Besides  these  remedies,  a  mustard  poultice  should  be  put  upon  the 
stomach,  and  hot  bricks  to  the  feet,  and  the  patient  be  kept  still  for 
some  hours.  The  diet  should  be  very  mild,  —  only  toast-water,  rice- 
water,  or  thin  gruel. 

Acute  Inflammation  of  the  Peritoneum. — Peritonitis. 

This  disease  affects  the  extensive  membrane  which  lines  the  whole 
inside  of  the  belly,  an  extenpion  of  which  forms  the  omentum  or 
apron.  It  is  an  inflammation  to  which  women  are  much  exposed 
after  confinement,  and  is  known,  in  such  cases,  as  child-bed  or  puer- 
pral  fever.     It  is  common  among  men  also,  and  is  a  grave  disease. 

The  accepted  notions  of  no  disease  have  undergone  so  much  of  a 
revolution  of  late  years  as  those  relating  to  peritonitis.  It  was  formerly 
considered  to  be  generally  of  spontaneous  or  idiopathic  origin,  whereas 
now  we  know  it  to  be  the  outcome  of  some  one  of  se .  o^al  diseases, 
but  lately  understood,  as  for  instance,  appendicitis,  septicaemia  or 
blood-poisoning,  inflammation  of  the  fallopian  tubes  and  ovaries, 
tuberculosis,  abscess  of  gall-bladder,  strangulated  hernia,  etc. 

Symptoms.  —  Like  other  forms  of  fever  and  inflammation,  it  is 
preceded  by  chills,  with  increased  heat  of  surface,  thirst,  full,  strong, 
and  frequent  pulse,  flushed  face,  and  red  eyes,  dry  tongue  with  red 
edges,  dry  skin,  restlessness,  short,  quick  breathing,  nausea  and 
vomiting. 

The  pain  is  increased  by  the  patient  sitting  or  standing  up,  —  the 
bowels  being  thus  pressed  against  the  inflamed  membrane.  Lying 
upon  either  side  is  painful  for  the  same  reason.  To  lie  flat  upon  the 
back,  with  the  feet  drawn  up,  is  the  only  endurable  position.  The 
patient  lies  still,  for  all  movements  give  pain. 

The  pain  in  this  disease  is  generally  sharp,  cutting,  and  pricking, 
but  is  not  always  equally  intense.  It  is  aggravated  by  the  passage 
of  wind  along  the  bowel,  by  which  the  inflamed  membrane  is  slightly 
stretched. 

When  the  disease  is  advancing  towards  a  fatal  termination,  the 
belly  becomes  greatly  swollen  and  tense,  —  having  to  the  hand  a 
peculiarly  tight,  drum-head  feeling ;  the  pulse  is  rapid  and  feeble ; 
the  countenance  is  full  of  anxiety,  and  is  pinched  and  ghastly ;  and 
a  cold  sweat  breaks  out. 

Treatment.  —  Small  doses  of  antimony,  lobelia,  or  ipecac,  to  pro- 
duce nausea  and  a  moisture  upon  the  skin,  are  generally  among  the 
first  things  given.  The  tincture  of  veratrum  viride,  in  five  to  ten- 
drop  doses,  repeated  every  hour,  will  accomplish  the  same  thing  more 
effectually  than  any  other  known  article.  For  such  purposes,  I  give 
it  the  first  place  among  medicines.  A  large  poultice  of  white  bread, 
rye-meal,  or  flax-seed,  may  be  spread  over  the  belly ;  or  cloths  wet 
with  cold  water  will  be  still  better,  if  the  patient  be  full-blooded, 
and  naturally  strong.     The  bowels  should  be  moved  at  once  by  some 


T)I8EASE8   OF  THE   ABDOMINAL   CAVITY. 


313 


active  physic,  as  Dutteriuit,  salts,  magnesia,  castor-oil,  or  cream  of 
tartar  (20),  (17),  (18),  (27),or  by  podophyllin,  etc.  (40),  (41),  (31). 

The  two  main  indications  in  the  treatment  of  peritonitis  after  having 
discovered  and  treated  the  causes,  are  the  thorough  draining  of  the 
bowels  of  their  watery  secretions  by  some  gentle  saline  which  will 
not  stir  them  up ;  and  secondly  to  maintain  them  in  a  state  of  quiet  and 
rest.  The  first  is  met  by  magnesia  in  the  form  of  the  solution  of  the 
citrate,  say  one-half  bottle  every  four  hours  till  copious  watery  move- 
ments occur.  Tliis  drains  the  glands  and  causes  a  flow  of  the  poi- 
sonous effete  material  into  the  bowels  and  rids  the  system  of  so  much 
poison.  The  second  indication  is  met  by  opium  in  some  of  its  many 
forms.  It  is  often,  however,  a  serious  problem  for  even  the  physician 
to  decide,  and  should  only  be  undertaken  with  his  advice. 

The  drinks  should  be  lemonade,  soda-water,  tamarind-water,  cur- 
rant-jelly dissolved  in  water,  and  preparations  (298)  and  (299). 
Indian-meal  gruel,  toast-water,  barley-gruel,  and  the  like,  are  the 
only  allowable  diet. 

Chronic  Inflammation  of  the  Peritoneum. 

When  the  acute  inflammation  of  the  peritoneal  membrane  is  not 
successfully  treated,  it  may  run  on  for  a  time,  and  then  subsid"  into  a 
lower  grade  of  inflammation,  called  chronic,  and  in  this  state  remain 
for  an  indefinite  time.  But  it  often  arises  independently  of  the  acute 
disease,  and  attacks  persons  of  both  sexes,  and  of  all  classes  and  ages. 
Scrofulous  children  have  it,  and,  wasting  away  under  it  to  mere  skel 
etons,  are  said  to  have  consumpdon  of  the  bowels. 

Symptoms. — These  are  sometimes  very  obscure,  and  the  advances 
of  the  disease  stealthy.  At  first  there  may  be  only  a  little  soreness 
of  the  belly,  so  slight,  as  not  to  be  noticed  except  after  hard  work,  or 
upon  some  wrenching  motion.  Generally,  there  is  a  sense  of  fullness 
and  tension  of  the  belly,  although  it  may  not  be  increased  in  size. 
After  a  time,  it  enlarges  a  little,  and  its  tension  or  tightness  increases, 
especially  towards  evening.  By  pressing  carefully  with  the  hand,  a 
deep-feeling  tension  may  be  detected,  giving  to  the  hand  a  sensa- 
tion as  of  a  tight  bandage  underneath,  with  the  skin  and  integu- 
ments sliding  loosely  over  it.  If  water  has  been  poured  out  into  the 
abdominal  cavity,  its  fluctuation  may  be  frequently  detected  by  press- 
ing upon  one  side  of  the  belly  with  the  palm  of  one  hand,  and  strik- 
ing the  other  side  with  the  ends  of  the  fingers. 

As  the  disease  goes  on,  the  features  become  sharp  and  contracted, 
and  the  countenance  grows  pale  and  sallow.  Costiveness  comes  on, 
sometimes  chills  and  fever,  with  debility,  loss  of  flesh,  cough,  difficult 
breathing,  hectic,  and  swelling  of  the  legs. 

Treatment.  —  Costiveness,  if  present,  may  be  relieved  by  Mettauer's 
aperient,  or  the  neutralizing  mixture,  assisted  by  coarse  bread,  and 
boiled  cracked  wheat. 


314 


DISEASES   OF  THE   ABDOMINAL   CAVITY. 


Daily  bathing  is  especially  necessary,  particularly  the  alkaline 
sponge  bath,  with  vigorous  friction  over  the  bowels.  The  warm  bith 
once  or  twice  a  week  will  be  useful.  In  some  cases,  a  wet  towel 
laid  upon  the  bowels  over  night,  and  well  covered  by  flannels,  will 
afford  relief ;  or  the  compound  tar-plaster  may  occasionally  be  used. 

If  there  be  dropsy  of  the  belly,  iodide  of  potassium  (138)  should 
be  taken  freely,  and  the  skin  made  sore  over  the  inflamed  part,  by 
tincture  of  iodine,  well  rubbed  in,  once  a  day. 

If  the  patient  be  pale  and  bloodless,  give  iron,  quinine,  etc.  (74) 
(76),  and  let  the  diet  be  nourishing ;  and  if  nervous  symptoms  be 
connected  with  the  debility  and  paleness,  add  some  nerve-tonic  (93), 
(81),  (316).  When  the  disease  is  known  to  be  the  outcome  of  a 
deposit  of  tubercles  on  the  peritoneum,  it  is  now  customary  to  open 
the  abdomen  under  antiseptic  methods  and  wash  out  the  cavity.  The 
effect  of  a  mild  sallrsolution  and  the  light  and  air  oftentimes  arrests 
the  disease. 

Acute  Inflammation  of  the  Bowels.  —  Enteritis. 

By  inflammation  of  the  bowels  is  generally  understood  an  inflamed 
condition  of  the  muc&us  membrane  which  lines  them ;  but  tliis,  most 
commonly,  is  only  a  part  of  the  disease ;  it  involves  more  or  less, 
besides  this  mucous  lining,  the  whole  substance  of  the  bowel.  After 
an  inflammation  has  existed  some  time,  and  even,  in  severe  cases,  at  the 
start,  certain  poisonous  substances  are  formed  as  the  result  of  germ 
invasion,  called  toxines.  These  are  genuine  poisons,  and  often 
spread  rapidly  through  the  walls  of  the  bowels  by  means  of  the 
numerous  lymphatic  vessels  to  the  peritoneum  itself, — that  delicate 
membrane  which  we  have  seen  covers  all  organs  within  the  abdomi- 
nal cavity.  When  this  membrane  once  becomes  poisoned,  an  acute 
inflammation  sets  up,  which  masks  all  other  symptoms,  and  is  indeed  a 
veritable  blood-poison.     We  have  then  to  deal  with  peritonitis. 

Symptoms.  —  The  disease  begins  with  a  chill,  and  with  uneasiness 
and  slight  griping  pains,  which  increase  in  severity  until  they  are  in- 
tense  and  burning.     Pressure  aggravates  the  pain,  which  is  most 
intense  about  the  navel,  but  extends  more  or  less  over  the  whole- 
bowels. 

From  the  beginning  there  is  sickness  at  the  stomach,  and  some- 
times vomiting  ;  there  is  loss  of  strength,  costiveness,  great  anxietfy, 
thirst,  heat  and  fever,  dry,  furred,  and  red  tongue,  and  but  little  urine, 
with  pain  in  passing  it.  The  matters  passed  from  the  bowels  are 
dark  and  fetid  ;  and  the  whole  belly  is  tender  and  sore  to  the  touch. 
The  pulse  is  quick,  hard,  and  small. 

The  stomach  will  be  but  little  affected,  comparatively,  when  the 
disease  is  at  some  distance  from  it  in  the  lower  portion  of  the  bowels. 
Indeed,  the  nearness  of  the  inflammation  to  the  stomach,  or  its  re- 
moteness from  it,  may  be  judged  pretty  correctly  by  the  degree  of 


DISEASES  OF   THE    ABDOMINAL   CAVITY. 


315 


disturbance  in  that  organ.  The  length  of  time  after  drink  and  medi- 
cines are  swallowed,  before  they  are  vomited  up,  is  a  pretty  good 
measure,  likewise  of  the  distance  of  the  disease  from  the  stomach. 

How  to  Discriminate This  disease  is  liable  to  be  confounded 

with  colic,  and  with  inflammation  of  the  peritoneum.  It  is  impoitant 
to  distinguish  it  from  colic,  particularly,  because  the  treatment  for  that 
would  aggravate  this.  In  this  disease  the  pain  is  increased  by  pres- 
sure; in  colic,  it  is  not,  but  is  rather  relieved.  In  enteritis,  the  pain 
remits,  but  never  ceaaes  wholly,  as  it  does  in  colic.  In  enteritis, 
the  knees  are  drawn  up,  and  the  breathing  is  short;  in  colic  it  some- 
times gives  relief  to  stretch  the  feet  down,  and  the  breathing  is  not 
altered. 

To  distinguish  it  from  inflammation  of  the  peritoneum,  take  notice 
that  diarrhoea  is  much  more  common  than  in  this  latter  complaint, 
while  the  pulse  is  not  as  quick,  nor  the  pain  as  severe. 

Treatment. — This  should  be  very  much  the  same  as  that  recom- 
mended for  peritonitis.  Perhaps  in  both  diseases  it  might  be  veil 
to  begin  with  covering  the  belly  all  over  with  leeches. 

The  tincture  of  veratrum  viride,  in  full  doses,  so  as  to  keep  up  a 
free  perapiration,  cold  compresses,  mustard  poultices,  hot  fomentations, 
poultices,  blisters,  soothing  and  quieting  injections,  and  demulcent 
drinks,  as  slippery  elm,  marshmallow,  flax-seed,  etc.,  if  judiciously  ap- 
plied, will  do  about  all  that  we  have  it  in  our  power  to  accomplish. 

In  this  disease  it  is  well  to  inquire  if  the  patient  has  a  hernia,  for 
if  so,  it  is  liable  to  become  strangulated  without  his  knowledge.  A 
strangulation  of  the  gut  may  be  the  cause  of  the  disease.  When  this 
happens,  the  complaint  is  very  unmanageable.  The  bowel  may  pos- 
sibly, in  such  case,  be  disentangled  by  applying  a  large  dry  cup ;  or, 
what  is  better,  a  number  of  small  ones ;  but  the  tenderness  of  the 
belly  makes  the  use  of  this  remedy  difficult.  Here  again  magnesia 
may  be  of  signal  benefit  unless  the  movements  are  already  too  copious 
and  exhausting,  in  which  case  disinfectants  or  astringents  must  be  re- 
sorted to.     The  possibility  of  tuberculosis  must  not  be  ignored. 

Chronic  Inflammation  of  tlie  Bowels. 

Like  other  chronic  inflammations,  this  may  follow  the  acute  torm, 
but  it  also  results  from  various  other  causes,  as  unripe  fruit,  taking 
cold,  drastic  physic,  and  improper  treatment  of  other  diseases. 

Symptoms.  —  Red  end  and  borders  of  the  tongue,  dull  pain  in 
belly,  increased  by  pressure  and  rough  motion,  abdomen  either  swelled 
or  flat,  skin  dry  and  husky,  feet  and  hands  cold,  small  frequent  pulse, 
thirst,  loss  of  flesh,  low  spirits,  urine  scanty  and  high-colored,  and 
dirty,  slimy  discharges  from  the  bowels,  from  one  to  four  times  a 
day. 

Treatment.  — To  begin  with,  blisters,  or  croton-oil,  or  mustard 


_ll 


316 


DISEASES  OF  THE   ABDOMINAL  CAVITY. 


poultices,  or  dry  cups,  if  the  tenderness  is  not  great,  or  leeclies  if  it  is. 
If  the  bowels  are  hot  and  feverish,  bind  a  cold  compress  upon  the 
belly  over  night,  covering  it  well  with  flannel.  The  warm  bath 
should  be  used  twice  a  week.  Salol,  ten  grains  every  three  hours, 
bismuth  and  opium,  are  in  this  case  very  valuable.  Wasliing  out  the 
lower  bowel  with  hot  water  by  means  of  a  syringe  often  soothes  and 
heals. 

The  diet  must  be  of  the  most  simple,  unirritating  kind,  beginning 
with  a  solution  of  gum-arabic,  rice-water,  barley-water,  arrow-root  or 
sago-gruel,  and  gradually  rising,  as  the  symptoms  improve,  to  beef- 
tea,  mutton  and  chicken  broth,  tender  beefsteak,  etc. 

When  the  strength  will  permit,  gentle  exercise  must  be  taken  in 
the  open  air,  but  not  on  horseback,  or  in  hard,  jolting  carriages. 

As  soon  as  the  inflammation  is  subdued,  some  mild  laxative  (35) 
may  be  given,  in  connection  with  an  infusion  of  wild-cherry  bark, 
geranium,  and  Solomon's  seal,  equal  parts. 


Appendicitis. 

This  is  one  of  the  so-called  modern  diseases, —  not  that  it  has  not 
existed  for  a  long  time,  but  that  not  till  lately  has  it  been  recognized 
as  a  distinct  ailment.  Formerly  it  fell  under  the  general  category 
of  peritonitis  or  inflammation  of  the  bowels.  American  physicians 
have  done  more  toward  discovering  its  characteristics  than  others. 
It  is  an  inflammation  of  the  appendix  vermiformis,  which  is  situated 
at  the  end  of  the  large  bowel,  in  the  right  flank,  close  to  the  junction 
of  the  colon  witli  the  small  bowel  (see  Fig.  60).  This  organ  is  a 
small,  round,  tail-like  body,  about  the  size  of  a  slate-pencil,  and  aver- 
ages some  three  inches  in  length.  It  is  hollow,  lined  with  mucous 
membrane,  and  covered  like  the  bowel  proper  with  a  peritoneal  mem- 
brane. It  secretes  mucus.  Its  use  is  as  yet  unknown,  being  thought 
by  many  to  be  a  rudimentary  organ  like  the  uvula,  without  function, 
and  possibly  analogous  to  the  herbivorous  stomach.  Whenever  small 
seeds  enter  the  cavity  of  this  organ  (which  is  in  reality  a  rare  occur- 
rence) or  whenever,  from  any  cause,  a  catarrhal  inflammation  is  de- 
veloped in  it,  the  secretion  increases,  and  being  confined,  aggravates 
the  trouble.  This  catarrhal  inflammation  is  generally  mild  and  the 
trouble  often  subsides  either  for  good  or  to  start  up  again  sooner  or 
later. 

The  inflammation  may,  however,  become  purulent,  the  germs  pen- 
etrating the  walls  of  the  appendix  and  causing  a  general  inflammation 
of  the  peritoneal  coat  of  the  bowel.  In  these  cases  nature  fights 
hard  to  resist  the  invasion  of  the  germ  and  throws  out  a  large  amount 
of  lymph  and  serum,  which,  when  it  hardens,  often  acts  as  a  barrier 
to  the  furtl  ,.'  progress  of  the  peritonitis  which  has  begun  about  the 
appendix.  These  cases  are  characterized  by  a  hard  lump  in  the  ap- 
pendicular region,  the  inside  of  which  contains  pus  as  a  rule,  which 


T>Wl)^ii|»l»lil.,-V.i||i,H,|ij.>  ■ 


DISEASES  OF   THE   ABDOMINAL  CAVITY 


317 


lies  if  it  is. 
upon  the 
i^arm  bath 
ree  hours, 
ig  out  the 
jothes  and 

beginning 
ow-root  or 
B,  to  beef- 

i  taken  in 
iages. 
ative  (35) 
erry  bark, 


it  has  not 
'ecognized 
I  category 
physicians 
an  others. 
is  situated 
e  junction 
)rgan  is  a 

and  aver- 
;h  mucous 
neal  mem- 
ig  thought 
,  function, 
ever  small 
are  occur- 
ion  is  de- 
tggravates 
i  and  the 
sooner  or 

erms  pen- 
ammation 
ure  fights 
je  amount 
}  a  barrier 
about  the 
in  the  ap- 
ile,  wliich 


has  escaped  from  the  bursting  appendix.  Cases  of  this  class  are  ex- 
tremely dangerou  <  and  require  the  immediate  aid  of  a  surgeon,  as 
they  are  bound  to  give  trouble  sooner  or  later,  even  if  the  first  attack 
does  not  prove  fatal. 

There  is  still  a  third  class  of  cases,  called  fulminating,  because 
from  the  very  first  they  seem  to  be  purulent,  and  spread  lapidly  into 
a  general  peritonitis,  death  occurring  within  a  few  days  from  the  ap- 
pearance of  the  fiiBt  symptoms.  These  cases  are  the  most  hopeless 
of  all,  and  must  be  operated  on  without  the  slightest  delay,  since  im- 
mediate evacuation  of  the  pus,  before  a  general  infection  of  the  ab- 
dominal cavity  supervenes,  is  the  only  possible  hope  of  saving  the 
patient. 

Symptoms.  —  The  disease,  as  generally  observed,  begins  with  lan- 
guor and  pain  in  the  abdomen,  with  special  soreness  on  the  right 
side,  oftentimes  nausea  and  vomiting,  constipation,  a  slight  rise  of 
temperature,  and  headache.  As  the  disease  progresses  the  tenderness 
amounts  to  pain,  a  bunch  may  be  felt  by  the  medical  attendant :  the 
temperature  gets  a  little  higher  and  symptoms  of  pus  formation  set 
in.  The  case  may  hang  in  this  initial  stage  (up  to  the  point  of  pus 
formation)  for  several  days  and  finally  subside,  ^t  being  a  more  or 
less  catarrhal  inflammation;  but  when  pus  has  nice  formed  the  pa- 
tient cannot  escape  without  an  operation  for  the  removal  of  the  of- 
fending body.  Many  surgeons  at  the  present  day  even  take  the 
ground  that  every  inflamed  appendix  should  be  removed. 

Treatment.  —  The  medical  treatment  consists  in  giving  magnesia 
in  form  of  the  solution  of  the  citrate,  with  a  light  diet,  and  keeping 
the  patient  in  bed.  Poultices  may  be  of  some  benefit.  Opium  should 
not  be  used  unless  pain  is  extreme. 

The  operation  for  appendicitis,  when  performed  between  the  attacks, 
is  a  comparatively  safe  one  in  competent  hands ;  but  it  becomes  a  very 
grave  one  if  pus  forms  rapidly  and  invades  the  general  abdominal 
cavity.  Between  these  two  classes  of  cases  there  are  all  grades  of 
difiiculty  and  danger. 

Cancer  of  Intestine. 

This  disease  is  much  less  frequent  than  cancer  of  the  stomach, 
constituting  about  five  per  cent  of  all  cases  of  cancer.  It  occurs 
usually  about  the  middle  period  of  life.  We  are  in  absolute  igno- 
rance of  its  causation  in  this  region.  The  rectum  is  the  most  favor- 
able part  of  the  bowel  for  its  development,  the  large  intestine  next, 
and  then  the  small  intestine. 

Symptoms.  —  Intestinal  hemorrhage,  pain ;  emaciation,  irregular 
movements  of  the  bowels,  pain  in  the  sacral  region,  radiating  to  the 
genitals  and  down  the  course  of  the  sciatic  nerves  (in  case  of  rectal 
cancer),  are  among  some  of  the  indefinite  symptoms  of  cancer  of  the 


0 


f 


818 


DIBKA8E8  OF   THK   ABDOMINAL  CAVITY. 


bowels.  When  well  marked  and  when  located  favorably,  a  tumor 
may  he  discovered  by  palpation,  but  often  this  cannot  be  felt  and  tlie 
masses  which  at  lirst  seem  to  indicate  cancer  may  afterward  prove 
to  be  merely  fajcal  accumulations.  When  the  mass  can  be  felt  in 
the  rectum  the  diagnosis  becomes  clearer.  The  prognosis  of  the 
disease  is  extremely  unfavorable. 

Treatment.  —  As  for  treatment,  only  in  rare  cases  is  much  aid 
ever  procured.  The  formation  of  an  artificial  anus  in  the  left  flank 
may  avert  for  a  while  the  final  end.  The  injection  of  the  new  cancor- 
serum  is  still  of  doubtful  success. 

Opiates  to  relieve  pain,  nourishing  food  frequently  repeated,  and 
the  use  of  antiseptic  enemas,  are,  for  the  most  jmrt,  the  chief  meas- 
ures that  afford  relief. 

Intestinal  Obstruction. 

This  is  a  mechanical  interference  with  the  movements  of  the  fce- 
ces,  and  is  caused  either  by  intussusception  or  invagination,  con- 
striction, twists,  stricture  or  hernia.  These  conditions  are  frequently 
produced  by  irregular  movements  of  the  bowels  as  a  whole,  and  by 
irregular  movements  in  various  parts  of  the  same,  there  being  an 
increased  peristalsis  in  one  part  and  constipation  in  an  adjacent  part. 
Many  cases  of  intussuception  occur  at  the  ileo-ctecal  valve,  the  small 
bowel  entering  the  large  lx)wel  and  being  driven  downward.  The 
circulation  of  the  bowels  is  naturally  interfered  with,  and  intense 
congestion  occurs,  with  swelling  and  final  obstruction  of  the  calibre 
of  the  gut.  Pain  becomes  paroxysmal  and  peritonitis  ensues.  Pain 
increases,  with  vomiting  and  the  discharge  of  mucoid  stools ;  finally 
the  patient  dies  of  exhaustion. 

Constriction  of  the  bowel  forms  the  larger  proportion  of  cases  and 
is  not  infrequently  caused  bj'  fibrous  bands  which  are  the  result  of 
inflammation.  Strangulation  may  be  produced  by  a  loop  being  held 
down  by  such  bands  or  by  being  twisted  about  it.  Intestinal  ob- 
struction, ulceration,  and  even  perforation  are  common  results. 

A  twist  or  volvultis  is  also  a  cause  of  obstruction,  though  less  com- 
mon than  the  two  causes  just  mentioned,  and  occurs  generally  near 
the  sigmoid  flexure. 

Stricture  of  the  bowel  usually  occurs  at  the  sigmoid  flexure,  or  in 
the  rectum,  and  is  not  usually  complete,  some  small  amount  of  fiecal 
matter  still  escaping.  Tumors,  like  cancer,  not  infrequently  cause 
stricture  by  their  compression. 

Functional  obstruction  occurs  chiefly  in  hysterical  females,  but  also 
in  disease  of  the  brain  and  spinal  cord,  as  well  as  from  peritonitis 
and  blows  on  the  abdomen.  It  is  the  result  of  a  paralysis  of  the 
bowel. 

Impaction  of  fauces  is  still  another  frequent  cause  of  obstruction. 
The  contents  of  the  bowels,  especially  in  the  rectum,  become  hard, 


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mSEASKS  OF  THK  ABDOMINAL  CAVITY. 


319 


iy,  a  tumor 
felt  and  the 
»rard  prove 
be  felt  in 
osis  of  the 

I  much  aid 
le  left  flniik 
uew  cancor- 

peated,  ami 
chief  meati- 


of  the  fee- 
lation,  con- 
frequently 
3le,  and  by 
e  being  an 
jacent  part. 
3,  the  small 
vard.  The 
md  intense 
the  calibre 
ues.  Pain 
ols;  finally 

F  cases  and 
e  result  of 
being  held 
testinal  ob- 
sults. 
h  less  com- 
lerally  near 

ixure,  or  in 
.nt  of  fiecal 
ently  cause 

Bs,  but  also 
peritonitis 
ysis  of  the 

ibstruction. 
3ome  hard, 


blocking  the  passage  till  quite  a  perceptible  bunch  may  be  felt  ex- 
ternally.    The  channel  is  notalways  blocked  completely.    Gall-stones 
may  become  impacted  near  the  ileo-cascal   valve  in  their  pasaage 
downward,  and  form  the  starting  point  of  the  faecal  accumulation. 
These  various  causes  produce  either  acute  or  chronic  obstruction. 

SymptomA.  —  In  the  acute  variety,  pain,  vomiting  and  constipa- 
tion are  the  prominent  symptoms.  There  are  at  first  some  digestional 
disturbances,  with  moderate  pain.  Afterwards  the  pain  becomes 
severe,  even  intense,  and  is  usually  located  near  the  seat  of  the  ob- 
struction. It  is  at  first  colicky  and  intermittent,  but  finally  becomes 
continuous  and  severe  over  the  whole  abdomen.  Vomiting  sets  in, 
first  of  food,  then  later  of  bile,  and  finally  stercoraceous  if  the  ob- 
struction becomes  complete.  Vomiting  occurs  whether  the  obstruc- 
tion is  in  the  large  or  small  bowel.  Before  the  close  of  the  soenr 
this  vomiting  a«sumes  a  ricewater-like  character,  perhaps  attended 
with  hiccough. 

There  is  an  absence  of  the  passage  of  wind,  although  at  fii-st  some 
small  amount  of  faecal  matter  may  pass.  In  intussusception  there 
are  usually  bloody  discharges  in  addition  to  constipation.  The  ab- 
domen of  course  soon  becomes  tympanitic  or  swollen,  and  sounds  of 
water  and  gas  may  be  heard  very  distinctly. 

The  general  symptoms  are  those  of  a  very  grave  disease,  —  restless- 
ness, cold  extremities,  pinched  features,  and  cold,  clammy  skin.  The 
pulse  is  small,  the  temperature  generally  subnormal,  tongue  dry,  and 
thirst  very  pronounced. 

In  the  event  of  chronic  obstruction,  all  these  symptoms  appear  very 
much  more  gradually.  Pain  is  less  severe,  vomiting  often  absent  tiU 
the  obstruction  becomes  complete.  The  faecal  matter  may  often  be 
several  feet  long  before  the  obstruction  becomes  severe.  Long-stand- 
ing constipation  which  does  not  respond  to  proper  laxatives  should 
arouse  suspicion.  The  stools  themselves  are  often  ribbon-like  in 
shape  and  very  small,  not  infrequently  resembling  the  faeces  of  sheep. 

The  prognosis  of  obstruction  of  the  bowels  is  usually  very  grave, 
and  the  duration  of  life  varies  from  a  few  hours  to  ten  or  twelve  days. 
The  higher  up  the  obstruction,  the  worse  the  prognosis.  Simple 
faecal  impaction  perhaps  offers  the  most  hope;  next  those  cases 
amenable  to  surgical  interference. 

Treatment.  —  Opium  to  relieve  pain  and  to  stop  the  exaggerated 
peristaltic  movement  in  parts  of  the  bowel  above  the  obstruction  is 
surely  indicated ;  it  also  relieves  the  vomiting.  Continued,  large 
enemas  of  suds  and  oil,  and  even  the  addition  of  turpentine,  should  be 
resorted  to  at  once  as  soon  as  the  trouble  has  been  made  out.  These 
are  best  given  with  the  hips  elevated,  and  should  consist  of  four  to 
six  quarts  of  water ;  they  are  to  be  given  slowly  and  without  much 
force.     Oftentimes  an  anaesthetic  is  needed. 

If  the  obstruction  is  from  fsecal  impaction,  small,  repeated  doses 


320 


DI8EARK8   OF  THK   ABDOMINAL   CAVITY. 


of  Bomo  fliUine  should  bo  used  ;  say  two  ouncos  of  tho  solutir  n  of  tho 
citmtu  of  magnesiu  every  two  hours.  Castor-oil  in  teaApoonful  (loses 
hourly  till  movement  occurs  is  also  good.  But  if  the  olwtructioii  is 
from  intussusception,  twist,  stricture,  etc.,  all  laxatives  must  Ikj 
strictly  interdicted.  Finally,  these  simple  means  failing  and  the  case 
lie  suspected  to  be  due  to  impaction  by  foreign  bodies,  fibrous  bauds, 
etc.,  the  abdomen  must  Imj  opened  and  the  seat  of  the  obstruction 
found  and  if  possible  removed.  The  operation  in  this  class  of  cases 
is  not  attended  with  a  great  percentage  of  recoveries,  and  yet  the 
fatal  termination  is  much  surer  if  left  alone  ;  in  many  cases  it  is 
brilliantly  successful. 

External  methods  of  treatment  by  hot  fomentations  of  turpentine, 
and  even  of  massage,  often  add  greatly  to  a  favorable  termination. 

The  diet  must  be  very  light  and  nutritious,  and  in  case  of  vomiting 
must  be  given  by  the  rectum.  After  Liie  obstruction  has  been  re- 
lieved, one  must  be  very  careful  about  the  diet  and  see  that  the  bow- 
els are  open  daily. 

Wind  Colic.  —  Platulent  Colic.  —  Interalgia. 

This  is  a  severe  and  distressing  pain  in  the  bowels, — sometimes  a 
stoppage,  and  a  swelling  about  the  pit  of  the  stomach  and  the  navel. 
What  children  call  belly-ache  is  a  mild  form  of  it.  The  wind  passing 
from  one  portion  of  the  bowel  to  another  causes  a  rumbling  noise. 
The  pain  is  not  increased  by  pressure ;  and  this  distinguishes  it  from 
the  pain  of  inflammation.  It  moves  about,  too,  from  place  to  place, 
and  is  much  relieved  by  the  escape  of  wind  up  or  down. 

The  complaint  may  be  caused  by  a  weakness  in  the  digestive  or- 
gans, by  eating  indigestible  food  or  unripe  fruit,  by  costiveness,  and 
by  taking  cold.  Some  persons  always  have  the  colic  excited  by  eat- 
ing certain  kinds  of  fruit. 

Treatment. — When  the  complaint  is  caused  by  an  indigestible  sul)- 
stance  taken  into  the  stomach,  the  offending  matter  should  be  thrown 
off  by  an  emetic  as  yoon  as  possible.  If  this  does  not  bring  relief, 
let  it  be  followed  by  a  dose  of  salts,  salts  and  senna,  compound  infu- 
sion of  senna,  elixir  salutis,  elixir  pro.,  or  sweet  tincture  of  rhubarb. 
If  there  is  no  sickness  of  the  stomach,  a  little  essence  of  peppermint 
or  spearmint  in  hot  water,  or  brandy,  gin,  or  whisky,  in  hot  water, 
may  prove  sufficient  to  expel  the  wind,  and  relieve  the  pain.  Ginger 
and  hot  water  does  well  with  some.  If  there  be  costiveness,  and  the 
pain  is  obstinate,  let  the  bowels  be  unloaded  by  a  stimulating  injec- 
tion (248),  (249),  (250).  Inject  one  dram  of  ether  in  a  little  starch- 
water  into  the  bowels,  and  relief  will  often  be  instant.  It  can  be 
repeated  every  half-hour.  The  injection  of  a  table-spoonful  of  tur- 
pentine in  suds  can  also  be  tried  and  repeated  eveiy  two  hours. 


■iWi  iiwa»i|»M.WltiVMI  jrjmTJIIiMiflUtWKI 


W»!l'  '      I._WJJ,.  J»-WJ'>W-W'!X». 


iticn  of  tlu! 

on  fill  (loHCK 

Htructioii  JH 
iH  must  be 
nd  the  ca8(! 
roiiH  haiulH, 
obstruction 

188  of   caBOS 

md  yet  tlie 
ca«es  it  is 

turpentine, 
nination. 
)f  vomiting 
IS  lieon  re- 
at  the  bow- 


Igia. 

ometimes  a 
1  the  navel, 
ind  passing 
iling  noise, 
hes  it  from 
e  to  place, 

gestive  or- 
■"eness,  and 
ted  by  eat- 

Bstible  sul)- 
'.  be  thrown 
ring  relief, 
ound  infu- 
if  rhubarb. 
)eppennint 
hot  water, 
in.  Ginger 
ss,  and  the 
ting  injec- 
btle  starch- 
It  can  be 
:ul  of  tur- 
ours. 


DI8KA8K8  OF  Tl«  ABDOMINAL  CAVITY.  321 


Air-Swelllngs.  —  Ti/mpaniteB. 

It  is  quite  common  for  persons  in  delicate  health  —  particularly 
females — to  have  their  stomach  and  bowels  swell  up,  sometimes 
slowly,  sometimes  suddenly,  so  that  they  cannot  bring  their  clothes 
together.  They  do  not  know  what  to  make  of  it;  it  sometimes 
(ilarins  them ;  and  they  ask  their  medical  adviser  what  it  means. 

These  swellings  may  occur  from  an  accumulation  of  air  within 
the  bowels,  and  also  within  the  abdominal  cavity.  This  latter  gives 
the  belly  a  peculiarly  hard  feel,  like  the  head  of  a  drum,  and  when  it 
is  pressed  upon  with  the  finger  no  indentation  remains.  It  usually 
is  the  result  of  a  weakened  sympathetic  nervous  system,  brought 
about  by  some  one  of  the  many  abdominal  diseases. 

Treatment.  —  If  the  air  be  in  the  intestinal  tube,  a  stimulating  in- 
jection may  bring  away  the  wind.  It  may  be  composed  of  one  pint 
of  infusion  of  peppermint,  one  gill  of  tincture  of  prickly-ash  berries, 
half  a  gill  of  tincture  of  castor,  and  a  teaspoonful  of  ginger.  The 
l)owels  of  the  patient  should  be  rubbed  for  a  long  time  ;  and  in  all 
forms  of  the  complaint,  it  would  be  well  to  do  this  every  day.  Some- 
times the  wind  may  be  drawn  off  by  inserting  into  the  rectum  a  long 
rubber  tube.  Treatment  often  resolves  itself  into  a  cure  of  some 
existing  uterine  or  ovarian  diseaae  and  the  various  phases  of  peri- 
tonitis, in  which  latter  case  there  is  fever  and  other  well  marked 
symptoms. 

The  best  constitutional  remedies  are  tonics,  —  iron,  quinine,  mineral 
acids,  and  bitters,  (48),  (65),  (59),  (60),  (62),  (63),  (64),  (71), 
(73). 

Exercise  in  the  open  air,  and  a  careful  regulation  of  the  diet,  will 
do  much  towards  removing  these  troubles.  Costiveness  must  be  care- 
fully guarded  against. 

Bilious  Colic. 

This  is  a  dangerous  disease.  There  is  pain  of  a  griping,  twisting, 
tearing  kind,  —  what  the  ancients  called  atrocious  pain.  It  is  chiefly 
about  the  navel,  but  sometimes  tortures  the  whole  bellv.  It  comes 
and  goes  in  paroxysms.  Sometimes  the  abdomen  is  drawn  in,  at 
other  times  it  is  swelled  out,  and  stretched  like  a  drum-head.  At 
first  the  pain  is  relieved  by  pressure  ;  after  a  time  the  belly  is  tender  to 
the  touch.  There  is  thirst  and  heat,  and  a  discharge  of  bilious  mat- 
ter from  the  stomach.  In  the  worst  cases,  the  pulse  is  small,  the  face 
pale,  the  features  shrunk,  and  the  whole  body  covered  with  cold 
sweat.  While  the  head  is  hot  the  feet  are  cold.  In  advanced  stages 
of  the  disease,  the  action  of  the  bowels  is  sometimes  reversed,  and 
the  fecal  matter  forced  up  through  the  mouth,  owing  to  impaction  of 
fteces  or  other  obstructions  of  the  bowel. 


822 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


Causes.  —  Costiveness,  irritating  substances  in  the  bowels,  thick, 
vitiated  bile,  long  exposure  to  cold,  torpidity  of  the  liver  and  skin, 
great  unnatural  heat,  with  dampness,  obstruc'  )d  gall-duct,  etc. 

These  attacks  are  usually  the  result  of  indigestion  in  the  upper 
bowel,  near  the  bile-ducts,  creating  a  thick  mucus  which  obstructs 
the  passage  of  bile  from  the  ducts  into  the  bowels.  A  regulation  of 
the  duct,  small  doses  of  podophyllin  or  the  acids,  with  daily  doses  of 
some  mild  bilious  laxative,  will  prevent  their  return.  Crab-orchard 
water,  sal-muscatelle,  and  other  simple  medicines  answer  every  pur- 
pose. 

Treatment. — Administer  an  active  purgative  injection  immediately 
(251),(252).  Internally,  dioscorin,  camphor,  etc.  (340),  every  fifteen 
minutes  until  relief  is  obtained,  at  the  same  time  'covering  the  whole 
belly  with  a  large  mustard-poultice.  A  strong  decoction  of  the  wild- 
yam  root,  drunk  freely,  is  a  medicine  of  some  value,  —  so  is  a  decoc- 
tion of  scullcap  and  high-cranberry  bark,  eoual  pai-ts.  This  latter 
article  is  excellent  in  spasmodic  affections,  ou  .vhich  account  it  has 
gained  the  name  of  cramp-bark.  The  sickness  at  the  stomach  may 
frequently  be  allayed  by  effervescing  drafts,  to  which  twenty-five  or 
thirty  drops  of  lavender  are  added.  Croton-oil,  given  in  one-drop 
doses,  done  up  with  crumb  of  bread,  will  sometimes  succeed  well  as 
a  purgative  medicine ;  or  castor-oil  and  spirits  of  turpentine,  equal 
parts,  in  two  great  spoonful  doses,  may  be  tried  before  the  croton 
oil. 

The  warm  bath  is  worth  remembering,  and  trying,  too,  if  the 
means  are  at  hand.  Hot  fomentations  of  the  bowels  with  a  decoc- 
tion of  poppy-leaves,  stramonium-leaves,  hops,  wormwood,  boneset, 
or  peppermint  leaves,  should  not  be  overlooked.  Bottles  filled  with 
hot  water,  or  hot  bricks  rolled  in  flannel,  should  be  placed  at  the  back 
and  feet  to  promote  perspiration. 

Persons  subject  to  this  complaint  may  derive  advantage  from  one 
pill  composed  of  extract  of  high-cranberry  bark,  etc.  (100),  taken  after 
each  meal  for  some  months.  At  the  same  time  a  reasonable  amount 
of  exercise  should  be  taken  out  of  doore,  and  a  sponge  bath,  with 
friction,  be  employed  daily.  Care  should  be  taken  not  to  be  often 
exposed  to  the  hot  sun. 

Painters'  Colic.  —  CoUca  Pictorum. 

This  form  of  colic  is  caused  by  the  slow  introduction  of  lead  into 
the  system,  —  generally  the  carbonate  of  lead.  It  passes  under  the 
different  English  names  of  painters'  colic,  Devonshire  3olic,  and  dry 
belly-ache.  The  first  of  these  is  the  name  by  which  it  is  most  com- 
monl}'  known,  f-om  its  frequent  occurrence  among  painters,  who  use 
white  lead  (carbonate  of  lead)  a  great  deal  in  the  preparation  of  their 
colors. 

Symptoms.  —  The  disease  generally  comes  on  in  a  very  gradual 


,<iiW<l)ip,mi»,||l|i<HBIHIi|ii|    .rillHH|iJI!aiillil»,iTO»Wl'JUI'HM«uiu  >.,L.  I- 


l'>"i!l,£ 


DISEASES  OP  THE    ABDOMINAL  CAVITY. 


823 


)wel8,  thick, 
sr  and  skin, 
st,  etc. 

1  the  upper 
jh  obstructs 
egulation  of 
lily  doses  of 
yiab-orchard 
'  every  pur- 

imraediately 
ivery  fifteen 
g  the  whole 
of  the  wild- 
[)  is  a  decoc- 

This  latter 
ount  it  has 
omach  may 
enty-five  or 
in  one-drop 
;eed  well  as 
titine,  equal 

the  croton 

too,  if  the 
th  a  decoc- 
)d,  boneset, 
1  filled  with 
[  at  the  back 

e  from  one 
I  taken  after 
ble  amount 
bath,  with 
to  be  often 


)f  lead  into 
I  under  the 

lie,  and  dry 

most  ccm- 

rs,  who  use 

ion  of  their 

3ry  gradual 


way.  At  first,  the  appetite  is  impaired,  there  is  a  slight  nausea, 
belching  of  wind,  languor,  very  obstinate  costiveness,  transient  pains, 
with  a  feeling  of  weight  and  tightness  in  the  belly,  and  a  disinclina- 
tion to  make  any  exertion. 

By  degrees,  the  pain  in  the  bowels,  and  particularly  about  the  na- 
vel, becomes  more  severe,  and  has  a  twisting  character.  The  belly 
becomes  hard,  drawn  in,  and  a  little  tender  to  pressure,  and  the  stom- 
ach very  irritable.  The  pain  occasionally  slacks  off  a  little;  but 
never,  even  in  mild  cases,  entirely  stops,  as  in  other  kinds  of  colic. 

In  some  severe  cases,  the  pain  runs  up  to  the  chest,  and  down  the 
arms ;  also  down  to  the  bladder,  causing  the  urine  to  be  passed  with 
pain  and  difficulty,  and  giving  a  sense  of  weight  and  liem  ing  down 
a  the  lower  belly.  During  the  severest  pains,  the  countt'nance  is 
pale,  conti-acted,  and  full  of  suffering ;  cold  sweats  break  out  upon 
the  face  and  limbs,  and  anxiety  and  agitation  seize  the  patient. 

When  the  disease  is  not  seasonably  removed,  it  degenerates  into 
the  chronic  form,  the  mental  and  physical  energies  become  torpid, 
the  circulation  in  the  small  vessels  inactive,  the  skin  dry,  harsh,  shriv- 
elled, pale,  sallow,  or  of  a  leaden  hue,  the  temper  irritable,  despond- 
ing and  gloomy,  and  the  body  wasted.  Besides  all  this,  the  muscles 
which  lift  up  the  lower  arm  become  palsied,  so  that,  when  the  aims 
are  niised,  the  hands  hang  down  in  a  helpless  condition.  In  some 
cases,  there  is  a  blue  line  along  the  edges  of  the  gums. 

Treatment.  —  For  relieving  the  pain  and  opening  the  bowels,  the 
treatment  should  be  very  much  the  same  as  that  for  bilious  colic. 
There  is  one  article,  however,  which  is  thought  to  have  some  special 
influence  in  cu'  ^ng  this  disease,  after  it  has  become  chronic ;  it  is 
alum.  Fifteen  grains  of  alum,  two  of  aloes,  two  of  jalap,  and  four 
of  ipecac  powder,  may  be  mixed,  and  taken  for  a  dose  two  or  three 
times  a  day.  If  the  muscles  of  the  arm  be  palsied,  one  thirtieth  of 
a  grain  of  strychnine  may  be  added  to  the  above.  The  aromatic  sul- 
phuric acid,  taken  as  a  drink,  fifteen  drops  to  the  tumblerful  of  water, 
is  always  worthy  of  trial. 

The  use  of  the  electromagnetic  machine  maybe  tried  for  the  palsy; 
or  a  splint  applied  to  the  arm  and  hand,  with  vigorous  friction  once  or 
twice  a  day,  will  sometimes  do  much  for  recovering  the  use  of  the 
muscles. 

But  the  best  remedy  for  the  palsied  muscles  is  iodide  of  potassium 
(146),  taken  freely.  The  P'llphuret  of  potassa,  one  ounce  dissolved 
in  a  quart  of  water,  au^  taken  in  teaspoonful  doses,  three  times  a  day, 
is  also  worth  a  trial.  The  affected  arm  should  be  soaked  an  hour, 
once  or  twice  a  day,  in  the  same  amount  of  this  latter  salt,  dissolved 
in  a  gallon  of  water. 

Means  of  Prevention. — The  numei-ous  persons  wl  3  work  in  lead 
should  comb  their  hair  with  a  fine  comb,  wash  their  hunds  and  face, 
and  rinse  their  mo^'th  s  dveral  times  a  day,  and  also  wash  the  whole 


824 


DISEASES   OF  THE   ABDOMINAL   CAVITY. 


person  with  soai)  once  or  twice  a  week,  and  with  clear  water,  or  sal- 
eratus  and  water,  once  a  da3\  Their  working  clothes  should  be  of  a 
kind  to  admit  of  being  washed  once  or  twice  a  week,  and  they  should 
be  put  off  for  others  when  out  of  the  workshop.  A  paper  cap  should 
be  worn  while  at  work.  The  food  of  the  workmen  should  not  be  ex- 
posed to  the  vapoi-s  or  floating  particles  of  lead,  and  consequently 
should  not  be  carried  into  the  shop ;  and  when  much  of  the  poison  is 
floating  in  the  air  of  the  workroom,  it  is  a  good  plan  to  wear  a  mask 
to  prevent  its  being  drawn  with  the  breath  into  the  throat  and  lungs. 
It  has  been  said  that  those  who  eat  freely  of  fat  meats,  butter,  and 
other  oily  substances,  are  not  attacked  by  the  disease,  though  exposed 
to  the  poisoA.  I  know  not  what  protection  this  can  give,  unless  the 
skfn  is  in  this  way  kept  more  oily,  which  prevents  the  absorption  of 
the  poison.  This  would  seem  to  afford  a  hint  in  favor  of  anointing 
the  whole  person  once  or  twice  a  week  with  sweet-oil. 

Costiveness.  —  Constipation. 

T?EW  disorders  are  more  common  than  costiveness.  By  this  term 
I  mean  a  sluggish  state  of  the  bowels,  which  causes  them  to  retain 
the  faeces  longer  than  is  warranted  by  health.  In  this  complaint,  the 
discharges  from  the  bowels  are  not  always  less  frequent  than  they 
should  be,  but  they  are  less  in  quantity,  are  compacted  and  hard,  and 
are  passed  bj  hard  straining,  and  sometimes  with  considerable  pain. 

Symptoms.  — Headache,  dizziness,  feverishnesa,  bad  feelings  in  the 
head  not  easily  described,  loss  of  appetite,  sometimes  nausea,  but 
little  desire  to  go  to  stool,  a  weight  and  heaviness  about  the  lower 
part  of  the  belly,  and  a  sense  of  confinement  over  the  whole  body. 

Causes. — Sedentary  habits,  particularly  when  connected  with  close 
application  of  the  mind ;  astringent  articles  of  medicine  ;  stimulating 
diet,  composed  chiefly  of  animal  food ;  various  diseases,  particularly 
those  of  a  nervous  character,  and  especially,  a  neglect  to  evacuate 
the  bowels  at  proper  periods.  All  these  causes  tend  to  weaken  the 
bowels,  and  gradually  to  arrest  that  peculiar  undulatory  movement, 
or  worm-like  action,  called  the  peristaltic  motion  of  x,ne  bowels.  It 
is  this  continual  contraction  of  the  muscular  fibres  of  the  intestines 
from  above  downward,  which  pushes  the  contents  steadily  along;  and 
whatever  weakens  the  force  of  this  vermicular  play  of  the  intestinal 
walls,  brings  on  constipation.  . 

Treatment.-  — One  of  the  first  things  to  be  done  is  to  establish  the 
habit  of  attemptinq  to  evacuate  the  bowels  at  a  particular  hour  every 
day.  The  best  time  for  most  persons  is  -soon  after  breakfast  in  the 
morning.  Whether  successful  or  not,  the  attempt  to  procure  an  evac- 
uation should  on  no  account  be  omitted.  This  regularity  will  often 
do  much  to  break  up  the  costive  habit. 

Diet.  —  To  this  should  be  added  a  careful  regulation  of  the  diet. 


DISEASES   OP  THE  ABDOMINAL  CAVITY. 


325 


iter,  or  sal- 
)uld  be  of  a 
they  should 

cap  should 
1  not  be  ex- 
)n8equently 
he  poison  is 
rear  a  mask 
t  and  lungs. 

butter,  and 
igh  exposed 
,  unless  the 
sorption  of 
f  anointing 


y  this  term 
n  to  retain 
nplaint,  the 
.  than  they 
d  hard,  and 
rable  pain. 

dings  in  the 
musea,  but 
i  the  lower 
ole  body. 

i  with  close 
stimulating 
particularly 
»  evacuate 
weaken  the 
movement, 
bowels.  It 
)  intestines 
along;  and 
e  intestinal 

stablish  the 
hour  every 
fast  in  the 
lire  an  evac- 
will  often 


if  the  diet. 


The  quantity  of  food  taken  should  be  no  greater  than  can  be  easily 
digested.  Full  meals  which  distend  the  stomach  and  cause  it  to  press 
upon  the  bowels  embarrass  their  movements.  Bread  made  from  fine 
wheat  flour  is  an  abomination  in  this  disorder.  Eat  only  that  from 
unbolted  flour.  Cracked  or  rolled  wheat,  prepared  as  directed  among 
dietetic  preparations,  is  excellent  for  the  cure  of  costiveness.  Fresh 
vegetables,  as  peas,  beans,  potatoes,  squashes,  and  ripe  fruits,  in  their 
season,  are  all  wholesome,  and  help  to  relieve  costiveness.  But  rich 
pies,  puddings,  cakes,  doughnuts,  and  all  that  sort  of  trash,  increase 
the  disorder. 

Water  Injections,  etc.  —  One  of  the  best  remedies  is  water,  cold 
or  tepid,  according  to  the  condition  of  the  patient,  injected  into  the 
bowels  with  the  fountain  syringe.  Syringes  for  this  purpose  may  be 
obtained  in  any  drug-store,  and  one  should  be  in  every  family. 
Water  used  externally,  in  the  form  of  the  sponge-bath,  is  also  useful. 

Medicines.  —  All  the  above  measures  having  failed  to  give  relief, 
take  Mettauer's  aperient,  or  the  neutralizing  mixture.  If  these  fail, 
podophyllin,  etc.  (36),  may  have  a  trial.  A  cold  decoction  of  thorough- 
wort,  drunk  daily,  sometimes  has  an  excellent  effect.  It  must  be  re- 
membered that  medicines  may  make  mattere  worse,  and  they  should 
be  used  cautiously.  Cascara  Sagrada  taken  in  small,  repeated  doses, 
say,  half  a  grain  once,  twice  or  more  times  daily  till  the  bowels  move, 
for  some  weeks,  then  gradually  decreased,  often  yields  excellent  re- 
sults. A  glass  of  some  aperient  like  Hunyadi  Janos  water,  one-third 
glass  with  one-half  glass  of  plain  water  on  rising,  will  then  take  the 
place  of  the  cascara ;  and  finally  a  glass  of  plain  water  will  accom- 
plish all  that  previously  required  the  use  of  the  cascara.  Daily  knead- 
ing of  the  bowels,  following  the  course  of  the  large  bowel,  will  add 
greatly  to  break  up  the  sluggishness  of  the  muscular  atony  of  the 
bowel-walls. 

Piles. — Hemorrhoids. 

There  are  few  complaints  more  common  than  the  piles,  and 
scarcely  any  which  cause  more  trouble  and  misery.  They  consist  in 
a  fullness  of  blood,  and  languid  circulation  in  the  lower  portion  of  the 
lower  bowel  or  rectum.  In  consequence  of  this  congestion,  either  the 
veins  of  the  gut  become  enlarged  or  varicose,  or  the  blood  gets  infil- 
trated into  the  cells  beneath  the  mucous  membrane,  and  collects,  so 
as  to  form  bloody  tumora. 

These  tumors,  which  are  seldom  absent,  are  the  leading  features  of 
the  piles.  They  sometimes  appear  externally,  around  the  anus  ;  this 
is  external  piles.  At  other  times  they  are  within  the  bowel ;  the  com- 
plaint is  then  called  internal  piles.  They  are  called  bleeding  piles 
when  blood  is  discharged,  and  blind  piles  when  it  is  not. 

Symptoms.  —  Usually  there  is  a  sense  of  weight  and  weakness  in 
the  lower  part  of  the  back  and  lions,  with  a  painful  itching  alxjut  the 


../ 


326 


DISEASES  OF   THE  ABDOMINAL   CAVITY. 


-•a  I 

■  il 


I 


anus.  On  going  to  stool,  there  is  a  burning,  cutting  pain  experienced, 
which  is  followed  by  bearing  down  and  tenesmus.  If  it  be  bleeding 
piles,  the  little  tumors  will  bleed  at  every  motion  of  the  bowels. 
There  are  frequently  disagreeable  sensations  in  the  head,  general  las- 
situde, an  irritable  state  of  mind,  and  a  sense  of  fullness  and  anxiety 
in  the  stomach.  The  pains  experienced  range  all  the  way  from  the 
slightest  twinges  up  to  the  most  terrible  sufferings,  which  appear  like 
tearing  the  body  asunder. 

Causes^ —  Everything  that  irritates  the  lower  bowel,  and  causes  a 
determination  of  blood  to  the  part.   All  drastic  physic  has  this  effect, 

—  particularly  aloes,  which  acts  especially  upon  the  rectum.  Habit- 
ual costiveness,  straining  at  stools,  riding  much  on  horseback,  sitting 
a  great  deal,  tight-lacing,  high-seasoned  food,  and  stimulation  gener- 
ally, lifting  and  carrying  heavy  weights,  and  indurations  of  the  liver, 
as  well  as  a  bilious  indigestion.  "^ 

Females  during  pregnancy  are  much  affected  with  piles,  which  are 
induced  by  the  costiveness  so  peculiar  to  their  condition,  and  by  the 
pressure  of  the  enlarged  womb  upon  the  veins  of  the  pelvis. 

Treatment.  — This  should  be  medicinal  and  dietetic. 

Great  care  must  be  observed  not  to  push  medication  too  far.  Ac- 
tive purging  will  do  great  mischief.  Yet  costiveness  must  in  some 
way  be  corrected.  For  this  purpose,  no  remedy  that  I  have  ever 
tried  has  done  better  in  this  complaint  than  an  electuary  composed 
of  confection  of  senna,  flowers  of  sulphur  and  cream  of  tartar  (6), 
taken  in  doses  just  sufficient  to  procure  one  natural  motion  of  the 
bowels  each  day.  Pills  made  of  extract  of  thoroughwort  are  said  to 
do  well.  If  the  liver  be  in  a  congested  state,  take  some  of  the  arti- 
cles recommended  in  the  chronic  inflammation  of  that  organ. 

For  the  local  treatment,  nothing  is  better  than  two  ounces  of  lard 
and  one  dram  of  the  flowers  of  sulphur  mixed,  and  rubbed  between 
two  plates  of  lead  until  they  are  well  blackened.  This  ointment  is 
not  only  soothing  but  curative,  both  in  the  bleeding  and  blind  piles. 
An  ointment  of  almost  equal  excellence  may  be  made  from  one  hand- 
ful each  of  witch-hazel  bark,  white-oak  bark,  and  sweet-appletree , 
bark,  boiled  together  in  one  pint  of  water  down  to  one-third  of  a  pint. 
Then  strain,  and  add  two  ounces  of  lard  and  simmer  away  the  water, 

—  stining  continually  before  and  after  removing  from  the  fire,  till  it 
cools.  Witch-hazel  suppositories  are  excellent,  as  is  also  an  oint- 
ment composed  of  1  ounce  stramonium  ointment,  6  grains  pulverized 
opium,  and  6  grains  tannin. 

If  there  is  much  inflammation  and  distress,  an  emollient  and 
soothing  poultice  should  be  applied,  composed  of  slippery-elm 
bark  and  stramonium  or  poke  leaves.  Steaming  the  parts  is  some- 
times useful,  by  sitting  over  a  hot  decoction  of  hops,  stramonium, 
and  poke. 

Piles  may  often  be  cured  by  the  use  of  the  domestic  syiinge.   Daily 


11 
^1 


sem 


mt 


fffm$^^ 


DISEASES  OP  THE  ABDOMINAL  CAVITY. 


327 


Jxperienced, 
be  bleeding 
the  bowels, 
general  las- 
and  anxiety 
ay  from  the 
appear  like 

ind  causes  a 
i  this  effect, 
im.  Habit- 
)ack,  sitting 
ition  gener- 
of  the  liver, 

s,  which  are 
and  by  the 
vis. 


10  far.  Ac- 
ist  in  some 
'  have  ever 
y  composed 

tartar  (6), 
tion  of  the 

are  said  to 
jf  the  arti- 
^n. 

ices  of  lard 
jd  between 
ointment  is 
blind  piles. 
a  one  hand- 
5t-appletree , 
I  of  a  pint. 
r  the  water, 
3  fire,  till  it 
lo  an  oint- 
pulverized 

)llient  and 
iippery-elm 
18  is  some- 
lamonium, 

ige.   Daily 


injections  of  cool  or  cold  water  will  do  much  to  strengthen  the  bowel, 
and  restore  the  dilated  veins  to  their  natural  condition. 

The  food  should  be  of  a  laxative  nature,  corn-bread,  rye-pudding, 
bread  of  unbolted  wheat  flour,  mealy  potatoes,  ripe  fruit,  pudding 
and  milk,  buckwheat  cakes,  broths,  and  a  little  tender  meat  once  a 
day. 

When  the  piles  are  very  painful  an  ointment  of  cocaine,  ten 
grains,  vaseline,  one-half  ounce,  smeared  well  over  them,  is  exceed- 
ingly grateful.  Five-grain  iodoform  suppositories  are  very  effective 
in  reducing  piles ;  its  odor,  however,  is  quite  objectionable  to  many. 
Surgical  treatment  is  often  the  only  resource  left  for  their  cure. 

Looseness  of  the  Bowels.  ^Diarrhoea. 

Looseness,  or  relax  of  the  bowels,  is  manifested  by  frequent,  copi- 
ous, and  thin  or  unusually  liquid  discharges.  The  excessive  dis- 
charge may  be  caused  either  by  irritating  and  unwholesome  food,  by 
inflammation  and  ulceration  of  some  portion  of  the  bowels,  or  by  de- 
bility. 

5yniptoins.  —  Rumbling  noise  in  the  bowels,  with  more  or  less 
weight  and  bearing  down  and  uneasiness  in  the  lower  part  of  the 
bowels.  This  pressing  down  and  uneasiness  are  relieved  as  soon  as 
the  evacuation  takes  place,  but  returns  when  another  is  near  at  hand. 
Griping  is  generally  present,  the  strength  is  reduced,  and  the  skin  is 
pale,  dry,  and,  after  a  time,  sallow. 

Treatment.-  —  When  the  complaint  is  caused  by  irritating  food,  it 
will  generally  stup  as  soon  as  the  offending  substance  is  removed,  and 
not  much  medicine  will  be  required. 

To  neutralize  any  acidity,  to  remove  wind,  allay  irritation,  and 
strengthen  the  stomach,  the  compound  syrup  of  rhubarb  and  potassa 
is  well  adapted,  given  in  teaspoonful  doses,  every  hour,  till  it  oper- 
ates. A  little  paragoric  added  to  it  occasionally,  or  essence  of  pep- 
permint, or  spearmint,  may  aid  its  good  effects. 

If  nausea  and  vomiting  are  present,  put  a  mustard  poultice  of  one- 
third  strength  upon  the  stomach,  and  give  one-tenth  grain  of  cocaine  in 
a  teaspoonful  of  water  every  fifteen  minutes.  If  there  is  much  grip- 
ing'  give  an  injection  (248),  with  twenty  drops  of  camphor  in  it. 
A  common  diarrhoea  may  generally  be  arrested  at  once  by  prescrip- 
tions 159  or  162,  in  teaspoonful  doses,  after  each  discharge. 

When  there  is  inflammation  and  ulceration  of  the  bowel,  the  treat- 
ment must  be  similar  to  that  for  dysentery,  —  fomentations  exter- 
nally, and  the  occasional  i  se  of  starch  injections,  mild  cathartics  (9), 
(10),  and  poultices  externally. 

Chronic  Diarrhoea. 

The  acute  form  of  diarrhoea,  not  being  properly  managed,  oft«n 
runs  on,  and  becomes  chronic,  aiid  is  at  times  exceedingly  difficult 
to  cure. 


13 1 


«1L 


328 


niSKASES   OF  THE   ABDOMINAL  CAVITY. 


Symptoms. —  Frequent  discharges,  generally  with  some  pain  and 
griping,  restlessness,  thirst,  poor  appetite,  debility,  loss  of  flesh,  dry, 
rough,  and  somewhat  sallow  skin,  and  tongue  dry  and  dark-colored. 
The  food  often  passes  through  the  bowels  pretty  much  in  the  condi- 
tion in  which  it  was  swallowed.  The  liver  is  generally  out  of  order, 
and  the  bowels  are  frequently  afflicted  with  a  low  grade  of  inflam- 
mation. 

Treatment. — In  this  form  of  the  disease,  astringents  and  tonics 
will  generally  be  required.  Sometimes  a  teaspoonful  of  brandy,  in  a 
little  sweetened  water,  or  in  clear  water,  several  times  a  day,  will 
effect  a  cure.  Good  cherry  brandy  is  a  valuable  remedy  ;  so  is  black- 
berry brandy.  Many  of  the  worst  cases  have  been  cured  by  taking 
no  nourishment,  for  a  long  time,  except  milk,  with  a  little  lime-water 
in  it. 

When  the  liver  is  involved  in  the  complaint,  as  evinced  by  light- 
colored  stools,  leptandrin,  geranium,  etc.  (341),  may  be  given  with 
advantage. 

In  some  instances,  when  there  is  considerable  debility,  pills  of 
quinine,  catechu,  etc.  (342),  will  do  well. 

A  sponge-bath  must  be  taken  daily,  and  the  skin  be  well  rubbed 
after  it. 

Cholera  Morbus. 

The  above  name  is  given  to  a  disease  common  in  warm  weather, 
and  characterized  by  sudden  attacks  of  bilious  vomiting  and  purging, 
with  severe  pain  in  the  belly,  cramps,  and  general  fever  and  sul)se- 
quent  prostration.  The  great  amount  of  bile  secreted  and  discharged 
has  given  it  the  name  cholera,  from  choloa,  bile. 

Symptoms.  —  The  disease  begins  by  sickness  and  distress  at  the 
stomach,  which  is  succeeded  by  violent  gripings,  with  vomiting  of 
thin,  dirty-yellowish,  whitish,  or  greenish  fluid,  with  discharges  from 
the  bowels  similar  to  that  vomited.  The  nausea  and  distress,  with 
some  few  exceptions,  continue  between  the  vomiting  and  purging, 
and  the  pain,  at  times,  is  intense.  The  pulse  is  rapid,  soon  becoming 
small  and  feeble,  the  tongue  dry,  the  urine  high-colored,  and  there  is 
much  thirst,  though  no  drink  can  be  retained  on  the  stomach.  It  is 
to  be  distinguished  from  diarrhoea  by  the  bilious  discharges. 

Treatment. — Apply  a  large  mustard  poultice  over  the  stomach  and 
liver,  and  give  tablespoonful  doses  of  compound  powder  of  rhubarb 
and  potassa,  every  half  hour,  until  the  vomiting  and  nausea  are 
checked,  adding  to  each  dose  five  to  ten  drops  of  camphor,  if  neces- 
sary. Perhaps  it  would  generally  be  best,  however,  to  give  liberal 
draughts  of  warm  water,  at  first,  or  flax-seed  tea,  that  all  the  solid 
contents  of  the  stomach  and  bowels  may  be  washed  out. 

A  teaspoonful  of  laudanum  in  a  wine-glass  of  flax-seed  tea,  given 
ns  an  injection,  every  two  hours,  will  sometimes  do  excellently  well; 


DISEASES   OF   THE   ABDOMINAL   CAVITY. 


329 


le  pain  and 
flesh,  dry, 

irk-colored. 
the  condi- 

at  of  order, 
of  inflam- 

and  tonics 
irandy,  in  a 
a  day,  will 
so  is  black- 
l  by  taking 
lime-water 

d  by  light- 
Sfiven  with 

y,  pills  of 

ell  rubbed 


n  weather, 
d  purging, 
and  subse- 
discharged 

ess  at  the 
jmiting  of 
arges  from 
tress,  with 
1  purging, 
L  becoming 
id  there  is 
ich.  It  is 
i. 

omach  and 
•f  rhubarb 
lausea  are 
,  if  neces- 
ve  liberal 
the  solid 

tea,  given 
ntly  well; 


or  a  tea  made  of  ohamoniile  flowers,  or  Colombo,  and  made  sour  by  a 
few  drops  of  nitric  or  sulphuric  acid,  and  given  internally,  will  some- 
times succeed  better  than  most  other  things.  One  grain  of  svapnia 
and  thirty  grains  of  bicarbonate  of  soda  dissolved  in  an  ounce  of  sweet 
tincture  of  rhubarb,  and  given  in  teaspoonful  doses,  every  half  hour 
will  often  have  a  fine  effect.  The  prescription  162  is  also  valuable. 
Hot-water  bags  should  be  applied  to  the  feet,  and  warm  flannels, 
or  other  kinds  of  dry  heat,  to  the  whole  body. 

Asiatic  Cholera. 

Besides  the  above  name,  this  fearfnl  disease  has  been  called  epi- 
demic cholera,  malignant  cholera,  spasmodic  cholera,  and  cholera 
asphyxia.  It  first  attracted  notice  in  Bengal  in  1817,  whence  it 
spread  westward  through  Europe,  and  in  1832  it  reached  Quebec,  on 
this  continent.  It  has  since  then  visited  Asia  and  Europe  several 
times  with  great  severity,  and  has  even  been  present  on  our  shores. 
But  at  the  present  day  the  strict  vigilance  of  sanitary  boards  has 
done  much  to  prevent  its  spread  and  mitigate  its  terrors.  Through 
the  investigations  of  Koch  and  other.-;  it  is  now  known  to  be  propa- 
gated by  a  microbe,  called  the  comma  bacillus,  and  the  efforts  of 
investigators  is  now  being  directed  to  the  discovery  of  an  agent  that 
will  destroy  this  germ  and  thus  control  the  disease. 

Symptoms ^  First    Stag^e. —  The    first,   premonitory   stage,    is 

mirked  by  derangement  of  the  digestive  organs,  rumbling  in  the 
bowels,  pain  in  the  loins  or  knees,  twitching  of  the  calves  of  the  legs, 
impaired  appetite,  thirst,  and  especially,  a  slight  diarrhoea ;  and  these 
symptoms  continue  from  a  few  hours  to  several  days.  I  should  add 
to  these  symptoms  what  is  said  to  have  been  recently  discovered, 
namely,  that  for  several  days  before  the  attack,  the  pulse  is  down  to 
forty  or  fifty  heats  in  a  minute.  This,  if  it  prove  to  be  reliable,  is  a 
veiy  valuable  symptom. 

Second  Stage.  —  This  stage  is  marked  by  vomiting  and  purging  a 
thin,  colorless  fluid,  looking  almost  exactly  like  rice-water ;  by  severe 
cramps  in  the  calves  of  tho  legs,  which  soon  attack  the  bowels  and 
stomach.  These  cmmpi  are  excessively  painful,  and  draw  the  mus- 
cles into  knots.  The  tongue  is  pale  and  moist;  the  pulse  feeble, 
though  sometimes  full  and  firm ;  the  breathing  hurried,  with  distress 
about  the  heart ;  great  thii-st ;  a  feeling  of  internal  warmth,  and  the 
secretion  of  urine  entirely  stopped. 

These  thin,  colorless  discharges  by  vomiting  and  purging,  are  the 
serum  or  watery  portion  of  the  blood,  which  oozes  through  the  sides 
of  the  blood-vessels,  and  runs  off  rapidly,  leaving  the  crassamentum, 
or  red,  solid  part  of  the  blood,  stranded  upon  the  inner  surfaces  of  the 
arteries  and  veins.  When  so  much  of  this  is  discharged  that  the 
blood  cannot  circulate  freely,  the  patient  sinks  into  the 


830 


DI8EA8E8   OF   THE   ABDOMINAL   CAVITY. 


4' 


Third  Stage,  which  is  characterized  by  great  prostration ;  pulse 
hardly  perceptible  ;  akin  cold  and  clammy ;  face  blue  or  [)urple,  and 
eyes  mnrh  Huuken  ;  liandH  dark-colored  and  sodden,  looking  like  a 
washerwoman's  ;  breathing  short  and  laborious ;  a  sense  of  great  heat 
ill  the  stomach  ;  and  intense  thirst.  Recoveries  from  this  stage  sel- 
dom take  place. 

Treatment.  —  In  the  first  stage,  the  diarrhoea  should  receive  the 
most  prompt  attention.  From  five  to  ten  drops  of  laudanum,  re- 
peated a  few  times,  every  three  hours,  will  generally  put  a  stop  to  it. 
Catechu  (162)  is  also  a  suitable  remedy.  The  compound  syrup  of 
rhubarb  and  potassa,  with  some  other  articles  (843),  in  tablespoonful 
(loses,  every  hour,  till  it  opei-ates  gently,  is  worth  a  trial.  The  diet 
should  of  course  be  very  carefully  regulated  at  such  a  time,  though 
not  particularly  changed,  except  to  leave  off  any  indigestible  article 
which  is  known  to  be  injurious,  and  to  be  made  a  little  more  sparing 
than  in  time  of  perfect  health. 

When  the  second  stage  has  set  in,  or  the  stage  of  vomiting,  purg- 
ing, and  cramps,  the  treatment  must  be  energetic.  The  sinking  pow- 
ers must  be  sustained  by  chloroform,  opium,  and  ammonia  (119),  or 
by  camphor,  opium,  and  cayenne  (344),  giving  one  pill  every  hour. 
Brandy  may  also  be  given  freely. 

The  warmth  o*  the  surface  must  be  promoted  by  all  possible  means, 
hot  bricks  and  bottles,  tincture  of  cayenne,  friction,  etc. 

In  the  third  stage,  the  remedies  recommended  above  are  to  be  pur- 
sued with  increased  energy,  particularly  the  stimulants,  and  the  efforts 
to  promote  the  warmth  of  the  surface. 


f ( 


Dysentery.  —  Bloody  Flux.  —  Colitis. 

This  is  an  inflammation  of  the  mucous  membrane  lining  the  lower 
or  large  bowels.  The  small  bowels  begin  at  the  stomach,  and  are 
eight  or  ten  yards  long  ;  being  largest  near  the  stomach,  and  dimin- 
ishing in  size  as  they  approach  their  termination  in  the  caecum.  The 
lower  or  large  bowels  are  two  or  three  times  as  large  as  the  small 
ones,  and  from  their  junction  with  the  latter,  they  extend  about  six 
feet  to  the  outlet,  or  anus.  The  large  bowels  are  composed  of  the 
caecum,  the  colon,  and  the  rectum.  The  rectum  is  about  one  foot  in 
length. 

In  most  cases  of  dysentery,  the  rectum,  and  about  half  the  adjoin- 
ing portion  of  the  colon,  experience  the  chief  force  of  the  inflamma- 
tion. Sometimes  the  whole  of  the  colon  and  caecum  are  affected. 
Sometimes  the  mucous  membrane  lining  these  is  ulcerated,  and,  be- 
coming wholly  disorganized,  passes  off  in  shreds. 

Symptoms.  —  The  disease  comes  on  with  loss  of  appetite,  costive- 
ness,  lassitude,  shivering,  heat  of  skin,  and  quick  pulse.  These  are 
followed  by  griping  pains  in  the  bowels,  and  a  constant  desire  to  pass 


DISEASES  OF  THE   ABDOMINAL   CAVITY. 


881 


ion;  pulse 
uiplt',  and 
ng  like  a 
great  heat 
stage  sel- 

3ceive  the 
!anum,  re- 
stop  to  it. 

syrup  of 
lespoonful 

The  diet 
le,  though 
ale  article 
re  sparing 

ing,  purg- 
king  pow- 
(119),  or 
^ery  hour. 

)le  means, 

to  be  pur- 
ihe  efforts 


the  lower 
,  and  are 
id  dimin- 
um.  The 
the  small 
ibout  six 
id  of  the 
le  foot  in 

le  adjoin- 

nflamma- 

affected. 

,  and,  be- 


I,  costive- 
rhese  are 
■e  to  pass 


their  contents.  In  general  the  passages  are  small,  composed  of  mucus 
mixed  with  blood.  These  passages  are  attended  and  followed  by 
severe  gripings  and  inclination  to  strain,  learnedly  called  tormina,  and 
tenesmus.  They  are  sometimes,  in  the  early  stages,  attended  by  nau- 
sea and  vomiting.  The  natural  feces,  which  do  not  pass  off  much, 
are  small  in  quantity,  and  formed  into  round,  campact  balls,  or  irreg- 
ular, hardened  lumps.  This  tenesmus,  or  great  desire  to  strain,  will 
continue,  perhaps  increase,  for  several  days — the  discharges  being 
mostly  blood  in  some  cases,  and  chiefly  mucus  in  others.  Having 
generally  but  little  odor  at  fii-st,  these  discharges  become,  as  the  dis- 
ease advances,  exceedingly  offensive. 

Causes.  —  Dysen  tery  is  very  frequently  caused  by  sudden  changes 
from  hot  to  cold,  by  which  sweating  is  suddenly  checked,  and  the 
blood  repelled  from  the  surface.  Hot  climates,  and  dry,  hot  weather 
are  predisposing  causes.  All  green,  unripe,  and  unwholesome  food, 
and  indigestible  food  of  every  sort,  may  induce  it. 

Treatment.  —  In  mild  cases  give  a  tablespoonful  of  castor-oil  and 
two  teaspoonfuls  of  paregoric,  mixed,  once  a  day.  Sometimes,  in 
place  of  the  above,  a  dose  of  rochelle  powder,  dissolved  in  water,  and 
eleven  or  twelve  drops  of  camphor,  may  be  taken.  A  moderate  quan- 
tity of  flax-seed  or  slippery-elm  tea,  may  be  taken  as  a  drink,  and  the 
bowels  be  well  emptied  by  an  injection  of  starch. 

When  there  is  much  pain  in-  the  bowels  a  mustard  poultice  laid 
upon  them  will  have  a  good  effect.  The  starch  injections  should,  in 
such  case,  have  half  a  teaspoonful  of  laudanum  mixed  with  it.  The 
compound  syrup  of  rhubarb  and  pdtassa  will  often  act  favorably, 
given  in  tablespoonful  doses. 

If  there  is  reason  to  suppose  the  liver  is  affected,  give  podophyllin, 
etc.  (46). 

The  patient  should  not  be  allowed  to  sit  up,  and  must  be  kept  very 
still,  and  be  allowed  only  a  very  scant  diet,  as  flour  porridge,  well 
boiled,  rice  water,  etc. 

Chronic  Dysentery. 

When  dysentery  "  runs  on  "  for  some  time,  it  is  liable  to  become 
chronic. 

Symptoms.  —  Looseness  of  bowels,  —  the  discharges  being  un- 
healthy, more  or  less  bloody,  attended  by  bearing  down,  or  a  desire 
to  strain,  and  being  in  number  from  two  to  forty  a  day.  There  is 
great  debility,  the  pulse  is  weak  and  quick,  the  tongue  slightly  furred, 
the  appetite  lost,  the  face  pale  and  sallow,  the  skin  dry  and  parched. 
Sometimes  the  relpx  alternates  with  costiveness. 

Treatment.  —  In  this  form  of  the  complaint,  astringents  will  be 
necessary  (169),  (161),  (162),  (345),  (346),  (347). 

Injections  may  be  used,  if  necessary,  composed  of  nitrate  of  sil- 


m 


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4 


382 


DISEASES  OF   THE   ABDOMINAL  CAVITY. 


ver,  fifteen  grains  to  the  ounce  of  water,  or  an  infusion  of  golden  seal, 
with  a  little  tincture  of  prickly-ash  berries  added  to  it. 

The  diet  must  be  very  light,  easy  of  digestion,  and  nutritious.  In 
Home  cases,  it  should  be  composed  chiefly  of  wheat  porridge,  or  boiled 
milk  and  boiled  rice.  In  other  cases,  a  little  tender  beef-eteak  should 
be  taken  once  a  day. 

Worms.  —  Vermes. 

The  intestinal  canal  is  subject  to  various  disturbances  from  the 
presence  of  worms.  Of  these  troublesome  tenants,  there  are  three 
principal  varieties. 

The  Ascaris,  or  pin-worm,  called  also  maw  or  thread  worm,  is  a 
small,  wliite,  thread-like  worm  from  half  an  inch  to  an  inch  in  length. 
These  worms  live,  in  great  number,  in  the  rectum,  where  they  excite 
great  irritation  and  itching. 

The  Lutnbricus,  or  atcaria  lumbricoideg,  is  a  round  worm,  about  an 
eighth  of  an  inch  in  thickness,  and  from  an  eighth  to  a  quarter  of  a 
yard  in  length.  Its  color  varies  from  a  milky  whiteness  to  a  deep 
red.     It  generally  occupies  the  small  bowels. 

The  Tenia  Solanum,  or  tape-worm,  is  a  flat  worm,  with  four  suck- 
ers at  the  head,  is  from  a  few  feet  to  some  hundreds  in  length,  and 
full  of  joints.  It  dwells  in  the  small  bowels,  and  feeds  on  the  chyle 
as  it  comes  along,  before  it  is  absorbed  by  the  lacteals.  In  this  way, 
it  robs  the  body  of  nourishment,  and  produces  great  loss  of  flesh,  and 
an  enormous  appetite. 

Symptoms.  —  In  the  grown  person  the  symptoms  of  worms  are 
qiiite  obscure,  except  an  intolerable  itching  within  the  anus,  which 
generally  indicates  pin-worms. 

In  children  worms  are  indicated  by  paleness,  itching  of  the  nose, 
grinding  of  the  teeth  and  starting  in  sleep,  irregular  appetite,  bad 
breath,  swelled  upper  lip,  picking  of  the  nose,  hard  swelled  belly,  and 
one  cheek  constantly  flushed. 

Treatment.  —  For  expelling  worms  various  articles  have  been  used. 
Among  these  spirits  of  turpentine  (165)  has  a  high  reputation.  The 
following  preparation  does  well :  Spirits  of  turpentine,  half  an  ounce ; 
essence  of  anise,  half  an  ounce ;  castor-oil,  one  ounce ;  worm-seed 
oil,  one  ounce.  Mix.  The  dose  for  a  child  one  or  two  years  old  is 
ten  to  twenty  drops,  eveiy  two  or  three  hours.  In  two  or  three  days, 
a  brisk  physic  should  be  given.  The  worm-powder  is  quite  success- 
ful. 

One  of  the  most  popular  remedies  is  the  pink-root.  It  should  be 
united  with  a  purgative.  The  following  is  a  good  preparation:  Pink- 
root  and  senna,  each  half  an  ounce ;  bitartrate  o^  potassa,  one  dram ; 
pulverized  jalap,  half  a  dram  ;  cardamom  seeds,  half  a  dram ;  extract 
of  liquorice,  two  drams.  Mix,  and  add  half  a  pint  of  boiling  water, 
liet  the  whole  steep  an  hour.  Give  a  tablespoonful  or  two,  occasion- 
ally, till  the  worms  are  expelled.  • 


DISEASES  OF  THE   ABDOMINAL   CAVITY. 


388 


An  injoction  composed  of  quassia  (66),  or  aloes  (22),  or  of  simple 
sweet-oil,  is  very  effectual  *in  removing  pin- worms  from  the  lower 
bowel.  So  is  an  injection  composed  of  the  red  iodide  of  mercury, 
one  grain;  iodide  of  potassium,  half  a  grain;  and  two  pints  of 
water. 

Most  of  the  above  preparations  are  thought  to  be  successful  in  ex- 
pelling all  kinds  of  worms ;  but  for  the  tape-worn  .o  other  remedy 
has  yet  shown  itself  as  effectual  as  pumpkinrseeda.  The  seeds  should 
be  well  bruised,  and  steeped  in  water.  This  should  be  drunk  freely 
for  several  days,  if  need  be.  It  is  believed  to  be  a  sure  remedy,  oven 
in  cases  of  several  years'  standing. 

In  all  cases  of  worms,  the  diet  should  be  carefully  chosen,  and  be 
connected  with  proper  exercise,  pure  air,  frequent  bathing,  and  all 
those  measures  which  tend  to  improve  the  general  health. 

After  the  expulsion  of  the  worms,  tonics  should  always  be  taken 
to  strengthen  the  bowels,  that  the  same  evil  may  not  return. 

Acute  Inflammation  of  the  Kidneys,  —  Nephritis. 

Before  speaking  of  this  disease,  I  wish  to  give  the  reader  a  general 
idea  of  a  kidney,  and  shall  do  so  by  the  use  of  two  cuts. 

Fig.  110  presents  the  external  surface  of  the  right  kidney,  with  its 
renal  capsule  mounted  on  top ;  i,  being  its  upper  edge  ;  /,  h,  superior 
and  inferior  branches  of  the  emplgent  artery ;  c,  d,  e,  three  branches 
of  the  emulgent  vein ;  a,  the  pelvis  of  the  ureter ;  b,  the  ureter. 

Fig.  Ill  is  the  same  kidney  laid  open ;  1,  being  the  super-renal 
capsule ;  2,  the  vascular  portion ;  3, 3,  the  tubercular  portion,  consisting 


FlO.  110. 


Fio.  111. 


of  cones  ;  4,  4,  two  of  the  calices  receiving  the  apex  of  their  corres- 
ponding cones;  5,  5,  5,  the  three  infundibula;  6,  the  pelvis;  and  7, 
the  ureter. 
The  kidneys  are  glands,  and  their  office  is  to  draw  or  strain  off 


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884 


DIBRABRS   OP  THE  ABDOMINAL  CAVITT. 


from  Lho  l)ody  those  effete  or  worn-out  particloH,  or  product*  of  deenif 
which  corUain  nitroi/en,  while  the  liver  tukes  away  thoHO  carhoiMceoum 
matters  whieh  have  no  nitrot/en.  These  UHeless  HulwtiinceH  which  jro 
out  tlirougit  tiie  kidneys  are  genenvUy  in  tlio  form  of  urea.  In  citrry- 
iiig  off  these  matters,  the  kidneys  may  have  more  to  do  than  properly 
belongs  to  them;  and  may  be  so  stimulated,  or  irritated,  or  injured 
in  some  way,  as  to  become  inflamed. 

Symptoms.—  Like  most  other  inflummatory  disesBes,  it  iHjgins  with 
cold  chills  and  rigoiv,  especially  in  the  back  and  loins,  followed  by 
fever  and  pain.  The  pain  frequently  extends  to  the  bladder,  the  loins, 
and  the  thighs,  and  is  of  a  severe,  lancinating  kind  —  though  some- 
times obtuse.  Pressure,  motion,  straining,  or  ttvking  a  full  breath,  add 
to  its  pungency.  The  urine  is  scanty,  high-colored,  sometimes  bloody, 
and  can  only  be  passed  drop  by  droj).  In  the  loins  theie  is  a  sense 
of  heat,  gnawing,  and  constriction  ;  the  bowels  are  either  constipated, 
or  relaxed  by  diarrhoja.  A  numbness  of  the  thigh,  and  drawing  up 
of  the  testicle  on  the  affected  side,  are  marked  and  peculiar  symptoms. 
In  some  cases,  there  are  nausea,  vomiting,  oppression  of  the  stomach, 
faintness,  hiccough,  drum-head  distention,  and  rumbling  of  the  bowels. 
The  skin  is  hot  and  dry,  the  pulse  hard  and  frequent. 

Causes. — The  use  of  cantharides,  oil  of  turpentine,  and  other  di- 
uretics, taking  cold,  violent  exercise,  mechanical  injuries,  the  transla- 
tion of  rheumatism  or  gout,  the  striking  in  of  skin  eruptions,  and 
gravelly  formations  in  the  kidneys  or  ureters. 

Distinctions This  disease  is  to  be  distinguished  from  colic  by 

the  pain  being  increaeed  by  pressure,  and  by  the  frequent  but  difficult 
discharge  of  red  urine ;  from  lumbago^  from  its  being  confined  fre- 
quently to  one  side,  and  also  by  the  urinary  troubles,  and  by  the 
nausea  and  vomiting;  and  from  all  other  diseases,  by  the  numbness 
)f  the  thigh,  and  the  drawing  up  of  the  testicles. 

Terminations  of  the  Disease.  —  It  runs  a  rapid  course,  and  may 
terminate  by  resolution,  or  by  suppuration.  When  the  latter  happens, 
it  is  indicated  by  the  decline  of  the  more  violent  symptoms,  a  throb- 
bing and  a  sense  of  weight,  with  chills,  followed  by  flushes  of  heat, 
and  sweating.  The  matter  formed,  generally  small  in  quantity,  may 
pass  into  the  cavity  of  the  kidney,  and  thence  through  the  bladder  to 
a  natural  outlet  with  the  urine. 

Treatment.  —  Either  put  the  feet  into  a  hot  mustaid-bath,  or  put 
mustard  drafts  upon  them.  At  the  same  time  apply  a  large  mustard 
poultice  upon  the  small  of  the  back,  and  follow  it  up  with  hot  fomen- 
tations of  stramonium  leaves  and  hops,  or  stramonium  and  wormwood 
or  tansy. 

Let  perspiration  be  induced  as  soon  as  possible  by  five  to  ten- 
drop  doses  of  tincture  of  veratrum  viride,  repeated  every  hour,  or  by 
teaspoonful  doses  of  the  compound  tincture  of  Virginia  snake-root, 
given  ever}'  half  hour. 


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Photographic 

Sciences 

Corporation 


33  WEST  MAIN  STREET 

WSBSTER,  N.Y.  14580 

(716)  872-4503 


CIHM/ICMH 

Microfiche 

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Collection  de 
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DISEASES   OP  THK  ABDOMINAL  CAVITY, 


If  costiveness  exist,  the  bowels  must  be  opened  by  epsom  salts, 
cream  of  tartar,  or  salts  of  tartar ;  or  by  copious  injections  of  warm 
water,  containing  a  few  drops  of  the  tincture  of  arnica-leaves.  Such 
injections  not  only  unload  the  bowels,  but  act  as  a  local  bath,  by  lying 
in  the  bowel  near  the  inflamed  kidneys. 

The  drinks  must  be  mucilaginous  and  diuretic.  The  marshmal- 
low  root  and  peach-leaves,  slippeiy-elm  bark,  flax-seed,  mullein,  elder 
blows,  hair-cap  moss,  and  cleavers,  are  all  valuable.  If  the  disease  is 
caused  by  gravel,  twenty  drops  of  liquor  potassse,  largely  diluted 
with  flax-seed  and  upland-cranberry  tea,  and  taken  freely  as  a  drink, 
is  excellent.     We  recommend  Poland  water  in  large  quantities. 

Chronic  Inflammation  of  the  Kidneys. 

This  is  frequently  the  result  of  the  acute  form  of  the  disease,  but  is 
also  produced  by  injuries  and  other  causes. 

Symptoms.  —  A  weakness  in  the  small  of  the  back,  and  a  dull, 
heavy  pain  in  the  kidneys.  The  urine  is  passed  often  and  in  small 
quantities.  It  is  alkaline — sometimes  white  and  milky — and  has 
in  it  deposits  of  phosphate  of  lime,  and  triple  phosphates. 

Treatment.  —  Infusions  of  pipsissewa,  uva  ursi,  trailing  arbutus, 
wild  carrot,  queen  of  the  meadow,  buchu-leaves,  or  foxglove  aie  use- 
ful diuretics,  and  may  be  taken  with  advantage. 

The  bowels  must  be  kept  open  with  some  gentle  physic  (18),  if 
they  are  costive ;  and  the  alkaline  sponge  bath,  with  friction,  be  used 
daily. 

An  eruption  may  be  brought  out  upon  the  small  of  the  back  by 
rubbing  on  a  few  drops  of  croton-oil ;  or,  if  the  patient  prefer  it,  a 
mustard  poultice  may  be  applied  two  or  three  times  a  week. 

The  food  should  be  nutritious,  and  easily  digested,  and  a  little  ex- 
ercise be  t<aken  daily  in  the  open  air. 

Acute  Inflammation  of  the  Bladder.  —  Cystitis. 

This  disease  affects  the  lining  membrane  of  the  bladder,  —  some- 
times its  muscular  substance.  It  may  attack  the  upper  portion,  the 
middle,  or  the  neck  of  this  organ.     It  runs  a  rapid  course. 

Symptoms. — Burning,  piercing,  and  throbbing  pain  in  the  region 
of  the  bladder.  The  pain  extends  to  the  perineum,  and  in  some 
cases,  to  the  testicles  and  thighs,  and  is  much  increased  by  pressure. 
The  perineum,  the  space  between  the  fundament  and  testicles,  feels 
sore  to  the  touch.  The  desire  to  pass  urine  is  incessant,  but  the 
effort  to  do  so  is  mainly  ineffectual.  The  water  passes  off  drop  by 
tlrop,  with  great  pain,  or  is  entirely  stopped,  causing  enlargement 
of  the  bladder,  and  great  distress.  Mucus  from  the  inflamed  lining 
of  the  bladder  passes  off  with  the  water.     Nausea,  vomiting,  and 


886 


DISEASES  OF  THE   ABDOMINAL  CAVITY. 


great  anxiety  are  common.  The  bowels  are  bound,  and  when  the 
disease  is  on  the  side  next  the  lower  bowel,  there  is  a  desire  to  empty 
the  bowels ;  and  if  the  inflammation  be  in  the  neck,  there  is  great 
pain  in  the  perineum,  and  frequently  an  entire  retention  of  the  water. 
The  pulse  is  full,  hard,  and  frequent,  the  skin  hot  and  dry,  the  thirst 
urgent,  and  the  patient  restless  and  dejected. 

Causes.  —  This  disease  may  be  produced  by  taking  cantharides  and 
turpentine ;  by  irritating  sutetances  forced  into  the  bladder  with  a 
syringe,  or  by  pushing  bougies  or  catheters  into  it ;  by  gravel-stones 
in  the  bladder ;  by  retained  urine ;  by  external  injuries ;  by  gonor- 
rhoea ;  and  by  cold  applied  to  the  feet,  or  to  the  lower  portion  of  the 
abdomen. 

Treatment.  —  If  the  urine  be  rettiined,  it  is  of  the  utmost  impor- 
tance that  it  be  early  drawn  off  with  the  catheter,  lest  a  distention  of 
the  bladder  bring  on  mortification.  Great  care  is  required  not  to  pro- 
duce irritation  by  any  roughness  in  introducing  the  instrument. 

Leeches  should  be  applied  upon  the  lower  part  of  the  bowels,  the 
perineum,  and  around  the  anus.  When  these  are  removed,  warm 
poultices  should  be  applied.  Cold  compresses  will  often  do  as  well. 
The  bowels  must  be  opened  with  epsom  salts.  Injections  of  warm 
water,  with  a  few  drops  of  tincture  of  arnica-leaves,  will  act  finely  as 
a  local  bath,  —  the  water  being  retained  as  long  as  possible. 

The  tincture  of  veratrum  viride  will  be  required  in  five  to  ten-drop 
doses,  or  the  compound  tincture  of  Virginia  snake-root,  to  induce 
perspiration.  Ex.  jaborandi  may  sometimes  be  used  for  the  same 
purpose. 

Drinks  must  be  taken  very  sparingly.  A  small  amouint  of  cold  in- 
fusion of  slippery-elm  bark,  or  marshmallow  and  peach-leaves,  or 
cleavers.  This  mucilaginous  drink  must  be  the  beginning  and  the 
end  of  the  diet  during  the  active  stage  of  the  disease.  Alkalis  are 
exceedingly  useful  in  allaying  the  pain  and  smarting  of  urination, 
perhaps  the  bestremedybeingliq.  potass,  citratis,  in  tablespoonful doses 
every  two  hours.  Suppositories  of  opium  and  belladonna  in  one-fourth 
grain  doses  by  the  rectum  every  two  to  four  hours  allay  the  frequent 
urination  and  pain  and  quiet  the  spasm  of  the  neck  of  the  bladder. 


Chronic  Inflammation  of  the  Bladder.—  Cystirrhoea. 

This  is  much  more  common  than  the  active  form  of  the  disease. 
It  often  arises  from  the  same  causes  which  produce  acute  inflamma- 
tion of  the  bladder. 

It  often  passes  under  the  title  of  "catarrh  of  the  bladder."  It  is 
a  chronic  inflammation  of  the  mucous  lining  of  that  organ,  and  is  a 
very  common  and  troublesome  affection  among  old  people. 

Symptoms.  —  Slight  lancinating  pains,  with  a  feeling  of  heat  in  tlu; 
region  of  the  bladder,  and  a  sense  of  weight  and  tenderness  in  the 


DISEASES  OF  THE  ABDOMINAL  CAVIIV. 


837 


when  the 
to  empty 
B  is  great 
the  water. 
,  the  thirst 

arides  and 
ier  with  a 
ivel-s  tones 
by  gonor- 
tior  of  the 

lost  impor- 
stention  of 
.  not  to  pro- 
iment. 
bowels,  the 
3ved,  warm 
do  as  well. 
ns  of  warm 
Lct  finely  as 
le. 

'.  to  ten-drop 
I,  to  induce 
ir  the  same 

t  of  cold  in- 
leaves,  or 

ig  and  the 

Alkalis  are 
urination, 

jonful  doses 

one-fourth 

le  frequent 

6  bladder. 

hfstirrhcea. 

the  disease, 
inflamma- 

ier."     It  is 
an,  and  is  a 

heat  in  tlx' 
Iness  in  the 


perineum  ;  frequent  and  tormenting  desire  to  pass  water,  with  occa- 
sional spasmodic  action  of  the  bladder.  The  urine  is  loaded  with 
tenacious  mucus,  just  as  the  expectoration  has  large  quantities  of 
mucus  in  it  when  there  is  inflammation  of  the  membrane  lining  the 
windpipe  and  bronchial  tubes.  When  the  water  has  stood  a  while, 
this  mucus  settles  at  the  bottom  of  the  vessel,  leaving  the  fluid  clear 
above.  Great  quantities  of  this  are  son^etimes  passed,  —  amounting 
even  to  pints  in  a  day.  The  triple  phosphates  of  magnesia  and  am- 
monia are  often  found  in  the  water. 

Frequently  there  are  demngements  of  the  appetite  and  digestive 
functions,  a  white  or  brown  fur  upon  the  tongue,  a  harsh,  dry  skin, 
with  thirst  and  general  debility,  —  especially  in  the  back  and  loins. 
Sometimes  there  id  a  little  fever. 

Treatment.  —  To  reduce  the  inflammation,  apply  leeches,  or  mus- 
tard, or  croton-oil,  or  a  cold  compress  every  night. 

As  a  diuretic,  give  an  infusion  of  buchu,  uva  urei,  trailing  arbutus, 
queen  of  the  meadow,  etc.  Tincture  of  veratrum  viride  and  sweet 
spirits  of  nitre  (125)  is  a  good  remedy.  The  compound  infusion  of 
trailing  arbutus  is  well  recommended.  So  is  the  compound  balsam 
of  sulphur.  An  infusion  of  the  pods  of  beans  has  been  well  spoken 
of. 

An  injection  into  the  bladder,  once  a  day,  of  a  tepid  infusion  of 
golden-seal  root,  with  much  care,  may  be  of  great  service;  or  an 
infusion  of  equal  parts  of  golden-seal,  witch-hazel,  and  stramonium. 
It  may  be  done  with  a  gum-elastic  catheter  and  a  small  syringe. 

The  bowels  must  be  kept  open  with  the  neutralizing  mixture,  or 
some  other  mild  physic ;  and  the  skin  bathed  with  saleratus  and 
water  once  a  day,  and  rubbed  well  with  a  coarse  towel. 

Should  there  be  any  scrofulous,  or  gouty,  or  rheumatic  condition  of 
the  system,  the  remedies  for  those  complaints  may  be  used  in  addition 
to  the  above. 

Disease  of  the  Supra-Renal  Capsules. 

The  supra-renal  capsules  are  sm^ll  bodies  situated  above  the  kid- 
neys. (Fig.  Ill,  i.)  Their  office  is  not  well  understood.  It  has 
been  found  of  late  that  they  are  subject  to  a  disorder  having  peculiar 
symptoms.     Tliis  is  a  comparatively  new  disease. 

Symptoms.  —  The  most  marked  symptom  is  a  peculiar  change  in 
the  color  of  the  skin,  called  "  bronzing."  This  bronzing  process  lo- 
gins in  patches  on  those  parts  exposed  to  the  sun,  and  to  friction, 
as  the  neck,  the  bsicks  of  the  hands,  the  fronts  of  the  thighs,  and  the 
arms.  These  patches  look,  in  color,  like  spots  upon  a  bronze  statue, 
deprived  of  their  gloss. 

Another  marked  symptom  Ls  a  general  debility,  which  comes  on 
witliout  any  apparent  cause,  —  there  being,  generally,  no  evidence  of 
niganic  disesise,  and  no  loss  of  flesh,  —  and  is  attended  with  faint- 


838 


DTSKASRS   OF  THK   ABDOMINAL  CAVITY. 


ings,  loss  of  energy  both  of  body  and  mind,  a  peculiar  flabbiness  of 
flesh,  and  an  early  death,  apparently  from  sheer  weakness. 

The  blood  becomes  depraved,  and  loses  its  coloring  matter,  as 
shown  by  the  paleness  of  the  skin  where  there  is  no  bronzing. 

The  pulse  is  generally  very  soft  and  compressible.  The  stomach  is 
irritable,  the  appetite  is  gone  ;  there  is  nausea  and  sometimes  vomiting, 
with  pain  and  a  sense  of  sinking  at  the  pit  of  the  stomach.  Fre- 
quently there  is  costiveness,  sometimes  diarrhoea,  and  pains  in  the 
back  and  loins.  In  some  cases  there  are  epileptic  fits,  failure  of 
memory,  change  of  temper,  or  a  numbness  of  the  fingers,  legt,  etc. 

Treatment This  disease  is  a  peculiarly  fatal  one.     As  no  mode 

of  treatment  has  yet  proved  successful,  it  is  well  to  observe  caution 
in  prescribing. 

The  treatment  prescribed  for  chronic  inflammation  of  the  kidneys, 
would  perhaps  be  as  safe  as  any  that  could  at  present  be  proposed. 

Bright's  Disease  of  the  Kidneys.  —  Albuminuria. 

This  peculiar  disease  was  first  explained  to  the  profession  in  1837, 
by  Dr.  Bright,  of  England,  whose  name  it  took.  It  consists  of  a  dis- 
order of  the  kidneys,  —  probably  a  congestion  and  an  obstructed  cir- 
culation in  them,  from  which  arise  two  most  important  effects  ;  first, 
albumen,  an  essential  alimentary  constituent  of  the  blood,  is  secreted 
and  passed  off,  in  larger  or  smaller  quantities,  in  the  urine ;  and  sec- 
ondly, urea,  the  worn-out  matters  of  the  blood  which  the  kidneys  are 
made  expressly  to  carry  off,  is  permitted  to  remain.  If  the  urine  of 
a  person  having  Bright's  disease  be  examined,  therefore,  albumen, 
which  should  not  be  there,  will  be  found,  and  urea,  a  natural  constitu- 
ent, will  be  absent.  The  presence  of  albumen,  however,  while  ab- 
normal, is  not  necessarily  indicative  of  Bright's  disease,  as  it  may 
proceed  from  indigestion  and  blood  disorders. 

Method  of  Examination To  discover  albumen  in  urine  suspected 

to  contain  it,  place  a  little  in  a  test  tube,  and  boil  it  over  a  spirit- 
lamp.  If  albumen  be  present  only  in  minute  quantity,  it  may  caupe 
only  a  delicate  opalescence  ;  if  in  larger  quan- 
tity, it  may  separate  in  curdy  flakes,  and  fall  to 
the  bottom  as  a  more  or  less  abundant  white 
precipitate.  If  very  abundant,  the  liquid  may 
become  nearly  solid. 

The  albumen  is  the  same  as  the  white  of  an 
egg,  and  the  boiling  has  the  same  effect  in 
whitening  and  hardening  it,  as  upon  that  sub- 
stance. 

no.  112.  Albumen  is  sometimes  found  in  the  urine  in 

a  coagulated  state,  and  having  the  shape  of  tubes  or  worms  (Fig. 
112).  This  is  quite  common  in  Bright's  disease.  The  deposit  seems 
to  be  made  up  of  fibrous  casts  of  the  uriniferous  tubes  of  the  kid- 
neys. 


»;a:«sa 


abbiness  of 

matter,  as 
izing. 

9  stomach  is 
J8  vomiting, 
lach.  Fre- 
ains  in  the 

failure  of 
legi,  etc. 

\8  no  mode 
rve  caution 

he  kidneys, 
proposed. 

ninuria. 

ion  in  1837, 
ists  of  a  dis- 
itructed  cir- 
fects  ;  first, 
,  is  secreted 
le ;  and  sec- 
kidneys  are 
;he  urine  of 
re,  albumen, 
ral  constitu- 
sr,  while  ab- 
3,  afi  it  may 

ae  suspected 
/er  a  spirit- 
t  may  cause 
arger  quan- 
,  and  fall  to 
idant  white 
liquid  may 

white  of  an 
le  effect  in 
jn  that  sub- 
he  urine  in 
i^orms  (Fig. 
sposit  seems 
of  the  kid- 


DI8EA8E8  OF  THE   ABDOMINAL  CAVITY. 


339 


Symptoms.  —  The  two  unnatural  conditions  mentioned  above 
give  rise  to  the  symptoms  of  Bright's  disease.  One  of  them,  how- 
ever, is  itself  the  most  constant  and  characteristic  symptom  of  the 
disease,  namely,  the  presence  of  albumen.  This,  too,  being  one  of 
the  nutritive  constituents  of  the  blood,  its  abstraction  thins  the 
serous  portion  of  the  blood,  and  causes  it  to  filter  out  of  its  vessels 
into  the  cells,  —  causing  dropsy  of  the  cells,  usually  called  cellular 
dropsy,  or  anasarca.  This  general  dropsy  begins  frequently  in  the 
face,  and  spreads  rapidly  over  the  whole  body  and  limbs.  In  addi- 
tion to  this,  there  are  pains  in  the  back  and  loins,  a  gradual  failing  of 
strength,  and  a  derangement  of  digestion.  The  skin  becc  mes  drj, 
with  a  pale  and  bloodless  appearance,  and  theie  are  frequently  thirst, 
nausea  and  vomiting.  The  urine  frequently  has  fat,  blood,  epithelial 
scales,  mucus,  blood-discs,  fibrous  casts  of  the  uriniferous  tubes,  and 
saline  sediments ;  and  is  genenally  lighter  l)y  weight  than  in  health, 
and  less  in  quantity,  and  is  apt  to  be  red,  brown,  or  dingy  in  color. 

The  retention  of  urea  in  the  blood  acts  as  a  poison,  and  causes, 
toward  the  latter  end  of  the  disease,  when  accumulated  in  large  quan- 
tity, drowsiness,  convulsions,  and  apoplexy. 

A  frequent  desire  to  make  water,  with  a  shifting  back  and  forth 
of  the  bowels  between  costiveness  and  diarrhaea,  are  common  symp- 
toms. 

Treatment.  — The  results  of  treatment  in  this  diseaso  are  often  un- 
satisfactory. Yet  if  biken  in  season,  investigated  with  proper  care, 
and  treated  with  due  diligence,  much  mfiy  be  done  for  its  cure.  It  is 
one  of  those  harassing  complaints,  which  physicians  in  family  prac- 
tice seldom  have  the  patience  to  investigate  and  manage  with  suffi- 
cient care. 

Let  the  healthy  and  active  condition  of  all  the  vessels  of  the  skin 
be  the  first  object  aimed  at.  Tliis  will  relieve  the  laboring  and  falter- 
ing kidneys  of  a  portion  of  their  burden.  The  alkaline  sponge-bath 
with  vigorous  friction  every  day  will  secure  tiiis  object. 

In  the  next  place,  the  skin  being  put  in  a  working  condition,  should 
be  made  to  work  by  some  internal  diaphoretic,  —  as  the  tincture  of 
veratrum  viride,  in  doses  of  from  five  to  ten  drops,  or  the  compound 
tincture  of  Virginia  snake-root,  in  teaspoonfnl  doses. 

The  kidneys  may  be  still  further  relieved,  especially  when  there  is 
considerable  tenderness  and  other  signs  of  inflammation,  by  cupping, 
leeching,  mustard-poultices  and  croton-oil. 

The  bowels  should  be  regulated  by  some  gentle  physic,  as  cream  of 
tarter  dissolved  in  flax-seed  tea,  lochelle  powders,  epsom  salts,  etc.  In 
some  cases,  podophyllin  and  leptandrin  (40),  or  tho  compound 
powdei  of  jalap  (41),  ai-e  useful. 

When  ithere  is  dropsy  of  the  cells,  elaterium  may  be  used  as  physic 
(31),  or  the  kidmys  may  ,be  jogged  by  digitalis  (130),  (129),  its  effects 
being  carefully  watched.  Cider,  freely  drunk,  has  been  found  useful 
in  some  cases. 


340 

To  restore 
the  essential 
the  vegetable 
be  used  daily. 

Coffee,  and 
bread,  high-se 
nothing  must 
cannot  easily 


DISEASES   OP   THE   ABDOMINAL   CAVITY. 

the  blood,  iron  (73),  (93),  (74),  (75),  (72).  (71)  is 
article.  When  there  is  considerable  debility,  some  of 
bitters,  as  quinine,  quassia,  gentian,  Colombo,  etc.,  may 

ail  indigestible  articles  of  food,  as  rich  pastries,  new 
lujoned  meat,  and  fats,  must  be  avoided,  —  in  a  word, 

be  taken,  either  in  kind  or  quantity,  wliich  the  stomach 
digest. 

Diabetes. 

This  disease  is  a  kind  of  diarrhoea  of  the  kidneys.  The  amount 
of  urine  secreted  and  discharged  is  large,  sometimes  enormous  in 
quantity,  amounting  even  to  seveial  gallons  in  twenty-four  houns. 
Everything  taken  into  the  stomach  seems  to  run  off  by  the  kidneys. 
The  food  and  drink  being  mostly  converted  into  urine,  do  but  little 
good.  The  kidneys  having  got  into  an  exalted  state  of  action,  do 
too  much,  —  just  as  the  mucous  membrane  of  the  air-tubes  does  in 
bronchitis. 

Nature  of  the  Urine — Not  only  is  there  too  much  urine  discharged, 
but,  instead  of  being  lighter  than  healthy  urine,  as  in  Bright's  disease, 
it  is  heavier,  and  instead  of  holding  albumen  in  solution,  it  contains 
grape-mgar. 

To  Detect  Sugar. —  Put  a  little  of  tlie  suspected  urin^  in  a  test- 
tube  ;  add  to  it  a  drop  or  two  of  solution  of  sulphate  of  copper,  which 
will  give  the  fluid  a  pale-blue  tint.  Now  add  liquor  potassa  in 
excess :  if  sugar  be  present,  this  will  throw  down  a  pale-blue  precipi- 
tate (hydrated  oxide  of  copper),  which  will  immediately  re-dissolve, 
forming  a  purplish-blue  liquid.  Boil  this  over  a  lamp ;  if  there  be 
sugar,  a  reddish  or  yellowish-brown  precipitate  (sub-oxide  of  copper) 
will  be  thrown  down ;  if  no  sugar,  a  black  precipitate  (common  oxide 
of  copper)  will  fall  to  the  bottom. 

Another  7fe««.— Place  a  little  urine  in  a  tesUube;  add  to  it  half 
its  volume  of  liquid  potassa,  and  boil  five  minutes.  If  there  be  sugar 
present,  the  liquid  will  take  a  brownish  or  bistre  tint. 

Growth  of  Torula  as  a  Teat.  —  Place  a  portion  of  saccharine  mine 
in  a  warm  place,  and  a  scum  will  soon  rise,  as 
if  a  little  flour  had  been  dusted  on  it.  This, 
when  examined  under  the  microscope,  proves  to 
be  minute  oval  bodies.  These  expand  and  dilate 
I  the  vesicle  containing  them  into  the  form  of  a 
'  tube.  They  still  continue  to  erdarge,  and  pro- 
ject from  the  parent  bladder,  like  buds.  The 
whole  then  resembles  a  jointed  fungoid  growth 
(Fig.  113),  which  finally  breaks  up,  and  falls  to 
the  bottom,  as  a  copious  deposit  of  oval  vesicles 
or  spores. 


FIO.  113. 


• 'iltTtitiiidinrriiifcTlir'"'"-'^""  ' 


DISEASES  OF  THE  ABDOMINAL  OAVITY. 


841 


)•    (71)    18 

,  some  of 
may 


etc. 


tries,  new 
II  a  word, 
a  stomach 


18  amount 
)rmous  in 
)ur  horn's. 
8  kidneys. 
I  but  little 
action,  do 
BS  does  in 

ischarged, 
t's  disease, 
t  contains 

I  in  a  testr 
per,  which 
potassa  in 
le  precipi- 
e-dissolve, 
:  there  be 
copper) 
laion  oxide 

to  it  half 
be  sugar 

rine  urine 
)n  rise,  as 
it.  This, 
proves  to 
and  dilate 
form  of  a 
and  pro- 
lids.  The 
id  growth 
id  falls  to 
il  vesicles 


Other  5ymptoms.  —  Great  thirst,  craving  appetite,  dry  skin,  a 
sense  of  weiglit  and  uMea.sine8s  in  the  stomach  after  eating,  dry  and 
parched  mouth,  wliiU?  and  foul  or  clean  and  red  tongue,  wasting  of 
llt'sli,  languor  and  aversion  to  exercise,  debility,  pain  and  weakness 
ill  the  loins,  co.>?tiveness,  loss  of  the  sexual  feeling,  and  cold  teet. 
As  the  disease  di-aws  towards  a  fatal  end,  the  gums  become  spongy, 
the  breath  fetid,  sometimes  smelling  like  urine. 

Treatment.  —  The  skin  should  have  about  the  same  treatment  as 
that  recommended  in  Bright's  disease.  Also,  the  same  counter-irrita- 
tion over  the  kidneys.  The  bowels  must  be  kept  open  by  some 
gentle  physic  (13),  (12),  (15). 

Tonics.  —  These  will  be  required  to  restore  the  tone  of  the  system, 
particularly  iron,  —  same  preparations  as  recommended  in  Bright's 

disease. 

Astringents  to  check  the  flow  of  urine  will  be  needed.  Alum,  in 
tliree-grain  doses,  three  times  a  day,  or  sugar  of  lead,  or  white  vitriol, 
or  clear  opium,  will  be  serviceable.  Creosote,  in  one  or  two-drop 
doses,  and  tincture  of  cantharides,  have  each  cured  cases. 

One  scruple  of  Peruvian  bark,  one  scruple  of  wild-cranberry  leaves, 
powdered,  and  half  a  grain  of  opium,  mixed  and  taken  three  times  a 
day,  is  a  good  remedy. 

All  articles  which  contain  sugar  and  starch  must  be  forbidden  in 
the  diet.  Bread  and  potatoes  contain  a  large  amount  of  starch ;  and 
beets,  parsni^^s,  and  some  other  vegetables,  have  sugar.  It  is  best 
to  confine  the  patient  almost  entirely  to  tender,  fresh  meats ;  and  the 
drink,  notwithstanding  the  great  thirst,  must  be  restricted  to  a  very 
small  quantity.  Saccharin  should  be  used  to  sweeten  drinks  instead 
of  sugar. 

Bleeding  from  the  Kidneys,  etc.  —  Hcematuria. 

By  this  I  mean  a  discharge  of  blood  from  the  urinary  passage.  It 
may  come  from  the  kidneys,  the  ureters,  the  bladder,  or  the  urethra. 

Symptoms.  —  The  passage  of  the  blood  is  preceded  by  pain  in  the 
region  of  the  bladder  or  kidneys,  and  accom- 
panied by  faintness.  There  is  generally  heat 
and  distress  in  the  loins,  and  tenderness  upon 
pressure  in  the  region  of  the  bladder  or  kid- 
neys, according  to  the  place  from  which  the 
blood  comes. 

It  is  sometimes  difficult  to  decide  whether 
the  coloring  matter  in  the  urine  is  really  blood. 
In  such  cases,  the  microscope  will  generally 
detect  the  blood  corpuscles,  if  present.  They 
commonly  appear  as  in  Fig.  114,  having  a  yellow  color,  and  being 
pretty  uniform  in  sxze. 


op 
o     P 


\o    o 

o  \      o 


0     O 


Fl».  114. 


342 


DISEASES   OF   THR   ABDOMINAL  CAVITY. 


Treatment. — This  must  of  course  vary  according  to  the  nature  of 
the  case,  and  the  immediate  cause  producing  it.  Where  active  bleed- 
ing exists,  the  patient  must  have  absolute  rest  in  bed,  with  applica- 
tions of  cold  to  the  hips  and  loins.  If  the  patient  l)e  strong  and  full 
of  blood,  w^et  cups  or  leeches  may  be  applied  over  the  kidneys,  or  the 
bladder.  In  such  cases,  too,  the  bowels  must  be  freely  moved  with 
some  preparation  of  salts  (14),  (18),  (20),  (25). 

Sugar  of  lead  is  a  valuable  remedy;  but  it  should  be  given  in  large 
doses  for  a  short  time,  rather  than  in  small  doses  for  a  long  time.  It 
is  best  taken  in  form  of  solution  (348),  two  great  spoonfuls  every 
two  hours,  until  five  or  six  doses  are  taken. 

But  the  best  remedy  is  gallic  acid.  It  seems  to  have  extraordinary 
power  in  this  complaint.  It  should  be  given  in  five-grain  doses, 
mixed  with  a  teaspoonful  of  mucilage  of  gum-arabic,  and  t'en  drops 
of  tincture  of  henbane. 


Suppression  of  Urine. — Ischuria  Renalis. 

This  disease  is,  in  one  respect,  just  the  opposite  of  diabetes. 
While  immense  quantities  of  urine  are  secreted  in  that,  none  is  se- 
creted in  this.  In  that,  the  kidneys  do  too  much ;  in  this,  they  do 
nothing. 

This  complaint  is  sometimes  called  paralysis  of  the  kidneys.  It 
usually  occurs  in  old  persons,  and  those  inclined  to  corpulency. 

Symptoms.  —  The  patient  makes  no  water;  and  if  the  catheter  be 
applied,  none  will  be  found  in  the  bladder.  The  patient  feels  unwell, 
restless,  anxious,  with  a  slight  pain  in  the  loins  and  bowels,  perhaps ; 
but  on  the  whole  not  illness  enough  to  give  any  very  good  account 
of  it.  After  a  little  time,  nausea  comes  on,  and  perhaps  vomiting, 
and  soon  drowsiness,  wanderings  of  mind,  incoherent  talk,"  hiccough, 
stupefaction,  and  death.  These  head  symptoms  are  caused  by  the 
shutting  up,  in  the  kidneys,  the  natural  outlet  of  urea,  of  an  excre- 
mentitious  matter,  which  acts  as  a  poison  to  the  nervous  system. 
Before  death,  the  perspiration  has  a  strong  smell  of  urine. 

Treatment. --The  cause  of  this  complaint  not  being  known,  the 
treatment  must  necessarily  be  a  little  uncertain.  We  cannot  go 
amiss,  however,  in  placing  the  patient  immediately  in  a  warm  bath 
for  fifteen  or  twenty  minutes.  Then  apply  wet  cups  over  the  kidneys, 
and  follow  these  either  by  mustard  poultices  or  by  hot  fomentations. 

Let  the  bowels  be  opened  by  the  compound  powder  of  jalap,  or  by 
elaterium  (31).  Epsom  salts  or  cream  of  tartar  might  in  some  cases 
be  substituted  for  the  above.  A  stimulating  injection  is  also  desira- 
ble (246). 

Diuretics,  as  sweet  spirits  of  nitre,  digitalis,  queen  of  the  meadow 
and  peach-leaves,  equal  parts,  and  marshmallow,  are  of  course  called 
for. 


le  nature  of 
ctive  bleed- 
ith  applica- 
ng  and  full 
neys,  or  the 
moved  witli 

ven  in  large 
g  time.  It 
nfuls  every 

traordinary 
[rain  doses, 
1  t«u  drops 


lis. 

)f  diabetes. 

none  is  se- 

his,  they  do 

idneys.    It 
idency. 

catheter  be 
eels  unwell, 
Is,  perhaps ; 
jod  account 
a  vomiting, 

,*  hiccough, 
ised  by  the 
an  excre- 
3U8  system. 
I. 

known,  the 
cannot  go 
warm  bath 

the  kidneys, 

mentations. 

jalap,  or  by 
some  cases 
also  desira- 

he  meadow 
)ur8e  called 


DISEASES   OF  THE   ABDOMINAL  CAVITY. 


343 


Much  of  the  poisonouM  matter  retained  mayln^  got  out  througli  the 
skin,  by  a  free  use  of  the  compound  tinclun;  of  Virginia  Hiiake-root 
or  tincture  of  vemtrum  viride  in  full  doses. 

Although  the  symptoms,  in  the  earlier  stages  of  this  (;omplaint, 
may  not  attract  much  attention,  or  Iw  thought  worthy  of  notice,  yet 
the  treatment  should  be  prompt  and  energetic,  as  a  fatal  termination 
is  sometimes  reached  in  the  brief  space  of  forty-eight  hours. 

Retention  of  Urine. 

This  disorder  is  often  confounded  with  suppression  of  the  urine, 
but  it  is  different  in  eveiy  respect.  In  suppression,  the  urine  is  not 
formed  by  the  kidnej^ ;  in  retention,  it  is  formed,  and,  in  some  cases, 
poured  into  the  bladder,  but  is  retaintd  on  account  of  some  inability 
to  pass  it. 

Ischuria.  —  This  is  one  of  the  forms  of  retention.  In  this  com- 
plaint, the  urine  has  passed  from  the  kidneys  to  the  bladder,  but  from 
some  cause,  generally  palsy  of  the  muscles  of  the  bladder,  it  cannot 
be  passed  off.  In  this  case,  there  is  no  pain,  but  the  stream  of  water 
flows  off  with  slower  and  slower  pace,  —  the  patient  having  to  make 
tiresome  efforts  with  the  abdominal  muscles  to  get  the  bladder 
emptied.  As  the  quantity  discharged  diminishes,  the  f'abire  to  uri- 
nate grows  more  urgent.  Pressure  just  above  the  pubes  gives  pain, 
and  the  bladder  feels  under  the  hand  like  a  large,  hard  tumor. 

Dysuria.  —  In  this  form  of  the  complaint,  the  water  is  passed  to 
some  extent,  but  with  pain  and  heat  along  the  water-pipe.  This  is 
generally  caused  by  some  inflammation  along  the  urethra. 

Strangury.  —  In  this  the  water  is  only  passed  drop  by  di-op,  and 
with  great  burning,  scalding,  and  tenesmus  in  the  neck  of  the  bladder. 
When  there  is  considerable  inflammation,  the  skin  becomes  hot,  the 
pulse  hard  and  quick,  and  the  tongue  covered  with  a  white  fur. 

Causes.  —  These  several  f oi-ms  of  the  complaint  are  caused  by  palsy 
of  the  bladder,  gonorrhoea,  inflammation  in  the  neck  of  the  bladder 
or  the  water-pipe,  mechanical  injuries  of  the  bladder  in  child-bearing 
or  otherwise,  by  tumors  pressing  upon  it,  by  irritation  from  gravel  or 
stone  within  its  cavity,  by  stricture  or  partial  closing  up  of  the  ure- 
thra, by  disease  of  the  prostate  gliind,  by  taking  spirits  of  turpentine 
or  cantharides,  or  by  the  absorption  of  this  latter  article  when  used 
as  a  blister. 

Treatment.  —  It  is  obviously  necessary  in  this  complaint,  that 
treatment,  in  order  to  be  of  any  avail,  should  be  prompt ;  for  when 
the  retention  is  complete,  the  bladder  will  burst  in  from  two  to  five 
dayrs,  and  cause  the  death  of  the  patient. 

The  treatment  must  vaiy  according  to  the  cause  of  the  retention. 

If  it  be  caused  by  palsy  of  the  bladder,  the  common  flexible  cathe- 


844 


DISEASES   OF  THE   ABDOMINAL  CAVITY. 


t«r  miiHt  b«  1186(1  daily  until  the  muscular  fibres  recover  their  IohI 
power.  When  much  irritation  is  caused  by  introducing  it,  it  is  better 
not  to  withdraw  it,  but  to  oIoho  its  oxtcrnal  orifice  with  a  Hinall  i)luf,', 
which  the  patient  vnu  remove  an  often  aH  necessary  to  let  off  the 
urine.  To  remove  the  paralynis,  the  electro-magnetic  machine  is 
woith  a  trial,  the  current  being  passed  through  the  bladder.  At 
the  Hame  time  let  the  patient  bike  stiychnia  (Sh),  (80),  (83),  (96). 
Cantharides,  in  the  form  of  tincture,  or  in  connection  with  strychnia 
(291),  is  ofter  used. 

If  the  retention  is  caused  by  inflammation  of  the  neck  of  the  blad- 
der, leeches  should  l)e  applied  to  the  perineum,  and  three  or  four  drops 
of  croton-oil  may  1k^  rubbed  on  just  above  the  pubes  to  bring  out  an 
eruption.  Warm  fomentations  will  also  be  serviceable,  and  warm 
hip-baths.  Cooling  diuretics,  as  infusions  of  marahmallow,  cleavers, 
pumpkin-seeds,  buchu,  sweet  spirits  of  nitre,  etc ,  must  not  b§  pmitted. 

Inability  to  Hold  the  Urine.  —  Enuresis. 

This  complaint,  generally  called  incontinence  of  the  urine,  is  quite 
common  among  children.  In  some  cases  the  child  has  no  ability  to 
hold  it8  water  at  any  time ;  but  generally  it  is  only  passed  off  invol- 
untarily at  night  while  in  bed.  In  adult  life  it  m  less  frequently  met 
with,  except  among  the  old. 

Causes.  —  Irritation  of  the  roots  of  the  spinal  nerves  which  go  to 
the  bladder,  mechanical  injuries  of  the  bladder,  palsy  of  the  bladder, 
particularly  in  old  people,  debility  of  the  neck  of  the  bladder,  a  gen- 
eral weakness  of  the  nervous  system,  worms  in  the  bowels,  piles, 
whites,  gravel  or  stones  in  the  bladder,  long  prepuce  in  boys,  etc. 

Treatment.  —  As  a  general  rule,  the  change  of  constitution  which 
occurs  at  puberty  cures  this  complaint.  But  as  this  does  not  always 
happen,  it  is  important  that  parents  do  everything  in  their  power  to 
break  it  up  earl^ ,  lest  it  become  an  affliction  for  life. 

Children  who  suffer  from  this  disorder  are  apt  to  drink  largely. 
This  habit  should  be  restrained.  But  little  drink  should  be  allowed, 
whatever  the  desire  for  it.  Care  should  be  taken  that  the  child  make 
water  before  going  to  bed,  —  also  that  it  be  aroused  at  a  late  hour  for 
the  same  purpose,  and  that  the  foot  of  the  bed  be  elevated  so  as  to 
draw  the  urine  away  from  the  neck  of  the  bladder. 

The  skin  should  be  washed  all  over,  every  day,  with  cool,  or  cold 
water,  and  vigorously  rubbed  with  a  coarse  towel.  This  will  cause 
the  excess  of  fluids  to  pass  off  thiough  the  skin,  and  lessen  the  action 
of  the  kidneys. 

In  some  instances  children  urinate  in  bed  through  carelessness, 
being  half  conscious  of  what  is  occurring,  but  not  caring  enough  to 
rouse  themselves.  In  such  cases,  they  are  often  cured  by  some  de- 
cided correction,  —  the  impending  act  of  passing  water  connecting 


DISEASES  OF  THE  ABDOMINAL   UAVITY. 


345 


their  IohI 
b  Ih  Ixitter 
[null  i>lug, 
3t  off  the 
mchinu  Ih 
Ider.  At 
53),  (95). 
Htrychtiia 

■  the  blad- 
four  drops 
ing  out  an 
ivnd  warm 
,  cleavers, 
1^  gmitted. 

is. 

16,  is  quite 

)  ability  to 

off  invol- 

uently  met 

/hich  go  to 
le  bladder, 
der,  a  gen- 
vels,  piles, 
ys,  etc. 

tion  which 
lot  always 
r  power  to 

k  largely. 
)e  allowed, 
lild  make 
te  hour  for 
3d  so  as  to 


ol 


or  cold 
will  cause 
the  action 


lelessness, 

enough  to 

some  de- 

jonnecting 


itself  in  their  mind  with  the  corrootion,  and  recalling  them  inHtaiiUy 
to  full  coMsciouNucss.  Of  ('ourse  this  mode  of  relief  should  be  resorted 
to  with  great  judgment  and  caution. 

When  the  complaint  proceeds  from  debility  or  rehxntioii  of  the 
neck  of  the  bladder,  the  compound  infusion  of  trailing  arbutus  and 
the  isinglass  custard  found  among  dietetic  preparations,  may  In;  used 
freely.  The  tincture  of  cantharides,  from  ten  to  forty  drofw  to  chil- 
dren, may  be  given,  and  increased  gradually  to  a  hundred,  or  until 
slight  difficulty  is  felt  in  puasing  the  water.  Then  stop,  and  give 
the  urticles  mentioned  al)<)ve.  Spirits  of  turpentine  is  useful  to  some 
extent,  given  also  in  stnall  doses,  and  (tontinued  for  some  time. 

If  the  disorder  be  caused  by  irritation  of  the  spinal  nerves,  cold 
water  douched  upon  the  back,  or  croton-oil  rubbed  along  the  spine, 
or  a  warm  stimulating  or  irrittiting  plaster  upon  the  lower  part  of  the 
back,  /ill  be  required.  The  electro-magnetic  machine  may  do  well 
in  some  cases.  Tincture  of  belladonna,  given  just  as  tincture  of  can- 
tharides above,  afternoon  and  at  Ixidtime,  gives  best  results  usually. 
Belladonna  after  a  while  troubles  tlie  eyes  and  must  be  stopped. 

Urinary  Deposits.  —  Gravel.  —  Stone. 

Unnatural  deposits  in  urine  are  to  be  regarded  simply  as  evi- 
dences of  changes  which  disease  is  making  in  the  body.  As  such 
they  are  valuable,  —  more  valuable,  in  many  cases,  than  any  or  all 
other  symptoms  we  can  study,  and  most  valuable  from  the  ease  with 
which  they  may  be  investigated.  Yet  but  very  few  physicians,  com- 
paratively, pay  any  special  attention  to  them,  or  make  any  effort  to 
acquire  the  small  amount  of  knowledge  needed  for  their  detection. 

Sources  of  the  Urine.  —  The  urinary  secretion  has  three  ;  irces. 
The  largest  bulk  of  it  comes  from  the  superabundance  of  drink  taken 
into  the  stomach.  This  is  shown  from  the  free  flow  of  pale  urine 
after  taking  copious  drafts  of  water  or  other  fluids.  Such  quantities 
of  water  as  are  often  drunk,  would  embarrass  the  functions  of  animal 
life,  were  it  not  pumped  off  by  the  kidneys. 

A  second  source  of  supply  for  the  urinary  secretion  is  to  be  found 
in  the  elements  of  imperfectly  digested  food,  and  also  some  abnormal 
elements  arising  from  incomplete  assimilation.  Oxalic  acid  is  a 
specimen  of  the  latter,  being  sometimes  largely  excreted,  in  dyspep- 
sia, soon  after  a  meal. 

The  third  source  of  urine  is  found  in  those  old  and  worn-out  atoms 
of  the  system,  which  can  serve  no  further  useful  purpose  in  the  ani- 
mal economy,  and  which  cannot  be  got  rid  of  by  the  lungs  or  skin. 
It  is  only,  however,  one  portion  of  the  dead  tissue,  namely,  that  which 
is  rich  in  nitrogen,  which  goes  out  through  the  ♦•  .1  strainer ;  an- 
other portion,  which  has  a  preponderance  of  inflai.  lable  elements  — 
carbon,  hydrogen,  and  perhaps  sulphur  —  takes  the  outward  channel 
t)i  rough  the  liver,  as  bile. 


I 


p5» 


346 


DISEASES  OP  THE   ABDOMINAL  CAVITY. 


^ 


Characteristics  of  Urine.  —  Healthy  uiihe  has  a  light  amber  color, 
is  transparent,  arul  has  different  degrees  of  density,  its  specific  gravity 
varying  from  1.003  to  1.030.  It  has  an  aromatic,  violet-like  smell, 
and  a  bitter,  disagreeble  taste,  like  salts. 

That  which  is  passed  a  little  time  after  drinking  largely,  is  pale, 
and  has  a  low  specific  gravity,  varying  from  1.008  to  1.009,  and  is 
called  urina  potus.  That  passed  soon  after  'he  digestion  of  a  full 
meal,  is  called  urina  chyli,  or  urina  cibi ;  it  has  a  specific  gravity  from 
1.020  to  1.030.  That  which  is  secreted  from  the  blood,  and  is  passed 
before  eating  or  drinking  iii  ,.he  morning,  is  called  urina  sanguinis; 
and  has  a  specific  gravity  of  from  1.015  to  1.026.  This  is  the  best 
specimen  of  the  average  density  and  nature  of  healthy  urine. 

Healthy  urine  contains  urea,  uric  acid,  sulphuric  acid,  phosphoric 
acid,  lime,  magnesia,  phosphate  of  soda,  etc.  It;  is  only  when  these 
are  discovered  in  excess,  that  they  indicate  disease. 

Examination  of  Urine^ — Let  a  piece  of  blue  litmus-paper  be  first 
dipped  in  the  urine ;  if  it  be  acid,  the  color  of  the  paper  will  be 
changed  to  red,OT  reddish-brown.  Should  the  blue  color  remain  un- 
changed, then  use  'yellow  turmeric  or  reddened  litmus  paper ; 
if  the  urine  is  alkaline,  the  turmeric  will  become  brown,  and 
the  reddened  litmus  will  be  changed  to  blue.  If  the  color  in 
both  cases  remains  unaltered,  the  urine  is  neutral ;  that  is, 
neither  acid  nor  alkaline. 

This  being  done,  let  the  specific  gravity  be  taken.  This  is 
easily  done  by  the  urinometer  (Fig.  116).  This  instrument 
is  known  also  by  the  names  hydrometer,  and  gravimeter.  It 
is  generally  made  of  glass.  When  placed  in  distilled  water, 
it  will  sink  to  a  certain  point;  and  as  all  bodies  immersed  in 
fluid  displace  a  bulk  equal  to  themselves,  it  follows  that  in 
a  fluid  denser  than  water,  the  instrument  will  not  sink  so 
deep.  The  Space  above  the  large  bulb  is  marked  off  into  de- 
grees corresponding  to  different  densities.  When  this  instru- 
ment is  immersed  in  urine,  and  has  come  to  rest,  the  number  on  the 
graduated  scale,  which  stands  at  the  surface  of  the  liquid,  when 
added  to  1.000,  will  represent  the  specific  gravity  of  the  fluid.  If,  for 
example,  the  surface  of  the  liquid  corresponds  with  9  on  the  scale, 
the  specific  gravity  of  the  urine  will  be  1.009 ;  if  at  26,  it  will  be 
1.025. 

By  attending  to  the  specific  gravity  of  the  urine,  the  physician  may 
often  gain  important  information  respecting  his  patient,  as  it  may  be 
made  to  show  him  how  much  solid  matter  is  daily  carried  out  of  the 
body  through  the  kidneys.  This,  at  the  bed-side,  may  often  give 
useful  hints  in  regard  to  treatment. 

The  following  table,  constructed  by  Dr.  Golding  Bird,  shows  at  a 
glance  the  amount  of  solid  matter  in  1000  grains  of  urine  of  different 
densities :  — 


FIO.  118. 


i  1 1  ilnliiMiillilljWMlMliimHIMi 


^M^a^ 


m 


mber  color, 
iific  gravity 
rlike  smell, 

ely,  is  pale, 
009,  and  is 
m  of  a  full 
[ravity  f  lom 
1(1  is  passed 

sanguinis; 
is  the  best 
ine. 

phosphoric 
when  these 

iper  be  first 
per  will  be 
remain  un- 
;mus  paper; 
brown,  and 
the  color  in 
al;  that  is, 

in.     This  is 

instrument 

dimeter.    It 

;illed  water, 

mmersed  in 

ows  that  in 

not  sink  so 

off  into  de- 

this  instru- 

mber  on  the 

quid,  when 

aid.     If,  for 

a  the  scale, 

),  it  will  be 

ysician  may 

18  it  may  be 

I  out  of  the 

often  give 

shows  at  a 
of  different 


DISEASES  OF   THE  ABDOMINAL  OAVITT. 


347 


Speoiflo 
Gravity. 

Solids. 

Water. 

Speciflc 
Gravity. 

SoUdi. 

Water. 

Speoiflo 
Gravity. 

SoUd(. 

Water. 

Specific 
Gravity. 

Solldi. 

Water. 

1001 

2.31'. 

997.67 

1011 

26.63 

974.37 

1021 

48.93 

951.07 

1031 

72.23 

927.77 

1002 

4.66 

905.34 

1012 

27.96 

972.04 

1022 

61.26 

948.74 

1032 

74.66 

926.44 

1003 

6.99 

993.01 

1013 

30.29 

969.71 

1023 

53.59 

946.41 

1033 

76.89 

923.11 

1004 

9.32 

990.68 

1014 

32.62 

9t)7.38 

1024 

55.92 

944.18 

1034 

79.22 

920.78 

1005 

11.6S 

998.35 

1016 

34.96 

!)65.05 

1026 

68.26 

941.75 

1036 

81.66 

'J18.46 

1006 

13.98 

986.02 

1016 

37.23 

962.72 

1026 

60.60 

939.42 

1036 

83.88 

916.12 

1007 

16.31 

683.69 

1017 

39.61 

960.39 

1027 

62.91 

937.09 

1037. 

86.21 

913.79 

1008 

18.64 

981.36 

1018 

41.94 

958.0(1 

1028 

65.24 

934.76 

1038 

88.54 

911.46 

1009 

20.97 

979.03 

1019 

44.27 

955.73 

1029 

67.67 

932.43 

1039 

91.87 

909.13 

1010 

23.30 

976.70 

1020 

46.60 

963.40 

1030 

89.90 

930.40 

1040 

93.20 

906.80 

The  mode  of  using  the  above  table  is  this.  Having  learned  the 
density  of  the  urine  passed  in  twenty-four  hours  by  means  of  the 
urinometer  (Fig.  115),  a  glanc  at  the  table  will  show  the  proportion 
of  solid  matter  and  water  in  1000  grains  of  the  urine.  Then,  by 
weighing  the  whole  quantity  of  urine  passed  in  twenty-four  hours, 
the  weight  of  solids  drained  off  by  the  kidneys  may  be  determined 
by  the  simple  rule  of  proportion. 

Symptoms  of  Qravel.  —  A  sudden  attack  of  pain  in  the  region  of 
the  kidneys,  so  acute  and  severe,  frequently,  as  to  cause  fainting  and 
even  convulsions.  The  pain  runs  down  to  the  groin  and  thigh,  caus- 
ing a  numbness  on  the  affected  side,  and  a  drawing  up  of  the  testicle. 
The  pain  is  excessive  at  times^,  and  then  remits.  Finally  it  stops 
suddenly. 

Leading  from  the  kidneys  to  the  bladder  are  two  small  tubes  about 
the  size  of  a  goose-quill,  called  ureters,  —  being  the  appointed  chan- 
nels of  the  urine.  The  pain,  of  which  I  have  spoken,  is  caused,  gen- 
erally, by  the  passage  of  a  stone  along  one  of  these  small  tubes.  If 
the  stone  happen  to  be  a- little  too  large  for  the  tube,  or  uneven  or 
ragged  upon  its  surface  so  as  to  bruise  and  tear  the  delicate  lining 
of  the  ureter,  severe  pain  is  the  result.  The  pain  is  intense  when  the 
stone  moves  along ;  remits  when  it  stops ;  and  suddenly  ceases  alto- 
gether, when  it  gets  through,  and  drops  into  the  bladder. 

Sometimes  there  is  no  pain,  the  gravel  being  so  fine  as  to  pass 
through  the  ureters  very  easily.  It  then  passes  through  the  urethra 
also,  and  is  found  as  a  sediment  of  the  urine  at  the  bottom  of  the 
vessel. 

These  urinary  deposits  are  various,  and  quite  unlike  each  other  in 
kind.  They  indicate  different  states  of  health,  and  require  to  be 
spoken  of  separately. 

Uric-Acid  Qravel. 

This  form  of  deposit  passes  indifferently  under  the  name  of  uric 
acid  gravel,  or  lithie  acid  gravel.  The  person  who  is  in  the  habit  of 
passing  this  kind  of  deposit  largely,  is  said  to  have  the  lithie  or  uric 
acid  diathesis  or  condition. 

The  urine  of  persons  in  this  state  lets  fall,  after  it  has  stood  awhile, 


1 


84a 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


' 


a  reddish  sediment,  like  brickdust.  This  consists  chiefly  of  urate  of 
ammonia  (Figs.  116  and  117),  tinged  with  certain  coloring  matters. 
This  coloring  substance  may  be  more  or  less  abundant,  anil  give  to 
the  deposit  various  shades,  as  dirt;y-white,  yellow,  pink,  and  red.    The 


FIO.  116. 


Fig.  117. 


pure  uric  acid  sometimes  appears  as  fine  sand,  or  large  crystals  (Fig. 

118).     The  urine  is  of  a  dark  copper-color,  about  like  brown  sherry^ 

and  is  more  scanty  than  in  health.  It  is 
also  highly  acid,  giving  to  litmus  paper 
a  deeper  shade  of  red. 

Persons  who  pass  this  kind  of  gravel 
largely  are  apt  to  be  troubled  with  in- 
flammatory complaints;  with  acidity  of 
the  stomach  and  heartburn;  and  some 
of  them  with  gout  and  rheumatism. 

Placed  under  a  blowpipe,  uric  acid  is 
decomposed,  and  gives  out  an  odor  like 
that  of  burnt  feathers,  combined  with 
the  oil  of  bitter  almonds,  it  is  dissolved 
by  liquor  potassa,  from  which  muriatic 
and  nitric  acids  precipitate  it;  and  by 
sulphuric  acid,  from  which  it  is  precipi- 
tated by  water.  Acetic,  nitric,  and  mu- 
FiG.  118.  riatic  acids,  alcohol,  ether,  and  water,  do 

not  dissolve  it. 

Causes.  —  Uric  acid  is  the  form  in  which  nitrogen  and  the  effete 
compounds  which  contain  it  are  got  out  of  the  body.  It  is  the  result 
of  the  decomposition  of  the  tissues  of  the  body.  Its  gravelly  particles 
are  the  sands  of  life  daily  washed  out  of  us,  —  reminding  us  always 
that  we  are  wasting  away.  Whatever  causes  the  body  to  waste 
rapidly,  produces  it  in  excess.  We  find  it,  therefore,  in  the  urine  of 
those  who  suffer  from  gout,  rheumatism,  dyspepsia,  fevers,  debility  of 
the  genital  organs,  straining  of  the  loins,  etc.,  which  produce  loss 
of  flesh. 

Treatment.  —The  remedies  for  this  uric-acid  gravel  are  the  alka- 
lies, bicarbonate  of  potash,  bicarbonate  of  soda  and  magnesia.     The 


ite 


■•«l»" 


DISEASES  OF  THE   ABDOlfflNAL  OAVITT. 


349 


:)f  urate  of 

g  matters. 

1^.  give  to 

red.    The 


■stals  (Fig. 
iwn  sherry, 
alth.  It  is 
tmus  paper 

d  of  gravel 

ed  with  in- 

acidity  of 

and  some 

latism. 

uric  acid  is 

n  odor  like 

bined  with 

dissolved 

muriatic 

;    and  by 

is  precipi- 

and  mu- 

water,  do 

the  effete 
the  result 
y  particles 
us  always 
to  waste 
\e  urine  of 
debility  of 
oduce  loss 

the  alka- 
is'm.     The 


first  named  is  generally  the  best.  It  may  be  used  in  the  form  of  the 
neutralizing  extract, — especially  if  there  be  costiveness.  If  the  bowels 
do  not  need  physic,  let  the  potash  be  taken  in  the  shape  of  lye  made 
from  hard- wood  ashes  ^300).  Fluid  magnesia  i&  an  excellent  remedy ; 
so  is  liquor  potassa,  taken  in  twenty  or  thirty-drop  doses.  The  urine 
must  be  w.itohed,  and  these  remedies  discontinued  when  it  becomes 
alkaline.     Black  coffee  drunk  freely  every  day  is  an  excellent  remedy. 

At  the  same  time  the  stomach  should  be.  supported  by  some  bitter 
tonic,  as  the  infusion  of  quassia,  gentian,  oolumbo,  Peruvian  bark,  etc. 

Iron  is,  in  many  cases,  not  to  be  ove:  )ked.  If  the  patient  be 
nale  and  bloodless,  some  of  the  preparations  of  this  metal  will  be 
needed  (61),  (73),  (74). 

Acid  must  be  carefully  avoided,  both  in  food  and  drink. 

The  diet  must  be  plain,  digestible  and  nourishing,  and  quite  mod- 
erate in  amount.  The  quality  is  of  less  consequence  than  the  quan- 
tity. 

Exercise  is  of  great  consequence,  and  must  be  regular,  and,  if  pos- 
sible, in  the  open  air. 

The  skin  must  receive  daily  attention  in  the  shape  of  an  alkaline 
sponge-bath,  with  friction.  This  will  throw  upon  the  skin  much  of 
the  labor  done  by  the  kidneys.  Poland  Spring  water  used  in  large 
quantities  is  good. 

Phosphatic  Deposits. 

These  deposits  are  indicated  by  a  state  of  the  urine  just  the  oppo- 
site of  that  which  contains  the  uric-acid  gravel.  They  are  contained 
in  urine  which  is  either  alkaline  when  passed,  or  becomes  so  very  soon 
by  standing. 

As  the  urine  cools,  a  white  sand  falls  to  the  bottom,  and  frequently 
a  film  forms  upon  the  surface  of  the  water.  Looking  at  this  film  in 
different  lights,  you  may  see  in  it  the  several  colors  of  the  rainbow. 
Skira  off  this  pellicle,  place  it  upon  paper,  and  let  it  dry ;  and  you 
may  then  see  the  little  shining  crystals.  This  urine  quickly  grows 
putrid  and  offensive.  Sometimes  it  smells  strongly  of  ammonia. 
The  more  phosphates  it  contains,  the  sooner  it  becomes  alkaline. 

These  deposits  are  generally  the  triple  phosphates.  Healthy  urine 
contains  the  phosphate  of  magnesia  in  a  state  of  solution.  Under 
some  circumstances,  the  urea  of  the  urine  is  decomposed  in  the  kid- 
neys, anr^.  ammonia  is  disengaged.  This  combines  with  the  phosphate 
of  magnesia,  and  forms  the  triple  salt  of  the  phosphate  of  ammonia 
and  magnesia,  which  is  not  soluble. 

Symptoms.  —  A  sallow  complexion,  a  languid,  spiritless  state  of 
mind,  and  an  exhausted,  debilitated  condition  of  body.  The  urine  is 
pale,  rather  copious,  slightly  turbid,  has  a  low  specific  gravity,  and 
smells  unhealthy,  having  sometimes  the  faint  odor  of  weak  broth. 
There  is  generally  derangement  of  the  digestive  organs,  windy  stom- 
ach and  bowels,  nausea,  constipation,  or  diarrhoea,  stools  of  various 


iir 


360 


DISEASES   OF  THE   ABDOMINAL   CAVITY. 


colors,  and  sometimes,  in  diarrhoea,  resembling  yeast,  and  an  aching 
pain  and  weakness  in  the  loins. 

Causes.  —  These  deposits  are  produced  by  great  debility  of  the 
constitution,  by  injuries  of  the  spine,  dyspepsia,  defective  assimila- 
tion of  food,  bad  diet,  irritation  of  the  neck  of  the  bladder,  and  or- 
ganic disease  of  the  kidneys.  But  they  are  caused  more  especially 
hy  whatever  wears  and  exhausts  the  nervovs  system^  as  heavy  cares,  de- 
pression of  spirits,  sedentary  habits,  great;  mental  exertions,  mastur- 
bation, and  venereal  excesses. 

Tre»tment. — These  deposits  being  connected  with  great  debility, 
care  i-ust  be  t^ken  not  to  make  the  matter  worse  by  taking  active 
purgatives,  by  extrexne  fasting,  or  by  any  means  which  will  incresise 
the  weakness. 

On  the  contrary,  the  strength  must  be  supported  by  all  the  means 
that  can  be  commanded.  With  this  ^  iew,  the  citrate  of  iron  (75) 
may  be  taken.  Arsenic  combined  with  iron  (80),  to  allay  irritability, 
and  impart  strength  at  the  same  time,  may  be  used.  The  valerianate 
of  iron  (93)  is  excellent  for  the  same  puipose. 

Connected  with  a  state  of  urine  just  the  opposite  to  that  which 
holds  the  uric-acid  deposits,  this  form  of  gravel  calls  for  the  opposite 
remedies.  Instead  of  the  alkalies,  the  acids  are  wanted.  The  nitric 
and  muriatic  acids,  with  a  vegetable  tonic  (Tfi),  may  be  used.  Borax 
is  spoken  of  in  high  terms,  and  is  thourht  by  some  to  have  great 
power  in  turning  alkaline  urine  acid.  T  e  compound  balsam  of  sul- 
phur is  highly  spoken  of,  and  the  compouii  infusion  of  trailing  arbu- 
tus is  also  mentioned  with  approbation. 

It  is  all-important  to  throw  off  care,  and  to  give  the  mind  a  chance 
to  rise  up  with  all  the  elasticity  it  has.  To  bring  this  about,  journeys 
and  amusements  are  useful.  The  society  of  lively,  laughing,  witty 
friends  will  do  a  great  deal  to  give  the  spirits  a  lebound,  and  the 
whole  health  an  upward  movement.  Such  persons  are  a  blessing  to 
th^  world ;  and  he  who  reckons  a  few  of  them  among  his  friends  will 
live  the  longer  for  it. 

The  skin  should  have  the  benefit  of  the  daily  tonic  effect  of  a 
sponge-bath,  with  water  at  first  tepid,  and  afterwards  cool ;  and  exer- 
cise, out  of  doors,  should  be  habitual,  and  connected,  as  much  as  pos- 
sible, with  objects  of  pleasure. 

The  drinking  of  hard  water  is  highly  injurious  ;  and  if  none  other 
can  be  had,  it  should  be  distilled,  and  then  spread  out  to  the  atmos- 
phere, in  shallow  vessels,  that  it  may  recover  its  pleasant  taste  by 
reabsorbing  air  and  carbonic  acid. 

Oxalic  Deposits. 

.  Oxalate  of  lime  a\  the  urine  is  the  cause  of  this  kind  of  gravel, 
It  appears  in  the  form  of  dumb-bells,  and  octahedral  crystals.  (Figs. 
119,  120,  and  121.) 


1  an  aching 

lility  of  the 
ve  assimila- 
ier,  and  or- 
B  especially 
f-y  cares,  de- 
3ns,  mastui- 

eat  debility, 
iking  active 
irill  increase 

LI  the  means 
f  iron  (75) 
r  irritability, 
3  valerianate 

I  that  which 
the  opposite 

The  nitric 
sed.     Borax 

have  great 
[vlsam  of  sul- 
railing  arbu- 

ind  a  chance 
)ut,  journeys 
yhing,  witty 
nd,  and  the 
blessing  to 
friends  will 

effect  of  a 
1;  and  exer- 
nuch  as  pos- 

E  none  other 
0  the  atmos- 
i,nt  taste  by 


d  of  gravel. 
T.h.     (Figs. 


DISEASES  OF   THE   ABDOMINAL   CAVITY. 


351 


The  urine  has  a  specific  gravity  of  1.015  to  1.025,  and  is  genemlly 
of  a  dark  amber-color,  and  clear  and  bright ;  it  is  generally  acid, 


Fio.  iia 


Fio.  lao. 


Fio.  121. 


though  occasionally  alkaline  or  neutral.     Urea  is  generally  found  in 

it,  and  epithelial  cells  (Fig.  122).     Unlike  the 

uric   and   phosphatic  urines,  it   is   quite   free 

from  sediments,  except,  as  often  happens,  there 

is  a  large  amount  of  urea  in  it,  in  connection 

with  the  oxalate  of  lime. 

When  the  urate  of  ammonia  is  combined  with 
the  oxalate  of  lime,  it  often  happens  that  the 
latter  has  to  be  dissolved  with  a  little  liquor 
potassa,  before  the  former  can  be  seen  with  the 
microscope.  *''*'•  *^- 

Symptoms. — Great  depression  of  spirits,  excitable  state  of  the  ner- 
vous system,  painful  susceptibility  to  external  impressions,  dyspeptic 
symptoms,  and  disturbances  of  the  liver,  a  fear  and  dread  of  consump- 
tion, emaciation,  inability  to  make  exertion,  —  the' smallest  exertion 
causing  fatigue ;  in  men,  a  deficient  sexual  power,  a  pain  and  weight 
across  the  loins,  and  some  irritability  of  the  bladder. 

Causes.  —  These  deposits  are  supposed  to  result,  like  most  other 
derangements  connected  with  loss  of  flesh,  in  too  great  a  degree  of 
oxidation.  Vegetables  produce  oxalic  acid  by  just  the  opposite  pro- 
cess, namely,  deoxidation. 

Whatever  depresses  the  vital  powers,  may  generate  this  deposit, 
as  mental  depression,  overwork  of  the  brain,  burdensome  cares,  idle- 
ness of  mind  or  body,  masturbation,  debaucheries,  intemperance,  vene- 
real excesses,  and  injuries  of  the  spine. 

This  deposit  may  also  be  produced  by  certain  articles  of  diet,  which 
contain  the  oxalic  acid.  Among  these  may  be  named  the  rhubarb 
plant,  which  in  summer  is  largely  used  for  tarts ;  and  sorrel. 

Treatment.  —  The  treatment  for  these  deposits  should  be  very 
much  like  that  for  the  phosphatic.  The  stomach  and  liver  should 
receive  some  special  attention.  A  pill  of  leptandrin,  podophyllin, 
etc.  (39),  may  be  usvorl  with  advantage.  The  preparation  of  nitric 
and  hydrochloric  acids  (76)  mu-^it  generally  be  taken  for  some  time. 
In  cases  of  great  irr'tability,  the  sulphate  of  zinc  (82)  does  well. 


i 


i 


II 


t 


352 


DISEASES  OF  THE   ABDOMINAL  CAVITY. 


The  diet  should  be  plain,  digestible,  and  nourishing, —  all  articles 
containing  oxalic  aoid  being  rejected,  as  the  rhubarb  plant,  sorrel, 
tomatoes,  onions,  etc. 

For  the  rest,  folJow  the  directions  for  the  treatment  of  phosphatic 
deposits. 

Urate  of  Ammonia  Deposits. 

The  urine  which  contains  these  deposits  is  generally  pale,  and  of 
low  specific  gravity,  about  1.012.  It  becomes  opaque  on  cooling, 
from  the  deposition  of  a  nearly  white  urate  of  ammonia.  Instead  of 
falling  down  readily,  tliis  forms  ropy  masses  in  the  fluid,  and  looks 
like  mucus  or  pus,  or  something  between  the  two.  Its  real  nature  is 
discovered  by  applying  a  little  heat,  which  quickly  dissipates  it. 

Microscopic  Character.  —  Place  a  drop  of  this  turbid  urine  te- 
tween  two  slips  of  glass,  and  examine  it  closely  with  a  microscope ; 
you  will  see  myriads  of  minute  globules  adhering  together  in  lirear 
masses.  Now  place  a  drop  of  the  turbid  urine  in  a  watch-glass,  and 
gently  warm  it ;  as  soon  as  it  has  become  clear,  add  a  drop  of  hydro- 
chloric acid  to  it,  and  when  it  is  cold,  examine  it  with  the  microscope. 
The  muddiness  will  be  gone,  and  you  will  now  see  lozenges,  or  thick 
cohering  prisms  of  uric  acid  (Fig.  123).  The  explanation  of  this  is, 
that  the  hydrochloric  acid  combines  with  the  ammonia,  forming  muri- 
ate of  ammonia  in  solution,  and  liberating  the  uric-acid  crystals. 


FiQ.  12a 


FIO.  124. 


Urate  of  soda  (Fig.  124)  is  sometimes  found  in  urine,  which  has 
similar  chemical  reactions  with  urate  of  ammonia. 

Causes.  —  These  deposits  are  generally  produced  by  some  over- 
eating, or  derangement  of  the  skin. 

The  treatment  is  the  same  as  that  for  uric-acid  gravel. 

Hippuric  Acid  Deposits. 

These  deposits  appear  in  the  healthy  urine  of  the  cow  and  the 
horse ;  and  also  in  that  of  human  beings,  but  in  such  small  quanti- 
ties as  to  be  scarcely  appreciable. 

They  sometimes,  however,  appear  in  unhealthy  proportions ;  but 
they  never  show  themselves  as  a  sediment,  until  after  the  addition 


-atasmaaCMMHaMH 


■  all  articles 
>lant,  Borrel, 

phosphatic 


pale,  and  of 
on  cooling, 
Instead  of 
1,  and  looks 
3al  nature  is 
pates  it. 

id  urine  l)e- 
microscope ; 
er  in  lii;ear 
sh-glass,  and 
op  of  hydro- 
micro3coi)e. 
ges,  or  thick 
on  of  this  is, 
irming  muri- 
jrystals. 


!,  which  has 
some  over- 


ow  and  the 
mall  quanti- 

)rtion8 ;  but 
he  addition 


DISEASES  OF  THE   ABDOMINAL  CAVITY. 


85S 


of  a  stronger  acid.     The  urine  containing  them  is  generally  slightly 
acid  or  neutral,  —  sometimes  alkaline,  —  having  a  low  specific  gravity, 

from  1.006  to  1.008.      The  triple  phosphates 
are  often  found  in  it. 

To  detect  these  deposits,  fill  a  large  watch- 
glass  with  urine,  and  evaporate  it  over  a  lamp 
to  a  few  drops.  Then  add  to  it  about  half 
its*  bulk  of  hydrochloric  acid,  and  set  it  aside. 
The  addition  of  the  acid  produces  a  bright 
pink  color,  and  an  odor  like  new  hay.  After 
a  few  hours,  if  the  hippuric  acid  be  present,  its 
'*»•  "»•  peculiar  crystals  will  be  seen.     (Fig.  126.) 

Cause.  —  In  man,  this  deposit  is  supposed  to  depend  on  the 
absence  of  food  having  a  good  share  of  nitrogen.  The  urine  of 
vegetable-eaters  contains  it  in  largest  quantities. 

Treatment. — The  only  treatment  required  is  a  diet  composed  in 
good  proportion  of  animal  food,  a  proper  attention  to  the  skin  by 
bathing,  etc.,  and  when  debility  exists,  tonic  medicines,  as  iron  and 
bittera,  with  out-aoor  exercise  enough  to  keep  the  muscles  in  working 
order. 

Cystine  Deposits. 

These  do  not  occur  in  healthy  urine,  and  rarely  as  an  element  in 
diseased  action.     They  contain  twenty-six  per  cent  of  sulphur. 

Urine  which  contains  cystine  is  of  a  pale  yellow  color,  and  has  a 
low  specific  gravity.  It  frequently  has  an  oily  appearance,  and  its 
smell  is  peculiar,  resembling  that  of  sweet  brier.  Sometimes  its  odor 
is  fetid,  like  putrid  cabbage.  On  being  kept  for  a  short  time,  it  has 
its  surface  covered  with  a  pellicle  which  looks  oily,  and  consists  of  a 
mixture  of  crystals  of  cystine  and  the  phosphate  of  ammonia  and 
magnesia. 

The  cystine  deposit  appears  to  be  diffused  through  the  urine,  which 
is  always  turbid  when  boiled.  It  is  a  white  or  fawn-colored  powder, 
and  falls  to  the  bottom  as  a  sediment.  It  undergoes  no  change  by 
warming  the  urine,  and  this  distinguishes  it  from  white  urate  of 
ammonia.  It  is  not  soluble  in  diluted  hydrochloric  or  strong  acetic 
acid,  which  distinguishes  it  again  from  the  earthy  phosphates. 

To  test  this  deposit,  add  liquor  ammonia  to  a  portion  of  it,  and 
shake  them.  If  the  deposit  be  cystine,  it  will  dissolve  readily.  Allow 
a  few  drops  of  the  solution  to  evaporate  on  a  slip  of  glass,  and  the 
six-sided  tablets  of  cjrstine  will  remain,  which  may  be  examined  under 
the  microscope.     (Fig.  126.) 

It  is  to  be  remembered  that  occasionally  the  chloride  of  sodium  or 
common  salt  crystallizes  in  octahedral  forms  (Fig.  127),  which,  in 
some  positions,  may  look  very  much  like  cystine.  The  r-^ady  solu- 
bility of  the  chloride  in  water,  and  the  absence  of  all  color  when  they 
are  examined  by  polarized  light,  will  prevent  mistaking  these  crystals 


I  IH 


354 


DISEASES   OF  THE   ABDOMINAL   UAVITY. 


for  cystine.  If  urine  containing  common  salt  Ix'  quickly  evap«»mtod 
on  a  slip  of  glacs,  and  be  then  examined,  instead  of  the  octahedrouH, 
we  find  crosslets  and  daggers.     (Fig.  128.) 


no.  136. 


FlQ.  127. 


FlO.  128. 


Cause«.  —  i\.n  excess  of  sulphur  in  the  tissues,  a  scrofulous  consti- 
tution, and  hereditary  predisposition,  with  defective  oxidation,  and 
torpidity  of  the  liver.  It  is  often  found  in  the  urine  of  girls  who 
have  the  green  sickness. 

Treatment. — The  great  object  is  to  improve  the  general  health, 
which  is  to  be  done  by  attending  to  the  skin,  and  the  administration 
of  iron  and  bitters,  and  also  alteratives.  The  syrup  of  iodide  of  ij-on 
is  a  valuable  remedy.  Podophyllin  and  leptandrin  (34)  are  wanted 
to  regulate  the  liver.     The  nitro-muriatic  acid  (76)  should  be  tried. 

The  daily  sponge-bath,  and  daily  exercise,  as  in  most  chronic  com- 
plaints, must  on  no  account  be  neglected.- 

Stone.  —  Calculus. 

It  often  happens  that  the  proper  treatment  for  removing  urinary 
deposits  is  not  adopted  in  season.  In  such  cases,  gravelly  particles, 
finding  a  lodgment  for  a  time,  in  the  kidneys  or  bladder,  are  apt  to 
draw  other  particles  to  themselves,  which  become  fastened  to  them, 
and  form  a  layer  quite  around  them.  Over  this,  other  layers  form  in 
succession,  until  a  stone  is  produced  so  large  that  it  cannot  pass  off. 
These  grow  to  various  sizes, — being  sometimes  so  large  as  to  fill  the 
bladder. 

Uric-Acid  Calculus. — The  most  common  of  these  formations  is  the 
uric-acid  calculus.  It  is  generally  smooth  or  slightly  tuberculated  on 
the  surface,  and  varies  in  color  from  a  pale  yellowish-fawn  to  a  red- 
dish-brown. When  sawn  through  the  centre,  its  layers  will  be  found 
tolerably  regular,  but  of  different  thickness.     (Fig.  129.) 

To  test  it,  place  a  small  fragment  upon  platinum  foil  under  the 
blow-pipe.  If  uric  acid,  it  blackens,  and  gives  out  an  odor  like  burnt 
feathers  mixed  with  the  oil  of  bitter  almonds. 

Mixed  Calculus.  —  These  calculi  are  frequently  composed  of  two 
or  more  different  kinds  of  matter  arranged  in  irregular  layers.  Fig. 
180  is  a  mixed  calculus, — the  dark  layers  being  oxalate  of  lime,  the 
light  ones  uric  acid. 


mum 


DI8KA8E8  OF  THE   ABDOMINAL  CAVITY, 


855 


■  evapomtod 
)ctahedronH, 


•'la.  128. 

iilous  consti- 
idation,  and 
of  girls  who 

leral  health, 
[ministration 
adide  of  ij-on 
I  are  wanted 
aid  be  tried, 
jhronic  com- 


rmg  urinary 
ly  particles, 
,  are  apt  to 
ed  to  them, 
yers  form  in 
lot  pass  off. 
as  to  iill  the 


In  testing  such,  fragments  of  each  ingredient  should  be  separately 
examined. 

Urate  of  Ammonia  Calculus.  —  We  occasionally  meet  with  a  cal- 
culus composed  of  the  urate  of  ammonia.  These  calculi,  whtn  found, 
are  generally  small  in  size,  smooth  or  slightly  tuberculated  upon  the 
surface  (Fig.  131),  and  of  a  pale  slate  or  clay  color.  When  heated 
before  the  blowpipe,  it  gradually  disappears. 


FlQ.  129. 


KlU.  130. 


PlO.  lUl. 


Phosphate  of  Lime  Calculus.  —  This  has  a  smooth  polished  s'm- 
face,  and  quite  regular  layers,  which  separate  easily  when  the  calculus 
is  cut  asunder.     It  has  a  pale  fawn  or  stone  color.     (Fig.  182.) 

It  chars  before  the  blowpipe,  and  gradually  becomes  wliite  as  the 
carbon  burns  away.  Diluted  nitric  or  hydrochloric  acid  dissolves  it 
without  effervescence. 

Oxalate  of  Lime  Calculus.  — ^  This  is  frequently  met  with  uncom- 
bined  with  others,  but  more  generally  its  nucleus  is  uric  acid  or  urate 
of  lime.  It  commonly  has  a  brown,  dark-olive,  or  dirty-purple  color. 
Its  surface  is  irregular  and  somewhat  rough.  It  looks  like  the  fruit 
of  the  mulberry,  and  is  known  as  the  mvlbenry  calculus.     (Fig.  138.) 

It  dissolves,  without  effervescence,  in  diluted  nitric  or  hydrochloric 
acid.  When  thus  dissolved,  the  addition  of  a  little  ammonia  will 
cause  it  to  fall  to  the  bottom  as  a  white  precipitate. 


lations  is  the 
erculated  on 
wn  to  a  red- 
^ill  be  found 

) 

1  under  the 

or  like  burnt 

osed  of  two 
ayers.  Fig. 
of  lime,  the 


FlO.  132. 


FIO.  133. 


FIO.  1S«. 


Fusible  Calculus. — This  is  a  mixture  of  phosphate  of  lime  and  the 
phosphate  of  ammonia  and  magnesia.  It  is  the  most  common  of 
all  the  calculi,  except  the  uric  acid.  It  has  an  oval,  irregular  form 
(Fig.  134),  and  is  white,  soft,  and  friable,  like  chalk.  Sometimes  it 
is  hard.  ' 

It  may  be  known  by  the  readiness  with  which  it  melts  down  before 
the  blowpipe,  without  being  consumed. 

Causes.  —  The  causes  of  the  different  kinds  of  gravel  have  been 
already  explained.     Generally  atones  of  the  bladder  are  formed  in  the 


366 


DIBBASES  OF   THE    ABDOMINAL   CAVITY. 


kidney,  and  descending  through  the  uretere  into  the  bladder,  arc  pr(>- 
vented  fi-om  passing  out  through  the  water-pipe  by  an  enhirged  proH- 
tate  gland.  Remaining  in  the  bladder,  they  soon  get  encrusted  over 
by  other  matters  in  the  nrine,  and  grow  by  ciccrotion  to  be  stones. 

Symptoms.  —  When  a  stone  in  the  bladder  reaches  a  certain  size, 
especially  if  it  is  rough,  it  always  produces  suffering.  A  dull,  annoy- 
ing pain  is  felt  at  the  end  of  the  penis.  The  desire  to  make  water  in 
frequent,  and  there  is  a  sense  of  weight  in  the  perineum.  Sometimes 
the  stream  of  urine  is  suddenly  stopped  by  the  stone  falling  on  the 
orifice  of  the  urethra.  As  the  bladder  becomes  nearly  emptied,  it 
embraces  the  stone,  and  the  pain  is  inci-eased.  Jolting  in  a  carriage 
causes  great  pain.  Mucus  passes  off  with  the  urine,  and  sometimes 
blood.  After  a  time,  the  appetite  fails,  hectic  sets  in,  albumen  ap- 
pears in  the  urine,  and  the  patient  sinks  under  inflammation  of  the 
bladder. 

These  symptoms  being  found  in  diseases  of  the  kidneys  and  blad- 
der, no  one  is  authorized  to  pronounce  upon  the  existence  of  stone, 
until  the  stone  has  been  touched  by  a  metallic  sound  introduced  into 
the  bladder. 

Treatment.  —  The  only  effectual  treatment  is  a  choice  between 
three  operations,  —  lithotrity,  lithotomy,  litholopaxy. 

The  first  consists  in  introducing  an  instrument,  a  kind  of  forceps, 
into  the  bladder,  through  the  urethra,  taking  hold  of  the  stone,  and 
crushing  it.  The  preparatory  treatment  consists  in  correcting  the 
unhealthy  state  of  the  urine,  and  the  frequent  introduction  of  bougies 
or  sounds  to  enlarge  the  water-pipe  for  the  easy  entrance  of  the 
crushing  forceps.  The  after  treatment  consists  in  diluent  drinks  to 
increase  the  urine,  injections  of  warm  water  to  wash  out  the  frag- 
ments, with  hip-baths,  soothing  injections,  and  leeches  or  cupping 
upon  the  perineum. 

Lithotomy  consists  in  making  an  incision  into  the  bladder  through 
the  perineum,  and  taking  out  the  stone  or  stones  whole. 

Litholopaxy  consists  in  crushing  the  stone  in  ntu  by  means  of  the 
lithotrite  and  syphoning  out  the  debris. 

Dropsy  of  the  Belly.  —  Ascites. 

This  is  a  collection  of  water  in  the  cavity  of  the  belly ;  sometimes 
the  fluid  is  outside  of  the  peritoneum,  and  next  to  the  muscles. 

Symptoms.  —  An  enlargement  of  the  belly,  with  a  sense  of  disten- 
tion and  weight,  —  particularly  on  the  side  on  which  the  patient  lies. 
When  the  collection  of  water  is  large,  .the  breathing  becomes  short 
and  difficult,  and  the  swelling  is  uniform  over  the  whole  abdomen. 

In  some  instances  the  fluctuation  of  the  water  may  be  distinctly 
heard  when  the  patient  moves  about,  —  just  as  we  may  hear  the 
water  in  a  half-filled  barrel  when  it  is  rolled  over.  This  sound  of 
the  fluid,  when  heard,  distinguishes  the  complaint  from  pregnancy. 


DIBEASES   OF  THK   ABDOMINAL   CAVITY. 


357 


iiiid  Ifom  the  drum-head  state  of  the  bowels.  This  fluctuation  nmy 
Hometimes  be  produced  by  pressing  ujKjn  one  side  of  the  belly  while 
the  patient  is  standing  or  sitting,  and  striking  the  other  side  with  the 
ends  of  the  fingers  of  the  other  hand. 

In  some  citses,  there  is  loss  of  appetite,  dry  skin,  eostiveness,  scanty 
urine,  oppression  of  tho  chest,  cough,  colic  pains,  and  variable  pulse. 

Causes.  —  A  frequent  cause  of  this  complaint  is  chronic  inflamma- 
tion of  the  serous  membrane  which  lines  the  abdomen,  —  I  mean  the 
peritoneum.  It  may  also  be  produced  by  scarlet  fever,  fever  and 
ague,  disease  of  the  heart,  particularly  dilation  of  the  right  cavities, 
and  diseases  of  the  liver,  particularly  the  shrivelled,  hobnail  condition 
of  the  liver,  —  in  short,  whatever  causes  a  pressure  upon  the  portal 
veins,  and  obstructs  the  venous  blood  returning  fi-om  the  intestines. 

Treatment. — The  remedies  for  this  disease  are  mainly  diuretics 
and  purgatives.  The  IwweLs  may  sometimes  be  reduced  in  a  few 
days  from  an  enormous  size,  by  medicines  which  excite  the  action  of 
the  kidneys.  Digitalis  combined  with  acetate  of  potash,  etc.  (130), 
forms  an  excellent  preparation.  The  patient  should  have  as  a  con- 
stant drink,  a  strong  infusion  made  from  two  parts  of  hair-cap  moss, 
and  one  each  of  juniper  berries  and  dwarf-elder  bark ;  also  an  infu- 
sion of  queen  of  the  meadow. 

The  purgatives  used  in  this  complaint  are  those  which  produce 
watery  stools.  One  of  the  best  of  these  is  elaterium.  It  will  some- 
times carry  off  the  water  with  great  rapidity ;  combined  with  some 
active  catliartics  (31),  it  will  have  all  its  good  effects  without  the 
griping  it  is  apt  to  occasion  alone. 

Cream  of  tartar,  taken  in  large  doses,  every  day,  will  sometimes  do 
wt  11.     Epsom  salts  produces  watery  stools,  and  is  a  good  remedy. 

For  promoting  absorption  of  the  fluid,  the  iodide  of  potassium, 
taken  in  from  three  to  ten-grain  doses,  three  times  a  day,  is  a  valua- 
ble medicine  in  many  cases.  The  compound  infusion  of  parsley  is 
said  to  be  still  better. 

The  skin  must  receive  careful  attention.  The  alkaline  sponge 
bath,  with  friction,  will  increase  the  tianspiration  of  fluid  through 
that  organ.  Exercise  does  much  to  keep  up  an  active  circulaticm, 
and  to  lessen  dropsical  effusions. 

The  strictest  temperance,  both  in  eating  and  drinking,  must  be 
olwerved.  A  light  and  nourishing  diet,  with  water,  tea,  and  the 
diuretics  named  above  for  drinks ;  beyond  these  the  patient  must 
not  go. 

A  kneading  and  shampooing  of  the  bowels  once  a  day  has  an 
excellent  effect ;  it  gives  activity  to  the  circulation  in  obstructed 
veins.  A  bandage  tied  close  ai'ound  the  bowels,  and  tightened  as 
the  water  diminishes,  has  an  effect  upon  the  sluggish  vessels  similar 
to  that  of  the  laced  stocking  in  varicose  veins  of  the  legs.  It  lessens 
the  liability  of  a  return  of  the  complaint.  * 


358 


IM.SKASKH   OK    THK    AUDOMINAI.   CAVITY. 


Dropsy  of  the  Cells.  — General  Dropsy.  —  Ananarra. 

JuHT  undcir  tho  Hkin  in  a  ineniimino  coinposed  (^liiufly  of  colls, 
called  tho  cellular  inombraiie.  When  a  ((mHideiablo  part  or  tlio 
whole  of  these  celln  are  filled  with  a  watery  lluid,  we  call  tho  com- 
plaint anaaarca,  or  cell-dropiiy.  If,  iMisideH  this,  there  isi  a  eoUectiuii 
of  water  in  the  large  cavities,  we  give  it  tho  name  of  general  dropty. 

Symptoms.  — The  dineaHe  generally  Iwgins  with  a  swelling  around 
the  ankle  aiul  leg,  which  is  more  visible  at  night  after  standing  and 
walking,  and  is  less  perceptible  in  the  morning  in  consecjuence  of 
the  horizontal  position  of  the  night.  To  tho  touch  of  another  person, 
dropsical  feet  and  legs  feel  a  little  colder  than  natural ;  and  when 
hard  pressed  with  the  finger,  a  pit  will  be  sunk  ii:  the  flesh,  which 
remains  some  time  before  it  fills  u[).  As  tlie  disease  advances,  the 
skin  of  the  legs  becomes  smooth,  shining,  and  sometimes  even  cracks 
open  to  let  out  the  water.  The  limbs,  and  indeed  tho  whole  person, 
become  stiff,  heavy,  and  clumsy. 

As  the  disease  advances,  and  ascends  to  the  belly  and  chest,  there 
is  shortness  of  breath,  a  sense  of  suffocation  on  moving  or  lying 
down,  a  tightness  and  distress  across  the  epigastrium,  thimt,  dryness 
of  skin,  wakefulness,  loss  of  appetite,  scanty  and  deep-colored  urine, 
and  a  slow  fever. 

Cause.  —  General  dropsy  is  caused  by  whatever  weakens  the  gen- 
eral system,  and  by  such  circumstances  as  obstruct  the  circulation  in 
the  veins.  The  most  frequent  causes,  therefore,  are  certain  diseases 
of  the  heart  and  kidneys. 

Explanation. — Modern  physiology  has  demonstrated  that  the  veins 
do  a  certain  part  of  the  work  of  absorption.  The  serous  membranes 
which  line  the  larger  cavities  of  the  body  exhale  watery  fluid  enough, 
and  no  more  than  enough,  to  keep  them  moist,  and  cause  the  organs 
within  to  play  smoothly  upon  their  surface.  If  the  fluid  were  not 
taken  away  as  fast  as  it  is  poured  out,  the  cavity,  being  a  shut  sac, 
would  become  full,  and  we  should  have  dropsy.  It  is  the  office  of 
the  veins  to  absorb  this  fluid  and  convey  it  away  in  the  general  cur- 
rent of  the  blood. 

This  is  the  method  of  their  doing  it :  The  walls  oi  the  veins  are 
80  constructed  as  to  permit  watery  fluids  to  pass  through  them,  either 
in  or  out.  When  they  are  comparatively  empty,  or  only  moderately 
full,  fluids  on  the  outside  pass  in,  and  mingle  with  the  contents. 
This  is  called  endosmosis.  When  they  are  very  full,  the  watery 
portion  of  the  blood  will  filter  through,  and  pass  out.  This  is  called 
exosmosis. 

Now,  if  the  reader  will  thmk  a  little,  he  will  easily  see  that  if  the 
veins  are  bavaly  full  enough  not  to  allow  any  fluid  to  pass  in,  the 
natural  exhalations  of  the  shut  sacs  would  bring  on  dropsy ;  but  if 


-  ' wwn.  'te'Xsfxt^.vi4stiMii»t)B,sj^^gg0ggg0fij^ffgfii^^ 


l« 


Hi  II  I'l 


DlrtEAHRS   OF   THE   ABDOMINAI,   CAVITY. 


369 


I  namrca. 

y  of  coll8, 
)art  ur  tlie 

II  tho  coin- 
i  collection 
tral  dropmj. 

iinfj  around 
niKling  and 
■»e(juenco  of 
;her  person, 
;  and  when 
llcsh,  which 
IvanceH,  the 
even  cracks 
lole  person, 

chest,  there 
iig  or  lying 
ii-st,  dryness 
lored  urine, 

ens  the  gen- 
irculation  in 
ain  diseases 

lat  the  veins 
membranes 
uid  enough, 

the  organs 
id  were  not 
a  shut  sac, 
le  office  of 
general  cur- 
ie veins  are 
them.,  either 

modei-ately 
le  contents. 

the  watery 
his  is  called 

3  that  if  the 
pa89  in,  the 
psy;  but  i? 


the  veins  are  ho  full  as  to  ciuse  water  U^  Jlau'  out,  then  the  dropsical 
accumulalion  will  Ixi  still  more  rapid. 

Such  being  tlu!  ollico  arid  nature  of  tho  veins,  the  reader  may 
learn  how  di.raxr  of  the  rii/ht  aide  of  the  heart  will  vn\i»o  droi^y. 
When  the  right  ventriclo  is  8o  dilated  and  weakened  that  it  cannot 
send  tho  blood  forward  to  the  lungs,  of  course  the  veins  which  bring 
it  to  the  right  nide  of  the  heart,  will  become  full,  and  greatly  distended. 
Dxosmosis  will  then  occur;  the  watery  portion  of  the  blood  will 
iwgin  to  run  out,  either  into  the  larife  cavities,  or  into  the  cells,  and 
dropsy,  either  general  of  local,  will  be  the  result. 

Treatment. — Tliis  niu  '  be  goverened  very  much  by  the  cause  of 
the  disease. 

In  dropsy  from  disease  Oi'  the  heart,  we  may  use  diuretics  and 
such  otlier  methods  as  are  recommended  for  dropsy  of  the  belly. 
If  the  urine  is  strongly  acid,  depositing  the  brick-dust  sediment, 
the  alkalin(!  diuretics  will  »,"  the  best,  as  the  acetate  and  bicarbon- 
ate of  potash  combined,  and  dissolved  in  water.  The  bitartrate  of 
potassa.  to  act  upon  the  bowels,  is  a  proper  remedy.  If  the  disease 
arise  from  general  debility,  the  following  powder  will  be  useful: 
(ligitalin,  three  grains ;  cinchonia,  half  a  dram ;  phosphate  of  iron, 
half  a  dram  ;  and  white  sugar,  one  dram.  Mix,  and  triturate  ;  divide 
into  sixteen  powders,  and  give  one,  iu  pumpkin-seed  tea,  four  times 
u  day. 


■^t:^ 


r 


»'•■     I. 


VENEREAL  OR  SEXUAL  DISEASES. 


Op  all  the  diseases  to  which  flesh  is  heir,  none  bring  so  much 
misery,  moral  and  physical,  as  those  called  sexual  or  venereal.  To 
the  physician,  they  are  the  source  of  the  greatest  anxiety  and  per- 
plexity. They  bring  him  into  possession  of  the  most  delicate  secrets, 
—  secrets  which  involve  the  peace  of  families  and  neighborhoods,  — 
secrets  which  his  honor  as  a  man,  and  his  truth  as  a  physician,  compel 
him  to  lock  fast  in  his  own  breast,  and  hold  sacredly  apart  even  from 
his  nearest  companions, — se'' "^ets  which,  if  revealed  would  fill  domes- 
tic circles  with  unuttemble  bitterness  and  heartburning's,  and  whole 
neighborhoods  with  scandsil  and  immorality.  These  secrets  are  often 
a  burden  to  him.  They  are  in  his  breast  like  undigested  food  in  the 
stomach,  —  disturbing  the  whole  nature. 

The  patient,  if  a  man  of  sensibility,  suffers  even  more,  of  course, 
than  his  physician.  In  many  cases,  he  is  a  man  of  virtuous  inten- 
tions, and  perhaps  of  religious  habits,  who  has  fallen  in  a  momtint  of 
temptation ;  and  he  fears  that  the  effect  of  his  sin  will  spread  itself 
through  his  whole  system,  and  extend  to  the  end  of  life ;  or,  still 
worse,  that  having  poisoned  the  fountain  of  his  life,  it  will  go  down 
as  a  heritage  of  misery  to  his  offspring ;  or,  what  he  would  deprecate 
as  almost  equally  calamitous,  that  the  partner  of  his  bosom  may  be- 
come the  innocent  partaker  of  his  disease. 

In  this  state  of  apprehension,  he  turns  to  his  physician,  not  merely 
to  keep  his  secret,  but  to  cure  his  disease.  How  great  a  pity  that,  in 
such  circumstances,  he  does  not  always  fly  immediately  to  an  honor- 
able physician,  instead  of  seeking  the  advice,  as  many  do,  of  those 
miserable  quacks,  who  l",i-e  liim  to  their  dens  only  to  get  his  money, 
having  no  intention  or  ability  to  cure  his  complaint. 

These  diseases  are  divided  into  two  great  branches,  characterized, 
in  part,  by  different  symptoms,  and  generally  held  to  be  entirely  dif- 
ferent complaints.     The  first  to  come  under  consideration  is- 

Pox.  —  Syphilis. 

This  disease  had  a  very  early  origin.  It  was  knf^wn  among  the 
Jews,  as  we  learn  very  clearly  from  the  fifteenth  chapter  of  Leviticus. 
Dr.  Adam  Clarke's  Commentary  upon  this  chapter,  at  least,  makes  it 
apparent.  David,  the  king  of  Israel,  has  unconsciously  left  on  record, 
in  the  thirty-eighth  Psalm,  a  most  graphic  description  of  Tertiary 

860 


\\ 


E8. 


80  much 
jreal.  To 
jr  and  per- 
kte  secrets, 
•rhoods,  — 
an,  compel 
even  from 
fill  domes- 
and  whole 
ts  are  often 
[ood  in  the 

of  course, 
lous  inten- 
moment  of 
iread  itself 
e ;  or,  still 
1  go  down 
deprecate 
m  may  be- 
not  merely 
ity  that,  in 
3  an  honor- 
o,  of  those 
his  money, 

Uracterized, 
ntirely  dif- 
iff 


among  the 
Leviticus. 

t,  makes  it 
on  record, 

f  Tertiary 


VKNEREAL   OR   SEXUAL   DISEASES. 


361 


18 


Syphilis,  experienced  in  liis  own  person.  Dr.  Clarke  says :  "  It 
most  likely  the  Psalm  was  written  in  reference  to  some  severe  afflic- 
tion that  David  had,  after  his  illicit  commerce  with  Bathsheha ;  but 
of  what  nature,  we  are  left  to  conjecture  from  the  third,  fifth,  and 
seventh  verses."  The  Psalm  is  dated  not  quite  a  year  after  the  act 
alluded  to,  —  about  the  right  time  for  the  terrible  symptoms  David 
describes  to  make  their  appearance. 

The  term  syplulis  is  from  a  Greek  word  signifying  filthy.  There 
is  one  unvarying  sign  of  this  disease,  —  the  existence  of  an  ulcer  or 
ulcei-s,  usually  upon  the  genital  organs.  The  French  call  this  ulcer  a 
chancre.     The  common  name  is  simply  vet  sore,  or  ulcer.     A 

pimple  first  appears ;  on  the  summit  of  this  t  ,tule  forms ;  then  the 
rupture  of  the  top  of  this  brings  to  view  the  ulcer  or  sore.  This  ulcer 
is  shallow,  more  or  less  circular  or  oval  in  form,  bounded  by  a  perpen- 
dicular and  slightly  jagged  border,  and  furnished  with  a  smooth,  yel- 
low base,  moistened  by  an  unhealthy  secretion.  The  skin  around  the 
sore  is  a  little  thickened  and  inflamed.  This  is  a  simple  venereal 
ulcer.     It  generally  lasts  about  five  weeks,  and  tiien  heals. 

But  it  is  not  always  thus  simple.  It  may  be  an  inflammatory 
chancre,  attended  by  excessive  inflammation.  It  may  be  what  is 
CitUed  a  doiighing  chancre,  characterized  by  the  perishing  and  falling 
off  of  large  parts  of  flesh.  It  may  be  gangrenous,  or  marked  by  a  ten- 
dency to  mortification.  It  may  be  phagedenic,  or  eating, — being  dis- 
tinguished by  a  rapid  loss  of  substance,  or  eating  away  of  flesh.  Or, 
finally,  it  may  be  indurated,  —  being  noted  for  the  peculiar  liardness 
of  the  base,  and  of  the  flesh  immediately  around  it. 

A  venereal  sore  is  the  result  of  impure  connection  with  a  person 
having  the  syphilitic  disease.  The  poisonous  secretion  of  a  sore, 
applied  to  the  skin  of  a  healthy  person,  produces  inocidation,  and  a 
new  sore  upon  the  previously  healthy  person  is  the  result.  This 
chancre  appears  in  a  few  days  after  coition,  —  a  certain  time  being 
required  for  it  to  produce  its  effect,  as  in  the  application  of  vaccine 
matter  to  the  arm. 

Bubo.  —  The  next  symptom  in  the  order  of  occurrence,  which  fre- 
quently follows  the  ulcer,  is  the  bubo.  It  is  named  from  a  Greek 
word  which  means  groin,  from  its  usually  appearing  in  that  part. 
It  is  a  painful  swelling  of  the  inguinal  gland  in  the  groin,  and  is 
caused  by  the  absorption  of  virus  or  poisonous  matter  from  the 
chancre.  This  gland  is  one  of  the  lymphatics,  a  class  of  vessels  as 
numerous,  all  over  the  system,  as  the  veins  and  arteries.  They  are 
likewise  called  absorbents.  Those  that  originate  from  the  private 
parts  absorb  the  poison  from  a  venereal  sore,  and  convey  it  to  the 
glands  in  the  groin,  which  being  poisoned  by  it,  inflame  and  swell. 

The  bubo  generally  appears  in  from  one  to  two  weeks  from  the 
appearance  of  the  ulcer.  It  is  usually  upon  the  same  side  which  the 
chancre  occupies  upon  the  penis.  When  the  bubo  advances  to  oup- 
puration,  and  becomes  an  open  sore,  it  is  then  a  glandular  chancre. 


i 


M 


■4 


t',   I 


362 


VENEREAL  OR   SEXUAL   DISEASES. 


^^egfetations.  —  These  are  peculiar  growths  appearing  upon  differ- 
ent parts  of  the  skin,  which  resemble  certain  vegetables.  They  are 
found  most  frequently,  in  the  male,  on  the  head  of  the  penis,  and  on 
the  membrane  lining  the  foreskin.  In  the  female,  they  are- found  at 
the  entrance  to  the  vagina,  and  not  infrequently  in  the  vagina  itself. 
They  sometimes  appear  on  the  neck  of  the  uterus. 

Primary  Disease.  —  Thus  far,  the  diseases  noticed  are  what  are 
dalled  primary.  If  properly  treated,  and  cured  in  season,  the  consti- 
tution is  not  infected,  and  no  subsequent  troubles  appear.  But  a 
result  so  fortunate  as  this  is  not  common.  Generally,  the  treatment 
is  either  too  long  delayed,  or  is  too  brief  and  superficial.  The  poison 
is,  in  consequence,  absorbed  into  the  circulation ;  the  whole  con- 
stitution becomes  infected  ;  the  fluids  and  solids  are  so  acted  on  and 
altered,  in  fact,  that  a  special  constitution  is  created.  For  this  reason 
the  affections  of  the  skin,  the  mucous  membranes,  the  bones,  etc., 
which  follow,  are  called 

Constitutional.  —  These  constitutional  diseases  never  appear  im- 
mediately, as  the  result  of  an  impure  connection,  but  only  after  those 
affections  already  noticed.  The  primary  diseases  are  local ;  the  con- 
stitutional affections  are  general. 

The  first  thing  which  strikes  the  eye  in  these  constitutional  com- 
plaints is  the  color  and  appearance  they  give  the  skin.  It  has  a  red- 
dish, coppery  tinge,  and  a  peculiarly  dirty  appearance. 

The  order  in  which  the  several  parts  are  affected,  are,  first,  the  skin 
and  mucous  membranes ;  second,  the  hard  substance  surrounding  the 
bones,  called  periosteum,  the  tendons,  and  the  bones  themselves. 
Those  affections  which  appear  upon  the  skin  and  mucous  membrane 
are  usually  called  secondary,  because  they  are  the  second  to  appear ; 
while  those  affecting  the  bones,  etc.,  are  denominated  tertiary,  be- 
cause, in  the  order  of  their  appearance,  they  are  in  the  third  class. 

Eruptions  of  tiie  SIcin,  and  Ulcers.  —  Of  the  constitutional  erup- 
tions, there  is  a  great  variety, — so  great  that  I  cannot,  in  small  space, 
give  a  minute  description  of  them.  The  breast  and  arms  are  not 
infrequently  the  first  to  be  affected.  Attending  these  eruptions  there 
is  little  uneasiness,  and  no  pain ;  though  there  is  sometimes  a  slight 
itching.  The  first  breaking  out  is  usually  of  a  copper  color,  some- 
what paler  than  it  subsequently  is.  The  eruption  is  often  in  the 
form  of  blotches,  elevated  only  a  very  little  above  the  skin.  They 
are  composed  of  small  pustules,  ^vith  a  little  fluid  in  them,  which 
soon  dries  away,  and  the  whole  may  be  rubbed  off  like  bran.  This 
may  leave  the  skin  looking  tolerably  sound,  and  inspire  the  belief 
that  no  further  mischief  is  to  be  experienced.  No  hope  can  be  more 
delusive.  Parts  afflicted  with  this  complaint  show  no  tendency  to  heal. 
The  first  crop  of  pimples  is  soon  followed  by  a  second,  which  pro- 
duces a  thicker  crust,  and  yields  a  larger  amount  of  bran.  This 
rubbed  off,  small  ulcers  appear  underneath. 


''•fmmamiomm 


upon  differ- 
They  are 
snis,  and  on 
,re- found  at 
agina  itself. 

re  what  are 
,  the  consti- 
jar.  But  a 
B  treatment 
The  poison 
whole  con- 
cted  on  and 
'  this  reason 
bones,  etc., 

'  appear  im- 
j  after  those 
al ;  the  con- 

itional  com- 
't  has  a  red- 

irst,  the  skin 
•ounding  the 

themselves. 
3  membrane 

to  appear; 

tertiary,  be- 
lird  class. 

itional  erup- 
small  space, 
:m8  are  not 
jtions  there 
nes  a  slight 
color,  some- 
)ften  in  the 
jkin.  They 
them,  which 
bran.  This 
e  the  belief 
can  be  more 
'Mcy  to  heal. 
,  which  pro- 
bran.     This 


VEKKREAL   OR  SEXUAL   DISEASES. 


363 


Vesicular  Uruptions. — There  is  another  syphilitic  affection  of  the 
skin,  which  appears  in  the  shape  of  vesicles,  like  small-pox.  These 
dry  and  leave  a  scab. 

5caly  Eruptions.  —  There  is  still  another  affection,  which  is  in 
the  form  of  scales,  and  one  scale  will  be  piled  upon  another.  It 
begins  with  an  eruption  of  copper-colored  blotches,  which  become 
covered  with  scales ;  these  are  succeeded  by  scabs,  and  when  these 
full  off,  shallow  ulcers  are  left  with  copper-colored  edges.  (Fig. 
135.)     This  is  a  stubborn  form. 


Fig.  136. 

Tubercular  Eruptions.  —  la  another  variety  of  the  disease,  broad, 
red,  copper-colored  tubercles,  or  hard  elevations  appear,  most  com- 
monly about  the  sides  of  the  nose,  or  on  the  cheeks.  Gradually  they 
suppurate,  and  are  succeeded  by  deep  ulcers,  terminating  in  scars. 
This  is  an  unfavorable  form  of  the  disease,  and  usually  appc  i-s  some 
considerable  time  after  the  primary  symptoms,  in  persons  whose  con- 
stitution has  been  shattered.     Plate  V. 

This  rather  belongs  to  the  tertiary  form  of  the  disease  ;  and  in  addi- 
tion to  the  above,  patches  of  unhealthy  inflanunation  are  apt  to  form 
on  the  tongue,  and  after  a  time  break,  disclosing  ragged,  orange- 
colored  ulcers.     Plate  VI.     Fig.  2. 

Many  other  forms  of  eruption  exist ;  but  in  a  popular  work  like 
this,  it  would  be  useless  to  make  the  nice  distinctions  which  their 
description  would  require. 

Some  of  the  worst  forms  of  the  secondary  affections  are  found 
upon  the  mucous  membrane  of  the  mouth  and  throat.  These  corres- 
pond, in  number  and  size,  with  the  affections  of  the  skin.  They 
affect  the  lips,  the  internal  sides  of  the  cheeks,  the  tongue,  the  tonsils, 
the  pharynx,  the  soft  palate,  the  nasal  cavities,  etc.  They  are  terribly 
destructive  in  their  effects,  forming  gaping  ulcers,  and  eating  deeply 
into  the  parts.  They  often  make  shocking  work  in  the  whole  mouth 
and  throat;  and,  when  attended  with  considerable  inflammation, 
make  it  almost  impossible  to  swallow  anything,  or  even  to  open  the 
mouth.  I  have  often  seen  breaches  through  the  palatine  arch  (Plate 
VI,  Fig.  1),  and  even  the  whole  arch  destroyed  (Plate  VI,  Fig.  2). 
Persons  have  often  died  from  starvation,  —  not  being  able  to  swallow. 
The  ulcers  sometimes  take  hold  of  the  tonsils,  and  "dig  them  out  as 
if  it  were  done  with  a  punch." 

These  ulcerations  affect  the  imicous  membranes  of  the  genital 
organs.  In  the  female,  they  often  affect  the  vagina  and  the  neck 
of  the  womb,  and  thus  may  exist  for  a  long   time,  as  the  cause 


364 


VENEREAL   OK   SEXUAL   DISEASES. 


1  .1 


of  whites,  without  being  suspected  as  such.  They  affect  also 
the  mucous  lining  of  the  fundament  and  the  large  bowel.  They 
sometimes  ex'  '  in  the  ear,  and  more  often  in  the  eye.  This  latter 
affection  pai^  "  ler  the  name  of  syphilitic  iritis.  In  Plate  V. 
the  artist  ha;  represented  this  form  of  constitutional  disease  in 

the  eye. 

The  disorder  having,  by  frightful  ulcers,  run  riot  upon  the  delicate 
structures  of  the  skin  and  mucous  membranes,  advances  boldly  on- 
wards, attacking  the  muscles,  the  tendons,  the  haid  covering  of  the 
bones  and  the  solid  bones  themselves.     No  part  of  the  human  franie- 

—  not  even  the  skeleton  —  can  escape  this  devouring  complaint. 
The  bones  of  the  nose  and  face  are  generally  the  first  to  be  attacked. 
These  perish  slowly,  —  falling  away  piece  by  piece,  —  the  nose,  in 
the  mean  time,  sinking  down  nearer  to  a  level  with  the  cheeks. 
From  these  parts  the  disease  may  spread  to  the  bones  of  the  whole 
system. 

These  affections  of  the  bones  are  attended  by  pains  of  almost 
every  kind  and  degree.  These  pains  are  sometimes  fixed  in  one 
place ;  at  other  times  wandering,  the  whole  skeleton  being  painful. 
In  these  latter  cases,  they  seem  to  the  sufferer  to  reach  the  very  mar- 
row. Sometimes  when  the  pain  is  fixed  in  one  place,  the  feeling  is 
such  as  might  be  supposed  to  be  experienced  if  the  bone  were  being 
bored.     These  pains  are  most  terrible  during  the  night. 

Upon  those  parts  where  the  skin  is  near  the  bone,  as  the  forehead, 
or  shin,  syphilitic  nodes  or  tumors  often  appear,  which  are  hard,  like 
cancerous  tumors.  Besides  the  above,  there  are  the  loss  of  the  hair 
(alopecia),  blindness,  deafness,  and  various  other  mischiefs,  resulting 
from  syphilis,  which  need  not  be  described. 

Is  the  Constitutional  Disease  Communicable  ?  —  Many  believe, 

—  even  among  those  who  are  eminent  in  the  profession  —  that  the 
constitutional  forms  of  the  disease  are  not  communicable.  A  few 
years  ago,  indeed,  this  latter  opinion  was  generally  received.  It  is 
now  quite  extensively  doubted,  or  rather  disbelieved.  Facts  are  con- 
stantly occurring  under  the  eye  of  unprejudiced  physicians,  which 
make  it  very  evident  that  the  constitutional  disease  may  be  commu- 
nicated from  one  person  to  another. 

The  Disease  Hereditary — Xt  is  no  small  amount  of  suffering, 
bodily  and  mental,  which  the  individuals  endure  who  contract  this 
disease.  But  the  inflictions  visited  upon  them,  severe  as  they  are, 
are  small  compared  with  the  aggregate  of  ills  entailed  by  it  upon 
the  long  line  of  their  posterity.  Whether  it  be  the  man  or  the 
woman  whom  the  sphilitic  virus  has  inoculated,  if  it  be  allowed  to 
be  absorbed,  so  as  to  affect  the  constitution,  it  will  be  very  likely  to 
be  sent  down  to  the  children,  and  children's  children.  The  divine 
law  which  links  the  sins  of  the  father  with  the  sufferings  of  even  the 
third  and  fourth  generation,  is  nowhere  more  painfvdly  illustrated 


'^!st;ssiaiti:tii9simm:giimm 


affect  also 
vel.  They 
This  latter 
Plate  V. 
1  disease  in 

the  delicate 
3  boldly  011- 
ring  of  the 
iman  frarae- 
coraplaint. 
36  attacked, 
the  nose,  in 
the  cheeks. 
I  the  whole 

8  of  almost 
xed  in  one 
ing  painful, 
tie  very  mar- 
ie feeling  is 
5  were  being 

;he  forehead, 

re  hard,  like 

of  the  hair 

fs,  resulting 

any  believe, 
that  the 

,ble.  A  few 
ived.  It  is 
cts  are  con- 

cians,  which 
be  commu- 

bf  sr.ffering, 
Contract  this 
I  as  they  are, 

by  it  upon 
man  or  the 

allowed  to 
[ery  likely  to 

The  divine 

of  even  the 
ly  illustrated 


VENEREAL  OH  SEXUAL  DISEASES. 


865 


than  in  the  scourging  descent,  through  many  generations,  of  this  ter- 
rible disease.  It  may  be  passed  down  to  posterity  by  either  of  the 
parents ;  but  if  both  be  diseased,  the  transmission  will  be  more  cer- 
tain. If  the  mother  be  infected,  she  will  infect  the  child  while  car- 
rying it.  If  the  father's  constitution  be  poisoned,  the  child  will 
receive  the  infection  from  him,  through  the  semen,  and  will  be 
likely,  while  in  the  womb,  to  infect  the  mother.  I  recollect  but  one 
author  of  note  (Ramsbotham)  who  has  mentioned  this  mode  of  in- 
fection.    I  have  myself  seen  two  cases  of  it. 

This  constitutional  disease,  whether  it  exist  in  the  mother,  or  be 
communicated  to  the  child,  and  thence  to  her,  by  an  infected  father, 
is  a  frequent  cause  of  abortion.  Throughout  nature,  blight  is  the  re- 
sult of  a  diseased  parentage.  Mature  fruit  is  seldom  obtained  from 
infected  seed. 

Is  the  Constitutional  Disease  Curable  ? — No  question  connected 
with  the  complaint  possesses  a  greater  interest  than  this.  None  is 
pressed  more  earnestly  upon  the  physician.  In  a  certain  sense  the 
disease  i«  curable.  Its  outward  manifestation  may  be  wholly  re- 
pressed. The  health  of  the  person  suffering  from  it  may  be  restored, 
and  become,  in  an  important  sense,  good.  But  this  cure  ia  iiever 
brought  about  by  nature  ;  it  may  he,  and  ia  often  effected  by  medicine. 
I  have  never  failed  to  effect  such  a  cure  in  any  case  which  has  come 
under  my  treatment.  Such  results  may  properly,  in  general  terms, 
be  called  cured. 

Yet  there  is  a  sense  in  which  a  cure  never  occurs.  It  is  a  well- 
attested  fact,  that  a  system  once  thoroughly  pervaded  by  the  poison 
is  never  completely  purged  of  it.  It  may  be  shorn  of  all  its  active 
malignancies ;  but  it  has  too  intimately  permeated  the  tissues  and 
solid  bones  to  bo  wholly  expelled.  Pursue  it  as  we  will  with  the 
remedial  forces  of  our  art,  it  still  takes  refuge  in  the  most  subtle  pro- 
cesses of  animal  life,  —  still  infects  the  currents  of  being,  and  finds 
expression  in  the  scrofula,  in  the  lupus,  and  in  the  scaly  affections  of 
other  generations.  Dr.  Erasmus  Wilson,  the  great  authority  in  skin 
diseases,  says :  "  I  feel  convinced  that  a  considerable  proportion  of 
those  diseases  which  pass  under  the  name  of  scrofula  are  the  produce 
of  the  syphilitic  poison, —  are,  in  fact,  not  scrofulous,  but  syphilitic." 
Astruc  thought  the  same,  and  suggested,  what  is  doubtless  true,  that 
the  transmission  of  syphilis  must  occur  through  several  generations 
before  it  becomes  scrofula.  Bierchn,  Campor,  Stoll,  Portal,  Hufeland, 
and  Alibert,  have  all  advocated  the  same  opinion. 

This  is  doubtless  right,  though  there  are  many  authorities  on  the 
other  side.  He  must  be  a  poor  observer  who  cannot  discover  a  prob- 
able filial  relationship  of  scrofula  to  s\nphilis. 

A  variety  of  facts,  admitted  by  the  vvrhole  profession,  go  far  towards 
<lemonstrating  this  relationship.  Scofula  is  always  herediiiuy.  It 
is  a  disease  of  the  parent,  imparted  to  the  offspring.  But  there  is 
scarcely  any  disease  so  certainly  sent  dov/n  to  posterity  as  syphJiis. 


i 


■%- 


866 


VEMEBBAL  OR  SEXUAL  DISEASES. 


1 


Scrofula  is  like  syphilis  in  many  of  its  characteristics.  It  is  like  it 
in  its  power  of  propagating  itself  from  parent  to  child.  It  is  like  it  in 
affecting  nearly  all  the  children  of  disesised  parents.  It  is  like  it  in 
the  variety  of  the  structures  it  attacks,' — affecting  the  skin,  tho 
mucous  membranes,  the  bones,  etc.  Like  syphilis  it  produces  hard 
tumors,  ulcefs  of  the  skin,  abscesses,  and  decaying  of  the  bones. 
And  finally,  the  great  remedy  for  tertiary  syphilis,  iodide  of  potas- 
sium, is  likewise  the  great  remedy  for  scrofula;  and,  indeed,  almost 
every  remedy  which  acts  favorably  upon  one,  is  found  useful  for  the 
other.  This  could  hardly  occur  were  not  the  diseases  identical  in 
nature. 

We  can  scarcely  be  surprised  tliat  a  disettse  so  widely  diffused  as 
scrofula  should  be  the  product  of  syphilis,  when  we  reflect  how  fright- 
fully prevalent  were  the  causes  of  this  latter  affection  during  the 
earlier  and  the  middle  ages  of  the  world. 

To  pass  over  the  records  of  earlier  times,  with  merely  mentioning 
Abraham,  and  Lot,  and  Jacob,  and  Reuben,  and  Samson,  and  David, 
and  Solomon,  and  numerous  females,  of  whom  some  singular  things 
Are  written  in  the  older  scriptures,  and  omitting  all  mention  of  the 
incredible  and  almost  universal  debauchery  and  prostitution  of 
Greece,  and  Rdme,  and  Persia,  and  Media,  and  Egypt,  I  may  say  that 
Europe,  in  the  middle  ages,  wag  well-nigh  converted  into  a  vast  brothel. 

Foremost  in  the  race  of  profligacy  were  those  in  authority,  kings, 
and  emperors.  The  licentiousness  of  Childeric  knew  no  bounds.  He 
carried  ofl'  and  violated  the  wives  and  daughters  of  his  vassals,  with- 
out regard  to  any  right,  human  or  divine.  His  successors  were  gen- 
erally a  race  of  lecherous  men,  who  spread  debauchery  on  every  hand. 
The  French  monarchs,  from  Pepin  and  Charlemagne,  were  a  race  of 
debauchees.  Their  coui-ts  were  national  brothels,  in  which  the  finest 
women  in  the  land  were  trained  in  the  arts  of  seduction  and  lust. 
Francis  I,  in  1516,  endeavored  to  invest  prostitution  with  elegance 
and  chivalry,  and  even  to  ennoble  it,  by  abandoning  the  public 
women  of  the  palace  to  his  subaltern  officers,  and  substituting  for 
them  ladies  of  noble  blood.  In  this  movement,  the  nobles  and  the 
officers  gave  the  king  their  support. 

*  ' '  They  are  all  gone  aside ;  they  are  altogether  become 

filthy;  there  is  none  that  doeth  good,  no,  not  one." 

Brantome  justifies  Francis  in  his  selection  of  girls  of  noble  blood, 
on  the  ground  that  "  they  could  not  communicate  the  venereal  dis- 
ease to  the  noblemen  of  the  courts,  like  the  common  prostitutes." 
But  the  king,  who  was  previously  diseased,  infected  them;  and  these 
noble  women,  so  called,  passing  from  the  arms  of  the  prince  to  those 
of  the  courtiers,  presented  to  them  the  fatal  infection  received  from 
the  king. 

The  way  in  which  Francis  himself  was  infected  illustrates,  in  a 
most  shocking  manner,  the  morals  of  the  times.     His  illicit  loves  with 


&i'Tr,ni»f«!lH«Mlil(i|iin|flilli  iltMiii 


I 


VENKRKAL   OK   SEXUAL    UI8EASEH. 


367 


It  is  like  it 
iH  like  it  in 

is  like  it  in 
e  skin,  the 
)duce8  hard 

the  bones, 
le  of  potiis- 
leed,  almoHt 
leful  for  tlie 
identical  in 

diffused  as 

.  how  f right- 

during  the 

mentioning 
and  David, 
fular  things 
ition  of  the 
Jtitution  of 
nay  say  that 
vast  brothel. 
ority,  kings, 
ounds.  He 
assals,  with- 
8  were  gen- 
every  hand. 
re  a  race  of 
the  finest 
[1  and  lust. 
;h  elegance 
the  public 
ituting  for 
es  and  the 


3me 

oble  blood, 
mereal  dis- 
rostitutes." 
and  these 
ice  to  those 
eived  from 

trates,  in  a 
i  loves  with 


tlu!  Bello  FerroniiNro  wore  not  concealed  from  her  huKband,  who, 
tlidUgh  obliged  oiitwaitlly  to  regard  the  dalliiince  of  hia  wife  with 
the  monarch  as  an  honor,  was  inwardly  indignant,  and  determined 
to  become  infected  himself,  and  thus  disease  his  wife,  and  revenge 
himself  upon  the  king.  This  plan  was  suggested  to  him  by  a  noble 
who  had  another  motive,  namely,  that  of  punishing  Francis  for  some 
pei-sonal  spite.  "  How,"  said  the  husband,  when  tlie  suggestion  was 
made,  "  shall  I  give  tliis  disease  to  my  wife,  when  we  are  both 
Hound?"  "  (ro  visit  an  infected  girl,"  said  the  noble,  "and  to  ren- 
der the  matter  certain,  as  I  am  infected,  I  will  see  your  unfaithful 
wife."  The  result  was  such  as  the  husband  desired ;  and  in  l/)47, 
FniiKUS  I,  the  gay  and  chivalric  monarch,  perished  of  the  most  foul 
and  loathsome  of  all  diseases. 

Debauchery  did  not  die  with  him.  It  was  cherished  by  his  succes- 
sor, Charles  IX,  and  his  mother,  Catherine  de  Medicis,  and  bis  grand- 
son, Henry  III.  The  reigns  of  Henry  IV,  Louis  XIII,  Louis  XIV, 
the  Regency,  and  of  Louis  XV,  were  stained  by  the  same  licentious- 
ness and  disregard  of  public  decency,  until  the  wliirlwind  of  the  revo- 
lution came  to  purify  the  moral  atmosphere. 

The  reader  will  now,  I  think,  be  in  no  mood  to  wonder  that  the 
men  and  women,  and  many  of  royal  progeny,  whether  the  dishonored 
occupants  of  thrones,  or  the  more  private  recipients  of  the  public 
bounty,  are  a  scrofulous  and  degenerating  race.  Nor  need  it  be 
much  wondered  at,  that  so  large  a  portion  of  men  and  women  every- 
where have  more  or  less  scrofula  in  their  frames.  Happy  are  those 
who  can  find  no  trace  of  this  complaint  in  their  constitution  1  They 
should  rise  up  and  call  their  virtuous  progenitors  blessed.  They 
should  especially  thank  God  that  they  have  sprung  from  the  loins  of 
a  race  more  noble  and  kingly  in  the  eyes  of  Heaven  than  all  the 
••oyal  lines  of  the  world. 

Treatment  of  Syphilis.  —  In  the  treatment  of  this  disease,  the  first 
tiling  which  requires  attention  is  the  pimple,  pustule,  or  sore.  This 
must  be  instantly  touched  with  caustic.  There  should  be  no  delay, 
for  if  the  sore  be  not  syjihilitic,  the  caustic  will  do  no  harm ;  and  if 
it  be,  the  most  terrible  results  may  be  averted.  The  general  belief  is 
that  poison  remains  in  the  sore  for  a  time  before  it  is  absorbed  into 
the  constitution.  It  is  of  the  utmost  importance  that  it  be  destroyed 
Itefore  the  ab.-iorption  takes  place. 

The  caustics  used  are  nitrate  of  silver  (stick  nitrate),  nitric  acid, 
cliloride  of  zinc,  potassa  with  lime,  caustic  potassa,  and  the  painle.ss 
(!austic. 

The  nitrate  of  silver  is  much  used,  but  the  best  surgeons  now  re- 
gard it  as  useless.  It  does  not  prevent  the  absorption  of  the  poison. 
The  caustic  potassa,  the  potassa  with  lime,  and  the  painless  caustic, 
are  the  sure  remedies,  —  that  is,  if  applied  in  season.  But  they  must 
be  employed  with  caution.  It  will  not  do  to  trust  them  in  bungling 
hands.     A  little  vinegar  and  water  must  be  immediately  used  to  neu- 


■m> 


368 


VKNKKKAL   OK   SEXUAL   DISEA8K8. 


! 


J 
i 


trolize  the  caustic  when  it  has  accomplished  what  we  desire.  After 
the  sore  is  cauterized,  a  piece  of  lint,  dipped  in  a  Holutioii  of  watery 
extatict  of  opium,  one  dram  to  four  ounces,  should  Ih)  laid  on  it;  and 
the  organ  enveloped  in  another  piece  of  lint  soakt'd  in  tepid  water, 
and  covered  in  oiled  silk.  The  patient  should  remain  at  rest  as  much 
as  possihle,  keeping  the  penis  elevated,  and  repeating  the  opium 
dressing  tt)  the  wound,  and  the  water  dressing  to  the  whole  organ, 
night  and  morning.  In  addition,  the  patient  should  take  two  pills 
(19),  to  be  followed,  night  and  morning,  for  three  or  four  days,  with 
a  tablespoon!  ul  of  (20).  In  some  cases,  a  piece  of  lint,  wet  with  the 
tincture  of  muriate  of  iron,  diluted  and  kept  upon  the  chancre,  will 
cause  it  to  heal  kindly,  and  with  safety  to  the  patient. 

If  this  treatment  be  adopted  early  and  properly,  the  patient  is 
cured,  and  nothing  further  needed.  But  time  is  generally  lost.  The 
poison  is  alworlKjd  before  the  patient  is  seen  by  the  physician ;  and 
the  question  then  is,  how  it  is  to  be  driven  out. 

To  accomplish  this,  the  diet  should  be  regular  and  unstimulatiiig; 
alcoholic  drinks  and  tobacco  should  be  forbidden ;  the  mind  should 
be  ke^>t  at  rest ;  a  cold  or  tepid  bath  should  be  taken  daily ;  the  ac- 
tion of  the  bowels  and  kidneys  should  be  kept  properly  regulated. 
These  things  will  put  all  the  expelling  agencies  in  proper  condition 
for  work  ;  and  no  single  medicine  will  put  them  all  into  action  like 
mercury.  For  this  reason,  no  other  single  drug  has  enjoyed  a  repu- 
tation for  curing  pox  so  wide  as  this. 

But  it  must  be  used  with  judgment.  No  remedy  is  more  safe,  if 
judiciously  employed,  or  more  destructive,  if  abused.  The  profuse 
and  ill-considered  way  in  which  it  was  used  in  former  times,  raised  a 
prejudice  against  it  which  is  un reasonably  cherished  at  the  present 
day.  Abuse  made  mercury  a  curse ;  judicious  use  makes  it  a  blessing, 
—  at  least  in  this  disease. 

The  blue  pill  is  one  of  the  best  forms  of  it  (148),  combined  with 
extract  of  henbane.  One  pill  at  night  is  the  usual  amount  to  he 
taken.  Some  prefer  the  mercury  with  chalk  (149) ;  others,  the  corro- 
sive sublimate  (160) ;  others,  the  proto-iodide  of  mercury  (136). 
Some  one  of  these  should  be  given  about  five  days,  in  the  doses  named 
under  the  recipes,  —  being  careful  not  to  produce  salivation.  After 
the  fourth  or  fifth  day  we  can  generally  increase  the  frequency  of  the 
dose.  Should  salivation  be  accidentally  induced,  it  should  be  arrested 
by  a  solution  of  chlorinated  soda  (205),  one  part  to  twelve  of  water. 
The  mercurial  treatment  should  continue  for  two  years  after  the  sore 
has  disa^^^icared;  after  this  prolonged  treatment  iodide  of  potassium  is 
used  for  another  year  in  as  lurge  doses  as  the  patient  can  take  with- 
out producing  ill  effects.  At  the  expiration  of  two  years,  if  the 
patient  has  taken  his  medicine  regularly,  he  may  be  considered  cured, 
at  all  events,  sufficiently  so  to  marry  and  have  children. 

Water  should  be  taken  freely,  and  various  diluent  drinks.  They 
wash  the  poison  out  through  the  millions  of  avenues,  called  pores, 
just  as  we  wsish  filth  out  of  cities  by  pouring  water  into  the  sewers. 


flesire.  After 
tion  of  watery 
aid  on  it;  and 
11  tepid  water, 
it  rest  as  niucli 
ng  the  opium 
whole  organ, 
take  two  pills 
our  days,  with 
t,  wet  with  the 
)  chancre,  will 

the  patient  is 
illy  lost.  The 
hysician ;  and 

instimulatinfr; 
mind  should 
daily ;  the  ac- 
)rly  regulated, 
oper  condition 
nto  action  like 
ijoyed  a  repu- 

i  more  safe,  if 
The  profuse 
times,  raised  a 
it  the  present 
is  it  a  blessing, 

;ombined  with 
amount  to  he 
iiers,  the  corro- 
orcury  (136). 
.e  doses  named 
nation.  After 
squencyof  the 
lid  be  arrested 
elve  of  water. 
i  after  the  sore 
»f  potassium  is 
3an  take  with- 
years,  if  the 
isidered  cured, 
1. 

irinks.  They 
,  called  pores, 
;o  the  sewers. 


t^mm 


k 


a»Wi!,«--rfe^-cr.^-iSis.-iy;'titfe,;j$BtjgESWi^ 


YKi'tKUKAL   OR  8BXUAL   UIHKASU. 


M» 


I  should  mention  that  there  are  those  who  claim  to  cure  the  disease 
with  other  remedies,  without  mercury,  and  I  am  not  disposed  to  be 
dogn.itical,  and  say  it  cannot  be  done.  F'or  tliis  purpose,  perhaps  as 
good  a  recipe  as  has  been  proposed  is  the  compound  syrup  of  stillin- 
gia,  tincture  of  poke-root,  tincture  of  sheep-laurel,  each  four  ounces, 
mixed ;  of  which,  from  a  teuspoonf ul  to  half  a  tablespoonf ul  is  to  be 
tiiicen  three  times  a  day.  I  think  well  of  this  remedy,  especially  if  it 
Ih)  in  connection  with  a  small  amount  of  mercury.  If  stillingia  be 
used,  obtain  McDade's  stillingia  comp.,  1  dram  three  times  daily. 

The  Bubo,  if  not  attended  with  pain,  may  be  treated  with  com- 
pression, by  a  piece  of  plaster  of  ammoniac  with  mercury,  or  by 
touching  it  with  nitrate  of  silver.  Should  there  be  inflammation, 
iiiid  the  formation  of  matter  bo  inevitable,  the  br  bo  should  be  opened 
by  touching  it  w'*,h  the  caustio  potassa ;  and  thj  resulting  sore  must 
be  treated  with  the  solution  of  opium  and  water  dressing.  Should 
the  sore  need  stimiilating,  it  may  be  touched  lightly  with  nitrate  of 
Hilver. 

Eruptions  upon  the  5kin. —  In  treating  the  disease  after  it  appears 
upon  the  skin,  etc.,  we  shall  derive  great  advantage  from  the  use  of 
either  the  warm  or  the  vapor  bath  once  a  day.  With  this,  if  the  case 
bo  not  very  old,  we  may  employ  (148)  or  (150)  ;  but  if  the  disease 
be  an  old  one,  showing  itself  in  the  throat,  or  attacking  the  bones  of 
tiie  face,  we  must  give  iodide  of.  potassium  (188),  combined  with 
compound  decoction  of  sarsaparilla.  This  i&  the  great  remedy  for 
tertiary  syphilis ;  but  when  the  case  is  obstinate,  it  may  sometimes 
be  discontinued,  and  the  corrosive  sublimate  (139)  be  subotituted 
for  it. 

It  is  to  be  observed  that  the  older  the  disease  grows,  and  the  more 
chronic  its  character,  the  more  does  mercury  lose  its  control  of  it.  In 
the  first  attack,  the  blue  pill  is  the  best ;  in  the  second,  as  a  general 
thing,  the  iodide  or  the  biniodide  of  mercury :  in  the  third,  the  cor- 
rosive sublimate ;  in  the  attacks  subsequent  to  this,  particularly  in 
the  tertiary  form  of  the  disease,  the  iodide  of  potassium.  When  the 
throat  and  nose  are  so  ulcerated  as  to  make  a  case  absolutely  terrible 
to  contemplate,  it  is  surprising  to  see  how  rapidly  the  recovery  will 
often  take  place  under  the  influence  of  this  latter  remedy. 

For  syphilitic  iritis,  apply  frictions  twice  a  day  on  the  eyelids  and 
oyebrows  with  ointment  (1T2),  (173)  ;  and  administer  internally  two 
pills  of  (186)  daily. 

Clap,  —  Gonorrhoea.  —  Blenorrhagia. 

The  reader  is  aware  that  the  nose,  mouth,  and  lungs  are  lined 
with  a  mucous  membrane,  which  is  liable  to  become  inflamed  from 
\  iirious  causes.  This  inflammation  we  call  a  cold  or  catarrh.  During 
its  continuance,  mucus  and  other  matters,  of  different  colors  and 
degrees  of  consistency,  are  more  or  less  freely  discharged. 


• 


i 


■,j 


870. 


YEKSBEAL  OR  SEXUAL   DISEASE& 


The  mucous  membrane  of  the  private  parts  of  both  sexes  is  just 
like  that  of  the  mouth  and  throat,  and  subject  to  similar  inflamma- 
tions and  discharges.  But  these  inflammations  of  the  private  parts, 
instead  of  being  produced  by  change  of  weather,  etc.,  generally  result 
from  the  application  of  tie  specific  poison  or  germ-microbe  of 
gonorrhoea.  When  r  woman  abandons  herself  to  unlimited  inter- 
course with  different  men,  the  private  parts  become  stimulated  to  so 
unnatural  an  extent,  that  the  secretions  of  the  parts,  which  are  largely 
augmented,  at  length  become  altered  in  their  nature,  acrid,  and  finally 
poisonous,  —  80  acrid  and  poisonous  that  they  cause  inflammation  of 
the  parts,  and  when  brought  in  contact  with  the  male  organ,  in  the 
sexual  act,  they  poison  and  inflame  that.  The  specific  germ  of 
gonorrhoea  is  called  the  gonnococcus. 

This  is  the  shortest  and  plainest  explanation  I  can  give  of  clap. 
From  this  explanation,  one  may  learn  why  a  man  will  sometimes  take 
a  disease  from  a  woman  who  has  never  had  any  evidenct  of  being 
diseased  herself.  If  she  have  indulged  her  sexual  propensities  un- 
reasonably, though  not  enough  to  produce  inflammation  upon  herself, 
her  secretions  may  yet  have  become  acrid  enough  to  poison  one  whose 
organs  are  delicate  and  sensitive.  And  more  than  this,  —  the  secre- 
tions of  a  female  may  become  acrid  and  poisonous  from  other  causes 
than  excessive  venery.  The  discharges  in  bad  cases  of  whites  will 
sometimes  irritate  and  inflame  the  male  organ,  and  induce  a  disease 
which  has  every  appearance  of  gonorrhoea.  A  husband,  in  great 
distress  of  mind,  sometimes  submits  a  case  of  this  sort  to  the  phy- 
sician's inspection,  and  lays  upon  him  the  delicate  and  responsible 
duty  of  deciding  whether  the  wife  has  been  unfaithful.  No  act  in  a 
whole  professional  life  can  be  more  momentous  than  a  decision  of  this 
sort.  If  a  man  be  well  skilled  in  his  art,  he  may  give  an  answer  in 
Buch  case,  which  shall  dispel  the  most  terrible  apprehensions,  and 
save  the  peace  of  a  loving  family. 

The  poison,  when  communicated  by  a  diseased  person  to  the  male 
or  female  organs,  requires  a  certain  time  for  the  germs  to  produce 
their  peculiar  effect,  —  generally  from  three  to  eight  days. 

Symptoms.  —  The  first  symptom  of  the  disease  is  uneasiness  in  the 
end  of  the  penis,  accompanied,  generally,  with  a  little  redness,  and 
diflBculty  in  passing  water.  The  color  of  the  first  discharge  may  be 
white  or  straw-colored.  There  is  tenderness  where  the  parts  are  red. 
Scalding  in  passing  water  is  sometimes,  not  always,  present  at  fii-st. 

This  is  the  beginning,  or  first  sfcige  of  clap.  Now  is  the  time  to 
cure  it  easily.  But,  unfortunately,  the  physician  seldom  sees  a  case 
in  this  early  stage.  Before  he  is  allowed  to  inspect  it,  the  second 
stage  has  generally  appeared,  which  is  known  by  violent  scalding 
when  water  is  passed,  by  chordee,  or  painful  erections  of  the  penis, 
and  by  an  increased  discharge  of  greenish  matter  often  tinged  with 
blood,  and  coming  from  much  farther  down  the  urethra,  or  water- 
pajsage.     The  matter  sometimes  comes  from  as  far  down  as  opposite 


-  ■>vvii'**fteifp 


'-sMiMfiBaaNH 


ii^HeSMMMB^', 


exes  is  just 
tr  inflamma- 
rivate  parts, 
erally  result 
-microbe  of 
naited  inter- 
ulated  to  so 
h  are  largely 
[,  and  finally 
tmmation  of 
rgan,  in  the 
fie  germ  of 

ive  of  clap, 
letimes  take 
Cfc  of  being 
tensities  un- 
pen herself, 
a  one  whose 
—  the  secre- 
)ther  causes 
whites  will 
ce  a  disease 
d,  in  great 
tx)  the  phy- 
responsible 
No  act  in  a 
ision  of  this 
1  answer  in 
nsions,  and 

to  the  male 
to  produce 

iness  in  the 
edness,  and 
rge  may  be 
jrts  are  red. 
at  at  fii-st. 
the  time  to 
sees  a  case 
the  second 
at  scalding 
the  penis, 
dnged  with 
I,  or  water- 
as  opposite 


VENEREAL  OR  SEXUAL  DISEASES. 


371 


the  scrotum,  or  bag  which  holds  the  testicles.  There  is  more  or  less 
pain  the  loins  and  back.  The  whole  body  of  the  penis  may  become 
affected,  and  abscesses  form. 

A  third  and  more  tenible  stage  of  the  disease  begins  when  the  in- 
fl".mmation  has  reached  the  lowest  part  of  tho  water-passage,  just 
where  it  enters  the  bladder.  Around  this  part  of  the  passage,  and 
lying  upon  the  bladder,  is  a  gland  in  size  and  shape  like  the  largest 
chestnut.  It  is  called  the  prostate  gland.  On  either  side  of  it  lie  the 
receptacles  of  the  semen,  each  of  which  sends  its  duct  into  the  water- 
piissage.  When  the  inflammation  extends  through  this  gland,  it  irri- 
tates the  neck  of  the  bladder,  and  causes  a  distressing  desire  to  pass 
water ;  and  from  its  proximity  to  the  larger  bowel,  it  sends  its  irrita- 
tion thither  likewise,  and  impels  a  terrible  effort  to  evacuate  the 
bowels,  called  tenesmus.  It  is  the  same  awful  feeling  experienced  in 
dysentery.  Few  things  can  be  more  terrible  than  these  two  distress- 
ing feelings  conjoined,  —  the  desire  to  pass  water  and  to  empty  the 
bowels.  Racked  with  terrible  pains  and  awful  tenesmic  distresses, 
and  often  with  painful  erections,  the  patient  passes  back  and  foi-th 
between  the  bed  and  stool,  —  often  vowing  in  the  sincerity  of  his 
heart,  that  if  he  can  but  recover  from  this,  he  will  never  be  caught 
again.  The  enlargement  of  the  prostate  gland  may  become  chronic 
and  permanent,  and  be  the  affliction  of  a  man's  life. 

Stricture.  —  One  of  the  most  troublesome  and  persistent  conse- 
quences of  gonorrhoea  is  a  partial  closing  up  of  the  water-pipe,  at- 
tended generally  by  quite  a  serious  obstruction  to  the  passage  of  the 
water.  It  is  called  stricture.  The  mucous  membrane  which  lines 
this  passage,  being  long  inflamed,  becomes  thickened  and  l6ss  pliable 
or  elastic.  The  tissues  which  lie  underneath  this  membrane  also 
become  swollen  and  hardened,  and,  pressing  upon  the  water-passage, 
lessen  it  still  further,  making  the  stricture  more  difficult  of  cure. 

In  stricture,  the  stream  of  urine  is  altered  in  size,  length,  and  force. 
Its  course  is  changed,  when  the  stricture  is  lateral.  The  stream  is 
often  flattened,  like  the  blade  of  a  pen-knife,  or  twisted  like  a  gimlet, 
or  forked,  one  stream  reaching  beyond  the  other.  In  consequence 
of  obstruction,  the  bladder  is  not  entirely  emptied,  and  the  desire  to 
urinate  immediately  returns,  and  is  very  urgent. 

Qleet. — Another  veiy  troublesome  result  of  gonorrhoea  is  gleet, — 
a  thin,  colorless  discharge,  which  persists,  in  a  chronic  form,  after  all 
active  inflammation  has  subsided.  It  is  very  annoying,  and  very  ob- 
stinate. It  is  often  dependent  on  the  altered  conuidon  of  the  mucous 
membrane  occasioned  by  stricture. 

Orchitis.  —  Another  very  severe  result  of  clap  is  swelling  of  the 
testicles,  called  or'ihitis.  .  It  begins  frequently  with  chills  and  fever, 
with  a  feeling  of  weight  in  the  scrotum,  and  pains  in  the  loins.  The 
swelling  rapidly  increases,  and  reaches  its  height  in  ham  three  to  five 

days. 


1 


III 


^iamitSmUmmm 


! 


*m 


iSRx 


372 


VXNEBEAL  OR  SEXUAL   DISEASES. 


% 


Besides  the  above,  there  are  still  other  mischiefs  which  follow  this 
disease,  such  as  inflammation  of  the  prostate  gland,  already  described, 
of  the  bladder,  and  of  the  kidneys. 

In  the  female  gonorrhoeal  inflammation  affects  the  external  geni- 
tals called  the  vulvae,  the  water-pipe,  the  vagina,  and  the  neck  of  tlie 
womb,  and  often  plays  havoc  with  the  ovaries  and  Fallopian  tubes.  In 
women  the  disease  is  often  fatal  by  ascending  the  tubes  and  penetrat- 
ing to  the  abdomen,  where  an  acute  peritonitis  is  set  up,  with  the 
formation  of  pus. 

There  is  a  difference  of  opinion  as  to  whether  gonorrhoea  ever  pro- 
duces secondary  or  constitutional  symptoms.  Ricord,  the  great 
French  authority  on  this  subject,  aflBrms,  and  with  him  a  great  num- 
ber of  followers,  including  most  of  the  profession  in  this  country, 
that  constitutional  symptoms  never  follow  clap ;  that  they  never  re- 
sult from  anything  but  a  »yphilitio  ulcer.  Vidal,  a  French  authority, 
safer,  in  my  judgment,  than  Ricord,  though  not  as  renowned,  says,  on 
the  contrary,  that  secondary  and  tertiary  complaints  do  follow  viru- 
lent gonorrhoea.  Wilson,  the  highest  English  authority,  and  many 
others,  agree  with  him.  Unprejudiced  observers  feel  well  convinced 
that  this  latter  opinion  is  right.  I  have  myself  seen  not  less  than 
half  a  dozen  cases  of  secondary  and  tertiary  syphilis,  which  were 
preceded  by  gonorrhoea,  and  nothing  more. 

Treatment. — In  the  first  stage  of  the  disease,  there  are  two  meth- 
ods of  treatment,  either  of  which  may  be  adopted  with  success.  The 
first,  which  has  many  advocates,  is  the  local  treatment.  An  injection, 
with  a  glass  syringe,  is  immediately  made,  of  a  solution  of  nitrate  of 
silver,  of  tho  strength  of  five  to  ten  grains  to  the  ounce  of  water.  It 
should  be  retained  from  one  to  five  minutes,  by  pressing  the  head  of 
the  penis  between  the  thumb  and  finger.  If  done  before  the  third 
day,  this  will  generally  cure  the  disease. 

The  physician  should  have  entire  control  of  the  patient,  and  com- 
pel him,  if  possible,  to  keep  his  room,  and  live  for  a  few  days  on 
crackers  and  water,  or  something  equally  simple.  All  meats  and 
stimulating  drinks  are  to  be  excluded. 

The  other  mode  of  treatment,  which  is  perhaps  the  more  commonly 
adopted,  is  more  general  in  its  nature.  It  embraces  the  use  of  warm 
baths,  warm  sweating  drinks,  and  rest.  If  the  patient  is  full  of  blood, 
and  strong,  from  five  to  fifteen  leeches  are  applied  to  the  space  be- 
tween the  scrotum  and  fundament.  These  things,  with  a  low  diet, 
will  frequently  reduce  the  disease  in  a  few  days.  If  the  discharge 
should  continue,  after  a  fair  trial  of  the  above,  then  copaiba  and 
cubebs  (272)  q,re  to  be  used.  Several  articles  are  added  in  the  above 
prescription,  to  make  the  copaiba  acceptable  to  the  stomach.  This 
preparation  can  be  taken  by  most  persons,  and  generally  produces 
very  gratifying  results.  Vidal  strongly  recommends  an  electuary,  or 
thick  paste  (278),  of  which  a  piece  twice  as  large  as  a  nutmeg  is  to 
be  taken  in  the  course  of  the  day.     The  prescriptions  which  contain 


- -•"•"~'T-"'°°iiftj|ifiitffTrr" 


h  follow  this 
dy  described, 

sternal  geni- 
B  neck  of  tlie 
in  tubes.  In 
and  penetrat- 
up,  with  the 

loea  ever  pro- 
d,  the  great 
a  great  num- 
this  country, 
bey  never  re- 
ich  authority, 
vned,  says,  on 

I  follow  viru- 
cy,  and  many 
ell  convinced 
lot  less  than 
,  which  were 

ire  two  meth- 
uccess.  The 
An  injection, 
of  nitrate  of 
of  water.  It 
r  the  head  of 
)re  the  third 

mt,  and  corn- 
few  days  on 

II  meats  and 

ire  commonly 

use  of  warm 

full  of  blood, 

ihe  space  be- 

;h  a  low  diet, 

he  discharge 

copaiba  and 

in  the  above 

mach.     This 

illy  produces 

electuary,  or 

lutmeg  is  to 

'•hich  contain 


VENERBAL  OR   SEXUAL   DISEASES. 


373 


copaiba  and  cubebs  are  numerous ;  but  the  above  two  are  as  good  as 
ii  hundred.  With  these  articles,  the  baths,  the  leeches,  and  the  re- 
pose, are  to  be  united. 

Vidal  says  he  never  resorts  to  injections  fn-st,  but  employs  the  anti- 
inflammatory course  Hist.  If  that  fail,  then  he  uses  the  injection 
(207),  three  or  four  times  a  day ;  and  if  he  employs  the  nitrate  of 
silver  at  all,  it  is  only  as  an  astringent  (208).  Prescription  (304) 
is  a  valuable  injection. 

When  the  second  stage  sets  in,  and  the  symptoms  become  more 
violent,  injections  must  not  be  used.  For  the  very  severe  scalding  in 
passing  water,  which  is  now  felt,  take  thirty  drops  of  a  solution  of 
potassa  in  half  a  tumblerful  of  water,  twice  or  three  times  a  day. 
Persons  of  full  habit,  may  be  benefited  by  dissolving  a  grain  or  two 
of  tartar  emetic  in  a  tumbler  of  water,  and  taking  to  the  extent  of 
producing  a  little  nausea.  Relief  is  occasionally  obtained  by  holding 
the  penis  for  some  time  in  warm  water. 

For  the  painful  chordee,  or  erections,  camphor  and  opium  (120)  ar*- 
required, — from  one  to  three  pills  a  day.  Thirty  drops  of  laudanum 
may  be  given  when  the  patient  retires.  Cold  applications  to  the  gen- 
ital organs,  or  walking  barefooted  upon  the  cold  floor,  will  frequently 
give  relief.  When  other  things  fail,  three  pills  a  day  may  be  taken 
of  extract  of  hyoscyamus,  containing  from  one  to  four  grains  each. 
The  quantity  of  cVrinks  must  be  diminished,  and  cold  lotions  must  be 
applied  to  the  penis  on  going  to  bed,  —  the  patient  covering  himself 
lightly. 

Qleet  is  generally  very  obstinate,  and  often  requires  a  very  pro- 
tracted treatment.  If  there  be  any  tenderness  along  the  under  side 
of  the  penis,  it  is  well  to  apply  three  or  four  leechet.  Occasionally 
recipe  (272)  will  have  an  excellent  effect.  But  gleet  is  an  unhealthy 
action,  sustained  by  habit,  and  may  often  be  cured  by  simply  exciting 
a  new  action  which  shall  break  the  old  habit.  It  is  alwa}'s  well, 
therefore,  to  resort  to  injections.  Sugar  of  lead  and  sulphate  of  zinc 
(207)  answer  a  good  purpose ;  or  sulphate  of  zinc  and  tonnin  (209) 
may  be  tried.  Chloride  of  zinc  (210),  does  well  in  some  obstinate 
cases. 

But  gleet  is  often  dependent  on  stricture,  and  when  this  is  the  case, 
we  must  learn  the  location  of  it  by  exploring  the  water-pipe  with  a 
bougie.  When  the  instrument  reaches  the  constricted  part,  the  pa- 
tient feels  pain,  or  the  surgeon  meets  an  obstruction,  —  often  both. 
When  the  stricture  is  found,  it  is  either  to  have  the  solid  nitrate  of 
silver  applied  to  it  with  an  instrument  called  the  parte  cauatique,  or  a 
solution  of  nitrate  of  silver  (211),  or  of  acid  nitrate  of  mercury 
(226),  with  a  shower-syringe.  When  these  means  fail,  we  must  pass 
a  small  bougie  gently  through  the  stricture ;  then  a  larger,  and  then 
a  still  larger  one,  until  the  obstruction  be  removed.  They  should  be 
used  once  or  twice  a  day,  and  not  be  retained  long  in  the  passage. 
They  frequently  have  to  be  used  ten  or  twelve  weeks,  and  should 


374 


VENEREAL   OR   SEXUAL   DISEASES. 


! 


i 


not  be  discontinued  till  the  cure  is  complete.  Put  no  confidence  in 
those  quacks  who  promise  to  cure  these  old  troubles  in  a  few  da}s. 
They  want  your  money,  but  have  no  expectation  or  ability  to  cure 
you  at  all. 

For  inflar'nation  of  the  testicles,  apply  leeches  at  once.  To  this 
should  be  ai  led  warm  fomentations  and  poultices.  If  these  means 
fail,  more  serious  measures  are  to  be  adopted,  which  it  would  be  oul 
of  place  to  describe  in  this  book. 

Inflammation  of  the  prostate  gland  is  also  to  be  treated  with 
leeches  and  poultices  ;  likewise  a  warm  hip-bath.  The  water  must 
be  drawn  off  with  a  catheter  until  it  can  be  passed  in  the  natural 
way. 

Prevention  of  Sexual  Diseases.  —  I  have  several  times  been  in 
doubt  as  to  the  best  method  of  presenting  some  of  the  topics  which 
the  wide  scope  of  this  book  has  brought  before  me ;  but  no  one  sub- 
ject has  perplexed  me  like  the  one  announced  in  the  above  head- 
ing,—  not  that  it  is  not  easy  enough  to  furnish  the  rules  for 
preventing  venereal  disease,  but  that  it  is  a  grave  question  in  morals 
whether  to  instruct  the  world  in  the  methods  of  such  prevention  is 
right.  Is  it  proper  to  give  any  other  advice  than  the  simple  direction 
to  abstain  from  all  liability  to  disease  ?     That  is  the  question. 

If  such  advice  would  be  heeded,  of  course  no  other  should  be 
given.  But  it  would  not.  If  the  person  disregarding  it  would  alone 
suffer  the  penalty  of  the  transgression,  it  might  then  be  best  to  em- 
body the  whole  advice  in  the  simple  imperative  word,  abstain  !  But 
this  cannot  be.  The  infection  will  be  imparted  to  a  third  person,  and 
onward  to  thousands ;  and  many  of  these  thousands  will  be  innocent 
wives,  who  will  perish  of  the  disease,  or  send  the  infection  down  to 
the  second,  the  third,  the  fourth,  and  to  all  generations !  While  a 
strict  morality  might  seem,  therefore,  at  first  view,  to  forbid  the  in- 
culcation of  rules  for  avoiding  infection,  the  good  of  the  race  would 
appear  to  justify  and  lequire  it. 

The  first  requisite  for  prevention  is  cleanliness.  Frequent  washing 
is  of  prime  importance. 

The  precautions  should  not  be  the  same  before  and  after  the  vene- 
real act,  when  a  person  is  about  to  expose  himself  to  risk.  Before 
the  act,  the  parts  should  be  carefully  examined  to  see  if  there  be  any 
break  in  the  skin.  The  least  breach  in  this  covering  of  the  penis 
greatly  promotes  contagion.  Before  coition,  there  should  be  no  wash- 
ing with  soap,  for  this  deprives  the  parts  of  the  mucus  and  oil,  — 
thus  rendering  the  naked  and  exposed  skin  liable  to  infection.  On 
the  contrary,  to  apply  a  solution  of  alum,  tannin,  or  a  decoction  of 
oak-bark,  or  aromatic  wine,  constringes  or  hardens  the  covering  of  the 
organ,  and  rendere  contagion  more  difficult.  An  article  called  con- 
dom is  often  used  to  ward  off  disease.  It  is  a  sack  made  of  gold- 
beater's skin,  and  is  drawn  over  the  penis  like  a  glove  over  the  finger, 
and  thus  protects  it  from  contact  with  poisonous  matter. 


^^><*^jfm^^Mi'^^^^memi^mismi^mmtm^mvmpm,-.-. 


iifidence  in 
.  few  days, 
lity  to  cure 

!.  To  this 
lese  means 
)uld  be  out 

eated  with 
ivater  must 
the  natural 

les  been  in 
)pic8  which 
no  one  sub- 
tbove  head- 
i  rules  for 
n  in  morals 
■evention  is 
)le  direction 
stion. 

•  should  be 
would  alone 
best  to  em- 
dain !  But 
peraon,  and 
be  innocent 
3n  down  to 
While  a 
■bid  the  in- 
race  would 

jnt  wflhing 

sr  the  vene- 
3k.  Before 
[here  be  any 

the  penis 
I  be  no  wash- 
and  oil,— 
tction.  On 
lecoction  of 
jring  of  the 
I  called  con- 
Ide  of  gold- 

the  finger, 


VENEREAL  OB  SEXUAL  DISEASES. 


375 


Of  still  greater  importance  are  prompt  measures  of  prevention 
nftp.r  the  act.  Lotions  should  be  immediately  applied  to  every  part 
of  the  organ,  and  in  the  case  of  females,  should  be  used  as  injections. 
These  lotions  should  be  acids  or  alkalies.  A  mixture  of  vinegar  and 
water  has  been  recommended  as  an  excellent  wash.  Ricord  recom- 
mends aromatic  wine;  Malapert,  corrosive  sublimate  (212),  in  the 
form  of  solution.  Probably  the  best  preventive  is  composed  mainly 
of  alcohol  and  soap  (213),  as  recommended  by  Langlebert. 

An  exposed  person,  using  any  one  of  these  solutions,  particularly 
the  last,  or,  in  the  absence  of  all  these,  washing  thoroughly  with  soap 
and  water,  will  be  likely  to  escape  contagion. 

Medical  Police.  —  What  is  called  general  prophylaxis,  or  preven- 
tion, or  medical  police,  is  not  a  subject  of  legislation  in  this  country. 
The  moral  sense  of  the  American  people  does  not  admit  its  necessity. 
In  Europe,  the  authorities  watch  over  prostitution.  They  even  go  so 
far  as  to  regulate  it.  They  appoint  practitioner,  whose  duty  it  is  to 
act  as  a  sort  of  medical  police,  and  particularly  to  visit  houses  of 
prostitution  once  or  twice  a  week,  and  examine  all  the  inmates. 
When  a  girl  is  found  diseased,  she  is  immediately  removed  to  a  hos- 
pital, and  not  permitted  to  return  until  she  is  well. 

5elf-Pollution.  —  Masturbation. 

There  is  probably  no  vice  to  which  so  many  boys  and  young  men, 
and  even  girls  and  young  women,  are  addicted,  and  from  which  so 
many  constitutions  break  down,  as  self-pollution.  Small  boys  and 
girls  learn  the  vile  practice  of  the  larger  ones  at  school,  and  generally 
continue  it  up  to  maturity,  without  the  least  suspicion  that  they  are 
inflicting  upon  themselves  either  a  moral  or  a  physical  injury. 

This  comes  of  the  false  modesty  and  bastard  morality  which  with- 
holds from  the  young  all  knowledge  of  the  proper  functions  of  their 
sexual  organs,  and  of  the  inconceivable  mischief  resulting  from  their 
abuse.  A  gentleman  of  distinction  lately  said  to  me :  "I  instruct  my 
boys  as  faithfully  on  this  subject  as  upon  any  other  moral  or  physical 
question,  and  I  tell  my  wife  it  is  her  duty  to  do  the  same  with  the 
girls."  This  is  wise.  Yet,  how  few  parents  ever  speak  to  their  boys 
or  girls  on  the  subject,  to  give  them  the  least  reason  to  suppose  there 
is  any  better  rule  for  their  conduct  than  their  own  desires  I 

Symptoms. — These  are  very  numerous.  The  principal  are,  head- 
ache, wakefulness,  restless  nights,  indolence,  indisposition  to  study, 
melancholy,  despondency,  forgetfuluess,  weakness  in  the  back  and 
private  organs,  a  lack  of  confidence  in  one's  own  abilities,  cowardice, 
inability  to  look  another  full  in  the  face,  and,  among  females,  hyster- 
ics, wliites,  and  a  desire  for  seclusion  from  society  and  solitude. 

I  have  already  spoken  of  the  receptacles  of  semen,  lying  on  each 
side  of  the  prostate  gland.  From  the  fore  part  of  these  receptacles, 
the  semen  passes  thixtugh  two- ducts,  about  a  finger's  breadth  in 


i 


I 


876 


VENEREAL   OR  SEXUAL   DISEASES. 


length,  into  the  urethra  or  water-pipe,  just  in  front  of  the  prostate. 
From  excessive  self-pollution,  these  ducts  become  very  irritable,  ami 
also  debilitated  and  relaxed, — so  much  so  that  they  will  not  retain 
the  semen ;  and  during  lascivious  dreams,  it  flows  off.  These  semi- 
nal losses  are  called  "nocturnal  emissions."  So  constant  is  the  drain 
they  keep  up  upon  many  young  men  who  have  abused  themselves 
excessively,  that  *the  whole  man,  mentally,  morally,  and  physically, 
becomes  a  wreck.  There  are  few  objects  more  pitiable  to  behold 
than  a  young  man  in  this  condition,  —  his  nervous  system  feeble, 
tremulous,  and  broken ;  his  memory  weakened  and  fading  out ;  his 
eye  unsteady  and  incapable  of  looking  a  friend  in  the  face ;  his  loins 
and  back  weakened,  giving  him  the  feeble  gait  of  old  age ;  his  once 
erect  form  cowed  and  bent;  his  high  sense  of  manliness  all  oozed  out 
of  him ;  his  mind  taking  up  and  dropping  the  simplest  threads  of 
thought,  losing  its  way  in  the  plainest  paths  of  reflection,  and  often 
starting  back  affrighted  at  the  glimpse  of  chaotic  insanity  opening 
before  him, — turning  here  and  there  for  relief,  but  finding  little  hope 
of  recovery,  except  in  marriage,  and  yet  knowing  himself  unfitted  to 
be  the  husband  of  an  intelligent  woman  I 

Treatment.  —  Every  kind  of  treatment,  no  matter  how  judicious  or 
well  applied,  will  be  unsuccessful,  unless  the  vice  which  has  produced 
the  diseap;:,  be  absolutely  and  entirely  abandoned.  This  is  the  first 
thing  to  be  seciu-ed.  It  may  be  extremely  difficult  for  the  patient  to 
do  this,  with  his  mental  and  moral  nature  all  broken  and  in  ruins, — 
with  no  heart  to  feel,  nor  will  to  execute ;  and  yet  it  must  be  done, 
or  a  cure  cannot  be  effected. 

To  bring  this  about,  everything  must  be  done  by  the  physician  to 
strengthen  the  moral  nature  of  the  patient,  and  to  raise  his  self-respect 
and  hope.  The  most  careful  directions  must  be  given  for  restraining 
the  imagination.  The  patient  must  be  directed  and  encouraged  to 
drive  out  from  the  mind,  instantly,  and  upon  all  occasions,  every 
lascivious  thought;  to  cultivate  the  society  of  the  most  intellect- 
ual and  virtuous  females ;  to  make  himself  hv^y  with  useful  and,  if 
possible,  agreeable  employment;  to  avoid  solitude;  and  to  sleep  with 
some  friend.  He  should  sleep  on  a  mattress,  and  never  on  feathers ; 
always  on  the  side,  never  on  the  back. 

Where  there  is  considerable  debility,  tonics  will  be  required,  as  the 
mineral  ids  (GO),  (62),  (78),  and  bitters  (77),  (67),  (66),  (59), 
and  str>oimine  (83),  (95),  (86),  and  iron  (80),  (93),  (72),  (73), 
(71).  In  addition  to  some  of  the  above  preparations,  the  syrup  of 
the  hypophosphites  should  be  taken  for  some  time. 

The  food  should  be  nutritious  and  easy  of  digestion,  and  the  cold 
alkaline  sponge-bath  should  be  taken  once  a  day,  with  brisk  rubbing; 
and  the  private  parts  should  be  washed  daily  with  cold  water,  espe- 
cially just  before  retiring. 

In  conclusi£>n,  I  say  emphatically  to  parents,  do  not  let  your  sons 
and  daughters  remain  ignorant  on  this  subject.     It  is  plainly  your 


38gaaa5^Kv;»aaihwtj.;^ifaM<aiiijiW>ia^^ 


VENEREAL   OB  SEXUAL  DISEASES. 


877 


le  prostate, 
ritable,  and 
not  retain 
rhese  semi- 
is  the  drain 
themselves 
physically, 

I  to  behold 
tern  feeble, 
ig  out;  his 
i ;  his  loins 
>;  his  once 

II  oozed  out 
threads  of 
,  and  often 
ity  opening 
;  little  hope 
unfitted  to 

iudicious  or 
«  produced 
is  the  first 
)  patient  to 
in  ruins, — 
st  be  done, 

lysician  to 
self-respect 
restraining 
ouraged  to 
ions,  every 
t  intellect- 
ful  and,  if 
sleep  with 
a  feathers ; 

ired,  as  the 
■66),  (59), 
:T2.),  (73), 
e  syrup  of 

id  the  cold 
k  rubbing; 
rater,  espe- 

your  sons 
ainly  your 


duty  to  enlighten  and  to  warn  them.  It  is  a  matter  in  which  young 
peraons  are  generally  disposed  to  do  right,  if  rightly  instructed. 
Avail  youi-self  of  your  right  to  give  counsel,  and,  if  need  be,  to  use 
authority. 

Says  Ware:  "The  deleterious,  the  sometimes  appalling  conse- 
quences of  this  vice,  upon  the  health,  the  constitution,  the  mind  itself, 
are  some  of  the  common  matters  of  medical  observation.  The  vic- 
tims of  it  should  know  what  these  consequences  are ;  for,  to  be  ac- 
quainted with  the  tremendous  evils  it  entails,  may  assist  them  in  the 
work  of  resistance. 

"  To  you,  parents,  on  whose  sho  ilders  is  carried  the  weighty  re- 
sponsibility of  rearing  your  children  In  a  pure  atmosphere,  let  me  say 
that  to  shut  your  eyes  against  the  p;  obabilities  of  youth  is  an  error 
and  a  sin.  Let  the  mother  learn  to  know  the  restlessness  and  ac- 
tivity of  youth ;  let  the  father  recall  his  early  ambitions,  his  longing 
for  excitement,  and  his  reaching  out  after  life  and  activity  in  various 
ways.  Do  not  repress  these  natural  instincts,  but  learn  to  guide  them 
into  proper  charmels.  Keep  at  home  the  attractions  of  public  places ; 
have  music  and  games,  mirth  and  gayety ;  invent  amusement  and 
mirth,  and  banish  dullness  and  apathy.  Do  not  argue  that  your  boy 
is  better  than  other  boys  and  your  daughter  superior  to  your  neigh- 
bor's frivolous  girls.  The  boys  and  girls  guilty  of  this  vice  are 
somebody's  children,  and  thesq  somebody's  children  are  nine  to  one 
your  children.  See  that  your  children  lead  an  active,  physical  life, 
that  out-door  games  and  gymnasium  exercises  enter  largely  into  their 
lives ;  keep  them  busy,  give  them  something  to  do  to  occupy  their 
attention  beside  their  studies ;  let  them  study  with  a  will  when  they 
study,  and  play  equally  hard  when  they  play.  Do  not  be  afraid  to 
talk  on»  these  matters  with  your  children,  and  explain  in  a  rational 
way  what  passion  is,  and  how  it  is  to  be  governed  and  how  used. 
If  you  have  that  unfortunate  amount  of  prudery  and  false  shame 
so  common  to  many  people,  and  feel  you  cannot  talk  with  your  chil- 
dren about  such  matters,  send  them  to  your  family  physician  and  let 
him  have  a  plain  honest  talk  with  the  children.  '  Well  stated  in- 
formation never  yet  contributed  to  human  inflammation.'  Read 
them  Storer,  Ware  and  Wilder  on  'What  Young  People  should 
Know,'  and  make  them  realize  tlxat  a  'healthy  knowledge  is  the 
best  preventive  r  gainst  an  unhealthy  ignorance.'  Do  not  wait  till 
the  young  have  already  grown  up  in  the  vice,  —  your  admonitions  may 
then  be  too  late,  —  nor  fancy  your  children  have  not  been  thrown  in 
with  influences  which  corrupt,  and  that  by  broaching  the  subject  to 
them  you  are  informing  them  of  a  subject  they  may  never  otherwise 
have  heard  of.  Remember  the  statement:  'whether  or  not  we 
ought  to  hide  this  subject  from  the  young,  if  we  could,  the  truth  is, 
we  cannot  if  we  would.' " 

To  you,  young  men,  in  particular,  let  me  warn  you  against  a  seem- 
ing propriety  on  your  part  to  keep  your  silence.     If  you  are  given 


I 


378 


VBNEREAL  OR  SEXUAL   DISEASES 


to  the  habit,  however  slightly,  go  to  your  father,  your  mother,  your 
family  doctor.  Confession  will  strengthen  your  will  and  purpose  to 
overcome  the  temptation.  Do  not  lie  to  the  family  physician  in  his 
inquiriea :  he  is  your  friend  and  wishes  you  only  success ;  he  is  ac- 
quainted with  these  ailments  and  knows  your  temptations ;  he  ap- 
preciates and  respects  your  noble  desire  to  rid  youiself  of  the  evil. 

Do  not,  above  all  else,  read  the  numerous  pamphlets  on  Sexual 
Debility,  Lost  Manhood,  etc.,  or  be  duped  into  answering  advertise- 
ments in  the  public  prints  offering  to  send  you  literature  on  the  8u]> 
ject.  No  man  can  afford  to  send  you  free  publications  and  postage- 
stamps  unless  he  sees  as  an  outcome  a  fee  at  the  end  of  the  book  in 
the  shape  of  medicines  and  other  promised  help.  Steer  religiously 
clear  of  these  smoothly  written  books  and  these  specialists  in  the  art 
of  restoring  lost  manhood.  Your  experience  with  them  will  be 
much  like  the  countryman  with  bunco^teerers. 

Make  every  honest  endeavor  to  conquer  an  unruly  passion  while 
it  is  young,  and  the  more  readily  conquerable,  but  never  despair  of 
being  helped  by  suitable  aid,  however  long  the  passion  may  have  been 
victorious  over  you.  Do  not  ascribe  your  weakness  in  fighting  temp- 
tation to  the  Almighty,  the  sins  of  your  parents,  or  the  example  of 
your  elders  or  associates,  but  go  at  the  demon  with  a  will  and  the 
fight  is  yours.  Having  conquered  the  enemy,  the  results  of  the  past 
can  be  overcome  by  a  pure  life  and  the  dictates  of  your  physician ; 
nay,  I  may  even  add.  Nature  restores  herself  if  only  she  can  be  as- 
sisted. In  fact  there  is  no  specific  for  the  troubles  that  arise  from 
this  vice.  The  only  rure  is  to  absolutely  stop  the  habit  and  imme- 
diately thrust  out  all  lascivious  thoughts  as  soon  as  they  enter  the 
mind.  Build  up  the  strength  and  in  time  nature  and  marriage  will 
do  the  rest. 


i 


Tt  i*yt^' 


.'^  JStti. 


nother,  your 
1  purpose  t(i 
iiciaii  in  his 
8 ;  he  is  an- 
ions ;  he  ai> 
i  the  evil. 
i  on  Sexual 
ig  advertise- 
3  on  the  8ul> 
and  postiige- 
the  book  in 
•  religiously 
ts  in  the  art 
lem  will  be 

assion  while 
r  despair  of 
lyliave  been 
fhting  temp- 
example  of 
i^ill  and  the 
i  of  the  past 
r  physician ; 
)  can  be  as- 
;  arise  from 
and  imme- 
jy  enter  the 
larriage  will 


FEMALE  DISEASES. 


In  addition  to  the  diseases  common  to  both  sexes,  women  are 
subject  to  a  class  of  distressing  complaints  peculiar  to  themselves, 
and  denominated,  in  general  terms,  female  diseases.  Involving  con- 
siderations of  a  delicate  nature,  these  complaints  have  too  generally 
and  too  long  been  shut  out  from  works  intended  for  popular  distribu- 
tion. Hence  there  is  a  general  ignorance  of  a  class  of  diseases  which 
are  fast  unfitting  woman  for  the  high  duty  of  continuing  the  race; 
and  the  subjects  of  these  maladies  are  generally  themselves  so  unin- 
formed of  the  true  nature  of  their  sufferings,  that  they  are  neither 
prepared  to  seek  relief  in  the  proper  direction,  nor  to  submit  to  the 
remedy  if  it  chance  to  be  proposed. 

It  is  intended  heie  to  speak  of  these  disorders,  as  I  have  done  of  all 
others,  in  a  plain  and  simple  way,  to  describe  them,  so  far  as  the 
present  state  of  medicine  permits,  just  as  they  are,  and  to  make 
known  the  modes  of  treatment  which  have  been  found  available  for 
their  cure.  The  sufferings  of  woman  require  this ;  the  interests  of 
humanity  require  it ;  and  the  writer  is  impelled  to  it,  as  he  thinks, 
by  a  just  sense  of  responsibility. 

Physicians,  in  my  judgment,  are  chargeable  with  a  great  wrong  in 
concealing  within  their  own  breasts  information  upon  what  are  called 
delicate  subjects,  —  information  which  the  good  of  the  world  requires 
should  be  divulged,  and  which  they  ought  to  pour  into  the  public 
mind,  and  make  common,  and  which  they  would  thus  popularize,  but 
for  their  stiff  pride  and  conservatism. 

The  idea  that  our  knowledge  cannot  be  imparted  to  the  world 
without  injuring  the  public  morals,  is  simply  absurd.  We  are  more 
afraid  of  bringing  the  common  people  too  near  to  us,  of  letting  down 
our  dignity,  and  of  opening  our  profound  secrets  to  popular  eyes. 
The  result  is  as  it  should  be,  that  unsophisticated  people  are  apt  to 
give  physicians  a  wide  berth,  and  to  have  nothing  to  do  with  them 
unless  necessity  compels.  Let  doctors  strip  off  their  reserve,  and 
while  they  remain  gentlemen,  become  likewise  companions,  impart- 
ing their  knowledge  freely  and  ic.miliarly  to  all,  and  the  public  con- 
fidence, now  considerably  shaken,  will  be  frankly  restored  to  the  pro- 
fession. 

It  should  be  the  object  of  a  good  physician  to  know  all  he  can,  and 

.    379 


"^.It.   .^Ll.l)f'SJL'l.'ILa  !TTC-:  ., 


380 


FKMALK   DI8EABKB. 


to  impart  hia  knowledge  to  as  many  as  possible.  Knowledge  is  nf»»i 
merely  power :  it  is  happiness,  it  is  wisdom,  it  is  health,  it  is  virtue  ; 
yes,  it  is  always  virtue,  except  in  some  rare  instances,  where  the  woret 
natures  pervert  it.  No  physicians  are  so  much  loved  as  those  who 
are  frank,  and  have  no  concealments.  The  day  for  mysterious  nods 
of  the  head,  and  rollings  of  the  eyes,  and  shrugs  of  the  shoulder,  has 
gone  by.  Men,  and  women  too  (or  those  of  them  who  are  wise), 
wish  to  know  distinctly  what  their  diseases  are,  and  what  is  necen- 
sary,  not  to  palliate  and  prolong,  but  to  cure  them. 

Time  when  Female  Diseases  Begin.  —  Female  coniplaints  begin 
to  make  their  appearance  at  the  period  of  life  called  puberty,  —  the 
time  when  the  girl  passes  from  childhood  to  womanhood.  This  is  the 
period  when  menstruation  is  established,  which  consists  of  a  discharge 
from  the  genital  organs,  composed  of  blood  and  mucus,  and  which 
occurs,  when  regular,  every  four  weeks.  Up  to  this  period,  the  system 
of  reproduction  has  remained  dormant.  By  the  intervention  of  this 
mjnsterious  function,  the  young  female  becomes  a  new  being.  The 
heart  unfolds  itself  to  new  emotions ;  the  mind  assumes  a  solidity 
before  unknown,  and  even  the  body  acquires  beauty  from  a  sudden 
rotundity  of  form. 

This  is  the  period  when  the  great  question  of  female  health  is  very 
apt  to  be  settled  once  for  all,  and  for  life.  The  girl  who  is  well 
trained  at  this  time,  generally  has  a  foundation  laid  for  health  and 
character,  which  is  worth  more  to  her  than  riches.  At  no  time  does 
the  mother  need  so  much  wisdom  and  knowledge  as  now.  To  es- 
tablish the  health  and  develop  the  affections  of  the  daughter  at  this 
critical  period,  is  a  sacred  trust  which  she  can  devolve  upon  no  other 
being ;  nor  can  she  meet  her  responsibilities  at  this  time,  unless  better 
informed  than  most  mothers  are.  The  general  apathy  in  regard  to 
this  maternal  duty  is  deplorable. 

False  Delicacy. — The  refmed  delicacy  which  withdraws  these 
subjects  from  the  public  gaze  is  commendable,  for  it  casts  a  beauti- 
ful charm  over  society;  but  when  carried  so  far  as  to  cast  a  veil  even 
over  the  eyes  of  mothers,  it  is  quite  unnatural,  and  leads  to  the  worst 
results ;  for  in  the  bad  management  of  girls  at  this  critical  period  is 
laid  the"  foundation  of  so  many  of  the  diseases  which  shatter  the  con- 
stitution of  so  many  women.  For  this  bad  management,  it  is  not 
mothers  alone  who  are  to  be  blamed.  The  neglect  of  the  medical 
profession  to  furnish  the  necessary  information  should  come  in  for  its 
full  share  of  reproach. 

The  Establishment  of  the  Menses. —  Nature  always  comes  slowly 
and  by  degrees  to  the  inauguration  or  establishment  of  any  of  her 
great  functions.  It  is  so  in  regard  to  menstruation,  or,  as  it  is  va- 
riously called,  "  the  menses,"  "  the  courses,"  "  the  change,"  etc.  For 
some  ti  >ne  btifore  the  flow  begins,  there  are  certain  symptoms,  or  pre- 
monitions, wliich  to  the  eye  of  the  physician  plainly  enough  foretell 


'€isi^^il£ 


ttMWlHii 


VKMALK  DISKA8RB. 


881 


[edge  is  nnf, 
it  is  virtue  ; 
ire  the  woi-st 
8  those  will) 
iterious  noils 
ihoulder,  has 
a  are  wise), 
lat  in  neces- 

plaints  begin 
berty,  —  the 
.  This  is  the 
t  a  discharge 
,  and  which 
i,  the  system 
ntion  of  this 
being.  The 
BS  a  solidity 
m  a  sudden 

lealth  is  very 
who  is  well 
r  health  and 
no  time  does 
low.  To  es- 
rhter  at  this 
ij)on  no  other 
unless  better 
in  regard  to 

idraws  these 
sts  a  beauti- 
jt  a  veil  even 

to  the  worst 
ical  period  is 
itter  the  con- 
sni,  it  is  not 

the  medical 
ome  in  for  its 

comes  slowly 
f  any  of  her 
r,  as  it  is  va- 
Te,"  etc.  For 
•toms,  or  pre- 
jugh  foretell 


the  impending  change.  To  the  mother  these  signs  would  be  equal- 
ly intelligible,  were  she  as  well  informed  as  she  should  bt.  It  is 
jilairly  her  duty  to  be  intelligent  enough  to  assist  nature  in  the  es- 
tablishment of  this  important  function.  But  how  often,  either  from 
ignorance  or  from  false  ideas  of  delicacy,  does  she  fail  to  interfere, 
and  allow  tlie  daughter  to  be  taken  by  surprise,  and  perhaus  fright- 
ened and  thrown  into  convulsions  1 

From  inquiries  made  of  about  one  thousand  women,  a  distin- 
guished English  physician  found  that  about  one-quarter  were  unpre- 
pared for  the  appearance  o5  the  menses.  Some  of  the  girls  were 
frightened  and  went  into  hysterical  fits;  others  thought  they  were 
wounded,  and  washed  with  cold  water.  The  flow  was  stopped  in 
several  cases,  and  in  some  never  restored ;  while  the  health  of  all 
in  whom  it  was  interrupted  was  seriously  impaired. 

Symptoms  of  the  First  Menstruation.  —  A  variety  of  symptoms 
precede  and  foretell  the  first  menstruatiou.  Headache,  dizziness, 
sluggishness  of  thought,  and  disposition  to  sleep  ;  these  occurring  in 
a  girl,  may  be  taken  tvs  hints  that  the  "  change  "  is  at  hand.  If  to 
these  be  added  pains  in  the  back  and  lower  limbs,  the  intimations 
will  be  still  more  significant. 

At  tliis  time  a  girl  loses  a  relish  for  the  society  of  children ;  she  is 
apt  to  acquire  a  taste  for  solitude  ;  her  temper  becomes  wayward  and 
fretful ;  her  eyes  acquire  a  peculiar  lustre ;  she  becomes  a  sort  of 
mystery  to  her  friends  and  herself ;  not  her  physical  frame  only,  her 
whole  character  is  changed.  She  is  about  stepping  into  a  new  life. 
Her  emotions,  thoughts,  anticipations,  retrospections,  are  all  new  to 
her,  and  her  outward  manifestations  are  new  to  her  friends.  An  in- 
telligent mother  will  not  fail  now  to  prepare  her  mind  for  the  impor- 
tant event  close  at  hand. 

The  age  when  this  change  takes  place  depends  very  much  upon 
a  variety  of  circumstances.  It  occurs  much  earlier  in  warm  than  in 
cold  climates.  It  is  hastened  by  high  living ;  by  the  whirl  and  bustle 
and  excitement  of  city  life ;  by  reading  novels  which  are  full  of  love- 
incidents  ;  by  attending  balls,  theatres,  and  parties  ;  and  by  mingling 
much  in  the  society  of  gentlemen. 

Early  Menstruation  not  Desirable. —  It  is  a  law,  both  in  animal 
and  vegetable  life,  that  the  later  the  period  at  which  maturity  is 
reached,  the  greater  the  solidity  of  the  body,  i  nd  the  longer  it  lives. 
Girls  who  menstruate  early  do  so  because  the  body  is  weakened  by 
climate  or  luxury,  and  tht  nervous  system  unduly  developed  by  ex- 
citement; while  those  who  come  late  to  womanhood  have  firmer 
constitutions,  enjoy  better  health,  and  live  longer.  Those  mothers, 
therefore,  commit  great  errors,  who  are  anxious  and  administer 
"  forcing  medicines,"  because  their  daughters  do  not  menstruate  at 
fourteen  or  fifteen.  If  girls  are  suffering  from  no  special  ill-health, 
no  anxiety  need  be  felt  if  «♦  the  custom  of  women  "  do  not  come  to 


382 


FBMALK   DISRABSH. 


,them  till  the  age  of  eighteen,  or  even  twenty  The  delay  should 
excite  thiiiikfulnoHH  mtlier  than  re^rret.  It  hIiowh  that  the  cuuHtitu- 
tion  has  not  in  it  the  Heeda  of  early  dissolution  ;  that  it  is  fortifying 
itself  against  future  disease. 

(lirls  who  (ionie  thus  tardily  t*")  maturity  are  much  more  "regular" 
in  after  life.  They  Ixjar  children  with  fewer  iu;cidents,  and  are  af- 
flicted much  less  with  female  diseases.  The  duty  of  mothers  is  i)lain: 
it  is  to  bring  their  daughtera  forward  as  late  as  possible,  by  refusing 
their  early  admission  to  society,  by  withdrawing  from  them  all  excit- 
ing reading,  by  prohibiting  their  early  attendance  at  parties  and 
theatrical  entertainments,  by  prescribing  for  them  the  most  unstimu- 
lating  diet,  and  by  requiring  a  large  amount  of  exercise  in  the  open 
air. 

A  wide  investigation  has  shown  that  the  first  menstruation  occurs, 
in  hot  climates,  at  the  average  age  of  thirteen  years  and  nineteen 
hundredths ;  in  temperate  regions,  at  fourteen  years  and  seventy-four 
hundredths  ;  in  cold  latitudes,  at  sixteen  years  and  fifty-three  hun- 
dredths. Under  the  hot-house  culture  of  modern  society,  and  espe- 
cially among  the  wealthy  classes,  where  indolence,  luxury,  and  excite- 
ment unite  to  weaken  the  constitution,  this  change  is  constantly  oc- 
curring at  a  more  tender  age. 

How  Female  Diseases  are  Induced.  —  All  living  things  have 
their  origin  in  germs.  The  germ  from  which  the  higher  animals 
spring,  man  included,  is  an  ovum  or  egg.  Every  animal  and  every 
vegetable  is  provided  with  an  organ  for  the  production  of  germs.  In 
woman,  this  organ  is  called  an  ovary.  There  are  two  ovaries,  about 
half  an  inch  in  length,  one  lying  on  each  side  of  the  womb,  to  which 
they  are  attached  by  ligaments  or  cords.  The  ovarian  bodies  con- 
tain vast  numbers  of  vesicles,  or  cells,  or  eggs,  which  are  the  true 
germs  of  human  life,  and  the  only  sources  from  which  it  can  spring. 

Between  the  ages  of  fourteen  and  forty-five  (speaking  in  geneml 
terms),  every  healthy  woman  matures  and  deposits  an  ovum  once  in 
twenty-eight  days.  This  vesicle,  some  time  before  the  monthly  flow, 
begins  to  germinate  and  swell,  and  after  a  time,  like  a  grain  of  wheat 
in  the  earth,  it  bursts  its  covering  and  springs  forth.  It  then  passes 
through  what  is  called  '  -  Fallopian  tube  into  the  womb,  whence  it  is 
cast  o£f. 

During  the  sv'  a  bui-sting  of  this  vesicle  or  germ,  the  ves- 

sels   of  the   c  Mii.  womb,  and  particularly  of  the  membrane 

lining  the  woj  i  its  neck,  are  so  crowded  with  blood  as  to  pro- 

duce in  the  parvo  a  state  of  congestion.  If  the  parts  be  examined 
with  a  speculum  at  this  time,  they  will  lie  found  red,  sensitive,  and 
almost  inflamed.  So  great  is  this  congestion,  that  the  woman  often 
complains  of  pain  in  the  ovaries  and  the  womb,  and  a  general 
sense  of  heat,  aching,  and  dragging  down  in  the  lower  part  of  the 
bowels.  The  pain  often  extends  to  the  back,  the  groins,  and  the 
thighs. 


11 


VXMALK  DI8KABKS. 


388 


lay  should 

le  constitii- 

fortifyitijj 

"  regular" 
vnd  are  af- 
I'sis  plain: 

y  refuHiiijf 
n  all  excit- 
)artie8  and 
t  iinstimu- 
n  the  open 

iion  ocoura, 
1  nineteen 
venty-four 
three  hun- 
,  and  espe- 
and  excite- 
stantly  oc- 

ings  have 
3r  animals 
and  every 
germs.  In 
ries,  about 
},  to  which 
)odies  con- 
8  the  true 
jan  spring, 
in  geneiul 
m  once  in 
nthly  flow, 
n  of  wheat 
hen  passes 
hence  it  ^^ 

n,  the  ves- 
membrane 
as  to  pro- 
examined 
sitive,  and 
nan  often 
a  general 
irt  of  the 
i,  and  the 


This  Condition  Repeated  Every  Month.  —  When  we  consider 
that  this  state  of  things  is  roiH^ated  every  four  weeks,  and  that  the 
congested  or  crowded  state  of  the  vessels  begins  somo  'lays  before 
the  monthly  flow,  and  lasts,  in  all,  some  ten  days,  making  about  one- 
third  part  of  every  month,  we  need  not  wonder  that  inflammation  so 
often  supervencH,  with  all  its  attendant  ill-health  and  suffering. 

Increased  by  VariouA  Causes If  re  reflect,  further,  that  this 

congestion  is  increased,  among  the  wealthy,  by  high  living,  and 
among  all  clasHcs,  by  over^itiniulation  of  the  nervous  system,  and  by 
the  lascivious  morals  of  the  age,  we  see  stronger  reasons  for  expect- 
ing—  what  is  reall}'  occurring  —  a  continually  increasing  amount  of 
suffering  from  female  diseases. 

And  when  we  know,  still  further,  that  American  females  are  care- 
less of  their  health  ;  that  they  often  attend  balls  and  theatres  at  the 
very  time  of  suffering  from  this  monthly  visitation ;  that  they  fre- 
quently wet  their  feet,  and  otherwise  expose  themselves  to  colds,  we 
cannot  feel  surprise,  even  when  we  learn  that  from  one-half  to  three- 
fourths  of  all  women  in  cities,  and  quite  a  large  proportion  of  them 
in  the  country,  have  inflammation  of  the  ovaries,  or  of  the  womb,  or 
of  the  neck  of  the  womb,  or  suffer  some  of  the  forms  of  displace- 
ment of  this  latter  organ. 

Child-Bearing.  — The  inflammatory  state  of  the  Titerine  organs  is 
often  induced  by  injuries  received  in  child-bearing,  and  by  excessive 
indulgence  in  sexual  pleasures. 

Wealcness  of  the  SexuaP  System The   womb,  moreover,  like 

any  other  organ,  may  be  naturally  frail,  and  easily  affected  by  dis- 
ease. This  weakness  of  the  sexual  system  is  indicated  by  the  diffi- 
culty with  which  menstruation  is  established,  and  the  presence  of  the 
whites,  both  before  and  after  each  monthly  flow.  Women  in  whom 
the  generative  organs  are  weak,  are  much  more  liable  to  inflamma- 
tion of  the  womb,  ^nd  to  all  complaints  peculiar  to  the  sex. 

Description  of  the  Sexual  Organs —  Before  describing  the  par- 
ticular diseases  to  which  the  female  generative  organs  are  liable,  it 
is  proper  to  give  the  reader  a  brief  description  of  the  chief  of  these 
organs. 

The  Womb  itself,  in  its  healthy,  natural  state,  is  about  two  inches 
long,  and  one  inch  broad  —  weighing  a  little  more  than  an  ounce, 
and  is  in  shape  like  a  pear.  It  is  lined  with  a  mere  rudimentary 
mucous  membrane. 

The  Necic  of  the  Womb  has  a  cavity  distinct  from  that  of  the 
body  of  the  organ,  and  is  lined  with  a  mucous  membrane  well  sup- 
plied with  follicles  or  glands. 

The  Fallopian  Tubes  open,  one  from  each  side  of  the  base,  or 
largest  end  of  the  womb,  and  extend  outward  to  the  ovaries. 


■'  Mjwwui-i  ommmMi 


WS^ 


384 


FEMALE   DISEASES. 


The  Ovaries  are  glandular  bodies  lying  one  on  each  side  of  the 
base  of  the  womb.  They  are  more  particularly  explained  else- 
where. 

Fig.  136  gives  some  idea  of  these  organs.  A,  is  the  body  of  the 
womb ;  B,  the  neck  of  the  womb  ;  C,  C,  the  vagina  ;  D,  one  of  the 


n 
\ 

■ 


FlO.  13S. 

ovPTies ;  F,  F,  the  Fallopian  tubes ;  E,  E,  the  fimbriated  extremi- 
tif  i ;  G,  the  small  ligament  attaching  the  fimbriated  extremity  to  the 
o'.ary. 

Inflammation  of  the  Neck  of  the  Womb.  —  Inflammation  of  the 
body  of  the  womb  is  a  comparatively  rare  disease,  but  inflammation 
of  the  neck  of  this  organ  is  so  common  that  in  nearly  nineteen  out 
of  twenty  cases,  when  *->male8  seek  relief  for  whites,  for  painful  men- 
struation, for  stoppage  of  the  menses,  or  even  for  what  they  suppose 
to  be  a  falling  of  the  womb,  a  careful  examination  will  show  that 
this  pendant  portion  of  the  womb  is  in  a  state  of  marked  inflamma- 
tion, or  of  absolute  ulceration.  The  whites,  if  they  continue  with- 
out intermission  from  one  menstrual  flow  to  another,  are  almost  al- 
ways the  result  of  one  of  these  conditions  of  the  uterine  neck. 

It  would  surprise  most  persons  out  of  the  medical  profession,  and 
many  physicians,  to  know  how  large  a  proportion  of  the  more  grave 
diseases  which  inflict  such  terrible  suffering  upon  woman,  and  so 
completely  shatter  her  constitution,  are  dependent  for  their  exist- 
ence upon  a  simple  local  inflammation,  either  in  the  neck  of  the 
uterus,  or  in  one  or  both  of  the  ovaries.  Many  a  female  has  for 
years  suffered  agonies,  greater  than  those  of  death  itself,  arising,  as 
she  supposed,  from  a  complication  of  ills  which  invade  every  part  of 
the  system,  while  the  whole  of  her  troubles  arose,  in  fact,  from  an  in- 
flammation of  the  neck  of  the  womb  merely. 

Difficulties  of  Studying:  Uterine  Diseases The  social  rela- 
tions of  the  sexes,  and  the  great  delicacy  of  the  matters  to  be  inves- 
tigated, for  a  long  time  prevented  direct  examination  and  investiga- 
tion, so  that  little  knowledge  was  gained,  and  as  little  benefit  con- 
ferred. 


4 


L  side  of  the 
:plained  else- 
body  of  the 
),  one  of  the 


kted  extremi- 
remity  to  the 

nation  of  the 
inflammation 
nineteen  out 
painful  men- 
they  suppose 
II  show  that 
ed  inflamma- 
)ntinue  with- 
'e  almost  al- 
e  neck, 
ofession,  and 
more  grave 
man,  and  so 
■  their  exist- 
neck  of  the 
nale  has  for 
[f,  arising,  as 
3very  part  of 
.,  from  an  in- 

I  social  rela- 

;  to  be  inves- 

id  investiga- 

benefit  con- 


B3i£^'«. 


FEMALE   DISEASES. 

Woman,  always  distinguished  for  her  modesty,  could  not  be  ex- 
pected to  invite  investigations  which  were  not  proffered,  whatever  the 
extremity  of  her  sufferings  ;  and  man,  scrupulously  sensitive  lest  he 
should  make  himself  an  intruder  by  stepping  within  delicate  enclos- 
ures, have  both,  in  times  past,  mistaken  their  duty  by  misinterpreting 
the  demands  of  the  highest  delicacy. 

Needful  Examination  not  Indelicate Rightly  viewed,  no  in- 
quiries or  examinations  are  indelicate  which  are  necessary  to  a  full 
understanding  of  the  nature  of  disease,  and  which  are  made  with  the 
sole  purpose  of  rendering  its  cure  possible.  I  agree  with  Dr.  Meigs, 
the  elder,  that  the  delicacy  or  indelicacy  of  examining  the  persons  of 
females  for  the  purpose  of  exploring  disease,  depends  on  the  motive 
with  which  it  Is  done.  To  pure-minded  persons,  it  is  never,  I  think, 
a  source  of  impurity.  On  the  contrary,  the  self-restraint,  the  honor- 
able feeling,  and  the  nice  sense  of  delicacy  which  it  calls  into  exercise, 
often  heighten  the  tone  of  a  man's  virtue,  and  certainly  increase  a  true 
woman's  respect  for  it.  Unfortunately,  there  is  now  and  then  a  gross- 
minded  man  in  the  profession,  who,  in  these  investigations,  will  vio- 
late the  most  sacred  of  all  trusts  committed  to  his  hands;  but  such 
monsters  —  few  in  number  —  soon  find  their  level,  and  are  shunned 
as  the  most  vile  of  the  race. 

It  is  now  80  well  understood,  that  these  investigations  do  not  lead 
to  immoralities,  that  the  most  highly  educated,  intelligent,  refined, 
and  virtuous  females  almost  invariably  raise  the  fewest  objections  to 
such  examinations  as  a  physician  of  character  may  propose. 

Methods  of  Investigating  Female  Diseases.  —  The  symptoms  of 
these  complaints  will  be  spoken  of  in  their  proper  place,  as  the 
several  diseases  come  under  a  brief  review.  I  merely  wish  to  allude 
here  to  the  methods  of  physical  exploration  which  modern  practice 
has  called  to  its  aid. 

Tile  Toucii.  —  These  methods  consist,  first,  of  what  is  called  the 
touch,  which,  is  made  either  externally  upon  the  bowels,  or  internally, 
with  the  index  finger,  through  the  vagina,  or  passage,  from  the  external 
genital  oi^ns  to  the  neck  of  the  womb. 

Tlie  Speculum.  —  In  the 

second  place,  of  ocular  in- 
spection of  the  vagina  and 
neck  of  the  uterus,  through 
an  instrument  called  the  spec- 
ulum. By  this  instrument, 
the  eye,  as  well  as  the  finger, 
is  made  to  assist  in  learning 
the  real  condition  of  the  parts. 
The  finger  informs  us 
whether  there  is  any  devia-  fio.  137.  simi'  speculum. 


'^f 


I     i 


386 


FEMALE   DISEASES. 


tion  from  nature  in  the  bulk,  the  firmness,  the  smoothness,  or  the 
sensibil'  y  of  the  parts ;  while  the  sight,  through  the  speculum,  affords 
absolute  certainty  as  to 
whether  the  parts  are  suf- 
fering from  inflammation, 
ulceration,  abrasion,  or 
eruption. 

There  are  a  variety  of 
specula  in  use  by  modern 
physicians,  but  all  are  es- 
sentially of  two  kinds ;  first,  a  so-called  Sims' 
Speculum  (Fig.  137),  the  end  of  which,  when 
inserted  into  the  vagina  and  pulled  upon,  allows 
the  air  to  enter  and  balloons  out  the  vagina  so 
that  the  parts  can  be  readily  seen.     This  specu- 
lum necessitates  what  is  known  as  Sims'  posi- 
tion, i.  e.  the  woman's  hips  resting  on  the  edge 
of  the  bed  or  table,  knees  flexed,  and  chest  rest- 
ing on  bed  with  left  arm  out  from  behind  her. 

The  second  variety  of  speculum  is  what  is 
known  as  the  duck-bill  pattern  (Fig.  138).  By 
a  separation  of  the  two  blades,  the  neck  of  the  womb  slips  in  between 
them.  The  speculum  is  then  fastened  with  a  thumb-screw,  leaving 
the  hands  of  the  physician  free.  This  speculum  is  used  with  the 
woman  on  her  back,  and  feet  resting  on  the  bed  or  table,  with  knees 
flexed. 

We  also  give  an  illustration  of  an  older  kind,  which  is  still  used 
to  some  extent.     The  end  is  so  shaped  as  to  catch  the  neck  of  the 


Fro.  138. 
Dack-biU  Speoolnm. 


Fio.  189. 


womb,  and  then  by  drawing  the  instrument  forward  slightly,  the 
diseased  surface  is  presented  for  as  perfect  inspection  as. if  located 
externally  (Fig.  139). 

Inflammation,  Ulceration,  and  Enlars^ement  of  the 
Neck  of  the  Womb. 

Inflammation  of  the  neck  of  the  uterus  is  very  common ;  ulcera- 
tion and  permanent  enlargement  (technically  called  hypertrophy),  are 
its  resulte,  when  it  is  not  arrested  in  due  time.  These  affections-  in 
fact,  and  the  same  troubles  as  they  affect  the  ovaries,  make  up  the 


FEMALE  DISEASES. 


387 


mess,  or  the 
ilum,  affords 


lo.  138. 

>ill  Speonlnm. 

8  in  between 
srew,  leaving 
jed  with  the 
,  with  knees 

is  still  used 
neck  of  the 


slightly,  the 
as. if  located 


;nt  of  the 

non ;  ulcera- 
•trophy),are 
iffections.  in 
nake  up  the 


bulk  of  female  diseases,  —  being  the  real  causes  of  the  most  of  those 
symptoms  which  have  passed  under  the  name  of  whites,  suppression, 
painful  menstruation,  sterility,  general  debility,  etc. 

The  ne(;k  of  the  womb,  when  healthy,  is  soft  and  smooth.  No 
hardness  or  condensation  of  tissue  can  be  felt  by  tlie  finger  c  ""ss- 
ing  over  it.  It  is  elastic,  too,  and  fef  Is  unctuous  to  the  touch.  This 
latter  sensation  is  communicated  by  the  layer  of  mucus  whicli  covers 
it.     Pressure  upon  it  produces  no  pain. 

Inflammation,  when  found  in  this  part,  may  begin  in  the  mucous 
membrane  which  covers  the  neck,  or  in  that  which  lines  its  cavity,  or 
in  the  small  glands  in  the  body  of  the  organ. 

Symptoms.  —  Inflammation  of  the  mucous  membrane  covering 
the  neck  of  the  uterus  destrojrs  the  unctuous  feel  which  it  has  in 
health.  It  also  causes  the  neck  to  swell,  its  vessels  being  crowded 
full  of  blood.  If  the  body  of  the  organ,  as  well  as  tlie  surface,  be 
reached  by  the  inflammation,  it  will  be  hardened  and  enlarged;  and 
in  consequence  of  its  increased  weight,  it  is  apt  to  drop  down  some- 
what into  the  cavity  of  the  vagina.  In  married  ladies,  it  is  often,  by 
physical  pressure,  pushed  a  little  backward,  or  retroverted.  Exami- 
nation with  the  speculum  shows  the  inflamed  neck  to  be  of  a  vivid 
red,  instead  of  a  pale  rose-color.  It  may  be  covered  with  red  or 
white  pimples,  which  are  glands  enlarged  with  muco-pus. 

In  the  healthy  state,  the  mouth  of  the  womb  is  so  much  closed  as 
to  be  just  perceptible  when  the  finger  passes  over  it.  Inflammation 
causes  it  to  be  more  or  less  open,  and  its  lips  to  be  parted. 

Inflammation  followed  by  Ulceration.  —  In  a  majority  of  cases, 
inflammation  of  the  neck  of  the  womb  and  of  its  cavity  is  soon 
followed  by  ulceration,  which  generally  appears  first  around  the 
mouth,  and  just  within  the  cavity  of  the  neck.  From  thencu  it 
spreads  both  inward  and  outward. 

Various  Degrees  of  Ulceration,  etc.  — Of  course,  these  inflamma- 
tions and  ulcerations  mix  and  run  into  each  other  in  all  possible 
forms,  —  presenting  excoriations,  or  raw  pl"'es;  gmnulations,  or 
pimply  surfaces;  and  indurations,  or  harde  d  parts.  Sometimes 
these  pimply  patches  will  be  red  and  hard,  and  again  the  whole  sur- 
face will  be  spongy,  and  will  bleed  upon  the  slightest  touch. 

In  many  cases,  these  ulcerations  make  wretched  work  with  the 
mouth  of  the  womb,  eating  deeply  into  the  cavity,  and  giving  it  a 
ragged  and  unsightly  appearance. 

Velvety  Feel  from  Ulceration. — Ulceration  generally  gives  to  the 
surface  on  which  it  exists,  a  soft,  velvety  feel,  which  the  finger  gener- 
ally recognizes.  This  velvety  sensation,  with  the  open  state  of  the 
mouth,  are  the  most  important  evidences  we  can  derive  from  the 
touch,  of  this  form  of  disease. 

The  Discharge  from  these  Ulcers  is  always  Pus,  or,  in  common 


388 


FEMALE   DISEASES. 


language,  matter.  It  is  sometimes  poured  out  scantily,  at  other  tiiues 
very  freely.  It  may  be  thick  and  yellow,  or  thin,  and  of  a  lighter 
color. 

The  inflammatory  and  ulcenited  condition  of  the  neck  of  the 
womb  often  gives  rise  to  pain ;  and  when  the  seat  of  the  disease  has 
not  been  examined,  as  it  should  be,  this  pain  has  frequently  been 
called  neuralgia.  In  this  way,  ignorance  has  compelled  neuralgia  to 
stand  sponsor  for  a  great  many  pains  with  which  it  has  had  nothing 
to  do. 

These  Ulcers  Disturb  Menstruation. — Menstruation  is  generally 
changed  more  or  less  in  its  character  by  the  presei  ^e  of  inflammar 
tion  or  ulceration  in  the  neck  of  the  womb.  It  usually  becomes  more 
painftd.  In  some  cases  it  is  made  more  profuse,  in  others  more  scanty. 
It  may  come  on  more  frequently,  or  it  may  be  postponed,  protracted, 
or  abridged  in  its  continuance.  There  is  generally  pain  of  a  dull, 
aching  kind,  low  down  in  the  back.  There  is  often  a  feeling  of  full- 
ness, pain,  and  a  sense  of  bearing  down  in  the  lower  part  of  the 
bowels ;  sometimes  the  pain  extends  to  the  groins  and  thiglis. 

Extensive  Disturbances  from  these  Inflammations,  etc.  —  The 

nerves  with  which  the  womb  is  liberally  supplied  belong  to  those  of 
the  sympathetic  system.  Hence,  the  condition  of  the  uterus  influ- 
ences a  wide  circle  of  sympathies.  By  these  nerves  this  organ  is 
brought  into  close  relationship  with  the  organs  of  animal  life.  If  the 
former  suffer,  the  latter  suffers  also.  The  stomach,  being  intimately 
connected  with  the  womb,  physically,  feels  keenly  these  inflammations 
and  ulcerations  of  the  uterine  neck.  At  times,  the  pain,  debility, 
general  disturbance,  and  dyspeptic  state  of  the  stomach  are  such  as 
to  cheat  both  the  doctor  and  the  patient  into  the  belief  that  this  organ 
is  the  seat  of  the  disease.  But  in  such  cases,  the  symptoms  of  stom- 
ach disease  will  all  disappear  the  moment  the  local  affection  is  re- 
moved from  the  neck  of  the  womb. 

The  liver,  too,  often  participates  in  these  troubles,  and  becomes 
sadly  deranged.  It  is  sometimes  even  greatly  enlarged  and  congested, 
a,nd  patients  frequently  have  the  various  symptoms  of  what  are  called 
liver  complaints. 

Severe  pains  are  sometimes  felt  under  the  breast-bone,  and  over 
the  chest  generally,  making  the  patient  apprehensive  of  disease  of 
the  lungs ;  and  indeed  consumption  is  not  a  very  infrequent  result 
of  uterine  diseases. 

Pains  are  often  felt  in  the  region  of  the  heart,  which  organ  is  often 
harassed  with  palpitations. 

The  flesh  is  apt  to  waste  under  the  symptoms  excited  by  these  in- 
flammatory and  ulcerative  processes  in  the  uterine  neck  ;  and  even 
the  brain,  though  lying  in  some  measure  beyond  the  circle  of  influ- 
ences set  in  motion  by  the  organic  nerves,  suffers  disturbance  and 
pain. 


at  other  tinioH 
I  of  a  lighter 

neck  of  the 
le  disease  has 
jquently  been 
I  neuralgia  to 

had  nothiug 


n  is  generally 
of  inflamma- 
aecoraes  more 
8  more  scanty. 
d,  protracted, 
ain  of  a  dull, 
jeling  of  fuU- 
r  part  of  the 
ihiglis. 

J,  etc.  —  The 

g  to  those  of 
uterus  influ- 
this  organ  is 
1  life.  If  the 
ng  intimately 
nflammations 
)ain,  debility, 
are  such  as 
hat  this  organ 
jOvciB  of  stom- 
Eection  is  re- 

and  becomes 
ad  congested, 
hat  are  called 

)ne,  and  over 
of  disease  of 
jquent  result 

srgan  is  often 

by  these  in- 
ik ;  and  even 
rcle  of  influ- 
urbance  and 


rEMALE   DISEASES. 


389 


Even  the  special  senses  of  sight  and  hearing  may  be  drawn  into 
this  general  vortex,  and  both  be  much  impaired.  And  to  crown  this 
catalogue  of  ills,  it  may  be  mentioned  that  those  distressing  things 
called  hysterical  fits  proceed  from  the  same  local  disorders. 

In  brief,  there  is  scarcely  a  point  in  the  human  body  to  which  these 
inflammatory  and  ulcerative  conditions  of  the  uterine  neck  may  not 
send  theii-  sympathetic  pains  and  aches,  and  where  they  may  not  in 
time  induce  real  disease.  This  is  the  reason  why  so  many  women 
suffering  from  these  local  complaints,  tell  the  physician,  when  con- 
sulting him,  that  they  are  "  diseased  all  over."  If  asked  where  the 
complaint  is  located,  they  will  answer,  "  It  is  everywhere."  In  the 
most  earnest  manner  the  assurance  will  be  given,  '■'■Doctor,  there  isn't 
any  well  part  about  me." 

Treatment.  —  It  is  just  as  unreasonable  and  useless  to  treat  these 
inflammations  and  ulcerations  through  the  stomach,  as  it  is  an  in- 
flamed or  ulcerated  throat.  They  are  local  diseases,  affecting  a  par- 
ticular part,  and  the  remedy  must  be  local. 

Like  all  other  affections,  these  can  only  be  managed  intelligently 
after  their  nature  is  well  understood.  Nothing  can  really  be  done  to- 
wards a  cure  until  it  is  known  what  the  matter  is{  and  no  competent 
physician  will  move  a  single  step  in  the  treatment  of  one  of  these 
cases  until  he  has  made  a  thorough  examination.  He  owes  this  to 
himself  and  to  his  patient,  the  more  so  as  the  neck  of  the  womb 
may  be  as  easily  examined  as  the  upper  part  of  the  throat,  and  the 
local  remedy  may  be  almost  as. readily  applied  in  the  former  case  as 
in  the  latter. 

If,  upon  the  introduction  of  the  speculum,  the  uterine  neck  be 
found  simply  inflamed  and  enlarged,  the  application  of  ichthyol  and 
glycerin  to  the  canal  will  reduce  the  swelling  and  inflammation ; 
while  a  tampon  of  wool  soaked  in  the  same  and  placed  beliind  the 
womb  will  reduce  the  entire  swelling-  of  the  womb  by  the  watery 
discharges  which  are  produced.  The  patient  must  learn  to  lie  down 
most  of  the  time.  If  this  should  not  succeed  (though  it  will  in  most 
cases)  then  introduce  a  speculum,  and  when  the  neck  of  the  womb 
is  fairly  lodged  in  its  extremity,  drop  in  two  or  three  leeches  and  al- 
low them  to  fill. 

One  who  is  not  accustomed  to  treat  these  affections  in  this  simple 
way,  will  at  first  be  surprised  at  the  rapidity  with  which  the  local 
trouble  will  disappear,  and  with  it  the  thousand  and  one  aches  and 
pains  which  torment  the  whole  body.  As  the  terrible  pains  in  the 
whole  face  and  head  which  are  produced  by  a  single  tooth  all  in- 
stantly come  to  an  end  when-  the  tooth  is  extracted,  so  do  the  bad 
feelings  all  over  the  body  subside  as  fast  as  the  local  ailments  of  the 
uterine  neck  are  cured.  There  is  no  exception  to  this  rule,  except 
where  the  sympathetic  affection  has  become  fixed  by  long  neglect 
of  the  primary  uterine  disease.  It  is,  therefore,  surprising  that  so 
many  excellent  women,  whose  lives  are  of  the  greatest  value  to  them- 


■  j-fyir-  yv^i^M 


■mnTrt^nti'ttfr  I'tiiiTt-iMwtifirr  >  ^'.?'^Ll'-''V'«?i«;>i'  il^.^.. 


390 


FEMALE   DIBEA3KS. 


; 


Helves  and  frieiitU,  should  be  permitted  to  perisli  of  these  ibilnionts, 
when  the  cure  is  so  simple,  and  many  times  so  entirely  within  tlu! 
reach  of  the  most  ordinary  skill.  It  is  a  reproach  to  the  pnifessioii 
which  should  be  wiped  away. 

If  there  are  a  Imndred  motives  for  gaining  the  mastery  over  other 
diseases,  there  are  a  thousand  for  learning  to  control  these.  More 
than  any  other  diseast  or  all  othei-s,  they  make  the  homes  of  men 
desolate,  by  robbing  them  of  women,  their  ornament  and  solace.  The 
physician  who  neglects  to  make  himself  acquainted  with  all  there  is 
to  be  known  of  these  complaints,  shows  himself  not  only  unfit  for  his 
profession,  but  deficient  in  some  of  the  prime  elements  which  combine 
to  make  a  true  man. 

Hardening:  of  the  Uterine  Neck. — In  many  cases  the  uterine  neck 
is  not  only  inflamed  and  enlarged,  it  is  indurated  and  hardened.  At 
times  it  is  enlarged  and  hardened  on  one  side,  and  not  much  on  the 
other.  In  still  other  cases,  there  are  enlarged  spots,  or  nodes,  giving 
the  whole  neck  a  knotty  feel  under  the  finger. 

These  hardened  conditions  of  the  uterine  neck  proceed  from  vari- 
ous causes,  and  are  more  difficult  to  cure  than  the  ordinary  inflam- 
mation, or  even  ulceration.  They  sometimes  indicate  cancerous  dis- 
ease, and  then,  of  course,  involve  the  most  serious  considerations. 
The  glycerin  tampon  and  the  hot  vaginal  douche  will  do  more  for 
this  hardening  than  all  else  combined. 

Uterine  Syringe. — For  applying  the  several  remedies  to  the  inter- 
nal cavity  of  the  uterine  neck,  I  have  contrived  a  silver  syringe,  which 
is  bent  a  little  at  the  extremity,  and  pierced  with  fine  holes  all  round. 
With  this  instrument,  the  remedy  is  carried  directly  to  the  diseased 
part,  and  applied  instantaneously  to  every  side  of  the  cavity. 

Besides  these  local  applications,  it  is  frequently  necessary  to  resort 
to  soothing  or  astringent  injections  into  the  vagina,  hip-baths,  and 
injections  into  the  bowels,  some  mild  physic,  and  rest  in  a  horizontal 
position.  These  matters  will  all  be  judiciously  regctlated  by  the  at- 
tending physician,  il  he  is  master  of  his  business. 

Inflammation,  etc.,  of  the  Ovaries.  —  Ovaritis. 

The  inflamed  condition  of  the  ovaries  is  indicated  by  increased 
heat,  and  pain  upon  pressure.  The  pain  in  the  ovarian  region  is 
sometimes  intermittent,  sometimes  constant,  and  occasionally  passes 
down  to  the  loins  and  thighs. 

There  are  acute  and  chronic  inflammations  of  the  organs ;  but  it 
will  be  sufficiently  accurate,  in  a  work  of  this  kind,  to  treat  of  them 
as  essentially  one. 

The  effects  of  inflammation  upon  the  ovaries,  as  upon  other  bodies, 
are  various,  sometimes  enlarging  and  hardening,  at  other  times  col- 
lapsing and  blasting  them.  This  last  effect,  it  is  hardly  necessary  to 
say,  cuts  off  all  hope  of  bearing  children. 


'--mmStSUti 


^•UfijiUK^"^'.  i.  y .' . . . '  i3tMtixr^i^  \^^\M 'ji 


FEMALE  DISEASES. 


391 


380  idlmonlx, 
y  within  tlu-, 
le  prt)fe88ioii 

•y  over  other 
ihese.  More 
jmes  of  men 
solace.  The 
h  all  there  is 
r  unfit  for  his 
lich  combine 

uterine  neck 
irdened.  At 
nuch  on  the 
nodes,  giving 

3d  from  vari- 
inary  inflani- 
ancerous  dis- 
msiderations. 
do  more  for 

s  to  the  inter- 
yringe,  which 
)le8  all  round, 
the  diseased 
ivity. 

isary  to  resort 
lip-baths,  and 
1  a  horizontal 
ed  by  the  atr 


Ovaritis. 

by  increased 
ian  region  is 
ionally  passes 

'gans;  but  it 
treat  of  them 

other  bodies, 
er  times  col- 
r  necessary  to 


The  Causes  of  ovarian  infiauunation  are  numerous.  One  of  the 
most  impoi'tiint  caiiHus  hah  already  been  noticed,  namely,  the  congen- 
tion  of  tht  parts,  for  several  days,  at  every  menstrual  period.  This, 
amounting  iw  it  does  almost  to  inflanimution,  is  often  intensified  by 
other  causes,  such  as  wetting  the  feet,  taking  sudden  colds,  excessive 
fatigue  from  dancing,  and  exciting  drinks. 

Sexual  indulgence  often  proves  a  cause  of  inflammation  ui  these 
bodies.  It  is  particulary  apt  to  have  this  effect  in  the  newly-married 
female,  with  whom  it  is  a  novel  stimulus,  and  often  applied  with  im- 
moderate excess.  In  late  marriages,  when  the  stimulus  i  the  ovaries 
liiis  long  been  denied,  its  sudden  presentation  is  liable  to  jake  an  in- 
flammatory impression.  Its  entire  absence,  too,  in  persons  of  strong 
passions,  may  result  in  ovarian  disease. 

This  inflammation  may  be  produced  by  the  new  state  of  things 
existing  at  the  critical  period  called  the  turn  of  life,  when  it  reacts  on 
the  womb,  producing  the  floodings  which  often  bring  menstruation 
to  a  close.  The  congestion,  too,  which  has  been  present  every  month 
for  many  years,  ''^es  not  immediatelv  cease  at  this  change ;  and  not 
finding  relief  by  the  accustomed  flo\^,  the  ovarian  bodies  are  exposed 
to  inflammation. 

In  all  large  cities,  the  pest-houses  of  civilization,  where  the  women 
are  more  numerous  than  the  men,  there  are  many  females  whose  vir- 
ginity is  a  burden,  and  numerous  others  who  give  themselves  up  to 
sexual  excesses ;  to  both  these  classes,  the  turn  of  life  is  very  liable 
to  promote  these  ovarian  disorders. 

There  is  another  class  of  causes,  which,  though  not  so  easily  re- 
cognized, are  equally  cogent  in  exciting  this  form  of  disease.  I  mean 
all  those  excitements  which  arise  from  unbridled  thoughts,  from 
books  of  questionable  character,  from  music,  social  intercourse,  and 
stimulating  food  and  drinks, — all  which  promote  and  intensify  burn- 
ing desires,  which,  though  natural  and  proper  in  themselves,  cannot 
lawfully  be  gratified  in  a  community  where  the  female  sex  greatly 
preponderates,  numerically,  over  the  male.  When  we  consider  how 
powerful  within  a  woman's  breast  the  conflict  often  is  between  the 
impulse  of  passion  and  the  dictates  of  duty,  and  how  strongly  this 
conflict  must  react  upon  the  sexual  organs,  and  especially  upon  the 
ovaries,  the  centre  of  the  sexual  system,  we  can  easily  see  in  how 
many  cases  they  may  become  inflamed. 

Another  cause  of  this  disease  ia  suppression  of  the  men  .  The 
engorged  and  crowded  state  of  the  vessels  of  the  womb,  of  the  ute- 
rine neck,  and  ot  the  ovaries,  not  finding  vent  in  the  accustomed  flow, 
inflammation  in  any  one  of  these  organs  is  a  very  natural  result. 

The  inflammation  of  these  ovarian  bbdies  is  a  frequent  result,  too, 
of  a  similar  condition,  previously  existing  in  the  neck  of  the  womb. 
In  passing  from  the  uterine  neck  to  the  ovarian  bodies,  the  inflamma- 
tory cofidition  often  fastens  itself  upon  the  broad  ligament,  the  fallo- 
pian tubes,  and  their  fimbriated  extreu^^ties.     The  whole,  it  will  be 


I 


1    - 


392 


FEMALR   DISEASES. 


seen,  prusenlH  an  amount  of  diHeane  which  it  in  painful  to  contem- 
plate. 

The  womb  l)eing  turned  over,  and  pressini^  ai;^in8t  one  of  the 
ovaries,  may  cauHO  it  to  inflame  by  mechanical  irritation.  Pessaries, 
injudiciously  used,  may  do  the  same  tiling. 

Symptoms.  —  The  first  and  most  obvious  symptom  is  a  pain  a  little 
to  the  right  or  left  of  the  womb.  This  pain  is  almost  always  increased 
by  walking,  riding,  or  by  external  pressure.  It  is  especially  aug- 
mented by  straightening  the  thigh,  by  which  the  parts  over  the  in- 
flammation are  put  upon  the  stretch.  When  standing  up,  ladies 
suffering  from  this  disease  are  generally  compelled  to  rest  the  foot 
on  a  stool,  so  as  to  bend  the  thigh,  and  relax  the  muscles.  The  pains 
radiate  from  the  ovaries,  and  go  down*  to  the  loins  and  thiglis,  and 
sometimes  to  the  fundament.  They  are  of  a  dull,  dragging,  heavy 
nature. 

Sometimes  the  ovarian  bodies  become  very  much  enlarged,  and 
dropping  down  somewhat,  press  upon  the  lower  bowel,  causing  con- 
stipation, or  upon  the  neck  of  the  bladder,  creating  a  frequent  desire 
to  urinate,  and  an  inability  to  pass  the  water  freely. 

Treatment.  —  As  inflammation  of  the  ovaries  is  always  increased 
during  the  .nenstrual  flow,  it  is  not  proper  to  meddle  with  it  at  these 
monthly  periods,  lest  the  trouble  be  aggravated.  Immediately  after 
one  of  the  turns  has  passed,  from  six  to  eight  leeches  should  be  aj)- 
plied  over  the  diseased  ovary.  When  the  bites  are  healed,  a  blister 
may  be  used  in  the  same  place.  The  scarf-skin  should  not  be  re- 
moved, and  the  irritated  surface  must  be  healed  as  soon  as  possible. 
The  blister  should  be  camphorated  to  prevent  strangulation.  The 
part  should  next  be  rubbed  for  a  few  minutes,  night  and  morning, 
with  an  alterative  and  anodyne  ointment  (169). 

After  the  next  menstruation,  the  same  things  should  he  repeated, 
and  again  after  the  next,  and  so  on,  for  five  or  six  monvii.^-,  or  even 
longer,  if  need  be.  The  already  bloodless  condition  of  the  patient 
may  require,  however,  that  the  leeches  should  not  be  applied  more 
than  once,  or,  at  most,  twice. 

The  bowels  should  occasionally  be  opened  by  some  simple  cathartic, 
for  the  purpose  of  removing  all  hard  substances  which  may  press 
against  and  fret  the  inflamed  ovaries.  The  purgatives  employed 
should  be  of  the  most  cooling  kind,  such  as  salts  or  oil ;  while  aloes, 
and  all  harsh  cathartics  must  be  avoided. 

Injections  of  tincture  of  belladonna  and  hyoscyamus  are  useful  for 
quieting  neighboring  parts,  and  warding  off  external  disturbances. 
They  act  like  soft  substances  thrown  upon  the  pavement  in  front  of  a 
sick  man's  house.  A  piece  of  flannel  soaked  in  hot  laudanum,  laid 
over  the  ovary  and  covered  with  dry  flannel,  will  give  great  relief  and 
enable  the  patient  to  sleep. 

The  patient  should  be  kept,  as  much  as  possible,  in  the  recumbent 


""^si 


FRMALR   niSEASES. 


398 


1  to  contem- 

;  one  of  the 
.     Pessaries, 

a  pain  a  little 
ays  increased 
pecially  aug- 
over  the  in- 
g  up,  ladies 
'est  the  foot 
.  The  pains 
.  thiglis,  and 
?ging,  heavy 

iilarged,  and 
causing  con- 
squent  desire 

lys  increased 
th  it  at  these 
jdiately  after 
lould  be  ai> 
led,  a  blister 
i  not  be  re- 
as  possible, 
lation.  The 
nd  morning, 

hs  repeated, 
tivii.^-,  or  even 
f  the  patient 
ipplied  more 

pie  cathartic, 

sh  may  press 

es  employed 

while  aloes, 

,re  useful  for 
disturbances, 
t  in  front  of  a 
idanum,  laid 
3at  relief  and 

le  recumbent 


position,  lying  upon  tlio  l)ed  or  the  lounge,  and  should  only  bo  i)er- 
luitted  to  move  about  to  such  extent  as  will  nou  irritate  the  inflamed 
parts. 

Whites.  —  Leucorrhwa.  —  Fluor  Albtia. 

Leucorbhcea  is  from  two  greek  words,  Xivxoi'  and  /»«(»,  and^^uor 
albus  from  two  Latin  words,  alhut  and  Jluo,  having  jjrecisely  the 
same  meaning  as  the  Greek,  namely,  a  white  discharge.  Flence,  in 
popular  language,  the  disease  is  called  the  "  whites  ";  it  is  also  called 
'■'■female  weakness." 

These  terms  are  well  enough,  perhaps,  if  we  have  in  mind  that 
they  convey  to  us  only  the  idea  of  a  symptom  of  disease.  They  all 
mean,  with  the  exception  of  the  last,  a  white  discharge  from  the 
female  genital  organs.  They  are  slightly  inaccurate,  as  the  discharge 
is  sometimes  yellow,  or  green,  ur  otherwise  variant  from  whit«i.  Any 
discharge  from  the  female  genital  organs  which  is  not  bloody,  comes 
under  the  term  "  whites." 

A  5ymptom  Only.  —  As  the  name  of  a  disease,  the  term  whites  has 
no  specific  meaning.  It  does  not  designate  any  particular  complaint. 
It  is  a  symptom,  just  as  the  matter  expectorated  and  raised  in  lung 
diseiises  is  a  symptom ;  and  as  such  only  should  it  be  regarded. 
When  persons  cough  and  raise  a  great  deal,  they  do  not,  on  consult- 
ing a  physician,  say  they  have  got  the  expectoration ;  but  they  say 
they  fear  they  have  some  disease  of  the  lungs,  because  they  expecto- 
nite.  They  look  upon  the  expectomtion  as  the  sign  or  symptom  of 
disease. 

So  females,  and  phyBicians  too,  must  learn  to  look  upon  the  whites, 
not  as  a  disease,  but  as  the  sign  or  symptom  of  disease,  which  sign 
they  should  become  skilled  in  interpreting. 

There  is  no  reason  why  the  discharge  from  the  genital  organs 
should  not  be  as  well  interpreted  as  the  expectoration  or  discharge 
from  the  throat.  The  parts  from  which  it  comes  may  be  about  aa, 
easily  and  as  well  inspected. 

No  Female  Ailments  so  Common. — There  are  no  female  troubles 
to  wliich  the  attention  of  the  physician  is  so  often  called  as  these 
annoying  and  debilitating  symptoms  called  whites  ;  and  there  is  no 
department  of  medical  practice  in  which  the  really  able  as  well  as 
conscientious  and  painstaking  physician  is  so  well  tested.  If,  re- 
garding these  discharges  as  they  are,  simply  as  signs,  he  searches 
faithfully  for  their  cause,  he  will  be  led  to  a  treatment  which  in  a 
great  majority  of  cases  will  be  successful.  And  surely  no  success  in 
life  can  be  more  prized  by  a  right-minded  physician.  It  procures 
health,  the  highest  earthly  boon,  for  suffering  woman,  and  gratitude, 
the  most  prized  of  all  rewards,  for  himself 

There  are  Four  Kinds  of  Discharges  from  tiie  female  genital  or- 
gans,— mucus,  pus,  mucus  and  pus  combined,  and  the  watery.     The 


i  i 


U. 


394 


FEMALK   niBRASIS. 


firet,  inucuH,  (Iooh  not  in  itAelf  imply  diHeaHt; ;  but  when  puH  iH  iHn- 
(shargnd,  wo  know  tlmt  inflammation  exiHtH,  IxHiauHe  huuIi  a  (;auH(; 
alonu  can  produce  it. 

Seat  of  the  Diseaae.  —  Ttie  cuiue  which  produces  the  whites  nmy 
have  itH  seat  either  in  the  vagina,  or  in  the  neck  of  tlie  womb ;  and 
in  practice  it  iH  of  courue  quite  important  to  know  where  its  location 
ia.  The  character  of  the  discharge  generally  settles  this  point.  If  it 
be  thin  and  watery,  or  thick  and  cream-like,  it  is  from  the  vagina  or 
passage  which  leads  to  the  womb ;  if  ropy,  gluey  or  albuminous,  like 
white  of  egg,  it  is  from  the  cavity  of  the  uterine  neck. 

Treatment.  —  Some  physicians  always  prescribe  the  same  remedy 
for  the  whites.  They  might  as  well  liave  but  one  proscription  for 
expectoration.  The  remedy  must  have  reference  to  tlie  cause  of  the 
discharge ;  until  the  cause  be  searched  out,  every  prescription  is  a 
mere  trial  at  guessing,  —  a  sort  of  practice  well  enough  adapt^ed  to 
quacks,  but  not  becoming  scientific  men. 

When  a  case  of  whites  is  brought  before  a  physician  who  under- 
stands his  business,  he  makes  no  prescription  until  he  has  discovered 
what  the  disease  is.  Having  determined  this  point,  his  remedies  have 
an  intelligent  bearing  upon  the  case. 

If  the  discharge  be  of  a  ropy,  tenacious  character,  one  of  the  best 
remedies  is  a  strong  solution  of  nitrate  of  silver,  used  as  an  injection 
with  a  female  syringe,  once  a  day  (254).  Of  this,  not  more  than  two 
teaspoonfuls  should  be  used  at  a  time ;  and  great  care  should  be  ob- 
served not  to  stain  the  underclothes  with  it.  When  the  discharge  is 
either  yellow  and  thick,  or  lighter  colored  and  watery,  some  one  of 
the  following:  (200),  (202),  (208),  (207),  (209),  (220),  (230), 
(282),  (248),  (244),  may  be  used  with  advantage  as  an  injection, 
twice  a  day.  An  infusion  of  the  white  pond-lily,  one  ounce  to  the 
pint  of  water,  makes  a  very  excellent  injection,  which  may  be  used 
twice  a  day.  A  very  simple  injection,  and  sometimes  quite  effectual, 
is  a  strong  infusion  of  green  tea. 

Some  one  of  the  above  remedies  will  generally  afford  some  relief; 
but  if  whites  exist  in  a  somewhat  aggravated  form,  they  furnish  evi- 
dence of  some  serious  disease  in  the  vagina  or  neck  of  the  womb, 
and  the  case  ought  to  be  submitted  to  a  competent  physician. 

Absence  of  the  Menses.  —  Amenorrhoea, 

The  absence  of  the  menses  is  divided  into  two  kinds,  —  retention 
and  mppreseian.  It  is  retention  when  the  montlily  flow  has  never 
appeared ;  suppression,  when,  having  been  established,  it  is,  by  one 
caxise  or  another,  stopped. 

Retention  Explained.  —  The  ovaries,  as  we  have  before  said,  are 
the  centre  of  the  female  sexual  system.     It  is  the  swelling  or  ripening 


r 


FKMALR   niSK/lSKS. 


395 


II    pus    \H    iVlH- 
itUcil    U    CllUHO 


le  whituH  liiiiy 
3  womb ;  and 
'6  its  lucatiun 
I  point.  I  f  it 
the  vagina  or 
uminouH,  like 


same  remedy 
ascription  for 
a  came  of  the 
scription  is  a 
h  adapted  to 

1  who  under- 
1H8  discovered 
remedies  have 

16  of  the  best 

a  an  injection 

more  than  two 

should  be  ob- 

le  discharge  is 

r,  some  one  of 

;220),  (230), 

an  injection, 

ounce  to  the 

may  be  used 

[uite  effectual, 

d  some  relief ; 
3y  furnish  evi- 
of  the  womb, 
rsician. 

hoea. 

is,  —  retention 
low  has  never 
I,  it  is,  by  one 

efore  said,  are 
ing  or  ripening 


of  an  ovum  or  egg,  everv  four  weeks,  which  causes  the  large  flow  of 
blood  to  the  parts,  and      e  consequent  menstrual  discharge. 

But  it  Hometime.s  happens  that  the  ovaries  are  not  dev«lo[)ed  at  the 
usual  time  of  life.  The  monthly  evacuation  does  not  then  appear. 
There  is  retention.  There  may  be  retention,  too,  from  other  causes, 
lifter  the  ovaries  are  matured.  Costiveness  may  sometimes  occasion 
it;  so  may  a  degenerated  and  low  state  of  the  blood. 

There  may  be  mechanical  causes  of  retention.  The  mouth  of  the 
womb  may  be  entirely  closed,  or  the  neck  may  Im  so  constricted  as 
to  close  the  passage  through  it,  leaving  no  outlet  for  the  montlily  ac- 
cumulation. The  hymen,  also,  may  have  no  opening  through  it. 
When  these  mechanical  obstructions  exist,  there  are  sometimes  large 
collections  of  fluid  in  the  womb,  which  cause  enlargenient  of  the  body, 
and  in  some  instances,  painful  suspicions  that  the  sufferer  has  com- 
mitted imprudences,  and  is  in  the  family  way.  Physicians  should  be 
on  their  guard  ogainst  falling  into  such  errors,  and  lending  the  sanc- 
tion of  their  name  to  these  oiasting  mistakes. 

Suppression  Explained.  —  Suppression  —  a  stoppage  after  flow 
has  been  once  established  —  may  be  caused  by  inflammation  of  the 
ovaries,  the  blood,  in  this  diseased  condition,  being  drawn  so  entirely 
to  these  swelling  and  genuinating  bodies,  that  the  accustomed  flow 
from  the  womb  does  not  take  place. 

Inflammation  in  the  neck  of  the  womb  may  also  cause  a  stoppage. 
So  may  a  fright,  as  from  a  fire  occurring  in  the  neighborhood,  or  a 
cold  taken  by  being  raught  in  a  shower.  Girls  sometimes,  in  their 
utter  thoughtlessness  or  ignorance,  dip  their  feet  in  cold  water,  when 
their  courses  are  upon  them,  and  bring  on  a  suppression  of  a  most 
dangerous  character.  The  most  lovely  and  innocent  girls  have  done 
this  for  the  purpose  of  attending  a  party ;  and,  in  some  instances,  the 
stoppage  induced  has  ended  in  death  within  a  few  hours.  The  pro- 
found ignorance  of  their  own  mechanism,  and  of  the  laws  which  gov- 
ern it,  in  which  girls  are  kept  who  are  just  budding  into  life,  is  a 
serious  reproach  both  to  parents  and  physicians. 

Suppression  may  be  induced  by  whatever  reduces  the  quantity  or 
quality  of  the  blood,  as  consumption,  or  by  great  depression  of  spirits. 
With  somj  rare  exceptions,  women  have  not  their  turns  while  in  the 
family  way. 

Treatment.  —  Before  anything  can  be  done  in  the  way  of  treat- 
ment, the  case  must  be  thoroughly  investigated,  and  the  specific  cause 
of  the  disease  searched  out. 

If  it  prove  to  be  retention,  and  arises  from  a  bloodless  condition 
and  an  undeveloped  state  of  the  ovaries,  iron  is  the  proper  remedy 
(61),  (73),  (74),  (76),  with  a  generous  diet  and  exercise  out  of 
doors.  If  caused  by  an  inflammatory  state  of  the  uterine  neck  or  ova- 
ries, the  proper  treatment  has  been  already  indicated.  If  from  cos- 
tiveness, relief  may  generally  be  found  from  prescriptions  (5),  (9). 


I 

li. 


I '' 


i,       y 

f  : 

i    ^ 


896 


FEMALE  DISEASES. 


The  mechanical  causes  alluded  to  above,  when  found  to  exist,  must 
be  removed  by  gently  dilating  the  mouth  of  the  womb  or  the  uterine 
neck,  with  bougies,  beginning  with  the  smallest,  and  increasing  the 
size,  or  by  puncturing  the  hymen,  as  the  case  may  require.  Per- 
manganate of  potash,  in  capsules  of  2  grains  each,  after  meals,  is 
one  of  the  best  remedies. 

In  Treating  Suppression*  it  should  be  borne  in  mind  that  at  a  cer- 
tain time  each  month  nature  makes  an  attempt  to  restore  the  lost 
function.  Even  when  she  is  not  successful,  probably  an  ovum  is  ma- 
tured and  in  some  way  disposed  of.  The  intelligent  physician  will  of 
course  avail  himself  of  this  favorable  moment,  to  try  his  skill  in  bring- 
ing about  the  desired  regularity.  When  this  time  arrives,  he  should 
order  three  or  four  leeches  applied  to  each  groin  at  night.  The  next 
night,  he  should  direct  the  use  of  a  pungent  foot-bath  (242) ;  also 
(16)  as  a  cathartic. 

When  suppression  exists,  it  is  not  always  proper  to  try  in  this 
direct  way  to  bring  on  the  turns.  There  may  be  no  blood  to  spare  ; 
and  this  may  be  the  sole  reason  why  the  courses  do  not  appear. 
When  this  is  the  case,  nothing  is  to  be  done  but  to  build  up  the 
health  as  rapidly  as  possible,  and  when  this  is  sufficiently  established, 
the  courses  will  be  all  right, 

Profuse  Menstruation.  —  Menorrhagia. 

Menstrttation  may.  continue  too  long,  or  occur  too  often,  or  be  too 
profuse  while  it  lasts;  or  all  these  irregularities  may  be  experienced 
by  the  same  person.  Any  one  of  them  will  prove  a  serious  irritation, 
and  a  drain  upon  the  constitution ;  the  whole  together,  if  not  arrested, 
will  undermine  and  destroy  it. 

Tlie  Cause  of  tliis,  like  the  source  of  all  other  female  diseases,  is, 
in  a  great  rr^jority  of  cases,  overlooked. 

It  is  not  to  be  attributed,  as  so  many  suppose,  to  a  congested  state 
of  the  womb ;  but  is  rather  the  result,  in  a  great  many  instances,  of 
the  inflammatory  or  ulcerated  condition  of  the  uterine  neck. 

In  still  another  large  number  of  cases,  it  arises  from  a  succession 
of  ovarian  abortions.  When  the  blood  has  Tvr.  low,  and  nutrition  is 
defective,  as  in  the  consumptive  habit,  the  ovarian  vesicles  fail  to 
reach  maturity.  Like  other  products  of  the  economy,  they  become 
blighted,  and  abort.  And  as  these  blights  occur  often,  nature  is  busy 
every  two  or  three  weeks  casting  them  off.  Hence,  the  menses 
appear  often.  They  come  and  go  without  order,  because  they  spring 
from  a  process  which  is  a  contraversion  of  nature's  laws. 

Profuse  menstruation,  like  scanty  menstruation,  is  a  sjrmptom  of 
a  variety  of  diseases.  The  quantity  may  be  increased  only  on  one  or 
more  days,  or  be  so  great  as  to  cause  death  from  hemorrhage.  At  all 
events,  the  amount  of  blood  lost  is  often  so  great  as  to  cause  aneemia 


:% 


I 


^  w 


I 


FEMALK   DISEASES. 


897 


exist,  must 
the  uterine 
reasing  the 
[uire.  Per- 
)r  meals,  is 

hat  at  a  cer- 
•re  the  lost 
»vum  is  ma- 
ician  will  of 
dll  in  bring- 
s,  he  should 
The  next 
^242);  also 

try  in  this 
)d  to  spare ; 
aot  appear, 
lild  up  the 
established, 


a. 

n,  or  be  too 
experienced 
s  irritation, 
lot  arrested, 

diseases,  is, 

nested  state 
nstances,  of 
ok. 

succession 
nutrition  is 
cles  fail  to 
hey  become 
ture  is  busy 
the  menses 
they  spring 

lymptom  of 
y  on  one  or 
age.  At  all 
use  aneemia 


and  impaired  health  for  a  long  time.  This  is,  however,  usually  the 
result  of  continued  free  bleeding  extending  through  a  number  of 
months. 

The  local  causes  of  uterine  hemorrhage  are  fibroid  tumor  of  the 
womb ;  inflammation  of  the  wcmb,  or  metritis ;  inflammation  of  the 
lining  membrane,  or  endometritis ;  uterine  congestions  from  any 
source ;  cancer  of  the  womb  in  its  early  stages  ;  retroversion,  or  tip- 
ping over  backward  of  the  womb  onto  the  rectum ;  polypus ;  enlarge- 
ment of  the  womb  following  labor  or  abortion ;  the  retention  of  pla- 
cental tissue,  etc.,  etc.  These  also  are  among  the  local  causes  of  hem- 
orrhage. But  not  infrequently  the  excess  of  flow  is  due  to  impaired 
general  health.  Wasting  diseases  like  phthisis  or  consumption  caus*^ 
the  blood  to  be  so  thin  as  to  render  it  unable  to  form  a  clot,  thuc 
facilitating  the  easy  or  profuse  hemorrhage  often  seen  in  young  girls 
in  the  earlier  stages  of  consumption ;  later,  amenorrhoea  ensues  from 
utter  lack  of  blood.  This  flowing  often  attends  acute  fevers,  pur- 
pura, Bright's  disease,  jaundice,  heart-disease  and  debility.  This 
last  cause  is  often  seen  in  the  case  of  young  girls  who  have  grown 
rapidly  since  puberty  and  pursued  a  vigorous  course  of  study  with 
little  or  no  out-door  exercise.  The  strain  on  the  nervous  system  in 
these  girls  is  kept  up  constantly  by  sharp  competition,  and  no  heed 
is  paid  to  nature's  demand  for  rest  and  relaxation  at  the  menstrual 
time.  The  claims  of  society  on  the  young  girl  add  no  small  share  in 
the  production  of  this  evil. 

Explanation.  -7-  It  is  not  easy  to  explain  how  inflammation  and 
ulceration  of  the  uterine  neck  should  in  one  case  produce  suppression, 
and  in  another  profuse  menstruation.  Yet  it  is  a  settled  truth  that 
such  opposite  results  do  come  from  one  and  the  same  apparent  cause. 
Probably  the  explanation  is  to  be  found  in  the  difl'erent  degrees  of 
inflammatory  action,  in  the  varieties  of 
constitution,  and  in  the  variant  degrees 
of  tenacity  with  which  the  vessels  hold 
the  blood. 

Bleeding  from  the  female  genital  or- 
gans may  be  produced  by  a  variety  of 
causes  which  have  nothing  to  do  with 
menstruation.  Such  bleedings  are  prop- 
erly uterine  or  vaginal  hemorrhc^es,  and 
not  profuse  menstruation.  They  are  the 
result  of  inflammations,  or  tumors  within 
the  uterine  neck  (Fig.  140),  or  weak- 
ness. The  womb  may  bleed  for  days,  or  even  months,  from  pure 
debility. 

Treatment.  '■ —  As  profuse  menstruation  and  uterine  hemorrhage 
spring  from  a  variety  of  causes,  so  the  remedies  are  various.  Here 
again  we  are  confronted  with  the  same        lute  necessity  to  investi- 


.FlO.  140. 


f    , 


I  ■ 


■5 


f        "^ 


i         I 


398 


FEMALE  DISEASES. 


gate  accurately  the  true  nature  of  the  complaint  before  we  venture 
a  single  prescription.  All  the  cases  present  one  general  feature. 
There  is  too  great  a  loss  of  blood;  and  the  first  thoughu  is  that 
astringent  medicines  are  necessary  to  arrest  it.  But  if  the  bleeding 
be  occasioned  by  a  polypus,  or  by  inflammatory  ulceration,  astringents 
would  not  arrest  it,  and  might  do  great  mischief. 

When  the  immoderate  flowing  is  caused  by  a  general  breakdown 
of  the  nutritive  powers,  and  by  ovarian  abortions,  the  great  aim  must 
be  to  rally  the  vital  powers  by  iron,  quinine,  porter,  wine,  a  generous 
diet,  exercise  on  horseback  and  on  foot,  and  warm  and  cold  bathing. 
When  produced  by  local  diseases  of  the  ovaries  and  neck  of  the 
womb,  the  treatment  is  to  be  local,  —  such  as  has  been  described.  If 
a  polypus  or  other  tumor  be  the  cause,  the  remedy  must  be  sought 
for  under  the  appropriate  head.  If  the  womb  has  become  relaxed, 
and  bleeds  from  pure  debility,  —  as  it  may,  —  something  must  be 
found,  if  possible,  which  will  condense  its  substance,  making  it 
harder,  smaller,  and  more  solid.  For  this  purpose,  cold  bathing,  as- 
tringent injections  into  the  fi-ont  passage,  and  acid  drinks  are  useful. 
But  one  of  the  best  remedies  is  the  wine  of  spurred  rye  (267).  One 
teaspoon  ful  should  be  taken  three  times  a  day.  This  article,  by 
causing  the  womb  to  contract,  solidifies  and  condenses  it,  thus  arrest- 
ing the  blood  which  oozes  from  its  relaxed  tissues.  Of  course,  the 
object  of  all  treatment  is  twofold :  the  one  to  stop  the  hemorrhage 
for  the  time  being,  the  other  to  remove  the  cause.  The  physician 
may  have  tb  be  called,  and  resort  had  to  tampons  in  the  vagina ;  the 
uterus  itself  might  have  to  be  packed  with  gauze ;  hot  douches  of 
115°  to  120°  F.  will  frequently  quiet  a  stubborn  hemorrhage,  espe- 
cially if  rest  in  bed  with  the  hips  elevated  be  strictly  enjoined.  The 
hot  douche  should  be  repeated  every  three  hours.  Besides  the  giving 
of  ergot,  hydi'astis,  hamamelis  and  atropia  are  also  quite  useful,  as, 
for  instance :  Fluid  extract  ei'got,  fluid  extract  hydrastis,  fluid  extract 
hamamelis,  of  each  twenty  drops,  in  water  every  three  hours,  with 
the  addition  of  jj^  graii  of  atropia  at  the  same  time. 

Sedatives,  like  the  bromide  of  soda,  in  ten-grain  doses  every  hour 
or  two,  will  be  of  service  if  the  hemorrhage  be  caused  by  fright,  grief, 
or  injury.  The  treatment  of  the  intervals  must  depend  on  the  cause, 
but  generally  some  systemic  tonics  like  iron  or  quinine  are  of  great 
service  ;  rest  in  bed  is,  par  excellence,  the  ti  "batmen  t  in  most  cases  at 
some  stage  of  the  flowing,  generally  during  the  flow  itself ;  but  rest 
from  excitement  and  freedom  from  overv/crk  are  ^oiial?y  important 
when  the  hemorrhage  is  due  to  this  cause.  Out-*.":' jv  exarcise,  fresh 
air  and  good  food  are  none  the  less  important  for  vvbary  brains  and 
tired  nerves. 

Hemorrhage  between  the  periods,  or  menorrhagia. — When  hem- 
orrhage from  the  womb  occurs  between  the  periods,  it  is  called  men- 
orrhagia, and  is  more  apt  to  occur  in  women  past  thirty  years  of  age, 
or,  at  all  events,  in  married  women.   It  is  of  more  significance  usually 


1^1: 


FEBIALE  DISEASES. 


399 


we  venture 
3ral  feature, 
iighi,  is  that 
the  bleeding 
I,  astringents 

[  breakdown 
;at  aim  must 
J,  a  generous 
jold  bathing, 
neck  of  the 
[escribed.    If 
st  be  sought 
jme  relaxed, 
ing  must  be 
},  making   it 
L  bathing,  as- 
£8  are  useful. 
(267).     One 
lis  article,  by 
t,  thus  arrest- 
f  course,  the 
)  hemorrhage 
'he  physician 
B  vagina ;  the 
)t  douches  of 
jrrhage,  espe- 
joined.     The 
ies  the  giving 
te  useful,  as, 
,  fluid  extract 
a  hours,  with 

es  every  hour 
T  fright,  grief, 
on  the  cause, 
!  are  of  great 
most  cases  at 
self ;  but  rest 
Ty  important 
sxsrcise,  fresh 
,ry  brains  and 

-When  hem- 
is  called  men- 
years  of  age, 
icance  usually 


than  profuse  menstruation,  and  almost  alway8  proceeds  from  the  womb 
itself.  This  bleeding  comes  on  often  after  the  menopause,  or  "change 
of  life."  The  causes  are  quite  similar  to  those  just  considered,  but 
local  causes  are  oftener  found.  Some  sloughing  surface,  as  from 
cancer,  fibroid,  erosion  of  the  lining  membrane,  exists  in  half  the  cases. 
Abortion,  and  the  retention  of  small  pieces  of  afterbirth,  are  frequent 
causes  of  this  kind  of  flowing. 

This  trouble  demands  the  immediate  attention  of  the  family  phy- 
sician or  the  specialist,  who  will  examine  the  uterus  and  ascertain  the 
cause ;  and,  as  not  infrequently,  the  cause  consists  in  something  to  be 
removed,  a  brief  mention  of  the  methods  employed  will  not  be  out  of 
place. 

The  size,  shape,  position  and  firmness  of  the  uterus  and  ovaries  are 
made  out  by  the  examining  fingers  of  the  left  hand  being  pressed 
into  the  abdominal  walls  above  the  bladder,  while  the  fingers  of  the 
right  hand,  with  the  knees  drawn  well  up,  are  introduced  into  the 
vagina  and  pressed  against  the  neck  of  the  womb.  An  endeavor  is 
then  made  to  bring  the  womb  between  the  two  sets  of  fingers,  which 
maps  out  its  locality,  position,  etc.  The  ovaries  and  ligaments  are 
likewise  located.  Any  erosion  of  the  mouth  of  the  womb,  foreign 
growth  there,  malposition,  excessive  size,  etc.,  can  thus  be  readily 
detected.  To  explore  the  inside,  one  of  the  various  specula  before 
described  are  used,  and  the  uterus  dilated  either  with  tents,  so-called, 
or  more  commonly  with  a  steel  dilator.  If,  then,  there  is  found 
aught  to  be  removed,  a  sharp,  spoon-like  instruntent,  called  a  curette, 
is  used  to  scrape  away  all  diseased  tissue  or  foreign  growth,  and  the 
womb  then  washed  out  with  some  antiseptic  solution.  The  womb  is 
then  often  packed  with  gauze  to  still  further  disinfect  its  interior  and 
afford  a  means  of  draining  away  all  oozing  blood  or  forming  mucus. 

This  operation  called  curetting  is  now  frequently  done  as  a  regfular 
means  of  treatment  to  do  away  with  the  causes  of  hemorrhage  and  to 
restore  the  normal  bulk  and  character  of  the  womb,  instead  of  resort- 
ing to  the  slow,  tedious,  and  less  successful  methods  of  former  times. 
It  is,  to  be  sure,  a  regular  operation;  but  when  done  under  so-called 
aseptic  methods,  to  be  described  later,  is  a  perfectly  safe  and  trust- 
worthy treatment,  far  in  advance  of  old-fashioned  methods,  which 
8eem  less  heroic. 

It  necessitates  rest  in  bed,  nursing,  and  the  disadvantages  of  sick- 
ness; but  on  the  other  hand,  it  saves  lives,  stops  disease,  and  renders 
useful  what  otherwise  might  become  useless  and  dangerous  to  life  and 
health. 

Painful  Menstruation.  —  Dysmenorrhoea. 

Dysmenoerhcea  is  from  three  Greek  words  Sw,  /a^  *^d  pim  which 
mean,  literally,  a  difficult  monthly  flow.  These  words  do  not  pre- 
cisely describe  the  complaint;  for  it  consists  not  so  much  in  a  diffir 
cult,  as  in  a  painful  flow. 


400 


FEMALE  DISEASES. 


Symptoms.  — This  affection  is  always  marked  by  more  or  less  pain 
while  the  courses  are  on,  —  especially  during  the  first  day  or  two. 
The  pain  sometimes  begins  two  or  three  days  in  advance  of  the  evac- 
uation. It  extends  over  the  whole  lower  part  of  the  belly,  running 
down,  at  timea,  to  the  thighs,  and  causing  great  distress  in  the  back. 
It  is  frequently  so  violent  as  to  resemble  the  pains  of  labor,  compel- 
ling the  sufferer  to  take  the  bed,  and  drawing  from  her  tears  and 
groans,  and  occasionally  throwing  her  into  Rpasms  most  painful  to 
witness.  So  terrible  are  the  monthly  suffeimgs  which  some  women 
experience  from  this  cause,  that  the  anticipation  of  it  destroys  much 
of  their  peace,  even  during  the  intervals  of  respite. 

The  Causes  of  this  complaint  are  very  numerous.  There  is, 
doubtless,  such  a  thing  as  pain  in  the  womb  from  rheumatism,  and 
especially  from  neuralgia,  though  these  are  much  rarer  forms  of  the 
complaint  than  many  suppose. 

Pains  at  the  monthly  periods  are  often  induced  by  a  displacement 
of  the  womb.  If  the  organ  fall  over  backward  or  forward,  its  nerves 
are  pressed  upon  in  an  unnatural  way,  and  when  the  parts  are  crowded 
with  blood,  it  is  very  natural  for  painful  sensations  to  be  excited. 
In  these  cases,  the  neck  of  the  organ  is  bent  at  right  angles,  and  the 
canal  which  passes  through  it  is,  of  course,  atrictured,  so  that  the 
evacuations  are  necessarily  made  with  difficulty. 

And  this  leads  me  to  remark,  that  the  passage  through  the  uterine 
neck  becomes,  occasionally,  from  inllammation  or  other  cause,  almost 
closed.  The  result  is,  much  difficulty  and  great  paiu  in  passing  the 
monthly  secretion. 

There  are  no  causes  which  excite  painful  menstruation  more  often 
than  inflammation  in  the  uterine  neck  and  the  ovaries.  An  increased 
flow  of  blood  to  an  inflamed  part  always  causes  pain.  An  inflamed 
foot  or  leg  has  to  be  laid  up  in  a  chair,  because  it  aches  when  put 
down.  The  reason  is,  that  when  hanging  down  it  is  more  full  of 
blood,  and  the  seutsitive  nerves  are  painfully  compressed.  When  the 
finger  is  hot  with  inflammation,  we  assuage  the  pain  by  holding  it  up 
for  the  blood  to  run  down.  For  the  same  reason,  the  inflamed  ovaries 
and  uterine  neck  ache  when  the  blood  flows  to  them  in  large  quanti- 
ties, at  the  menstrual  period. 

Congestion  of  the  lining  membrane  of  the  womb  itself  is  a  frequent 
cause  of  painful  menses.  It  is  a  condition  of  the  membrairxe  of  the 
womb  similar  to  thai,  of  the  larynx  in  membranous  croup.  There  is  the 
same  pouring  out  of  what  physicians  call  coagulable  lymph,  which 
forms  itself  into  a  membrane.  This  membrane  the  womb  strives  by 
strenuous  conti-actions  to  throw  off,  and  linally  succeeds  in  expelling 
it,  not  whole  and  entire,  but  in  shreds  and  patches'.  These  shreds, 
which  women  sometimes  call  skinny  substances,  are  characteristic  of 
the  disease.  The  efforts  to  expel  them  cause  pains  very  much  like 
those  of  natural  lalwr,  and  sometimes  almost  as  severe. 

Treatment.  —  Painful  menstruation,  excited  by  the  falling  over  of 


-  yfU  f-" '  i-f i>  Ifiiilt  i*iVitFili  mUhiWii  rrfi'<>-ic 


FEMALK   DISEASES, 


401 


or  less  pain 
day  or  two. 
of  the  evac- 
lly,  running 
in  the  back, 
bor,  compel- 
er  tears  and 
b  painful  to 
lome  women 
istroys  much 

There  is, 
matism,  and 
iorms  of  the 

iisplacement 
I'd,  its  nerves 
1  are  crowded 
»  be  excited, 
gles,  and  the 
,  so  that  the 

h.  the  uterine 
3au8e,  almost 
1  passing  the 

n  more  often 
An  increased 
An  inflamed 
les  when  put 
more  full  of 
.  When  the 
holding  it  up 
amed  ovaries 
large  quanti- 

is  a  frequent 
nbrmie  of  the 

There  is  the 
Lymph,  which 
mb  strives  by 
J  in  expelling 
rhese  shreds, 
iracteristic  of 
iry  much  like 

ailing  over  of 


the  womb,  backward  or  forwaic,  is  cured,  of  course,  by  putting  the 
organ  back  into  its  proper  position. 

Pains  caused  by  stricture  of  the  canal  through  the  uterine  neck, 
are  cured  only  by  enlarging  the  passage.  This  is  effected  by  intro- 
ducing at  first  a  very  small  bougie,  and  then  a  larger  and  a  larger, 
until  the  passage  is  of  the  usual  size.  It  is  a  delicate  operation, 
quite  successful  in  careful  and  skillful  hands,  but  liable  to  produce 
mischief  when  improperly  conducted. 

In  all  the  forms  of  this  disease,  the  treatment  should  aim,  not 
merely  at  palliation,  but  at  a  cure.  And  generally,  I  am  happy  to 
say,  a  cure  is  attainable.  Yet  how  many  women  suffer  for  years 
until  health  has  fled,  and  life  has  become  a  burden,  receiving  from 
their  medical  attendant  the  assurance  that  palliation  only  is  possible  1 

It  is  necessary  at  each  monthly  turn  to  do  something,  in  these 
cases,  to  quiet  the  pain.  For  this  purpose,  twenty  drops  of  spirits 
ether  in  a  wineglass  of  tepid  water,  thrown  into  the  bowel,  will  be 
liighly  serviceable.  For  a  like  purpose,  one  pill  (116)  may  be  taken 
twice  a  day,  beginning  one  day  before  the  menstrual  flow.  A  bella- 
donna ointment  (170)  maybe  rubbed  upon  the  neck  of  the  womb 
with  great  advantage,  and  a  teaspoonf  ul  of  viburnum  compound  taken 
each  hour. 

In  the  congestive  form  of  this  disease, —  that  in  which  the  membrane 
is  formed  on  the  internal  surface  of  the  womb,  and  thrown  off  in  f raff- 
ments,  — ■  the  liquid  acetate  of  ammonia,  or  spirits  of  Mindererus,  is 
a  very  valuable  remedy  taken  in  two-teaspoonful  doses,  in  a  table- 
spoonful  of  cold  water,  three  or  four  times  a  day,  while  the  pain  lasts. 

Medicines  almost  innumerable  have  been  put  on  the  market  for 
this  complaint,  of  which  Hayden's  viburnum,  liquor  sedans,  diovi- 
bumum,  and  a  host  of  others,  are  examples.  These  are  usually 
harmless,  and  may  be  used.  Gin,  in  goodly  doses,  is  often  service- 
able by  stimulating  the  circulation.  Turpentine  cloths,  the  hot-water 
bottle,  rest  in  bed,  etc.,  also  help  amazingly.  But  whatever  remedy 
may  be  used  at  the  time,  even  though  the  pain  be  severe  enough  to 
require  an  anodyne,  the  cause  must  be  sought  and  treated. 

Chlorosis.  —  Green  Sickness. 

Before  the  age  of  puberty,  the  girl  is  only  i  child.  She  has 
witiiin  her  only  the  elements  of  a  woman.  The  change  to  which  she 
is  destined  brings  with  it  a  wonderful  development  both  of  body 
and  mind. 

To  effect  this  development,  and  bring  out  the  new  being  iu  the 
perfection  designed  by  the  Creator,  a  large  amount  of  hidden  nerve- 
power  is  required.  She  requires  to  have  been  born  with  a  well-vital- 
ized constitution,  and  to  have  been  physically  trained  in  a  way  to 
harden  and  energize  it.  Without  these  antecedents,  her  development 
at  puberty  will  be  feebly  and  imperfectly  made.     Her  development 


":il 


FEMALE  DISEASES. 


and  evolution  of  germs  will  be  so  defective  as  to  cause  her  menstrua- 
tion to  be  only  partially  established,  or  to  fail  altogether. 

Symptoms.  —  Where  the  inherent  powers  of  the  system  are  just 
sufficient  to  bring  about  a  first  menstruation,  it  often  happens  that 
they  seem  to  be  spent  by  the  effort,  and  that  the  evacuation  fails  to 
appear  again  for  several  months.  Indeed,  the  whole  organization 
may  break  down  at  this  point,  and  become  blasted,  as  it  were,  like  a 
blade  of  wheat  which  has  grown  well  for  a  time,  but  which  fails  to 
develop  the  kernel. 

The  blood  at  this  period  may  become  impoverished,  and  fail  to 
distribute  adequate  nourishment  and  development  to  the  various 
tissues.  When  this  occurs,  it  loses  a  part  of  its  red  globules,  and 
increases  its  watery  portion.  As  a  result,  the  skin  becomes  pale,  and 
sometimes  of  a  yellowish  hue,*  the  bowels  become  torpid  and  con- 
fined ;  the  nervous  system  sensitive  and  weak ;  the  digestion  is 
impaired ;  the  appetite  is  either  lost,  or  perverted,  —  longing  for  un- 
natural food ;  the  tongue  is  white  ;  the  heart  palpitates ;  the  spirits 
are  depressed ;  the  temples  and  ears  throb ;  the  head  occasionally 
aches  and  whirls  with  dizziness ;  the  sleep  is  disturbed  and  abbrevi- 
ated, and  hysterics  are  now  and  then  superadded  to  close  the  cata- 
logue of  ills. 

This  is  Chlorosis,  briefly  depicted  in  its  origin  and  its  symptoms. 
The  word  is  from  the  Greek  x^<"P<'«»  which  means  green  and  pale. 
By  nurses  it  is  called  the  "  green  sickness." 


Its  Causes  are  quite  numerous,  among  which  may  be  reckoned 
impoverished  diet,  damp  atmosphere,  sedentary  habits,  long  confine- 
ment indoors,  overworking  the  mind  in  childhood,  constipation  of  the 
bowels,  and  an  inherited  feeble  constitution.  This  disease  is  very 
frequently  met  with  in  domestics  emigrating  to  this  country  from 
Ireland,  Sweden,  and  the  Provinces,  and  depends  on  the  failure  of 
Nature  to  accustom  herself  to  the  new  climate.  These  cases,  how- 
ever, all  respond  well  to  treatment,  but  when  left  alone,  lapse  into 
consumption,  Bright's  and  similar  diseases. 

Treatment. — Chlorosis,  as  a  general  thing,  is  connected  either 
with  retention  or  suppression  of  the  menses ;  and  in  treating  it, 
physicians  are  too  much  in  the  habit  of  resorting  indiscriminately  to 
forcing-medicines,  called  emmenagogues.  From  such  practice  great 
injury  often  results. 

It  is  not  always  sufficiently  considered  that  a  woman  fails  to  men- 
struate, or  ceases  to  do  so,  because  she  is  sick  ;  and  if  we  would  cause 
her  courses  to  return,  we  must  restore  her  health.  To  do  this,  should 
generally  be  the  great  object  of  treatment.  Let  the  health  be  restored, 
and  the  menses  will  come  back.  The  only  philosophical  treatment  is 
that  Avhich  will  invigorate  the  system. 

In  chlorosis,  the  vital  powers  are  in  a  state  of  dilapidation.  How 
can  they  be  roused?     By  exercise  on  horseback  and  on  foot;  by 


(ti^W'  r':iJXi%Mf\AniL>uuMJij^\M^u^, kr^.. 


FEMALB  DISEABB8. 


403 


ler  menstruii- 
r. 

stem  are  just 
happens  that 
lation  fails  to 
organization 
it  were,  like  a 
i'hich  fails  to 

i,  and  fail  to 
3  the  various 
globules,  and 
>mes  pale,  and 
rpid  and  con- 
;  digestion  is 
inging  for  un- 
js ;  the  spirits 
1  occasionally 
I  and  abbrevi- 
close  the  cata- 

its  symptoms. 
'een  and  pale. 

'  be  reckoned 

long  confine- 

tipation  of  the 

iisease  is  very 

country  from 

the  failure  of 

3se  cases,  how- 

»ne,  lapse  into 

(ineSled  either 

ill  treating  it, 

jcriminately  to 

practice  great 

n  fails  to  men- 
re  would  cause 
do  this,  should 
Ith  be  restored, 
al  treatment  is 

idation.  How 
d  on  foot;  by 


wearing  clothing  enough  to  keep  warm;  by  a  tepid  bath  two  or 
three  times  a  week,  and  brisk  rubbing  with  a  coai-se  towel ;  and  by 
a  generous  diet,  composed  of  tender  meats,  animal  broths,  etc. 

This  treatment,  however,  should  be  preceded  by  unloading  the 
bowels  with  prescription  (35)  or  (40),  according  to  choice.  One 
pill  should  be  taken  at  night.  When  the  liver  is  considerably  de- 
ranged, perscription  (40)  will  be  particularly  serviceable.  Half  a 
pint  of  tepid  water  thrown  into  the  bowel,  night  and  morning,  will 
help  relieve  costiveness. 

The  bowels  having  been  well  opened,  give  a  tablespoonful  of  pre- 
scription (59),  two  or  three  times  a  day;  or  of  prescription  (60),  a 
teaspoonful,  the  same  number  of  times  each  day. 

In  the  treatment  of  this  disease,  iron,  in  some  form,  is  almost 
always  needed.  Prescriptions  (61),  (71),  (73),  (74),  (76),  (80) 
and  (316),  are  suitable  preparations.  Among  the  more  recent 
remedies  for  building  up  the  blood  in  chlorosis,  perhaps  none  is  more 
successful  than  the  combined  pill  of  iron  and  manganese,  called 
Bland's  modified  pill,  or,  if  preferred  in  liquid  form,  the  same  remedy 
may  be  obtained  in  still  milder  and  more  physiological  form  in  the 
preparation  known  as  Gude's  Peptomangan.  The  peptonate  of  iron 
is  also  one  of  the  best  modem  remedies. 

A  girl  suffering  from  this  disease  should  always  be  taken  out  of 
school.     The  mind  should  be  divided  between  rest  and  recreation. 

Cessation  of  the  Menses.  —  Turn  of  Life. 

There  is  probably  no  period  in  woman's  earthly  existence  which 
she  approaches  with  so  much  anxiety  as  that  which  she  is  in  the 
habit  of  calling  "  the  turn  of  life."  The  aniiety  is  not  without  some 
reasonable  ground  for  its  existence.  She  has  been  accustomed,  for 
thirty  years  or  more,  to  lose,  every  four  weeks,  a  certain  amount  of 
blood.  When  this  evacuation  stops,  disturbancep  of  the  system  may 
well  be  expected.  So  well  is  this  understood,  that  this  climacteric 
has  come  by  general  consent,  to  be  called  the  "  critical  period "  in 
female  lif^ 

If  it  be  well  and  safely  passed,  the  health  is  generally  better  than 
before,  and  a  "  green  old  age  "  is  likely  to  follow.  But  if  the  seeds 
of  disease  are  in  the  system,  —  if  there  be  a  tendency  to  cancer  or 
other  malignant  disease,  which  has  been  held  in  check  by  the  monthly 
fiow,  it  now  takes  up  its  destructive  work,  and  shows  itself ;  or,  if 
there  be  a  predisposition  to  apoplexy  or  congestion  of  any  organ,  it 
is  more  likely  to  become  active,  now  that  the  accustomed  waste-gate 
is  closed.  A  distinguished  writer  has  said  that  about  half  the  deaths 
among  women,  about  the  age  of  forty-four,  are  from  cancer. 

Nervous  Complications It  is  the  duty  of  the  physician  to  look 

carefully  after  those  females  who  come  under  his  care  at  this  critical 
time.     For,  in  addition  to  the  organic  and  malignant  diseases  which 


404 


n5MALR   RISEASKS. 


attivck  her  at  this  time,  she  in  exposed  to  a  host  of  nervous  irritations, 
which,  if  neglected  or  badly  managed,  make  her  life  a  cions  and  a 
burden.     The  symptoms  of  these  irritations  are  in  number,  legion. 

Age  at  which  the  turn  of  life  come«.  —  As  a  general  rule,  tlie 
turn  of  life  comes  between  the  ages  of  forty  and  fifty ;  but  oycasion- 
ally  occurs  at  other  periods,  varying  from  thirty  to  seventy.  If  tlie 
menses  appear  early  in  life,  they  terminate  early. 

Symptoms.  • —  When  there  is  a  tendency  to  corpulency  at  this 
period,  the  symptoms  are  headache,  dizziness,  and  a  sense  of  suffocja- 
tion.  It  is  common,  when  the  period  of  cessation  approaches,  for 
deviations  from  regularity  to  occur.  At  one  time  the  menstrual  dis- 
charge will  be  profuse ;  at  another,  scanty.  It  will  now  disappear 
for  a  time,  and  be  replaced  by  the  whites.  Then  it  will  appear  for  a 
few  times  with  considerable  regularity.  Next  will  come  a  suspension 
for  several  months,  to  be  followed  by  a  flow  of  such  profusion  as  to 
amount  almost  to  flooding. 

Mixed  up  with  these  irregularities  will  be  palpitations  of  the 
heart,  constipation  of  the  bowels,  a  variable  appetite,  and  broken 
sleep,  weakness  and  inquietude,  timidity,  a  dread  of  impending  evil, 
irritability  of  temper,  hysterical  attacks,  bad  feelings  in  the  head, 
with  sounds  in  the  ears,  as  of  the  rolling  of  carriages,  sparks  before 
the  eyes,  and  an  unsteady  gait. 

Treatment.  —  If  there  be,  at  this  period,  fulness  of  habit,  with 
dizziness,  headache,  sparks  before  the  eyes,  a  sense  of  suffocation, 
etc.,  there  is  a  plain  indication  that  the  brain  is  oppressed  with  too 
much  blood.  I  am  not  much  in  favor  of  bleeding,  but  this  is  a  case 
in  which  from  a  gill  to  a  half-pint  of  blood  may,  if  ever,  be  drawn 
from  the  arm  with  positive  advantage.  Cups  applied  to  the  back  of 
the  neck  will  also  be  useful.  Give  at  night,  also,  three  of  the  com- 
pound cathartic  pills,  and  then  keep  the  bowels  regular  with  pre- 
scription (18),  — a  wineglassful  to  be  taken  occasionally.  The  diet 
should  be  spare,  and  strictly  vegetable :  to  which  should  be  added 
much  daily  exercise. 

For  the  flushes  and  sweats  to  which  women  are  subject  at  this 
time  of  life,  ergot  often  answers  admirably,  in  teaspoonful  doses 
every  few  hours.  Atropia  in  -j^grain  doses  not  infrequently  helps 
the  sweating. 

Purging  should  not,  in  any  case,  be  carried  too  far.  If  nervous 
affections  show  themselves,  with  disturbance  of  the  digestion,  and 
general  debility,  even  leeches  would  be  improper,  and  physic  should 
be  swallowed  very  sparingly. 

When  serious  organic  disease  is  suspected,  as  cancer,  it  is  the  duty 
of  the  physician  to  inT  stigate  the  case  very  thoroughly,  and  to  give 
the  patient  the  advantage  of  the  most  prompt  and  decided  treatment. 
That  treatment  is  spoken  of  in  the  proper  place. 


FEMALE   DISEASES. 


405 


rous  irritations, 
!  a  ciosH  and  ii 
mber,  legion. 

meral  rule,  the 
;  but  occiwion- 
sventy.     If  the 

lulency  at  this 
ense  of  suffoca- 
approaches,  for 
}  menstrual  dis- 

now  disappear 
rill  appear  for  a 
me  a  suspension 

profusion  as  to 

itations  of  the 
te,  and  broken 
impending  evil, 
fs  in  the  head, 
IB,  sparks  before 

of  habit,  with 
of  suffocation, 
)re88ed  with  too 
it  this  is  a  case 
ever,  be  drawn 
1  to  the  back  of 
iree  of  the  cora- 
igular  with  pre- 
lally.  The  diet 
hould  be  added 

subject  at  this 
laspoonful  doses 
frequently  helps 

far.  If  nervous 
e  digestion,  and 
id  physic  should 

er,  it  is  the  duty 
[hly,  and  to  give 
cided  treatment. 


Hysterics. — Hysteria. 

The  name  of  this  complaint  is  from  a  Greek  word  signifying  the 
womb.  It  took  this  name  from  the  belief  that  this  organ  is  the  scat 
of  the  irritation  which  produces  the  hysteric  disturbance. 

This  belief  is  correct,  if  we  include  with  the  womb  the  ovaries 
and  the  other  sexual  organs.  The  sexual  system  is  doubtless  the 
centre  of  the  reflex  nervous  derangement  called  hysteria. 

It  has  been  sufficiently  demonstrated  that  hysterics  are  dependent 
for  their  existence  either  upon  organic  disease,  or  upon  simple  irrita- 
tion of  the  sexual  organs.  Sir  Benjamin  Brodie  mentions  cases  of 
the  hysteric  paroxysm,  produced  by  pressing  upon  an  inflamed  and 
tender  ovary. 

Symptoms.  —  An  attack  of  hysterics  is  generally  preceded  by  de- 
pression of  spirits,  restlessness,  and  a  frequent  desire  to  pass  water. 
It  is  sometimes  marked  by  convulsions,  or  fits ;  at  other  times,  it  is 
not.  At  times,  the  attacks  are  local,  and  are  manifested  by  spasms 
of  the  throat  at  the  top  of  the  windpipe,  or  in  the  bronchial  tubes  ; 
the  patient  feels  a  ball  rise  up  in  her  throat  (globus  hystericus),  her 
heart  beats  violently,  and  she  laughs  and  cries  by  turns. 

When  the  disease  is  more  general,  the  muscles  of  the  lim^js  are 
thrown  into  spasms ;  the  patient  struggles  violently  ;  rising  up  in  a 
sitting  posture,  and  then  throwing  herself  back ;  twisting  the  body 
from  side  to  side,  clenching  the  hands,  and  throwing  the  arms  about, 
so  that  she  is  with  difficulty  held  by  persons  much  stronger  than 
herself.  Soon  after  these  paroxysms,  the  patient  generally  passes  a 
large  quantity  of  very  pale  urine. 

The  Causes  of  this  complaint  are  as  numerous  as  the  causes  of 
female  diseases,  for  in  truth  there  is  no  female  complaint  which  may 
not  produce  it.  Whatever  develops  and  excites  the  sexual  system, 
and  at  the  same  time  weakens  the  constitution,  lays  the  foundation 
of  this  malady.  Nervous  women  are  much  inclined  to  it.  In  large 
cities  there  is  more  of  it  than  in  the  country,  because  there  is  more 
excitement  and  luxury,  and  more  of  their  consequences,  —  nervous 
and  female  diseases. 

Treatment.  —  To  treat  this  complaint  successfully,  it  is  necessaiy 
to  search  out  its  cause,  and  remove  that.  Like  the  whites,  it  is  not 
so  much  a  disease  in  itself  as  a  symptom. 

The  first  inquiry  to  be  made  should  have  reference  to  the  real 
origin  of  the  complaint.  Is  it  dependent  upon  inflammation  of  the 
f^varies  or  the  womb,  or  to  displacement  of  this  latter  organ  ?  or  does 
it  arise  from  the  low  state  of  the  blood,  and  the  weakened  condition 
of  the  nerves,  acted  upon  by  some  irritation  or  heightened  sensibility 
of  the  sexual  organs  ? 

If  dependent  vpon  inflammatory  disease,  that  is  to  be  treated  ac- 
cording to  directions  elsewhere ;  if  upon  falling  of  the  womb,  no 


""Tmi.,^ 


406 


FEMALE    DISSABES. 


remedies  will  avail  until  t*>at  is  put  in  its  proper  place.  If  diluted 
blood  and  weakened  nerves  be  the  cause,  iron  and  quinine  art!  tin; 
remedies.  When  the  complaint  arises  from  deficient  menstruation, 
iron  and  aloes  (47)  will  be  serviceable.  The  nervous  spasni  can 
sometimes  be  broken  up  by  pouring  cold  water  upon  the  head,  or 
face,  or  limbs  of  the  patient. 

The  Hysienlc  and  Moral  Treatment  are  of  great  consequence. 
The  complaint  is  very  much  under  the  control  of  the  will.  Whatever 
tones  the  moral  nature  and  strengthens  the  will,  tends  to  subject  this 
disorder  to  the  control  of  the  patient.  Plain,  wholesome  diet,  exer- 
cise, bathing,  and  the  enforcing,  as  far  as  possible,  of  a  rugged,  self- 
reliant  habit,  generally  go  far  towards  breaking  its  force. 

Polypus  of  the  Womb. 

This  is  simply  a  foreign  body,  or  tumor,  growing  either  within  the 
womb,  or  in  the  vagina,  and  attached  to  the  uterine  neck.  It  is 
rather  a  serious  affection. 

These  tumors  vary  in  weight  from  half  an  ounce  and  less  to  many 
pounds.  They  are,  in  color,  whitish,  red,  brown,  and  even  black. 
They  have  almost  every  consistence,  —  being  soft,  spongy,  gfristly, 
and  hard. 

The  Symptoms  of  poljrpus  are  various,  resembling  those  of  almost 
every  other  womb-complaint.  It  is  often  mistaken  for  displacement 
of  the  womb,  for  dropsy  of  this  organ,  and  for  pregnancy. 

These  tumors  are  apt  to  give  rise  to  dangerous  bleeding  from  the 
womb,  and  other  discharges  which  greatly  weaken  and  derange  the 
system.  They  are  liable  to  terminate  in  cancer.  In  pregnancy,  they 
may  produce  miscarriage.  When  they  are  suspected,  therefore,  the 
utmost  scrutiny  should  be  employed  to  search  them  out.  This  is 
especially  desirable,  since  the  fallen  or  inverted  womb  may  carelessly 
be  taken  for  a  polypus,  and  be  operated  on  as  such. 

Treatment  —  This  is  of  two  kinds,  medical  and  surgical.  The 
first  consists  in  means  of  supporting  the  strength  of  the  patient,  and 
checking  the  discharges  by  means  of  injections,  rest,  etc.,  and  in  en- 
deavoring to  cause  the  removal  of  the  tumor  by  absorption. 

This  last  object  is  sometimes  effected  by  an  unstimulating  diet ; 
and  by  the  use  of  iodine  (101)  for  some  time.  This  treatnc^ent  does 
not  often  succeed,  however,  and  cannot  be  relied  upon.    ■ 

If  the  polypus  be  within  the  womb,  of  course  it  cannot  be  reached. 
The  only  thing  to  be  done,  in  such  case,  is  to  cause  its  expulsion. 
This  is  sometimes  effected  by  causing  the  womb  to  contract  by  the 
use  of  spurred  rye  (267),  or  by  the  use  of  the  electro-magnetic 
machine.  This  latter  remedy  can  do  no  harm,  and  had  better  be 
tried  first. 

When  the  polypus  is  outside  the  womb,  the  methods  of  removing 


se.  If  diluted 
iiiiiine  are  tin; 
menstnmtioii, 
)118  HpuNiii  uaii 
n  the  head,  or 


:  consequence. 
11.  Whatever 
to  subject  this 
)me  diet,  exer- 
a  rugged,  self- 


ther  within  the 
e  neck.     It  is 

d  less  to  many 
id  even  black, 
pongy,  gristly, 

:hose  of  almost 
r  displacement 
acy. 

ding  from  the 
d  derange  the 
regnancy,  they 
,  therefore,  the 
out.  This  is 
may  carelessly 

jurgical.  The 
le  patient,  and 
3tc.,  and  in  en- 
)tion. 

nulating  diet; 
breatn^ent  does 

lot  be  reached, 
its  expulsion, 
ontract  by  the 
ectro-magnetic 
had  better  be 


r 


i    i 


i  I 


FEMALE   DISEASES. 


407 


it  are  various.  Tt  is  HometimeH  done  by  cauterization,  or  burning  it 
i)(T  by  bot  ii'oM  or  ciiUNtiu.  This  iH  a  baixb  inetbod,  and  not  leHorted 
to  by  Mkillt'ul  HurgoonH.  Another  method  iH  that  of  crushing  the  tumor 
with  an  inHtnmiont.  Another  still  in  that  of  torsion,  or  twisting  it 
off.  And  still  another,  that  of  applying  a  ligature,  or  tying  a  string 
around  the  neck  of  the  tumor,  and  strangling  it  by  preventing  the 
blood  from  going  to  it.  By  this  means  it  falls  off  in  a  few  days. 
There  is  one  other  method,  that  of  cutting  the  tumor  away  with  a 
knife,  or  with  a  pair  of  curved  scissoi-s.  These  three  last  methods 
are  the  chief  ones  now  used  by  skillful  surgeons. 

Uterine  Hydatids. 

This  name  is  given  to  a  bladder-liko  substance,  occasionally  found 
growing  in  the  womb.  It  is  filled  with  a  white  or  yellowish  fluid. 
Sometimes  a  bundle  of  them  grow  together,  like  a  bunch  of  grapes. 
Some  are  elongated,  like  a  bean,  and  have  a  sort  of  claw,  by  which 
they  are  nttached;  others  are  shaped  like  an  egg. 

Those  with  a  claw  are  generally  .supi)osed  to  be  living  beings,  like 
worms  in  the  bowels.  When  expelled  from  the  womb,  they  move 
about  if  placed  in  warm  water. 

The  Causes  which  produce  these  singular  growths  are  obscure. 
Probably  whatever  improperly  excites  or  irritates  the  uterine  organs 
may  produce  these  vesicular  bodies. 

The  Symptoms  may  be  easily  mistaken  for  those  either  of  preg- 
nancy, or  of  water  or  inflammation  in  the  womb. 

From  the  growth  of  these  bodies,  the  bowels  may  enlarge,  the 
breasts  swell,  and  the  menses  stop.  If  to  these  symptoms  be  added 
sickness  at  the  stomach,  the  woman,  if  married,  feels  confident  she  is 
in  the  family  way.  There  is  no  certain  method  of  correcting  this 
mistake,  until  the  collection  of  bladder-like  bodies  is  expelled  from 
the  womb. 

It  is  rare  that  these  bodies  appear  in  the  virgin  woman.  They  are 
supposed  to  be  connected,  in  some  way,  with  imperfect  conception. 

Treatment.  —  We  can  seldom  say  absolutely  that  hydatids  exist, 
until  we  see  them  expelled.  Whatever  will  produce  contractions  of 
the  womb,  will  cause  their  expulsion ;  but  it  will  not  do  to  give  these 
remedies  indiscreetly,  lest  the  cause  be  one  of  real  pregnancy  instead 
of  hydatids.  When  once  reasonably  assured  that  hydatids  do  exist, 
the  only  logical  treatment  consists  in  their  removal.  This  is  best 
effected  by  the  dilatation  of  the  womb  and  a  thorough  curetting  or 
scraping  as  described  under  hemorrhages.  Ergot  often  causes  suflB- 
cient  contraction  of  the  womb  to  drive  out  these  masses,  and  may  be 
judiciously  tried  before  resorting  to  the  curette.  It  should  be  given 
in  teaspoonful  doses  every  four  hours  till  pains  ensue. 


iiliiMiki 


408 


FEMALE   DISEASES. 


■^  I 


t  1 


i^ 


Inflammation  of  the  Womb.  —  Metritis. 

This  disease  very  often  follows  delivery,  and  is  connected  with 
child-bed  fever. 

Various  Causes  also  produce  it  in  the  unimpregnated  state.  Im 
flammation  of  the  ovaries,  or  of  the  uterine  neck,  may  extend  to  the 
womb.  Falling  of  the  womb  may  caure  it  to  be  irritated  by  being 
placed  in  a  new  position,  and  thus  bring  on  inflammation.  In  some 
temperaments,  marriage  may  produce  this  disease  ;  in  others,  single- 
ness. It  may  also  be  biought  on  by  painful  menstruation,  by  forcing 
medicines,  by  constipation,  by  tight  corsets,  by  solitary  vices,  and  by 
excited  sexual  feeling. 

This  is  the  most  common  variety  of  inflammation  found  in  the 
pelvis.  It  is  often  limited  to  the  neck  of  the  womb,  and  is  then  called 
endocervicitis ;  it  may  be  limited  to  the  lining  membrane  of  the  womb, 
and  is  then  called  endo-nietritig,  but  practically  it  is  all  one  and  the  same 
disease,  and  sooner  or  later  involves  not  only  the  mucous  m  •  Torane 
of  the  interior,  but  also  the  muscular  structure  of  the  womb  itself. 
It  is  now  considered  a  germ-disease  and  rarely  results  in  spontaneoxis 
cure.  It  proceeds  from  the  entrance  of  germs  into  the  uterus  either 
at  the  time  of  labor  or  miscarriage,  or  from  the  entrance  of  the  germ 
of  gonorrhoea  ;  germs,  however,  from  the  vagina,  which  are  normal  to 
that  region,  may  ofteu  be  carried  into  the  cervix  and  there  set  up  a 
trouble. 

Symptoms: — Pain  in  the  back,  nape  of  the  neck,  the  right  or  left 
iliac  region ;  leucorrhcea ;  painful  menses ;  hemorrhage  from  the 
womb;  symptoms  from  neighboring  organs  (bladder,  rectum)  ;  and 
symptoms  from  distant  organs,  as  stomach,  heart,  nerves,  etc. 

Ino  disease  gives  rise  to  so  many  and  so  complex  symptoms.  Nau- 
sea and  vomiting,  flatulence,  constipation,  palpitation,  headaches, 
cough,  nervousness,  loss  of  appetite,  etc.,  are  frequent  symptoms  of 
the  various  forms  of  metritis.  On  examination  a- hard,  congested 
womb  is  felt,  with  perhaps  enlargement  either  of  the  neck  or  the  en- 
tire organ,  erosions,  ulcerations,  eversion  of  the  lips  from  a  tear  may 
be  found,  while  issuing  from  the  mouth  of  the  womb  is  seen  a  plug  of 
mucus  which  is  either  white,  translucent  and  ropy,  or  yellow  and 
more  pus-like.  The  womb  is  tender  to  touch,  and  this  tenderness 
may  be  transmitted  to  the  appendages  (tubes  and  ovaries). 

Trea.ment.  — This  varies  with  the  variety  and  the  length  of  time 
the  disease  has  existed.  If  there  is  inside  the  uterus  any  retained 
product  of  c  inception,  placental  tissue  or  granulating  surfaces,  they 
must  be  curetted  out  as  descnbec'  in  a  previous  article.  This  process 
is  practically  an  operation  and  must  be  done  thoroughly  and  under 
ether.  If  there  is  active  inflammation  going  on  in  the  tubes  or  ova- 
ries, this  procedure  must  be  postponed  and  milder  measures  used  for 


ly 


PEMALE   DISEASES. 


409 


iritis. 
onnected  with 

ted  state.  Ixv- 
extend  to  the 
tated  by  being 
ion.  In  some 
others,  single- 
ion,  by  forcing 
J  vices,  and  by 

found  in  the 
i  is  then  called 
6  of  the  womb, 
le  and  the  same 
ous  m  •  ibrane 
16  womb  itself. 
in  spontaneous 
e  uterus  either 
ce  of  the  germ 
1  are  normal  to 
there  set  up  a 

[le  right  or  left 
lage  from  the 

rectum)  ;  and 
,res,  etc. 
nptoms.  Nau- 
lon,  headaches, 
t  symptoms  of 
lard,  congested 
neck  or  the  eii- 
rom  a  tear  may 
3  seen  a  plug  of 

or  yellow  and 
this  tenderness 
tries). 

length  of  time 

15  any  retained 
r  surfaces,  they 
.  This  process 
rhly  and  under 

16  tubes  or  ova- 
lasures  used  for 


the  time  being,  such  as  painting  the  vagina  and  neck  of  the  womb  with 
iodine  and  similar  remedies. 

Tampons  of  wool  wet  with  glycerine  are  frequently  used  to  de- 
plete the  engorged  womb,  applications  of  creosote  and  iodine  will 
often  heal  over  simple  erosions,  while  hard  cicatricial  masses  are  often 
absorbed  by  applications  of  iron.  Tampons  are  to  be  worn  from 
twelve  to  forty-eight  hours,  but  should  be  removed  whenever  pain  is 
produced.  Leeches  applied  to  the  neck  of  the  womb  often  relieve  a 
congested  state.  The  womb  is  to  be  thoroughly  scraped  and  washed 
out,  and  a  good  drainage  kept  for  the  escape  of  forming  secretions 
whenever  there  is  severe  inflammation  oi'  the  body  of  the  organ. 
Lacerations  of  the  neck,  when  extensive,  are  to  be  sewn  up,  but  when 
only  moderate  may  be  successfully  treated  with  strong  styptic  iron. 
Hot  douches  lot  only  serve  a  good  purpose  in  reducing  congestion 
and  inflammation,  but  are  often  very  soothing.  They  are  to  be  taken 
in  the  recumbent  position ;  the  water  to  be  hot  as  can  be  borne  — 
110°  to  112°  F. — and  as  much  as  six  quarts  are  to  be  used.  One 
should  purchase  for  this  purpose  a  large  fountain  syringe,  or  a  tin  pail, 
and  hang  it  two  feet  above  the  head ;  it  is  to  be  used  twice  daily,  and 
may  be  used  every  three  or  four  hours.  Patients  suffering  with  this 
and  similar  diseases  must  not  dance  or  take  long  walks,  nor  should 
they  use  the  sewing-machine ;  neither  should  tliey  stand  long  at  a 
time,  but  should  have  light  exercise  in  the  open  air  and  general  sys- 
temic medicine  ;  they  should'  lie  down  every  day  from  two  to  four 
hours,  and  in  severe  cases  must  retain  the  recumbent  position.  The 
bowels  must  be  kept  relaxed  with  cascara-sagrada  or  some  morning 
saline  ;  a  teaspoonful  of  the  aromatic  cascara  at  night,  or  a  half-glass 
of  Hunyadi  Janos  water  on  rising,  are  excellent  for  this  purpose. 
If  the  woman  is  pale,  a  prescription  of  some  iron  tonic  will  be  useful, 
such  as  the/owr  chiorides  or  Aikevk%  tonic  pill, 

Faliing  of  the  Womb.  —  Prolapsus  Uteri, 

The  womb  is  often  found  out  of  its  natural  and  proper  place. 
There  are  certain  ligaments  and  muscles  intended  to  act  as  stayB, 
and  hold  it  up  in  its  position.  These,  from  various  causes,  become 
relaxed.  It  then,  losing  its  support,  drops  dovm  into  the  vagina,  be- 
tween the  bladder  in  front  and  the  large  bowel  called  the  rectum, 
behind.     It  is  then  said  to  be  fallen  or  prolapsed. 

The  womb  of  a  married  woman  is  more  apt  to  become  prolapsed 
than  that  of  the  unmarried,  because  it  i-^j  r^ore  liable  to  have  its  weight 
increased  by  congestions,  enlarges,    t,  toin  perineum,  etc. 

The  Symptoms  are  dull  pain  in  the  small  of  the  back,  a  dragging 
sensation  in  the  groin,  and  a  feeling  of  fullness  around  tlie  funda- 
ment; dragging  pain  in  the  nape  of  the  neck;  headache,  constipation, 
etc. 

.  Treatment.  —  The  complaint  is  easily  cured  if  the  remedies  oe 


wmmmmmmm 


I    i 


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410 


FEMALE   DISEASES. 


applied  early.  If  the  prolapse  be  due  to  relaxed,  weakened  supports, 
tonic  constitutional  remedies  must  be  employed.  The  diet  must  be 
full  and  easy  of  assimilation ,  exercise  taken  in  the  open  air,  proper  rest 
secured,  and  electricity  be  used. 

If  the  womb  be*  tipped  over,  some  support  must  for  a  while  be  used 
in  the  shape  of  pessaries.  If  by  i-eason  of  its  increased  size  and  weight 
the  womb  hang  too  low  down  in  the  pelvic  cavity,  then  it  must  be 
made  smaller  and  lighter  by  treating  the  coexisting  inflammation  and 
subinvolution.  If  the  floor  of  the  vagina  has  been  torn  during  labor, 
thus  allovnng  the  womb  to  sag,  this  must  be  sewn  up  and  a  new  floor 
formed. 

In  complete  prolapse  of  the  aged,  the  uterus  often  protrudes  from 
the  vagfina.  This  condition  in  the  middle-aged  is  best  met  by  ampu- 
tation ;  while  in  the  very  aged  a  support  may  be  adjusted  after  hav- 
ing replaced  the  organ. 

Falling  Over  of  the  Womb. 

Anteversion. — The  womb  sometimes  falls  over  forward  upon  the 
bladder,  towards  €  o  pubes.  This  is  called  anteversion.  The  top  is 
turned  forward  to  the  bladder;  the  mouth,  back  towards  the  large 
bowel.    (Fig.  141,  6.) 

a  be 


Retroversion.  —  When  the  womb  falls  over  JatfAfwarof,  between  the 
rectum  and  the  vagina,  it  is  said  tc  be  retroverted  (i).  This  is  just 
the  opposite  of  being  anteverted.  In  this  displacement,  the  mouth  is 
turned  forward,  the  top  backward. 

This  displacement  may  occur  suddenly  or  gradually.  If  the  former, 
there  is  generally  great  distress,  and  the  organ  should  be  immediately 
put  back  in  its  place;  if  the  latter,  the  pain  will  be  less  intense,  and 
the  replacement  must  be  e£fected  by  pessaries, — particularly  with  the 
ring  pessary,  made  of  India  rubber. 


I 


mi-  m 


FEMALE  DISEASES. 


411 


tied  supports, 
iiet  must  be 
r,  proper  rest 

tvhile  be  used 
56  and  weight 
a  it  must  be 
mmation  and 
during  labor, 
d  a  new  floor 

otrudes  from 
net  by  ampu- 
»d  after  hav- 


ard  upon  the 

The  top  is 

ds  the  large 


,  between  the 
This  is  just 
the  mouth  is 

;f  the  former, 

immediately 

intense,  and 

arly  with  the 


Anteflexion  and  Retroflexion.  —  When  these  occur,  the  womb  is 
dovhled  upon  itself,  the  mouth  of  the  organ  not  being  tilted  up  before 
or  behind,  but  retaining  its  natural  position.  These  flexions  are  rep- 
resented by  a,  tf,  and  e. 

Besides  these  more  common  displacements  of  the  womb,  there  are 
several  slighter  deviations  which  it  is  scarcely  necessary  to  describe. 
There  is  the  obliquity  of  the  womb,  which  is  simply  a  leaning  of  the 
organ  backward  or  forward,  or  to  one  side. 

There  are  still  other  more  serious  troubles,  which  are  so  very  rare 
as  not  to  require  me  to  dwell  upon  them,  such  as  the  inversion  of 
the  womb,  or  turning  it  wrong  side  out,  like  the  finger  of  a  glove ; 
and  the  hernia  of  the  womb  (hysterocele),  which  is  like  that  of  the 
bowel. 

/^essaries.  —  Much  might  be  said  about  pessaries :  they  are  at 
times  of  the  greatest  assistance  in  keeping  a  badly  placed  uterus  in 
its  proper  position  ;  on  the  other  hand,  they  are  serious  hindrances 
to  health.  By  their  pressure  they  often  cause  inflammation  of  the 
ovaries  and  tubes  and  light  up  afresh  old,  quiescent  chronic  inflam- 
mations. They  often  stretch  unduly  the  uterine  ligaments  and 
make  a  relaxed  vagina.  But  it  must  be  said  that  often,  too,  they 
keep  in  place  a  simply  misplaced  womb  with  no  trouble  and  little 
expense  to  the  wearer,  thus  avoiding  long  treatment  and  perhaps  an 
operation.  TBey  should  always  fit  accurately  and  nicely  and  should 
never  cause  pain  or  make  the  wearer  conscious  that  she  wears  such  a 
thing.  The  soft  rubber  variety,  or  at  least  those  made  of  wire  and 
covered  with  rubber,  are  the  least  likely  to  cause  trouble ;  but  they 
need,  on  the  other  hand,  more  frequent  •inspection  and  cleansing. 
The  hard  rubber  are  more  easily  kept  clean,  but  are  more  dangerous. 
Whenever  a  pessary  is  worn,  it  should  be  under  the  surveillance  of 
the  family  doctor,  lest  ulceration  of  tl^  vagina  and  undue  pressure 
on  the  internal  parts  ensue.  Pessaries  no  doubt  are  very  use- 
ful in  keeping  in  place  a  womb  that  has  been  replaced  and  in 
warding  off  an  operation  otherwise  indicated.  They  are  of  all 
shapes  and  designs,  so  that  a  description  of  them  seems  superfluous 
here. 

Displacements.  —  The  various  displacements  of  the  womb  are 
such  common  occurrences  among  womankind  that  they  have  always 
received  considerable  attention  by  the  gynaecologist.  They  result 
from  falls  in  young  girls,  from  enlargement  of  the  organ,  from  weak 
uterine  supports  and  poor  health,  from  torn  muscles  of  the  vagina 
during  labor,  and  irom  new  growths  in  the  womb. 

The  symptoms  of  a  misplaced  womb  are  from  nothing  to  an  amaz- 
ing amount  of  trouble.  Many  a  woman  goes  tlirough  life  with  a 
badly  torn  vaginal  floor  and  retroflexed  worab  without  the  slightest 
ill-effect,  while  her  neighbor  suffers  intensely  from  a  much  less  de- 
gree of  displacement. 


warn 


wmwukMi  .M.  .i.  .unJMii  ^^ ":  ■",:.'!. ''u:.; , 


FEMALE   DISEASES. 


Operative  Treatment.  —  When  for  any  reason  a  pessary  cannot 
or  ought  not  to  be  worn,  and  there  is  much  inconvenience  from  the 
misplacement,  resort  must  be  had  to  packing  the  vagina  and  reducing 
the  size  of  the  womb,  and  allaying  inflammation  and  pain  before  again 
trying  a  pessary,  or  else  some  of  the  several  operations  must  be  per- 
formed. Of  these  latter  there  are  at  the  present  day  three  principal 
methods  in  vogue,  viz. :  — 

Alexander's  operation  consists  in  cutting  down  on  the  little  holes 
in  the  lower  abdomen,  near  the  pubic  bones,  called  the  hernial  rings, 
through  which  in  the  male  the  cord  and  vessels  of  the  testes  run, 
where  hernia  or  rupture  occurs,  and  through  which  in  the  female  the 
the  round  ligament  of  the  womb  runs.  This  ligament  is  a  small 
round  cord  attached  to  the  anterior  and  top  part  of  the  uterus,  acting 
as  a  stay.  This  ligament  is  dissected  out  and  pulled  up  taut  on 
either  side  (there  are  two,  one  on  each  side  of  the  womb)  till  the 
womb  is  brought  up  into  its  normal  position  and  there  fastened. 
This  operation  is  a  very  ingenious  one,  and  answera  well  in  simple 
uncomplicated  cases. 

Ventral  Fixation  is  a  second  method  of  fastening  the  womb  in 
place,  and  consists  in  opening  the  abdomen,  lifting  up  the  womb  and 
fastening  it  to  the  under  side  of  the  abdominal  wall.  This  method 
is  tolerably  free  from  danger,  like  the  preceding,  but  has  the  advan- 
tage of  parting  adhesions  which  may  bind  down  the  uterus  and  pre- 
vent its  rising,  and  of  permitting  the  operator  to  see  and  correct  any 
existing  disease  of  the  tubes  and  ovaries  which  so  commonly  accom- 
pany bad  cases. 

Vaginal  Fixation  is  a  third  method,  whereby  the  uterus  is  likewise 
fixed,  but  this  time  to  the  vagina  in  front  of  the  bladder.  This  last 
method  is  at  present  receiving  considerable  attention  ;  but  it  may  be 
said  that  no  one  method  is  the  best  for  all  cases,  the  surgeon  being 
the  best  judge  of  the  situatio».  These  operations  are  safe  and  effi- 
cient, and  forever  do  away  with  pessaries  and  the  existing  disease. 
Women  go  on  to  term  in  labor  quite  generally  after  these  operations. 

Tumors  of  the  Womb. 

The  womb  is  especially  prone  to  be  the  location  of  foreign  growths. 
These  occur  mostly  in  middle  life,  and  ai*  commonly  either  of  a 
fibroid  or  cancerous  nature. 

The  fibroid  is  a  firm,  hard  mass  of  fibrous  tissue,  growing  either  on 
the  inside  waU  and  suspended  like  a  polypus,  or  developing  in  the 
uterine  muscle  itself,  or  on  the  outside  of  the  womb  in  the  abdominal 
cavity.  They  attain  oftentimes  huge  proportions  and  weigh  many 
pounds.  They  are  not  necessarily  fatal  to  life  or  detrimental  to 
health,  but  usually  give  rise  to  a  train  of  symptoms  which  may  be 
annoying  and  fatal.  Hemorrhage  and  profuse  menstruation  to  such 
an  extent  that  the  patient  is  rendered  pale  and  almost  blanched  are 


3sary  cannot 
ce  from  the 
nd  reducing 
tefore  again 
nust  be  per- 
'ee  principal 

little  holes 
emial  rings, 
3  testes  run, 
d  female  the 
b  is  a  small 
terus,  acting 
up  taut  on 
mb)  till  the 
re  fastened, 
11  in  simple 

16  womb  in 
e  womb  and 
^his  method 
8  the  advan- 
rus  and  pre- 
correct  any 
lonly  accom- 

s  is  likewise 
■.  This  last 
at  it  may  be 
rgeou  being 
ife  and  effi- 
;ing  disease, 
e  operations. 


gn  growths, 
either  of  a 

ng  either  on 
ping  in  the 
e  abdominal 
iveigh  many 
brimental  to 
lich  may  be 
tion  to  such 
ilauched  are 


FEMALB   DISEASES. 


413 


not  infrequent.  Pressure  on  the  bladder  and  surrounding  organs 
often  causes  serious  disturbance  to  urination  and  defecation;  di- 
gestion is  interfered  with,  and  pain  is  frequently  present.  When 
these  tumors,  which  are  of  slow  growth,  are  small,  painless  and  free 
from  trouble,  they  may  be  let  alone ;  but  when  large,  bleeding  freely, 
and  causing  symptoms  of.  pressure,  they  must  be  dealt  with.  Many 
gynaecologists  of  the  present  day  claim  that  every  fibroid  should  be 
removed;  but  as  this  means  the  enucleation  of  the  womb  and  ovaries 
(hysterectomy),  —  a  very  severe  operation, — we  cannot  endorse  this 
view,  especially  as  hundreds  of  women  go  through  life  unscathed 
even  with  large  tumors. 

The  menopause,  or  "  change  of  life,"  has  a  twofold  effect  on  them : 
some  begin  to  atrophy  and  g^row  small  after  the  blood  ceases  to  come 
to  these  parts  in  regular  mon- hly  congestion,  and  they  may  even  dis- 
appear entirely :  others  are  increased  in  size  and  even  change  their 
structure  into  malignant  gfrowths.  Hence  it  will  be  seen  that  these 
tumors  require  the  supervision  of  the  family  doctor  or  specialist,  that 
their  growth  may  be  watched.  It  remains  to  be  added  that  many 
advocate  the  use  of  strong  galvanic  currents,  applied  according  to 
the  method  of  Apostoli,  a  noted  French  savant,  to  diminish  the  size 
of  these  tumors.  Many  cures  are  claimed,  and  at  one  time  it  seemed 
as  though  this  method  was  destined  to  supersede  all  others ;  but  now, 
after  a  few  years'  trial  all  over  the  world,  it  is  generelly  conceded 
that  only  certain  varieties  are  amenable  to  this  treatment,  and  that 
the  tumor  does  not  entirely  disappear.  This  method,  however,  ob- 
viates the  necessity  for  operating,  and  is  in  many  cases  an  admirable 
way  of  reducing  and  keeping  in  check  what  otherwise  might  threaten 
life.  It  is  still  a  much  used,  though  often  abused,  method  of  treating 
them,  and  appeals  to  tlia  timid  and  obdurate. 

Cancer  of  the  Womb. 

This  is  another  but  more  dangerous  growth  of  the  womb,  and  oc- 
curs mostly  in  women  near  middle  life,  especially  in  cases  which  have 
a  family  predisposition  to  cancer,  and  when  the  neck  of  the  womb 
has  been  badly  lacerated  from  labor  or  miscarriage.  It  usually  be- 
gins in  the  neck  of  the  womb  like  a  little  bunch,  which  bleeds  easily 
on  touch,  and  extends  rapidly  into  the  neck  and  finally  up  into  the 
body  of  the  uterus.  Its  entire  life-dumtion  may  not  exceed  one  or 
two  years  before  death  claims  the  sufferer.  Hemorrhage  and  foul 
leucorrhoea  are  often  the  only  signs  which  attract  the  patient's  notice. 
Pain  finally  sets  in,  with  breaking  down  of  the  cancerous  tissue,  and 
then  a  very  foul  and  peculiar  odor  commences.  This  odor  is  very 
penetrating  and  is  characteristic  of  the  disease.  Emaciation,  loss  of 
appetite  and  strength,  painful  days  and  nights  supervene,  and  finally 
death  comes  to  relieve  the  sufferer  of  one  of  the  worst  diseases  to 
which  womankind  is  liable. 


1 1 


414 


FEMALE   DISEASES. 


Treatment.  —  The  only  treatment,  consists  in  the  early  detection 
of  the  disease  and  the  enucleation  of  the  entire  uterus  by  the  vagina. 
If  it  has  been  discovered  early,  before  the  cancer-cells  have  got  out- 
side of  the  womb,  it  may  be  successfully  treated  at  least  for  a  num- 
ber of  years.  I  can  not  better  advise  M^omen  than  by  warning  them 
to  consult  a  physician  at  once  on  the  occurrence  of  any  unusual 
hemorrhage  near  the  change  of  life.  So  many  ascribe  these  slight 
hemorrhages  and  aches  to  this  broad  mantle  of  ignorance,  that  pre- 
cious time  has  been  wasted  and  the  golden  opportunity  passed  for 
curing  the  dread  disease.  Do  not  waste  time  and  money,  either  on 
nostrums  or  other  quackish  methods,  nor  listen  to  what  Mrs.  So-and- 
So  did,  but  proceed  at  once  to  the  best  authority  you  have  at  your 
disposal.  So  much  is  being  successfully  done  now  for  the  relief 
and  cure  of  these  growths,  women  owe  it  to  themselves  and  their 
families  to  take  advantage  of  modern  skill  and  knowledge.  The 
microscope  will  detect  it  earlier  than  the  eye  or  finger,  and  th-is  a 
suspicion  may  be  corroborated  or  a  fear  dispelled  by  timely  advice. 

Of  palliative  treatment,  the  application  of  styptics  and  the  curette 
cause  a  delay  of  the  growth  and  a  cessation  of  hemorrhage ;  while 
anodynes  like  morphine  or  opium  in  some  of  its  forms  will  allay  pain 
and  anguish. 

Ovarian  Tumors. 

Ovarian  tumors  are  rather  frequent  growths,  occurring  for  the 
most  part  as  cysts  and  attaining  a  huge  size ;  not  infrequently  they 
grow  to  such  an  extent  that  their  weight  far  exceeds  that  of  the  en- 
tire body.  They  are  filled  with  a  clear  light-yellow  fluid.  Their 
treatment  consists  in  their  removal  through  the  abdomen  (ovari- 
otomy), and  should  be  operated  upon  as  soon  as  detected.  The  rate 
of  mortality  following  these'  growths  is  not  large.  It  was  this  oper- 
ation, began  in  America  in  the  forties,  that  was  the  beginning  of  a 
new  era  for  surgery  of  the  abdomen.  Only  when  neglected  does  one 
now-a-days  meet  with  these  enormous  growths. 

When  for  any  reason  an  operation  is  inadAasable,  they  may  be 
tapped  and  comfort  received  for  a  long  time.     ' 

The  ovary  is  likewise  the  seat  of  otiier  growths  both  benign  and 
malignant. 

Inflammation  of  tlie  Fallopian  Tubes. 

To  speak  of  this  disease  means  to  review  the  growth  of  gynsecolo 
gical  science  within  the  last  fifteen  years. 

The  operation  of  laparotomy,  or  opening  the  abdomen,  is  now  per- 
formed so  successfully  by  almost  every  surgeon,  that  it  has  taken  its 
place  among  the  every-day  mea-sures  for  relief,  and  frequent  oppor- 
tunities have  of  course  been  presented  to  the  profession,  of  corrobo- 
rating or  refuting  some  old-time  theories.  Many  a  notion  of  inflam- 
matiou  of  the  bowels,  or  peritonitis,  has  become  a  thing  of  the  past ; 


:  J  .yjMKfwemK'V 


iKu. »i#Mffffj  hr" rfHrifcrtlito.iUiH 


PEMALK   DISEASES. 


415 


rly  detection 
Y  the  vagina, 
lave  got  out- 
t  for  a  num- 
arning  them 
any  unusual 

these  slight 
ce,  that  pre- 
;y  passed  for 
ey,  either  on 

Mrs.  So-and- 
have  at  your 
or  the  relief 
'68  and  their 
rledge.  The 
,  and  tLv.s  a 
lely  advice, 
d  the  curette 
rhage;  while 
nil  allay  pain 


rring  for  the 
jquently  they 
lat  of  the  en- 
fluid.  Their 
omen  (ovari- 
The  rate 
as  this  oper- 
^inning  of  a 
sted  does  one 

they  may  be 

benign  and 

bes. 

I  of  gynsecolo- 

1,  IS  now  per- 
has  taken  its 
quent  oppor- 
a,  of  corroho- 
Lon  of  inflam- 
of  the  past ; 


many  an  unexplained  death  has  been  made  clear,  and  many,  many 
lives  have  been  saved  by  a  timely  recognition  of  the  true  state  of 
affairs  within  the  pelvis. 

Many  cases  of  what  formerly  was  regarded  as  peritonitis  are  now 
known  to  have  been  either  salpingitis,  ovarian  abscess,  appendicitis, 
etc.  Of  these  diseases  the  most  prolific  of  trouble,  as  well  as  the 
most  common,  is  salpingitis,  or  inflammation  of  the  tubes  which  con- 
duct the  ovum  to  the  interior  of  the  womb,  where  it  is  f-uctificd  by 
the  male  germ. 

These  tubes  are  lined  with  a  mucous  membrane  like  that  of  the 
interior  of  the  womb,  and  continuous  with  it,  so  that  whenever  in- 
flammation from  whatever  source  is  present  in  the  cavity  of  the 
womb,  it  is  extremely  liable  to  travel  up  the  tubes,  even  to  the  ova- 
ries and  peritoneum.  This  inflammation  may  be  merely  catarrhal, 
and  only  become  bothersome  by  its  chroaicity,  or  it  maj'  become 
purulent  and  suddenly  cause  violent  illness. 

The  catarrhal  form  begins  very  slowly  and  gradually  from  some 
old  neglected  uterine  disorder,  or  it  may  follow  a  labor  where  there 
was  some  septicsemia  or  blood-poisoning;  it  may  spring  from  venereal 
disease,  either  contracted  by  the  woman  illicitly  or  given  her  by  her 
husband ;  and  it  may  come  in  several  ways  not  of  general  interest  to 
the  reader.  At  all  events,  it  is  essentially  a  germ-disease,  and  when 
anyways  severe  has  a  tendency  to  spread  and  become  worse. 

Symptoms.  —  These  little  tubes,  which  are  normally  about  the 
size  of  a  slate-pencil,  become  swollen,  and  very  painful  and  tender, 
causing  inability  on  the  woman's  part  to  do  a  full  day's  work,  and 
even  confining  her  to  bed.  The  temperature  is  raised,  the  belly 
bloated,  the  urine  often  being  frequently  passed ;  the  bowels  are 
constipated,  appetite  poor,  and  digestion  bad;  sleep  is  disturbed  and 
the  nei-ves  weakened. 

On  examination,  the  trained  finger  in  the  vagina  feels  a  large, 
swollen,  tender  tube  on  the  affected  side,  and  often  a  bulging  of  the 
roof  of  the  vagina. 

Treatment.  —  Rest  in  bed,  hot  douches,  painting  the  side  with 
tincture  of  iodine,  and  the  using  in  the  vagina,  every  night  and 
morning,  of  a  suppository  of  five  grains  of  ichthyol,  with  laxatives 
and  nerve  sedatives,  will  do  much  toward  reducing  a  slight  and  even 
moderate  attack.  The  disease,  however,  does  not  usually  exist  alone, 
and  therefore  much  time  is  generally  necessary  in  eradicating  it. 

When  the  catarrhal  form,  however,  gets  worse,  and  pus  forms,  we 
then  have  the  so-called  purulent  salpingitis,  or  pus-tvbe.  Pus  gathers 
here  as  elsewhere,  stretching  the  tube  more  and  more ;  finally  the 
pus-germs  work  through  the  tube  and  out  of  the  end,  where  they  set 
up  an  active  inflammation,  and  new  tissue  forms  about  the  tube, 
shutting  it  off  from  the  general  cavity.  Everj'thing  in  the  neigh- 
borhood becomes  glued  together,  fixing  the  womb  in  an  immovable 


SBTiiBE&l 


•'••Jiif^:  - 


416 


FEMALE  DIBKA8ES. 


position.  The  tube  goes  on  stretcliing  more  and  more,  till  finally  it 
becomes  one  large  abscess-cavity.  It  may  then,  at  times,  be  punc- 
tured through  the  vagina  and  thus  drained ;  but  generally  an  opera- 
.  tiou  is  required,  either  to  remove  the  womb  auu  its  appendages 
through  the  vagina,  or  else  to  open  the  abdomen  and  take  away  the 
large  msiss  of  exudation,  in  the  centre  of  which  is  the  pus-cavity. 
When  matters  Imve  reached  this  stage,  the  patient  is  of  course  in  a 
very  grave  condition.  There  is  a  high  fever,  with  sweats  and  perhaps 
chills,  loss  of  appetite,  pallor,  pain,  and  all  the  evidences  of  Imng 
extremely  sick.  The  patient  either  dies  shortly  or  becomes  bed-rid- 
den, unless  an  operation  can  relieve  her.  This  latter  variety  of  the 
disease  is  calle  pyoaalpinx. 

Acute  Salpingitis  is  best  treated  by  rest  in  bed,  douches,  saline 
purgatives,  and  a  liquid  diet.  It  gradually  subsides  without  serious 
results. 

Chronio  Salpinitgis  is  the  more  common  variety,  is  very  protracted 
iii  its  course,  and  rarely  ends  in  spontaneous  recovery.  It  requires 
great  patience  on  the  part  of  both  physician  and  patient,  and  often 
can  only  be  cured  by  the  removal  of  the  offending  organ  by  lapar- 
otomy. 

It  must  be  remembered  that  all  these  various  forms  of  tubal  dis- 
ease are  produced  by  one  foi-m  or  another  of  bacteria  or  disease-germs, 
and  that  in  their  treatment  strict  cleansing  of  the  vagina  by  antisep- 
tics is  necessary. 

Salpingitis  is  always  preceded  by  some  form  of  metritis  or  endo- 
metritis, as,  for  instance,  the  gonorrhoeal  metritis,  that  caused  by 
septicsQmia  or  blood-poisoning,  tiie  metritis  following  labor,  etc. 

Inflammation  of  the  Vagina. 

This  may  be  produced  by  many  of  the  same  causes  which  induce 
inflammation  of  the  uterine  neck.  It  may  follow  t-edious  child-bear- 
ing, especially  if  instruments  have  been  used.  Marriage  is  not  an 
infrequent  cause  of  it,  — so  may  a  pessary  be,  if  an  improper  one. 

The  Symptoms  are  pain  in  the  groins,  a  feeling  of  heat  and  tight- 
ness in  the  passage,  and  a  difficulty  in  passing  water.  In  a  few  days 
a  discharge,  like  gum-water,  begins  to  flow,  which  gradually  becomes 
tliicker,  like  cream,  and  is  green  or  yellow.  Sometimes  the  disease 
gets  well  in  a  few  days ;  at  other  times  it  degenerates  into  the  chronic 
forms,  and  lasts  a  long  time.  It  should  be  cured  as  soon  as  possible, 
lest  the  inflammation  cause  the  walls  of  the  passage  to  grow  together, 
and  make  a  stricture,  as  in  Fig.  142. 

In  this  Figure,  b  represents  the  mouth  of  the  womb;  a  is  the 
lower  entrance  to  a  narrow  passage  in  the  vagina,  called  a  stricture. 
It  is  caused  by  inflammation,  which  so  thickens  the  walls  of  the 
vagina  as  to  bring  their  inner  surfaces  near  together.  In  examining 
a  case  of  this  sort,  a  practitioner  needs  to  be  on  his  guard  lest  he 


FKHALE   DISEASES. 


417 


,  till  finally  it 
rnes,  be  yunc- 
ftUy  ail  opera- 
«  appendages 
take  away  the 
he  pus-cavity, 
if  course  in  a 
ts  and  perhaps 
nces  of  lieing 
somes  bed-rid- 
variety  of  the 

ouches,  saline 
rithout  serious 

ery  protracted 
•.  It  requires 
ent,  and  often 
rgan  by  lapar- 

j  of  tubal  dis- 
disease-germs, 
ina  by  antisep- 

tritis  or  endo- 
hat  caused  by 
labor,  etc. 


i  which  induce 
ious  child-bear- 
iage  is  not  an 
iproper  one. 

heat  and  tight- 
In  a  few  days 
iually  becomes 
les  the  disease 
nto  the  chronic 
)on  as  possible, 
grow  together, 

omb;  a  is  the 

led  a  stricture. 

e  walls  of  the 

In  examining 

guard  lest  he 


mistake  the  entrance  to  the  stricture,  a,  for  the  mouth  of  the  womb, 
A, — a  mistake  wliich  might  lead  to  evil  consequences  as  well  as  seri- 
ously damage  his  professional  character. 


FIO.  143. 


Treatment.  —  The  diet  should  be  light  and  unirritating.  The 
bowels  should  be  kept  open.  A  cooling  wash  (207),  (218),  should 
be  used  several  times  a  day,  until  the  discharge  becomes  thick;  then 
employ  injections  (232),  (202),  (244),  (243),  of  a  more  astringent 
nature.  Let  the  marriage-bed  be  abandoned  till  the  recovery  is  com- 
plete. 

When  the  discharge  arises  from  small  granular  elevations  upon 
the  inner  surface  of  the  vagina,  the  whole  diseased  surface  should 
be  painted  over  with  a  solution  of  nitrate  of  silver,  twenty  grains  to 
the  ounce  of  water,  —  the  disease  being  brought  to  view  by  the  use 
of  a  speculum.     This  may  be  done  every  other  day, 

Itching:  of  the  External  Parts,— Prurigo  of  the  Vulva. 

This  complaint  is  apt  to  attack  females  about  the  cessation  of  the 
menses,  though  they  are  liable  to  it  at  other  periods.  It  is  a  most 
annoying  and  distressing  affection.  So  terrible  and  tormenting  at 
times  is  the  itching  of  the  external  genitals,  that  the  woman  is  una- 
ble to  avoid  rubbing  and  scratching,  and  she  is  occasionally  compelled 
to  absent  herself  from  all  society.  She  feels,  as  she  says,  as  though 
she  could  tear  herself  to  pieces. 

Sometimes  this  irritation  of  the  sexual  organs  excites  venereal 
thoughts  so  dominant  and  controlling  as  to  constitute  a  real  mania, 
called  nymphomania,  from  the  name  of  a  part  involved. 

This  complaint  generally  indicates  some  disease  of  the  womb,  or 
its  appendages,  or  of  the  bladder.  When  this  is  the  case,  of  course 
it  cannot  be  cured  without  seeking  out  and  removing  the  disease  of 
which  it  is  a  symptom. 

Treatment.  —  To  alleviate  the  local  suffering,  the  lotion  (228), 
or  the  ointment  (171),  maybe  applied  to  the  parts  several  times  a 
day.    I  prefer  the  lotion.     A  weak  solution  of  nitrate  of  silver  (211) 


iii 


418 


FBMALK   DISEASES. 


r  ^ 


t    : 


%4 


'«S3 


will  sometimes  do  well.     A  four  per-cent  solution  of  cocaine  is  the 
best  application. 

When  the  disease  is  brought  on  by  masturbation,  as  it  sometimes 
is,  this  habit  must,  of  course,  be  broken  off  before  a  cure  can  ha 
effected.  In  this  cohc,  also,  moderately  cold  water  must  be  applit-d 
to  the  parts  several  times  a  day ;  some  of  the  preparations  of  iron 
should  be  taken,  and  some  active  employment  be  engaged  in,  which 
will  absorb  the  energies  of  mind  and  body. 

Tubal  Pres:nancy. 

Tubal  or  ectopic  pregnancy  is  mentioned  here  in  connection  with 
womb  diseases,  because  it  assumes  the  symptoms  of  certain  uterine 
affections,  and  must  be  so  treated. 

When,  for  any  reason,  the  ovum  cannot  pass  through  the  Fallo- 
pian tube  into  the  womb,  where  it  is  normally  impregnated  by  the 
male  germ,  but  is  arrested  in  the  tube,  it  not  infrequently  happens 
that  the  spermatozoon  of  the  male  travels  upward  through  the  womb 
into  the  Fallopian  tube,  and  there  meets  the  impeded  ovum.  Fecun- 
dation takes  place,  the  ovum  swells  and  grows,  the  tube  stretches 
more  and  more  till  it  bursts,  and  then  a  hemorrhage  occurs  into  the 
abdominal  cavity,  from  the  leaking  tube.  A  large  clot  of  blood  is 
formed,  which  generally  arrests  further  hemorrhage  and  causes  the 
death  of  the  embryo,  but  not  necessarily ;  aftor  a  time,  another 
hemorrhage  occurs,  with  pain,  fainting,  and  even  collapse,  depend- 
ing on  the  severity  of  the  hemorrhage.  If  allowed  to  follow  its 
natural  course,  the  hemorrhage  finally  causes  the  patient's  death. 
She  dies  suddenly,  as  if  she  were  bleeding  from  a  ruptured  artery. 
The  cause  of  all  this  mischief  lies  in  the  diseased  tube  in  which  the 
obstruction  occurred.  The  Fallopian  tubes  are  lined  with  a  beauti- 
fully constructed  mucous  membrar.e:  on  the  ends  of  the  cells  are 
small  rod-like  processes,  which  look  (qnder  the  microscope)  like  a 
field  of  grain  swaying  with  the  wind ;  they  move  in  one  direction, 
from  an  erect  position  toward  the  uterus,  and  then  relax  and  straighten 
up  again  to  repeat  the  process  ;  thus  the  ovum  which  has  been  grasped 
by  the  fimbriated  ends  of  the  tube  from  off  the  outside  of  the  ovary 
(see  Fig.  136)  is  carried  down  into  the  interior  of  the  womb,  where 
nature  meant  it  should  be  impregnated.  Now,  when  these  tubes  be- 
come diseased  by  catarrhal,  and  especially  by  purulent  inflammation 
(see  Salpingitis),  the  little  rod-like  extremities  of  the  cells  are  de- 
stroyed, and  the  ovum  finds  no  ready  way  of  getting  into  the  womb. 
An  unusually  active  spermatazoon  climbs  up  into  the  tube,  because 
it  has  the  power  of  motion  so  long  as  it  lives ;  and  thus  the  trouble 
begins. 

Symptoms.  —  A  woman  misses  her  menstruation,  and  goes  on  a 
month ;  possibly  missing  a  second  or  even  a  third  menstruation, 
without  many  of  the  usual  accompp.nying  symptoms,  till  suddenly 


FEMALE  DISEASES. 


419 


cocaine  is  the 

}  it  Bometimes 
I  cure  can  ixj 
list  be  applied 
•ations  of  iron 
iged  in,  whicli 


snnection  with 
;ertain  uterine 

igh  the  Fallo- 
ignated  by  tlie 
lendy  happens 
)Ugh  the  womb 
)vum.  Fecun- 
tube  stretches 
occurs  into  the 
lot  of  blood  is 
and  causes  the 

time,  another 
Uapse,  depend- 
i  to  follow  its 
jatient's  death, 
jptured  artery. 
be  in  which  the 
I  with  a  beauti- 
if  the  cells  are 
roscope)  like  a 
1  one  direction, 
c  and  straighten 
las  been  grasped 
le  of  the  ovary 
le  womb,  where 

these  tubes  be- 
lt inflammation 
;he  cells  are  de- 
into  the  womb, 
le  tube,  because 
thus  the  trouble 

I,  and  goes  on  a 
I  menstruation, 
IS,  till  suddenly 


she  is  seized  with  cramp-like  pains  in  the  lower  bowel,  and  takes  her 
h«^(l ;  she  may  get  up  from  this  first  shock  of  pain  (due  to  hemorr- 
liiige),  till  a  second,  or  even  a  third  still  severer  attack  ensues,  when 
the  doctor  is  culled.  If  he  is  thoughtful,  he  at  once  examines  and 
li;  'Is  a  bunch  in  the  pelvis,  on  the  side  of  the  pain.  This  bunch  is 
tilt!  clot,  and  the  contained  sac  with  the  foetus.  Not  every  case  is 
taken  alike,  but  many  are  crippled  at  the  first  onset  of  pain  a 
hemorrhage ;  inflammation  ensues,  and  sickness  in  bed  attracts  the 
attention.  Usually,  there  is  some  slight  hemorrhage  of  blood 
escaping  tlirough  the  tube  into  the  womb  and  out  into  the  vagina. 

Treatment.  —  This  disease,  like  appendicitis,  belongs  to  modem 
surgery,  as  only  recently  has  it  been  recognized,  and  treatment  on 
a  sound  basis  been  formulated.  Death  is  sure,  unless  surgical  aid 
comes  to  the  rescue.  Laparotomy,  or  opening  of  the  abdomen,  must 
he  performed  at  once,  the  clots  washed  out  of  the  abdomen,  of  which, 
usually,  there  are  a  quart  or  more,  the  sac  containing  the  embryo 
removed,  and  the  tube  tied  off.  The  successes  are  brilliant,  and 
lives  are  daily  saved.  I'le  operation  is  a  grave  one,  but  not  as  much 
so  as  many^  others  performed  on  the  abdomen. 

Sterility  or  Barrenness. 

It  has  doubtless  occurred  to  every  person  who  has  thought  upon 
the  subject,  that  there  must  be  some  special  reasons  why  so  many 
women  do  not  and  cannot  bear  children.  These  reasons  I  propose 
now  to  explain  as  simply  and  as  plainly  as  the  nature  of  the  subject 
admits.  To  tliis  explanation  I  shall  add  some  remarks  upon  treat- 
ment ;  for,  in  nine  cases  out  of  ten,  barrenness  is  completely  curable. 

Reproduction.  —  Throughout  nature,  life  is  perpetuated  by  repro- 
duction. The  vegetable  and  the  animal  die;  but  before  death  comes, 
they  reproduce  the  germ  of  a  new  thing,  or  being,  which  lives  after 
them.  The  law  of  reproduction,  throughout  the  realm  of  nature,  is 
one,  and  but  one.  All  living  things  have  male  and  female  structures. 
Every  new  being  is  evolved  from  an  Qgg,  the  product  of  an  antece- 
dent parent. 

Reproduction  consists  in  the  growth  of  an  egg,  or  germ,  in  con- 
nection with  some  living  part,  until  it  is  capable  of  independent  exist- 
ence. This  germ  or  egg  is  the  product  of  the  female  parent,  and  will 
abort  or  perish  unless  brought  into  connection  with  a  fructifying  ele- 
ment from  the  male.  Thus,  two  palm-trees,  growing  about  forty  miles 
from  each  other,  the  one  with  stamens  (the  male  organs),  the  other 
with  pistils  (the  female  organs),  bore  no  seed  for  many  years;  but 
when  they  had  risen  in  height  above  all  intervening  and  obstructing 
objects,  ihe  winds  bore  the  pollen  from  the  stamens  of  one  to  the 
pistillate  flowers  of  the  other,  which  immediately  began  to  produce 
fruit.     A  knowledge  of  tliis  great  law,  as  applicable  to  all  living 


HOB 


wsiamf 


420 


FKMALU   DISEA8RS. 


'    I 


'Si 


f     I   I 


things,  enableH  horticulturiBtA  to  raise  Hiich  varieties  of  fruit  an  tliey 
wish,  by  shaking  the  blooming  iniile  branch,  which  liiis  stumenH,  uvor 
the  female  flowers,  supplied  with  pistils.  Sometimes  the  male  and 
female  flowers  are  upon  the  same  plant,  at  other  times,  upon  differ- 
ent ones.  The  strawl^erry  is  of  the  latter  kind,  —  the  pollen  being 
found  only  on  the  plants  which  have  the  largest  flowers,  —  the  pistil- 
late flowers  Iwing  only  on  the  smaller  plants.  The  pollen,  or  dust, 
is  carried  from  the  male  to  the  female  plant,  on  the  feet  of  honey- 
bees, as  they  fly  from  flower  to  flower.  It  has  been  discovered  that 
the  reason  why  many  beds  are  unfruitful  (strawberry  beds,  I  mean), 
is  that  the  large  maUvplants  are  allowed  to  monopolize  the  beds  to  the 
exclusion  of  the  smaller  female  plants.  The  plants  with  large  flowers 
should  be  thinned  out,  leaving  only  a  few  to  furnish  pollen  for  the 
females,  which  are  the  real  bearers. 

A  N  TV  Branch  of  Industry.  —  It  is  only  comparatively  recently 
that  tiiiB  law  has  been  understood  in  its  wide  applicability.  How 
wise  and  merciful  an  arrange  Jient  of  Providence  that  an  unseen 
hand  should  turn  for  man  the  mystic  leaves  of  knowledge  at  the  very 
time  when  he  is  most  in  need  of  the  instruction  imparted !  At  this 
very  moment,  the  more  complete  knowledge  of  this  great  hiw  is  open- 
ing a  new  branch  of  industry,  and  a  new  supply  of  food,  and  is  thus 
helping  the  solution  of  the  great  problem  of  how  the  increasing  in- 
habitants of  civilized  countries  are  to  be  worked  and  fed.  I  refer  to 
the  propagation  and  culture  of  fish. 

A  <3ommittee  appointed  by  the  leg^lature  of  Massachusetts,  re- 
ported very  ably  upon  this  subject.  The  eggs  of  the  fish  may  be 
fecundated  almost  as  easily  ao  the  pistillate  flowers  of  the  plant.  It 
is  only  necessary,  when  the  eggs  of  the  female  are  mature,  to  hold 
her  over  a  basin  of  water,  and  make  gentle  pressure  upon  the  belly, 
when  the  eggs  will  pass  freely  into  the  water;  then  to  pass  the  milt 
of  the  male  into  the  same  water,  and  shake  them  thoroughly  together. 
By  this  means,  the  eggs  are  impregfnated,  and  fish  may  be  raised  to 
any  extent. 

The  egg  of  the  higher  animals  is  more  difficult  to  fecundate,  and 
that  of  the  human  female  most  difiicult  of  all ;  for  in  nature,  as  in 
art,  the  more  perfect  structures  are  begun  and  reared  with  less  ease. 

Propriety  of  Impartins:  this  Knowledge.  —  Men  are  naturally 
curious,  and  love  to  understand  the  myst«ry  of  their  own  origin ; 
and  yet  there  is  scarcely  any  subject  upon  which  they  have  so  little 
reliable  information.  It  has  been  held  that  this  is  a  kind  of  informa- 
tion which  it  is  not  proper  to  impart  to  the  multitude;  that, the  curi- 
osity which  seeks  this  knowledge  is  based  upon  improper  feelings ;  and 
that  to  gratify  it  by  imparting  what  is  sought,  would  lead  to  imrao^ 
ality. 

I  do  not  believe  it.  Such  ideas  are  based  upon  a  shallow  philoso- 
phy.   They  overlook  the  fact  that  nothing  excites  the  imagination 


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FEMALE   DISEASES. 


421 


like  that  which  is  covered  with  mystery.  It  is  because  the  immensely 
important  subject  of  the  procreation  of  the  race  is  so  carefully  hidden 
from  the  public  eye  ;  because  it  is  purposely  buried  so  deep  in  obscu- 
rity, that  any  allusion  to  it  excites  improper  thoughts.  If  the  subject 
be  properly  viewed,  it  is  no  more  indelicate  to  explain  the  mode  of 
reproducing  a  human  being  than  to  explain  that  of  propagating  a 
plant  or  a  fish.  Both  are  effected  in  the  same  way,  under  precisely 
the  same  natural  law. 

True,  the  propagation  of  the  human  being  involves  moral  laws 
likewise ;  but  these  relate  only  to  the  social  relations  in  which  it  may 
take  place,  and  do  not  affect  in  any  way  the  propriety  of  making  it 
xmderstood  by  the  people. 

The  Qerm  Furnished  only  at  Certain  Periods.  —  These  general 
remarks  bring  me  to  the  immediate  subject  in  hand.  Throughout 
animated  nature,  the  female  furnishes  the  mature  germ  or  egg  only 
at  certain  periods.  The  healthy 
human  female,  —  as  I  have  al- 
ready explained,  —  matures  a 
germ  once  in  four  weeks.  These 
germs  or  eggs  are  constantly 
advancing,  in  succession,  from 
the  rudest  beginning  to  a  state 
of  ripeness  or  maturity.  Every 
'  person  must  have  seen  the  eggs 
taken  from  a  hen  when  killed 
in  the  laying  season.  Fig.  143 
furnishes  a  good  illustration. 
They  are  in  all  stages  of  progress, 
from  the  invisible  germ  up  to 
the  nearly  mature  egg. 

Such  is  the  progress  of  the 
human  egg,  —  only  that  it  does 
not  attain  to  any  such  size.'  So 
far  as  the  maturing  is  concerned, 
it  occurs  in  the  same  gradual  way, 

Conception  or  Impregnation  can  take  place  only  when  a  germ  or 
egg  is  ripe ;  and  as  an  egg  ripens,  bursts,  and  passes  into  the  Fallopian 
tubes  and  thence  to  the  womb  only  at  the  time  of  menstruation,  it  is 
plain  that  conception  must  happen  somewhere  in  the  neighborhood 
of  this  period.  Intercourse  with  the  male  may  take  place  at  interme- 
diate times  ;  but,  except  in  some  rare  instfiuces,  conception  will  not 
occur,  because  there  is  no  mature  egg  to  be  impregnated. 

Now,  as  every  healthy  woman  brings  to  maturity  a  germ  or  egg  at 
the  time  of  every  monthly  flow,  and  as  every  ripened  egg  is  capable, 
under  favorable  circumstances,  of  being  fecundated,  it  follows  that 
every  woman  who  menstruates,  and  is  well,  can,  under  certain  cir- 


FlO.  143. 


'-.Vii 


422 


FEMALK   DISEASES. 


i'^ 


cuinstanccs,  Ito  iniprcgnated.  'I'o  effect  it,  it  is  only  necessary  that 
the  vivifying  portion  of  llic  male  semen,  ealled  spermatozoa,  come 
into  union  with  the  ripened  egg. 

Tliis  union  (for,  that  men  and  women  may  have  a  ehanee  to  know 
as  much  about  themselves  as  they  do  about  fishes  and  plants,  I  i)ro- 
pose  to  make  tlie  whole  subject  plain)  takes  place  in  the  following 
way.  In  the  act  of  copulation,  the  male  organ  penetrates  the  vagina, 
and  deposits  the  sperm,  spermatic  fluid,  semen,  or,  as  the  scriptures 
call  it,  the  "  seed,"  directly  at  tlie  mouth  of  the  uterine  neck.  Some 
suppose  that  when  the  sensation  of  the  female  is  at  its  height,  the 
womb  opens  to  receive  the  injected  semen.  But  this  is  uncertain. 
This  spermatic  fluid  is  composed,  in  large  part,  of  mucus.  A 
smaller  ])ortion  of  it  is  secreted  by  the  testi- 
cles, and  is  the  true  semen,  or  life-giving  prin- 
ciple. Tills  last  portion  is  composed,  almost 
entirely,  of  fertilizing  filaments  or  vesicles, 
which  look  like  small  animals  (Fig.  144),  and 
for  a  long  time  were  supposed  to  be  animal- 
cules. They  are  generally  called  spermatozoa. 
By  some  mysterious  law  of  their  nature,  they 
are  endowed  with  the  power  of  motion;  and 
when  deposited  near  the  mouth  of  the  womb, 
they  immediately  begin  to  move,  as  if  by  in- 
a   ripened   egg. 


FIO.  144. 


stinct,  in  search  of 
Passing  through  the  uterine  neck,  they 
enter  the  womb.  If  an  egg  be  found, 
in  its  ripened  condition,  they  imme- 
diately embrace  it,  and,  in  some  mys- 
terious way,  mingling  their  own  con- 
tents with  the  contents  of  the  egg, 
they  impregnate  or  fertilize  it.  Fig. 
145  shows  the  womb  divided  length- 
wise. A,  is  the  internal  mouth  (os  in- 
ternum), or  point  where  the  canal 
through  the  uterine  neck  entei-s  the 
body  of  the  womb ;  B,  is  the  external 
mouth  (os  externum) ;  the  space  be- 
tween A  and  B,  the  passage  through 
the  neck;  and  C,  C,  the  points  where 
tlie  Fallopian  tubes  begin.  By  looking 
back  now,  and  examining  Fig.  136,  the 
whole  thing  will  be  undei-stood. 

This  is  a  very  brief  and  simple  ac- 
count of  impregnation.  It  is  supposed 
to  be  capable  of  taking  place  either  a 
little  before  or  a  little  after  the  monthly 
flow,  and  not  at  intermediate  times,  for  the  reason  already  stated. 


— 

I 1 

n 

-1 

i-=- 

no.  14S. 


:i 


FEMALK   DISEASES. 


423 


ecessaiy  that 
iitozoii,  (;oiiie 

nice  to  know 
plants,  I  i)ro- 
he  following 
3S  the  vagina, 
le  scriptures 
neck.  Some 
B  height,  the 

uncertain, 
mucus.     A 

by  the  testi- 
!-giving  prin- 
josed,  almost 

or  vesicles, 
ig.  144),  and 
;o  be  animal- 

spermatozoa. 

nature,  they 
motion;  and 
>f  the  womb, 

as  if  by  in- 


ready  stated. 


There  are  some  reasons  for  believing  that  the  same  egg  or  germ,  if 
fertilized  just  before  the  courses,  will  grow  to  be  a  male,  while,  if 
fecundated  after  tlie  tui-ns,  it  will  be  a  female.  One  reason  for  this 
su[)position  is,  that  plants  may  be  made  to  bear  male  or  female 
flowers  by  simply  subjecting  them  to  different  degrees  of  heat.  If 
tliere  be  more  heat  than  light,  male  flowers  are  produced ;  if  more 
liglit  tlian  heat,  female  flowers  are  the  result.  The  heat  of  the  female 
generative  organs  is  raised  to  its  highest  degree  about  the  time  the 
egg  bursts  its  covering,  wliich  is  just  before  the  beginning  of  the  flow. 
It  has  been  thought  that  the  right  ovary  produces  males,  and  the 
left  ovai  y  females ;  but  tills  theory  is  not  supported  by  any  facts,  and 
is  probably  not  true. 

Causes  of  Sterility.  —  From  what  has  been  said,  it  would  appear 
that  to  ensure  cliild-bearing  it  is  only  necessary  that  semen  or  seed, 
containing  spermatozoa,  come  in  contact  with  a  germ-vesicle  or  egg, 
at  the  right  time  ;  that  there  be  no  hindering  disease  ;  and  that  the 
parties  cohabiting  be  adapted  to  each  other. 

It  is  evident  enough  that  a  want  of  adaptation  between  the  parties, 
physical  or  mor.al,  or  both,  is  often  an  absolute  bar  to  conception. 
A  lack  of  moral  adaptation  was  probably  the  obstacle  in  the  case  of 
Napoleon  and  Josephine,  —  her  marriage  with  a  previous  husband, 
and  his  with  a  subsequent  wife  having  both  been  fruitful. 

It  is  certain  that  indifference  on  the  part  of  the  wife  to.wards  the 
husband,  and  especially  repugnance,  may  prove  an  obstacle.  A  mere 
lack  of  sexual  feeling  does  not  necessarily  prove  a  bar,  though  it 
probably  lessens  the  chances  of  a  fruitful  union. 

Conception  may  fail  to  take  place  from  the  diminutivoness  of  the 
male  organ,  —  the  semen  not  being  deposited  in  the  right  place  ;  or, 
from  its  excessive  largeness, —  penetration  of  the  vagina  being  impos- 
sible. In  some  rare  cases,  the  womb  is  absent.  The  inflammation 
of  the  ovaries  often  prevents  the  ripening  of  eggs.  The  Fallopian 
tubes  occasionally  get  diseased  and  plugged  up,  so  that  no  egg  can 
pass  to  the  womb.  Inflammation  in  the  cavity  of  the  uterine  neck 
is  probably  the  most  frequent  of  all  the  causes  of  sterility.  The 
viscid,  gluey  matter  which  is  secreted  in  inflammatory  conditions  of 
this  part,  plugs  up  the  passage,  so  that  no  spermatozoa  can  pass  up 
in  search  of  the  egg.  The  acrid  discharges  in  most  of  the  cases  of 
whites  destroy  the  fertilizing  spermatozoa,  and  render  conception  im- 
possible. All  the  displacements  of  the  womb  may  act  as  bars  to 
impregnation.  If  it  fall  over  backward  or  forward,  the  mouth  is 
tilted  up  before,  or  down  behind,  and  is  not  in  the  right  position  to 
receive  the  semen.  One  of  the  most  general  causes  is  trying  to  avoid 
pregnancy  in  early  years  of  married  life. 

Treatment.  —  Judicious  treatment  will,  in  most  cases,  remove 
sterility,  and  open  that  "  well-spring  of  pleasure,"  which  the  poet 
has  so  felicitously  described  as  —  "a  baby  in  the  house." 


424 


FEMALK   DISEASES. 


The  obstacles  to  conception,  stated  above,  are  chiefly  those  diseanes 
which  have  been  previously  described.  To  cure  those  diseases  is  [,0 
remove  tlie  obstacles.  When  it  is  dependent  on  the  causes  whicJi 
produce  j)aiiiful  menstruation,  or  profuse  menstruation,  or  a  suppres 
sion  of  menstruation,  the  remedies  are  the  same  as  are  pointed  out 
for  those  complaints.  If  inflammation  of  the  ovaries  be  the  cause,  a 
cure  may  be  effected,  provided  the  inflamed  condition  be  removed 
before  the  bundle  of  eggs  be  destroyed.  If  inflammation  or  ulcera- 
tion of  the  neck  of  the  womb  be  the  obstacle,  the  remedy  may  be 
found  in  the  treatment  recommended  for  those  affections. 

Sterility  depending  on  the  causes  just  mentioned,  I  have  had  the 
pleasure  of  curing  many  times.  When  dependent  on  a  lack  of  phys- 
ical or  moral  adaptation  between  the  parties,  it  does  not,  of  course, 
admit  of  relief.  It  is  a  misfortune  to  be  borne  in  silence.  It  has 
happened,  perhaps,  through  a  lack  of  judgment  or  care  in  selecting 
a  partner,  and  is  one  of  the  mistakes  of  a  lifetime  which  a  lifetime 
cannot  repair.  When  this  want  of  adaptation  is  not  complete,  a  rem- 
edy may  frequently  be  found. 

Unfortunately,  many  females  do  not  regard  sterility  as  an  evil  to 
be  deplored,  but  rather  as  a  blessing  to  be  desired.  Life,  to  them, 
has  no  high  aims  or  duties,  —  it  is  a  round  of  fashion  and  pleasure. 
To  bear  and  rear  children  interrupts  their  frivolities,  and  they  seek  to 
escape  such  abridgement  of  their  pleasures.  This  is  wrong.  Life  is 
a  great  theatre,  in  which  all  should  strive  to  act  some  worthy  part, 
and  feel  that,  upon  retiring,  it  would  be  wrong  to  leave  their  garments 
upon  the  vacant  stage,  with  none  to  put  them  on,  and  continue  the 
drama. 

Midwifery. 

A  STOPPAGE  of  her  courses  is  most  commonly  the  first  notice  a 
woman  has  of  her  being  in  the  family  way.  This  is  perceived  about 
tk'.-ee  weeks  after  conception,  when  she  begins  to  experience  other 
feolings  peculiar  to  the  situation.  These  feelings  are  nausea  and  vom- 
iting^ or  a  decided  languor,  in  the  morning ;  swelled  and  sometimes 
painful  breasts ;  the  areolae,  or  colored  rings  around  the  nipples,  darker 
than  usual ;  pain  in  the  lower  part  of  the  back ;  and,  occasionally,  a 
good  deal  of  spitting  of  a  frothy,  cotton-like  substance. 

These  symptoms  are  more  or  less  severe  in  different  cases,  and 
under  different  circumstances,  according  to  the  state  of  the  patient's 
bowels  and  her  habits  of  exercise.  Ordinarily,  she  suffers  most  dur- 
ing the  second  and  third  months,  on  account  of 

Sinking  Down  of  the  Womb,  which,  from  soon  after  the  period  of 
conception,  is  gradually  increasing  in  size  and  weight.  As  it  grows 
larger  and  heavier,  it  sinks  lower  in  the  cavity  of  th«  pelvis,  until 
about  the  fourth  month,  when,  becoming  so  large  that  it  cannot  longer 
be  accommodated  within  the  narrow  limits  of  this  unyielding  box  cf 


X\, 


litwHlri'  .-^J'-rii 


'■•^' --fitilt-ftiiii  II II    III 


J^* 


FEMALE    DISEASES. 


425 


those  (liseiwes 
disen-sesj  is  U) 
causes  which 
or  a  suppres 
!  pointed  out 
e  the  cause,  a 
I  be  removed 
ion  or  ulcera- 
medy  may  be 

18. 

have  had  the 

lack  of  phys- 

ot,  of  course, 

ence.     It  has 

>  in  selecting 
ch  a  lifetime 
raplete,  a  rem- 

as  an  evil  to 
Life,  to  them, 
and  pleasure, 
i  they  seek  to 
'ong.     Life  is 

>  worthy  part, 
heir  garments 

continue  the 


first  notice  a 
irceived  about 
)erience  other 
lusea  and  vom- 
nd  sometimes 
lipples,  darker 
)ccasionally,  a 

3nt  cases,  and 
:  the  patient's 
Eers  most  dur- 

the  period  of 

As  it  grows 

R  pelvis,  until 

cannot  longer 

ielding  box  cf 


honest,  it  is  obliged  to  mount  higher  to  find  room  in  the  ampler  and 
more  distensible  belly.  This  low  position  of  the  womb  in  the  early 
iiionthi  of  pregnancy  occasions  many  disagreeble  sensations,  —  iis 
pain  in  the  lower  part  of  the  back  and  sickness  at  the  stomach. 

The  Costiveness,  too,  from  which  women  suffer  so  much  at  this 
time,  is  often  caused,  in  part  at  least,  by  the  pressure  of  the  enlarged 
womb  upon  the  lower  bowel.  Costiveness,  thus  induced,  at  length 
becomes  itself  a  cause  of  serious  mischief.  The  lower  bowel,  filled 
and  enlarged  with  its  hardened  contents,  reacts  upon  the  womb, 
crowding  it  still  lower  in  its  narrow  quarters,  and  greatly  increasing 
its  excitability.  The  enlarged  bowel  and  womb  combined  make 
constant  pressure,  sometimes  upon  the  urethra,  or  water-pipe,  causing 
pain  and  difficulty  in  making  water,  and  always  upon  the  ascending 
veins,  checking  the  return  of  blood,  and  producing  congestion  in  the 
lower  bowel,  manifested  by  troublesome  piles. 

Treatment  of  Pregnancy.  —  When  the  pregnant  woman  first  rec- 
ognizes her  situation,  she  should  determine  to  "  observe  moderation 
in  all  things."  Let  her  avoid  violent  and  sudden  exertion,  and  move 
about  more  calmly  and  evenly  than  usual.  By  this  is  not  meant  that 
she  should  give  up  her  customary  occupation ;  but  that  she  should 
pursue  it  with  becoming  carefulness,  resolved  in  no  case  to  hazard 
over-exertion,  and  rather  leaning  to  the  side  of  indolence.  This 
would  not  be  real  indolence,  for  she  is  doing  a  great  work  internalli/, 
and  should  not  unduly  withdraw  her  energies  to  external  affairs. 

Let  her  not  be  too  much  in  the  erect  position.  If  of  delicate 
constitution,  and  not  in  vigorous  health,  she  should  make  it  a  point 
to  lie  down  several  times  during  the  day.  The  standing  position, 
continued  for  a  long  time,  especially  if  it  be  under  circumstances 
to  induce  fatigue,  greatly  favors  the  descent  of  the  womb,  —  while 
a  frequent  rest  in  a  horizontal  position  may  enable  it  to  keep  its 
place. 

An  Objection. — It  may  be  objected  by  some,  that  a  large  majority 
of  the  mothers  in  the  world  are  wo'-king  women,  and  obliged  to  con- 
tribute by  their  industry  to  the  support  of  their  families ;  and  that 
they  cannot  afford,  therefore,  to  lie  still,  and  mind  directions. 

To  this  it  may  be  answered,  that  it  is  a  great  advantage  to  under- 
stand the  best  way,  so  as  to  have  the  privilege  of  at  least  aiming  at 
it.  Much  is  accomplished,  in  all  circumstiinces,  by  aiming  at  doing 
the  best  thing ;  and  few  women  are  so  situated  that  they  could  not 
so  favor  themselves  as  to  obey  the  laws  of  health  a  little  more  per- 
fectly, if  they  thoroughly  understood  them.  All  can  better  afford  to 
avoid  sickness,  than  to  be  sick.  Many  occupations,  also,  unless 
money  tempt  to  excessive  application,  become,  when  steadily  fol- 
lowed, comparatively  easy  and  unexciting.  Thus,  most  people  can 
go  through  their  usual  round  of  duties,  because  they  have  got  v^ed 
to  it.     Indeed,  there  is  nothing  but  indolence  itself,  to  which  we  may 


1' 


'1    '■>( 


426 


FEMALE   DISEASES. 


not  become  accustomed.  The  difference  between  the  laboring  and 
the  privileged  classes  is  more  imaginary  than  real.  All  mujt  work. 
None  can  escape  the  primeval  decree  —  "  In  the  sweat  of  thy  face 
ahalt  thou  eat  bread." 

Many  women,  when  they  find  themselves  in  the  family  way,  will 
observe  no  caution,  but  work  all  the  harder,  and  even  use  other 
means  for  the  purpose  of  bringing  on  abortion,  and  preventing  an 
increase  of  children.  This  unnatural  and  wicked,  but  too  prevalent, 
disposition,  results  sometimes  from  a  fear  of  the  pains  of  cliild-birth, 
sometimes  from  a  desire  to  avoid  the  necessaiy  care  and  confinement 
connected  with  raising  children,  but  most  often  from  a  wish  to  escape 
the  expenses  which  the  prevailing  fasliions  and  customs  of  society 
connect  with  a  large  family.  The  cost  of  a  shattered  nervous  sys- 
tem, and  of  a  body  weakened  and  poisoned  by  powerful  drugs,  is  not 
considered,  because  not  understood!  Hence  the  success  of  those 
quack  advertisements,  impudently  professing  to  cure  female  diseases, 
but  whose  chief  object  is  disclosed  by  the  insertion  of  the  hypocritical 
caution  —  "  Be  careful  not  to  take  this  medicine  during  pregnancy,  as 
it  will  be  sure  to  produce  abortion." 

It  seems  as  if  the  world  would  never  learn  that  God  loves  children, 
although  since  Abraham's  day  he  has  said  so  much  about  them  in 
his  Word,  although  His  Son,  sent  into  the  world  on  purpose  to 
show  the  disposition  of  the  Father,  took  them  up  in  his  arms,  and 
blessed  thera,  and  although  He  has  implanted  a  most  wonderful 
love  of  them  in  the  soul  of  man. 

Costiveness  and  Piles.  —  Let  the  pregnant  woman  use  all  proper 
means  to  keep  her  bowels  in  order.  She  will  thus  greatly  diminish 
the  distressing  nausea,  and  may  entirely  prevent  the  accession  of 
piles.  To  accomplish  this  object,  the  saline  aperients  (7),  (5),  or,  oc- 
casionally, other  mild  cathartics  (10),  (12),  (14),  maybe  used.  But 
more  important  than  either  or  all  of  these  is  the  frequent  use  of  a 
good  self-injecting  family  syringe.  An  injection  of  half  a  pint  of 
cold  water  every  morning  will  do  much  towards  regulating  the 
bowels,  and  preventing  or  curing  piles. 

Nausea.  —  If,  as  sometimes  happens,  there  should  be  persistent 
nausea  after  the  first  three  months,  it  will  need  to  be  combated  by 
mild  tonics  and  stimulants,  as  chamomile  tea,  or  clove  tea  (58), 
(114),  and  by  seeking  a  kind  of  diet  which  will  be  agreeable  both  to 
the  palate  and  the  stomach.  Ten  grains  of  ingluvin  after  each  meal, 
and  on  arising,  oftentimes  prevent  vomiting.  Stretching  the  neck 
of  the  womb  moderately,  and  replacing  a  retroverted  womb,  are  fore- 
most in  importance  of  treatment  when  structural  causes  demand  such 
interference. 

The  Nipplej.  —  During  the  last  month,  particular  attention  should 
be  paid  to  the  nipples.  Untold  misery  often  results  to  the  young 
mother  from  sore  nipples;  and  it  is  well  worth  her  while  to  use  every 


FEMALE   DISKASES. 


427 


I  laboring  and 
.11  mujt  work, 
sat  of  thy  face 

mily  way,  will 

ven  use  other 

preventing  an 

too  prevalent, 

of  cliild-birth, 

id  confinement 

wish  to  escape 

oras  of  society 

i  nervous  sys- 

al  drugs,  is  not 

ccess  of  those 

emale  diseases, 

he  hypocritical 

J  pregnancy,  as 

loves  children, 
about  tliem  in 
on  purpose  to 
his  arms,  and 
lost  wonderful 


L  use  all  proper 
reatly  diminish 
le  accession  of 
(7),(5),or,oc- 

be  used.  But 
[juent  use  of  a 

half  a  pint  of 
regulating   the 

i  be  persistent 
)e  combated  by 
;love  tea  (58), 
;reeable  both  to 
iftereach  meal, 
ching  the  neck 
womb,  are  forc- 
es demand  such 


.ttention  should 
s  to  the  young 
lie  to  use  every 


precaution  against  them.  The  nipples  are,  of  course,  in  an  excitable 
state  during  the  whole  period  of  gestation,  and  at  length  frequently 
become  irritable  and  tender.  Let  them  be  daily  bathed,  for  three  or 
four  weeks  before  confinement,  with  some  astringent  and  cooling 
lotion,  as  oak-bark  decoction,  borax  water,  alum-water,  or  a  solution 
of  tannin  (200),  (201),  (202),  (203). 

The  object  of  treatment,  in  this  case,  is  to  toughen  them  and  ren- 
der them  less  susceptible,  so  that  they  may  not  be  made  tender  by  the 
subsequent  application  of  the  child's  lips. 

When  a  woman  is  peculiarly  liable  to  this  trouble,  the  further  pre- 
caution of  having  them  gently  drawn  by  some  friend,  every  day, 
during  this  last  month,  would  be  of  great  service. 

At  all  events,  let  no  pains  be  spared  to  guard  against  this  evil ;  for 
sore  nipples  make  sore  breasts, and  sore  breasts  make  broken  breasts; 
and  broken  breasts  are  terrible  things.  They  make  the  mother  sick ; 
and  if  the  mother  is  sick,  the  child  is  sure  to  be  sick ;  and  all  hands 
soon  get  sick  and  worried,  and  the  whole  business  of  having  children, 
and  taking  care  of  them,  is  deprived  of  its  peculiar  joys  and  consola- 
tions, and  brought  into  undeserved  disrepute.  Whereas,  under  wise 
and  prudent  management,  there  is  something  delightful  to  the  young 
mother  in  yielding  sustenance  to  her  dependent  offspring.  For,  when 
her  nipples  and  breasts  are  in  a  healthy  state,  she  can  say  with  the 
poet,  as 

"  The  starting  beverage  meets  its  thirsty  lip, 
'Tis  joy  to  yield  it,  as  't  is  joy  to  sip." 

Swathing:.  —  In  advanced  pregnancy,  much  assistance  in  supporting 
the  burden  is  sometimes  derived  from  swathing  the  bowels.  Healthy 
and  vigorous  women,  however,  need  no  such  assistance ;  it  is  chiefly 
appUcable  to  cases  of  debility,  either  constitutional,  or  resulting  from 
neglect,  or  from  over-exertion  during  former  pregnancies. 

■  Cramp  In  the  Stomach  is  sometimes  very  severe,  and  if  allowed  to 
continue,  may  kill  the  child.  The  best  remedies  are  warm  carmina- 
tives (114),  (115),  or  anodynes,  et  \  (121),  (122),  or  antispasmodics 
(90),  (94).  :  ; 

Headaches.  —  These  maybe  relieved  by  antispasmodics,  etc.  (90), 
(94),  or  anodynes  (121). 

Palpitation  of  the  Heart  may  prove  very  distressing  to  delicate 
women.  The  remedies  are  the  antispasmodics,  with  rest.  Some- 
times tonics  are  useful,  such  as  the  muriated  tincture  of  iron  (73). 
The  bowels  should  be  carefully  regxilated. 

Fainting,  which  occurs  before  or  at  the  time  of  quickening,  is  some- 
times very  troublesome.  The  proper  treatment  is  the  avoidance  of 
fatigue,  and,  during  the  fainting  fit,  the  recumbent  posture,  cool  air, 
application  of  cold  water  to  the  face,  and  ammonia  to  the  nose. 

Cough  is  sometimes  present.     It  is  caused  by  the  upward  pressure 


428 


FEMALE  DISEASES. 


of  the  diaphragm  against  the  lungs,  hy  which  they  are  irrita':ed  and 
convulsed.  The  remedies  may  be  selected  from  tlie  cough  prepara- 
tions among  the  prescriptions. 

Varicose  Veins.  —  These  cannot  be  removed  during  pregnancy; 
but  they  may  be  relieved  by  great  care  of  the  bowels,  and  by  wearing 
tight  bandages,  or  elastic  stockings. 

Swelling  of  Lower  Limbs  is  caused  by  pressure  of  the  enlarged 
womb  upon  the  veins ;  and  may  be  relieved  by  care  of  tlio  bowels, 
and  diuretics  (130). 

Itching  of  tlie  Oentials  may  be  much  relieved  by  lx)rax,  camphor, 
etc.  A  four-per-cent  solution  of  cocaine,  painted  on,  gives  most 
relief,  and  is  mobt  curative. 

Miscarriage.  —  Abor'ion. 

When  a  woman  in  the  family  way  throws  off  the  contents  of  her 
womb,  or  loses  her  child,  during  the  first  six  months,  the  accident  is 
a  miscarriage,  or  abortion  ;  when  the  same  thing  happens  during  tlie 
last  three  months  of  her  term,  it  is  a  premature  labor.    - 

Symptoms.  —  If  abortion  occur  during  the  first  month  after  con- 
ception, the  symptoms  may  not  attract  much  attention  or,  L.ay  be 
regarded  only  as  an  irregularity  of  menstruation.  Occurring  at  later 
periods,  it  is  frequently  indicated  by  some  feverishness,  coldness  of 
the  feet  and  legs,  a  puffed-up  condition  of  the  eye-lids  with  purplisli 
discolorations,  shooting  pains  in  the  breasts,  which  become  soft,  pains 
in  the  back,  bearing-down  pains  in  the  lower  part  of  the  bowels, 
which  come  and  go,  and  at  length  take  the  character  of  real  labor 
pains.  As  these  pains  increase,  blood  begins  to  appear,  and,  sooner 
or  later,  the  bag  of  water  breaks,  and  the  faatus  is  thrown  off. 

Causes.  —  These  are  very  numerous.  Some  of  the  principal  are, 
displacement  of  the  womb ;  ulceration  of  its  neck  ;  syphilitic  disease 
of  the  foetus  received  from  the  parent ;  too  much  exercise ;  heavy 
lifting ;  falls,  particularly  when  the  woman  comes  down  upon  the 
feet,  and  is  heavily  jarred ;  emetics ;  powerful  purges ;  and  too  much 
nuptial  indulgence. 

I 

Treatment.  —  Where  the  symptoms  are  but  slight,  nothing  may 
be  required  more  than  a  little  caution  for  a  few  days,  and  rest  in  the 
horizontal  posture,  using  cold  drinks,  and  taking  for  two  or  three 
nights,  at  bedtime,  perhaps,  a  pill  composed  of  one  grain  of  camphor 
and  two  grains  of  sugar  of  lead.  Besides  these  remedies,  it  may  be 
well  to  put  a  mustard-poultice  low  down  upon  the  back. 

If,  notwithstanding,  flooding  comes  on,  and  the  symptoms  of  mis- 
carriage increase,  a  napkin  wetted  with  cold  water,  or  vinegar  and 
water,  or  a  bladder  partly  filled  with  ice,  should  be  laid  upon  the  ex- 


ii'w'»Tiffiii'ilil1  "frtril  IT 


Hiil^   1  ihiiiJWlimwfj" 


LijtfrtU>-*<.«wjiitlifMili<HW,il 


y'ypiw 


»iw. 


iim-itiiiiiiri-,7Tm'»rnrTTff°fi'i' 


■■ijiSy-'^ 


FEMALE   DISEASES. 


429 


e  irrit8':ed  and 
lOUgh  prepara- 


ig  pregnancy; 
nd  by  wearing 

f  tlie  enlarged 
of  tlio  bowels, 


oiax,  camphor, 
n,  gives  most 


ontents  of  her 
the  accident  is 
BUS  during  the 

)nth  after  con- 
)n  or,  L.ay  be 
urring  at  later 
88,  coldness  of 
with  purplish 
)me  soft,  pains 
af  the  bowels, 
'  of  real  labor 
ir,  and,  sooner 
iwn  off. 

principal  are, 
ihilitic  disease 
ercise ;  heavy 
own  upon  the 
and  too  much 

nothing  may 
nd  rest  in  the 

two  or  three 
in  of  camphor 
lies,  it  may  be 
k. 

ptoms  of  mis- 
'  vinegar  and 
1  upon  the  ex- 


ternal genitals,  and  pulverized  alum,  mixed  up  with  a  little  honey, 
must  1h)  given  internally,  every  half  hour ;  and  if  the  flooding  still 
increase,  it  may  be  proper  in  some  cases  to  resort  to  the  tampon  or 
Itlug.  To  do  this,  take  either  lint,  or  absorbent  cotton,  or  a  piece  of 
line  sponge,  and  having  soaked  it  full  of  a  strong  solution  of  alum, 
or  tannin,  or,  still  better,  Monsel's  pei-salt  of  iron,  one  part  to  six 
parts  of  water,  fill  the  vagina  full,  and  then  place  a  fold  of  linen 
in  the  genital  fissure,  and  apply  a  bandage.  This  will  generally  stop 
the  flow;  but  the, plug  must  be  removed  in  from  five  to  ten  hours. 

If  the  abortion  cannot  be  prevented,  —  especially  in  the  lattei- 
niontlis  of  gestation,  —  then  the  case  is  to  be  permitted  to  go  on, 
and  to  be  treated  the  same  as  a  natural  labor.   ■ 

Abortion  (Criminal). 

Many  married  people  who  consider  the  bearing  of  children  a  bur- 
den, and  those  who  suffer  from  a  lapse  of  virtue,  are  tempted  to 
commit  abortion. 

I  wish  it  were  possible  for  me  to  express  to  them  the  sin  and  folly 
of  such  a  course.  The  sufferings  ahd  evils  that  almost  always  follow 
are  far  worse  than  any  care  or  shame  which  come  from  letting  nature 
take  its  course.  Any  crime  against  nature  is  sure  to  be  punished. 
In  this  case,  consumption,  nervous  prostration,  and  various  womb 
complaints  are  the  usual  accompaniments,  ruining  the  future  life  or 
usefulness  of. the  woman,  until  finally  life  becomes  a  burden  to  her- 
self and  friends ;  it  usually  being  impossible  to  obtain  a  cure,  though 
she  seek  it  carefully  and  with  tears.  No  conscientious  physician  will 
commit  abortion.  She  will  be  obliged  to  trust  herself  in  the  hands 
of  quacks  and  rascals,  who  commit  the  crime  either  with  medicine 
or  instruments,  in  one  case  ruining  the  digestion,  in  the  other  the 
womb.  Nature  has  not  provided  any  way  in  which  it  can  be  done 
with  safety,  and  it  is  justifiable  in  no  case  except  when  it  will  save 
the  life  of  the  mother. 

Prevention  of  Pregnancy. 

There  are  many  cases  in  which,  on  account  of  some  contagious 
or  hereditary  disease,  it  is  not  advisable  for  the  wife  to  become  preg- 
nant. It  is  not  always  advisable  for  a  wife  to  have  children  too  fast, 
the  constitution  not  being  strong  enough  to  stand  the  strain  of  bear- 
ing children,  or  the  care  of  bringing  them  up.  In  such  cases,  while 
it  would'  be  wrong  to  commit  abortion,  it  would  be  desirable  to  avoid 
pregnancy.  I  do  not  agree  with  many  of  the  fashionable  women  of 
this  age  wh( .  consider  the  bearing  of  children  a  burden,  and  who  do 
not  know  the  joy  of  a  baby  in  the  house.  How  little  they  realize 
that  the  happiness  and  pleasure  of  a  family  of  children  is  far  greater 
than  the  care.  That  love  makes  labor  light.  It  is  hard  for  the 
young  to  realize  the  lonesomeness  of  childless  old  age. 


* 


430 


KKMALR   DIBKASRB. 


While  it  may  not  be  l)e8t  to  have  children  too  fast  when  yoinig, 
they  must  realize  that  if  protective  measures  are  carried  on  too  Umjr 
it  will  be  impossible  for  the  woman  to  become  pregnant.  Nature 
has  provided  a  reasonable  way ;  if  there  is  no  coition  for  ten  days 
after  the  courses,  or  three  days  before,  the  chances  of  pregnancy  an; 
much  diminished.  Douching  with  warm  or  tepid  water  (never  on  any 
condition  use  cold  water),  immediately  after  coition,  is  perhaps  the  most 
commonly  used  method  to  prevent  conception.  The  addition  of 
carbolic  acid  (one  tcaspoonful  to  the  pint  of  water)  is  an  extra  safe- 
guard. Two  quarts  of  water  is  none  too  much  to  use,  although  a 
pint  might  bo  suHicient.  The  safest,  least  harmful  method  to  the 
woman  with  which  I  am  acquainted,  consists  in  the  insertion  into  the 
vagina,  as  high  as  possible,  of  a  tampon  of  wool.  This  piece  of  wool 
must  first  Ik;  moistened  with  glycerine  and  ''ater,  or  vaseline,  and 
bound  by  a  small  string  to  its  centre.  It  should  be  i.bout  two  inches 
square,  possibly  a  bit  smaller  for  some  women.  It  '"•  most  easily 
iuserted  by  the  woman  when  lying  on  her  back.  .After  coition,  tliis 
wool  is  withdrawn  by  means  of  the  string,  and  a  warm  douche  taken. 
This  procedure  is  not  only  certain  to  prevent  conception,  but  is  abso- 
lutely devoid  of  danger. 

There  are  condoms  made  of  fine  rubber,  which  can  be  bought  of 
druggists,  which  are  absolutely  safe ;  before  use  they  should  be  wet 
with  soap-suds  or  vaseline.  This  is  not  a  healthy  habit,  and  I  would 
not  advise  its  use,  except  where  there  is  danger  of  a  contagious  dis- 
ease, or  where  it  would  endanger  the  life  of  the  woman  by  becoming 
pregnant. 

In  conclusion,  I  would  say,  the  nearer  a  couple  live  to  nature,  the 
better  and  happier  they  will  be. 

Labor.  —  Delivery. 

The  expulsion,  at  full  term,  of  the  child,  the  after-birth,  the  mem- 
branes, and  the  fluids,  constitutes  labor,  or  delivery.  It  is  supposed 
to  occur  about  two  hundred  and  eighty  days  after  the  last  menstrua- 
tion ;  but  authors  reckon  it  differently ;  in  truth,  it  is  not  possible  to 
fix  it  exactly,  for  it  evidently  varies  in  different  cases. 

When  the  time  of  her  lying-in  arrives,  let  every  woman  meet  it 
with  calmness  and  undoubting  confidence.  There  is  every  reason  to 
encourage  this  state  of  mind.  Think  of  the  vast  multitudes  of  peo- 
ple in  the  world.  Each  once  existed  in  the  womb  of  a  mother,  and 
had  to  pass  through  itn  narrow  portals  to  be  admitted  to  the  light. 
Successful  delivery  is  the  rule,  the  worla  over ;  and  it  should  be  the 
rule  to  confidently  expect  it. 

In  the  midst  of  the  pains  of  labor,  nothing  does  more  to  bring  to 
favorable  result  than  courage  and  patience.  Patience  is  able  calmly 
to  survey  all  the  difficulties  before  her,  because  she  never  attempts  to 
encounter  but  one  at  a  time.     There  is  much  philosophy  in  the  story 


■Irt.li'iaJi^ftttTlii'ridi'iitfwi 


■i,dJit«tBiaa*Mki,ii.  'nfc.iW  ;■>■>*«  w- 


FKMALK    1)IHKA8K». 


431 


when  younjj, 
)d  on  too  long 
lant.     Nature 

for  ten  dajK 
pregnancy  arn 

(never  on  any 
rhai)8  the  nioHt 
e    addition  of 

an  extra  safe- 
ise,  although  ii 
method  to  the 
lertion  into  the 
1  piece  of  wool 
r  vaseline,  and 
3Ut  two  inches 
''  most  easily 
er  coition,  this 

douche  taken, 
in,  but  is  abso- 

1  be  bought  of 
should  be  wet 
it,  and  I  would 
contagious  dis- 
\,n  by  becoming 

}  to  nature,  the 


birth,  the  mem- 
It  is  8uppose«l 
last  menstrua- 
not  possible  to 

yoman  meet  it 
every  reason  to 
Ititudes  of  peo- 
a  mother,  and 
d  to  the  light, 
t  should  be  the 

lore  to  bring  to 
3  is  able  calmly 
ver  attempts  to 
jhy  in  the  story 


of  the  ^^digcontented  pendulum"  wlu(;h  got  discouraged,  one  morning, 
from  reflecting  how  many  millions  of  tiihes  it  would  have  t(>  swing 
during  succeeding  yrai-s,  but  became  reius.sured  upon  con.sidering  that 
a  single  stroke  cost  but  a  very  triHing  (iffort,  and  that  it  really  had 
to  make  but  one  at  a  time.  So  it  is  with  labor;  it«  pains,  which  are 
really  severe  and  agonizing,  will  become  comparatively  tolerable,  if 
the  whole  attention  of  the  woman  Ih'  confined  to  present  sutfering, 
and  her  whole  stock  of  courage  and  patience  be  brought  to  l)ear  upon 
OTie  pang  at  a  time. 

Lot  her  ri!sist  the  temptivtion  to  a  feeling  of  haste.  Nature  will 
often  proceed  more  eveidy  and  more  speedily  if  allowed  to  take  her 
own  time.  A  hurry  to  get  through  is  a  great  obstacle  to  successful 
delivery;  it  always  puts  things  back. 

Symptoms;  —  One  of  the  Hrat  indications  that  lal)or  is  about  to 
iHjgin  is,  that  the  woman  finds  herself  umaller,  —  the  child  having 
sunk  down  lower  in  the  abdomen,  and  she  accordingly  breathes 
easier.  The  genital  organs  become  relaxed  and  moist,  and  mucus 
escapes,  which  is  called  "  the  shows."  The  woman  finds  herself  dis- 
posed to  be  nervous  and  fidgety,  and  perhaps  a  little  depressed  in 
spirits. 

When  labor  has  fully  set  in,  it  is  marked  by  lowness  of  spirits, 
ttiishes  of  heat  and  cold,  a  great  desire  to  empty  the  bowels  and  to 
make  water,  and  grinding,  cutting  pains,  which  grow  stronger  aud 
more  continuous,  with  intervals  of  ttju  or  fifteen  minutes'  ease  be- 
tween. Vomiting  in  the  early  sttiges  of  labor  often  occurs,  and  may 
be  regarded  m  favorable, —  indicating  the  softening  and  opening  of 
the  mouth  of  the  womb. 

Treatment  of  Labor.  —  When  labor  liegins,  the  attention  should 
be  directed  to  the  state  of  the  bowels  and  bladder.  The  child's  head 
l)egins  early  to  press  upon  t'  -^  bladder  and  lower  bowel,  causing  the- 
desire  to  make  water,  etc. ;  and  these  should  be  immediately  emptied 
to  make  room  for  the  head  to  pass  more  easily.  The  bowel  may  be 
freed  by  a  dose  of  castor-oil  (10),  if  there  is  time  for  it  to  operate, — 
but  more  surely,  and  more  satisfactorily,  by  an  injection.  Relief  in 
the  bladder  ma^ ,  perhaps,  be  obtained  by  a  different  position  of  the 
woman  in  the  act  of  making  water.  ■  It  is  the  pressure  of  the  child's 
head  upon  the  water-pi[)e  which  causes  the  trouble  ;  and  to  relieve  it, 
the  woman  shouh^  get  upon  her  hands  and  knees,  with  her  shoulders 
lower  than  the  hips,  so  as  to  throw  the  child  upward  and  forward 
towards  the  cavity  of  the  abdomen.  Thus  situated,  she  may  often 
find  it  easy  to  make  water,  when  in  the  ordinary  position  it  would  be 
impossible.  If,  howevei-,  this  mantwuvre  does  not  succeed,  and  the 
bladder  becomes  greatly  distended,  the  catheter  must  be  used. 

The  B*^d  and  Habiliments.  — In  the  next  place,  fix  the  bed  and 

the  patient's  ha'  nents.  Reject  feather  beds;  use  the  mattress. 
Cover  this  with     rubber  cloth,  i.'  convenient,  and  then  with  folded 


432 


FEMALE   DISEASES. 


sheets  to  absorb  the  discharges,  and  protect  the  bed.  Let  the  woman 
be  arrayed  in  the  same  garments  she  expects  to  wear  after  the  com- 
pletion of  the  labor,  and  let  these  be  well  tucked  up  under  her  anus, 
and  let  the  lower  portion  of  her  body,  from  the  waist  downwards,  be 
enveloped  in  a  sheet.  This  sheet  can  be  easily  removed,  and  the 
clean  clothes  pulled  down  without  greatly  disturoing  the  patient  when 
in  the  exhausted  state  which  follows  labor,  and  when  it  would  subject 
her  to  great  iatigue  to  be  obliged  to  sit  up  in  bed  to  have  her  clothes 
changed.  Let  her  lie  upon  her  Ifeft  side,  with  her  body  shortened  by 
bending  forward^  so  that  the  muscles  may  be  relaxed ;  let  her  head 
be  placed  in  the  middle  of  the  bed,  and  her  feet  press  against  the 
right  foot-post.  Around  this  post  a  shawl  or  towel  may  be  faatened, 
upon  which  she  may  be  allowed  to  pull  during  the  pains. 


Antiseptic  Dressings. 

In  one  essential  particular,  the  case  of  the  modem  woman  differs 
■widely  from  that  of  our  grandmothers.  Childbed-fever,  blood-poison- 
ing, and  other  similar  germ-diseases,  have  been  from  time  immemo- 
rial the  hSte  noire  of  the  lying-in  chamber,  and  the  odium  of  the 
medical  profession.  Since  the  discovery  by  Sir  Joseph  Lister,  of 
England,  that  these  diseases  were  caused  by  the  introduction  of 
germ  bacilli  into  the  living  tissue,  and  that  to  prevent  them  it  is 
only  necessary  to  kill  these  germs  on  all  things  which  in  any  way 
come  in  contact  with  the  motlier's  private  parte,  these  diseases  have 
become  very  much  less  frequent  in  occurrence,  and  much  less  fatal. 
We  know  now  that  the  skin  and  vagina  even  normally  contain  living 
germs  which  act  as  scavengers  of  dirt,  and  exert  a  beneficial  influence 
on  health,  so  long  as  they  remain  in  their  natural  abodes ;  let  them, 
however,  be  introduced  into  the  system  through  raw  surfaces,  tears 
and  excoriations  consequent  on  labor,  and  the  group  of  symptoms 
generated  by  this  poison  is  truly  frightful  to  think  of. 

To  avert  such  catastrophes,  it  must  be  the  aim  of  the  physician 
and  nurse,  and  even  the  patient,  to  use  scrupulous  care  in  keeping 
away  from  the  patient  anything  which  has  not  first  been  rendered 
absolutely  clean  or  germ-free. 

It  thus  becomes  evident  that,  first  of  all,  as  soon  as  labor  sete  in, 
the  thighs  and  privates  should  be  thoroughly  washed  with  soap  and 
some  antiseptic,  as,  for  instance,  a  five  per-cent  solution  of  carbolic- 
acid,  or  better,  sulpho-naphthol  solution,  which  may  be  made  by  adding 
one-half  teaspoonf  ul  of  sulpho-naphthol,  or  "  oil  of  milk,"  to  a  quart  of 
water ;  l)etter  still  is  a  solution  of  corrosive  sublimate  of  the  strength 
of  one  part  in  two  or  three  thousand  parts  of  water.  This  poison- 
ous drug  is  best  bought  in  tablet  form,  so  that  by  adding  one  tablet 
to  two  quarts  of  water,  we  have  the  required  solution.  During  labor, 
and  even  after,  all  napkins  and  cloths  used  to  protect  or  wipe  the 
woman,  must  be  wet  in  one  of  these  solutions,  or  otherwise  disin- 


rSMALG   DISEASES. 


433 


et  the  woman 
if  ter  the  coni- 
ider  her  arms, 
ownwards,  be 
oved,  and  the 
5  patient  when 
would  subject 
ive  her  clothes 
J  shortened  by 
let  her  head 
38  against  the 
ly  be  fastened, 
ns. 


•woman  differs 
r,  blood-poison- 
time  immemo- 
odium  of  the 
seph  Lister,  of 
ntroduction  of 
ent  them  it  is 
ch  in  anyway 
e  diseases  have 
nuch  less  fatal. 
J  contain  living 
eficial  influence 
)des;  let  them, 
r  surfaces,  tears 
p  of  symptoms 

i  the  physician 

sare  in  keeping 

been  rendered 

is  labor  sets  in, 
with  soap  and 
ion  of  carbolic- 
made  by  adding 
k,"  to  a  quart  of 
!  of  the  strength 
r.  This  poison- 
Iding  one  tablet 
During  labor, 
;ect  or  wipe  the 
otherwise  disin- 


fected. Every  examination  by  the  physician  or  nurse  must  be  made 
only  after  thorough  scrubbing  of  the  hands  with  soap  and  some  dis- 
infectant. The  napkins  used  may  either  be  wrung  out  of  these  colu- 
tions,  or  steamed  an  hour  before  using. 

By  such  precautions  we  may  expect  to  avoid  blood-poisoning.  The 
nurse  must  always  wash  and  disinfect  her  hands  before  giving  a 
douche  or  handling  the  patient's  private  parts.  The  douche  is  always 
a  source  of  vexation  to  nurses,  a'.id  the  matter  may  here  be  thus 
stated :  unless  there  has  been  given  an  order  hy  the  phjrsician  to  the 
contrary,  never  use  a  douche  after  the  baby  is  born. 

Remember  the  principle  of  always  keeping  surgically  clean,  i.  e. 
germ-free,  all  objects  which  come  in  contact  with  the  lying-in  woman. 

The  Presentation.  —  An  examination  with  the  finger  is  to  be  made 
to  learn  the  presentation, — that  is,  to  learn  which  part  of  the  child 
"omes  first  into  the  mouth  of  the  womb. 

Head  Presentation If  the  head  present,  the  labor  will  probably 

go  on  without  the  need  of  medical  aid.  But  in  all  labors  there  is  a 
liability  to  dangers  from  unforseen  accidents,  which  renders  the  at- 
tendance of  an  intelligent  physician  highly  prudential. 

Breech  or  Feet  Presentation.  —  If  the  feet  or  breech  present,  it  is 
desirable  to  have  the  first  part  of  the  labor  proceed  slowly,  so  that 
the  passage  may  become  well  dilated,  and  prepared  for  a  more  rapid 
delivery  of  the  head.  If  the  breech  present,  do  not  pull  down  the 
feet ;  let  the  child  come  double ;  it  will  make  more  room  for  the  head. 
If  the  feet  present,  let  there  be  no  pulling  upon  them  to  hasten  the 
birth  of  the  breech. 

After  the  feet  and  breech  have  fully  cleared  the  external  orifice, 
the  delivery  may  be  judiciously  hastened  for  the  purpose  of  prevent- 
ing the  death  of  the  child  from  pressure  on  the  umbilical  cord,  before 
its  head  is  brought  to  the  air,  and  the  act  of  breathing  thus  permitted. 
For  after  the  pulsations  of  the  cord  cease,  the  child  must  either 
breathe  or  die. 

In  this  kind  of  presentation,  therefore,  the  child's  life  is  in  great 
danger.  After  the  birth  of  the  lower  half  of  the  body,  the  cord  ex- 
periences severe  pressure,  gufficient  to  interrupt  if  not  wholly  prevent 
its  pulsations.  It  then  becomes  necessaiy  to  hasten  the  birth  of  the 
upper  extremities  and  head  by  ali  prudent  means.  Violence  is  never 
in  order  in  midwifery ;  but  considerable  force,  skillfully  directed,  may 
sometimes  be  safely  used.  After  the  shoulders  are  delivered,  the  pas- 
sage of  the  head  may  be  facilitated  by  carefully  pulling  down  the 
arms.  Then,  as  soon  as  possible,  introduce  the  finger  into  the  mouth 
of  the  child.  Tins  will  serve  the  double  purpose,  perhaps,  of  per- 
mitting a  little  air  to  make  its  way  into  the  child's  lungs,  and  of  fur- 
nishing a  hold  by  which  its  head  may  be  gently  dmwn  along  into  the 
world. 

If  there  is  much  delay  at  this  juncture,  perhaps  in  some  cr.ses  the 


ri 


434 


FEMALE  DISEASES. 


child's  life  may  be  preserved  by  inserting  into  its  mouth  one  end  of  a 
male  catheter,  —  thus  furnishing  an  open  tube  for  the  passage  of  air, 
until  more  vigorous  pains  shall  introduce  it  into  the  full  liberty  of  the 
atmosphere.  While  the  head  is  yet  undelivered,  great  care  should  be 
used  to  keep  the  child's  body  warm  by  covering  it  with  flannel,  and 
also  to  keep  it  in  a  correct  relative  position  with  the  head.  If  the 
body  be  incautiously  turned  round,  of  course  the  neck  will  be  twisted ; 
and  the  child's  subsequent  delivery  with  a  broken  neck  will  be  the 
miserable  result,  bringing  confusion  to  the  medical  attendant,  and 
uuhappiness  to  all  concerned. 

Arm  or  Shoulder  Presentation.  —  If  the  arm  or  shoulder  present, 
the  child  will  probably  have  to  be  turned.  In  case  this  cannot  be 
effected,  its  chest  must  be  opened  and  emptied  of  its  contents,  that 
there  may  be  room  to  bring  down  the  head.  It  is  barely  possible  to 
avoid  a  resort  to  art  in  this  presentation. 

Flooding  or  Hemorrhage,  occurring  to  an  alarming  extent,  is  hap- 
pily one  of  the  rare  incidents  or  consequences  of  labor.  But  when  it 
does  occur,  it  demands  the  most  serious  and  prompt  attention. 

Profuse  bleeding  from  the  womb  is  most  commonly  owing  to  a 
partial  separation  of  the  placenta,  or  afterbirth,  from  its  attachment 
to  the  internal  cavity;  and  it  has  been  observed  that  the  flow 
proceeds  more  rapidly  from  the  detached  portion  of  the  afterbirth 
than  from  the  corresponding  exposed  surface  of  the  womb.  A  knowl- 
edge of  this  fact  has  an  important  practical  bearing ;  for  if,  in  severe 
cases  of  flooding,  the  partially  detached  afterbirth  can  be  entirely 
separated,  the  bleeding  will  often  be  speedily  arrested. 

The  most  dangerous  floodings  occur  in  cases  of  placenta  previa, 
when  the  aftt^rbirth  is  over  the  mouth  of  the  womb.  In  such  cases, 
when  the  labor  commences,  and  the  womb  begins  to  open  itself,  the 
afterbirth  of  course  must  be  partially  separated.  These  cases,  unless 
promptly  relieved  by  art,  may  prove  fatal  in  a  few  minutes.  Yet 
there  is  ordinarily  sufficient  time,  if  it  be  improved,  calmly  to  choose 
and  pursue  the  proper  treatment.  If  the  flooding  be  immediately 
dangerous  to  life,  the  child  must  be  turned  and  delivered,  or  the 
tampon  or  plug  be  applied,  as  directed  under  the  head  of  abortion. 
This  expedient  is  used  when,  through  rigidity  of  the  mouth  of  the 
womb,  the  delivery  is  inadmissible. 

Before  Delivery In  all  cases  of  flooding,  we  prescribe  quiet,  the 

recumbent  posture,  cold  applications  to  the  abdomen  and  the  external 
genitals,  and  the  internal  administration  of  astringents  and  anodynes 
(151). 

After  Delivery,  our  object  is  to  promote  contraction  of  the  womb 
by  cold  applications  and  frictions  externally,  or,  if  necessary,  by  the 
introduction  of  the  hand  into  the  womb,  for  the  purpose  of  removing 
the  afterbirth,  clearing  out  clots,  or  stimulating  it  to  shut  itself  up  for 


'■TatiUliiitiitliiiitiMii'<n^^^^ 


FEMALE   DISEASES. 


435 


tth  one  end  of  a 
5  passage  of  air, 
nil  liberty  of  the 
t  care  should  be 
tritli  flannel,  and 
e  head.  If  the 
;  will  be  twisted ; 
leck  will  be  the 
1  attendant,  and 

boulder  present, 

this  cannot  be 

ts  contents,  that 

arely  possible  to 

ig  extent,  is  hap- 
or.    But  when  it 

attention, 
only  owing  to  a 
1  its  attachment 
jd  that  the  flow 
jf  the  afterbirth 
vomb.  A  knowl- 
;  for  if,  in  severe 

can  be  entirely 
id. 

•  placenta  previa, 
In  such  cases, 
)  open  itself,  the 
lese  cases,  unless 
y  minutes.  Yet 
calmly  to  choose 

be  immediately 
delivered,  or  the 
lead  of  abortion. 
16  mouth  of  the 

■escribe  quiet,  the 
1  and  the  external 
nts  and  anodynes 

Lion  of  the  womb 
necessary,  by  the 
rpose  of  removing 
I  shut  itself  up  for 


the  expulsion  of  the  offending  substance.  Until  this  contraction  is 
secured,  the  plug  should  not  be  used,  lest  internal  bleeding  into  the 
enlarged  and  expanded  womb  should  be  profuse,  and  fatally  exhaust 
the  patient. 

After  the  Child  is  Born,  our  first  duty  is,  if  possible,  to  see  that  it 
breathes.  In  the  vast  majority  of  cases,  the  well-known  cry  which 
salutes  the  ear  gives  proof  that  the  duty  is  unnecessary.  But  some- 
times we  do  not  hear  the  welcome  sound.  The  umbilical  cord  may 
be  once  or  repeatedly  wound  around  the  child's  neck,  and  must  be 
immediately  removed  to  prevent  strangulation ;  or,  the  child's  mouth 
may  be  filL  with  phlegm,  or  some  sticky  mucus,  which  must  be 
poked  out  with  the  ringer,  and  its  exit  favored  by  turning  the  face 
downward;  or,  after  tedious  labors,  the  child  may  be  bom  in  a  very 
feeble  state,  and  may  need  the  stimulus  of  cold  water  thrown  sud- 
denly, in  small  quantities,  upon  its  chest  and  body,  with  considerable 
rubbing,  and  perhaps  the  inflation  of  its  lungs  with  air  blown  into  its 
mouth. 

Tying  the  Cord When  breathing  is  established,  a  piece  of  narrow 

tape  or  common  twine  is  to  be  tied  tight  around  the  navel-string, 
about  two  inches  from  the  child's  navel,  and  the  cord  is  then  to  be 
cut  off,  with  a  pair  of  sharp  scissors,  from  half  to  three  quarters  of 
an  inch  outside  the  place  where  it  is  tied.  The  child  is  then  to  be 
delivered  to  the  nurse. 

Washing  the  Child.  —  The  child  is  now,  while  the  physician  is  at- 
tending to  the  mother,  to  be  washed  and  dressed  by  the  nurse.  Its 
skin  is  at  this  time  covered  with  a  suet>-like  substance,  called  the 
verniz  caseosa.  To  remove  this,  it  should  be  washed  all  over  gently 
with  warm  water  and  castile  soap.  It  is  not  material  that  this  coat- 
ing should  be  absolutely  all  removed  at  the  first  washing ;  but  the 
soap  and  water  should  be  again  gently  applied  in  eight  or  ten  hours 
from  their  first  use.  It  is  improper  to  use  spirits  for  this  cleansing. 
All  rough  rubbing  must  be  avoided  as  injurious  to  the  delicate  skin 
of  so  tender  an  infant.  Washing  with  cold  water  would  lower  the 
temperature  to  a  dangerous  degree,  and  should  in  no  case  be  allowed. 

Removal  of  the  After-Birth.  — The  woman  having  rested  fifteen 
or  twenty  minutes,  a  little  gentle  soliciting  or  pressure  on  the  womb 
will  generally  bring  away  the  after-birth.  If,  however,  any  serious 
obstacle  prevent  its  expulsion,  it  may  be  slowly  and  cautiously  taken 
away  by  the  hand  introduced. 

Cleansing  the  Bed,  and  Applying  the  Swathe.  — Upon  the  re- 
moval of  thu  afterbirth,  a  disinfected  napkin  is  immediately  applied 
to  the  external  organs,  a  drink  of  water  or  tea  administered,  and 
another  rest  of  an  hour  or  more  allowed.  The  swathe  may  consist 
of  a  towel  pinned  snugly  around  the  body,  or  of  a  cloth,  cut  and 
fitted  exactly  for  the  purpose.  Its  object  is  to  afford  a  fii-m  and 
steady  aupport  to  the  contracting  womb. 


II 


436 


FEMALE   DISEASE& 


The  DressiniTS  for  the  Child's  Navel  should  be  so  fixed  that  the 
navelHString  or  cord  will  not  be  left  in  contact  with  the  healthy  skin. 
To  effect  this,  make  a  hole  large  enough  to  admit  the  cord  in  the 
centre  of  a  piece  of  linen  cloth  four  inches  square ;  pull  the  cord 
through  this  hole,  leaving  the  cloth  lying  flat  upon  the  child's  belly; 
then,  having  bandaged  the  cord  down  to  the  belly,  fold  the  cloth  over 
it,  and  appTj'  the  belly-band.  The  interposition  of  these  dressings 
will  thus  keep  the  cord,  which  is  dead  and  in  process  of  decomposi- 
tion, from  irritating,  and  perhaps  excoriating  the  living  flesh,  with 
which  it  must  otherwise  be  in  close  contact.  To  wrap  the  stump  of 
the  cord  in  fresh  absorbent  cotton  is  another  neat,  dry,  and  practical 
method  of  treating  it. 

Nourishment  of  the  Child,  etc.  —  After  being  dressed,  the  child 
should  be  kept  next  the  body  of  the  mother  or  nurse,  that  it  may 
receive  the  natural  warmth  thus  to  be  derived.  Its  nourishment 
shoi'ld  be  obtained  exclusively  from  the  mother's  breast.  If  it  is 
hungry,  be  cure  and  keep  it  so.  There  is  nothing  more  appropriate 
than  a  hungry  child  all  ready  to  take  hold  and  exhaust  the  full  and 
almost  bursting  breast  on  the  third  day,  when  the  milk  has  come. 
Alas  I  How  many  children  have  been  fed  on  sweetened  water,  and 
on  milk  and  water,  till  they  have  lost  all  instinctive  idea  of,  and  all 
appetite  for,  nursing !  and  how  many  bowel  complaints  and  broken 
breasts  have  been  the  miserable  consequence !  But  meddlesome 
f^iend^  are  afraid  the  "  little  dears  "  will  starve  ;  and  therefore  thoy 
must.i.  st  be  made  sick  by  unnatural  diet,  and  then  for  their  cure  be 
treated  that  filthy,  harsh,  and  indecent  substitute  for  medicine, 
ehamber-c^    and  molasses  ! 

But  it  may  be  asked,  "must  not  the  child  be  fed  at  all,  if  it  is  hun- 
gry, and  cries  a  great  deal,  and  there  is  nothing  in  the  mother's  breast 
for  it  ? "  Such  cases  will  be  exceedingly  rare,  if  the  breasts  have 
been  properly  solicited  from  the  first  by  a  hungry  child.  When  they 
do  occur,  being  themselves  exceptions,  their  treatment  must  be  ex- 
ceptional; but,  even  then,  only  so  far  as  is  absolutely  necessary.  If 
fed  at  all,  the  child  should  not  be  fed  to  satiety,  but  as  little  as  the 
circumstances  will  possibly  permit.  The  great  rule  remains :  keep 
the  child  as  hungry  as  possible  till  the  milk  comes.  When  it  has  to 
be  fed,  imitate  the  mother's  milk  as  nearly  as  possible  in  the  prepar 
ration  of  the  artificial  diet.  A  little  sweet  cream,  warm  water  and 
sugar,  should  be  so  mingled,  that  in  warmth,  richness,  and  sweetness, 
the  mixture  may  closely  resemble  human  milk.     (See  page  447.) 

Diet  of  the  Mother. — For  the  first  few  days  after  confinement,  the 
most  appropriate  diet  for  the  mother  is  gruel,  cocoa,  rice-water,  crust 
coffee,  or  some  similar  liquid  nourishment.  Different  constitutions, 
however,  need  somewhat  different  management. 

A  woman  naturally  robust,  and  of  full  habit,  should  confine  herself 
more  strictly,  and  for  a  longer  time,  to  this  light  diet,  than  one  whu 


I 


Miiinu'wwiwmjittoi  ft  »!■■ 


wmmn 


FEMALK   DISEASES. 


437 


10  fixed  that  the 
the  healthy  skin, 
the  cord  in  the 
! ;  pull  the  cord 
the  child's  belly; 
>ld  the  cloth  over 
these  dressings 
188  of  decomposi- 
iving  flesh,  with 
rap  the  stump  of 
ry,  and  practical 

Lressed,  the  child 
irse,  that  it  may 
Its  nourishment 
breast.  If  it  is 
more  appropriate 
lUst  the  full  and 
I  milk  has  come, 
stened  water,  and 
e  idea  of,  and  all 
aints  and  broken 
But  meddlesome 
id  therefore  thoy 
I  for  their  cure  be 
ute  for  medicine, 

at  all,  if  it  is  hun- 
he  mother's  breast 
the  breasts  have 
hild.  When  they 
nent  must  be  ex- 
ely  necessary.  If 
it  as  little  as  the 
lie  remains:  keep 
When  it  has  to 
,ble  in  the  prepa- 
,  warm  water  and 
iss,  and  sweetness, 
See  page  447.) 

ir  confinement,  the 
a,  rice-water,  crust 
:ent  constitutions, 

lid  confine  herself 
iiet,  than  one  who 


is  more  slender  and  feeble.  In  some  cases,  weakly  women  require 
the  juice  of  meat,  and  even  wine  or  ale,  as  early  as  the  second  or  third 
day.  If  she  be  subject  to  canker,  or  nursing-sore  mouth,  a  generous 
diet  is  particularly  serviceable.  After  the  first  week,  she  may  gradu- 
ally i-eturn  to  her  customary  diet. 

Costiveness  may  be  treated  with  the  usual  remedies.  It  was  an 
old  rule  to  give  a  dose  of  castor-oil  on  the  third  day,  when  there  is  a 
little  increa.se  of  excitement  in  the  system,  from  the  filling  of  the 
breasts.  This  is  not  always  necessary,  and  in  most  cases  an  injection 
would  be  far  better.  The  mother  should  stay  in  bed  from  three  to 
four  weeks,  according  to  the  state  of  her  general  health.  A  little 
time  now  is  a  great  gain  later. 

The  Perpendicular  Position During  the  first  month,  let  the 

woman  avoid  being  often  or  long  on  her  feet.  This  is  a  very  essential 
caution  to  avoid  prolapsus,  or  falling  of  the  womb,  with  all  its  atten- 
dant weaknesses  and  pains,  and  to  ensure  a  good  "  getting  up,"  with 
a  sound  womb,  in  the  right  place,  and  subsequent  months  of  health 
and  enjoyment. 

Milk  Leg.  — Phlegmasia  Dolens.  —  Crural  Phlebitis, 

The  Pv  pular  idea  is,  that  in  this  disease  the  woman's  milk  has 
fallen  into  her  leg,  which  has  inflamed.  This  is  of  course  absurd. 
As  to  the  real  nature  of  the  complaint,  there  are  various  opinions,  — 
some  holding  it  to  consist  in  inflammation  along  the  sciatic,  crural, 
and  pubic  nerves  ;  others,  that  it  is  an  inflammation  of  the  lympha- 
tics of  the  groin  which  causes  it ;  others,  that  it  is  an  inflammation 
of  the  crural  veins.  The  fact  of  the  matter  is  that  tliis  disease  is  one 
of  the  many  evidences  of  septic  matter  entering  the  circulation  and 
setting  up  local  trouble  where  it  is  deposited.  It  is,  in  other  words, 
a  mild  form  of  pre-existing  blood-poisoning. 

Symptoms.  — The  disease  begins  in  from  two  to  seven  weeks  after 
delivery,  with  pain  in  the  lower  bowel,  groin,  or  thigh.  The  pain  is 
more  violent  when  the  thigh  is  extended.  In  a  day  or  two,  the  pain 
diminishes,  and  the  limb  begins  to  swell,  frequently  in  the  calf  of  the 
leg  first,  thence  extending  upward ;  but  generally  in  the  groin,  and 
extending  gradually  down.  The  skin  becomes  entirely  white,  smooth, 
and  glossy,  does  not  pit  when  pressed,  is  painful  to  the  touch,  and  is 
hotter  than  the  skin  upon  the  other  limb.  In  connection  with  this 
local  disease,  there  is  general  fever,  with  small  and  rapid  pulse,  thirst, 
etc. 

Treatment.  —  The  patient  must  lie  flat  upon  her  biick,  with  the 
swelled  limb  placed  upon  pillows,  or  a  bolster,  raised  so  that  the  foot 
shall  be  a  little  higher  than  the  hip,  and  then  charged  not  to  put  her 
foot  down  upon  the  floor  until  she  is  very  nearly  well. 

Apply  a  narrow  blister  along  the  course  of  the  crural  vein.     When 


i.'-^ 


438 


FEMALE   DISEASES. 


this  is  removed,  take  a  large  piece  of  flannel,  —  Dr.  Meigs  says  an  old 
flannel  petticoat,  with  the  hem  and  the  gathei-s  cut  oft',  —  and  dip  it 
in  vinegar  and  hot  water,  equal  parfo. ;  wring  it  out,  and  t;ovei-  the 
whole  limb  with  it.  I*ut  a  piec!^  of  blanket  or  oiled  silk  over  it  to 
keep  it  from  wetting  the  bed.  Repeat  this  and  keep  it  up  for  six 
hourd.  When  it  becomes  tedious  to  the  patient,  remove  it,  and  bathe 
the  limb  witli  warm  sweet-oil,  two  parts,  and  laudanum,  one  part,  and 
cover  it  with  flannel.  In  two  or  three  houi-s,  return  to  the  first  appli- 
cation of  hot  water  and  vinegar.  Continue  this  for  five  or  six  hours, 
and  then  take  warm  sweet-oil  and  laudanum :  and  thus  pass  front 
one  to  the  otiier  until  the  inflammation  is  subdued,  or,  as  Dr.  Meigs 
says,  till  the  calf  of  the  leg  can  be  shaken. 

If  the  bowels  are  confined,  let  them  be  gently  moved  by  some 
mild  physic  (13),  (14),  (18),  (25),  (27),  (41). 

In  many  cases,  diuretics  and  cathartics  combined  will  be  proper 
(302),  or  diuretics  only  (128),  (130). 

While  the  inflammation  lasts,  and  there  is  fever,  the  tincture  of 
veratrum  viride  must  not  l)e  forgotten. 

If  recovery  does  not  take  place  after  the  active  inflammation  has 
subsided,  the  limb  should  be  bandaged  from  the  toes  to  the  groin. 

Wrap  up  the  leg  in  wet  flannels,  covered  air-tight  with  rubber 
cloth,  and  great  quantities  of  water  will  exude  from  the  leg. 


Child-Bed  Fever. 


—  Puerperal  Fever.  —  Septiccemia. 
Blood- Poisoning. 


Few  complaints  more  justly  excite  the  dread  of  the  practitioner 
than  this.  It  cuts  down  woman  at  a  time  when  she  can  least  of  all 
be  spared  by  her  young  offspring,  and  at  a  moment  when  she  most 
excites  the  love  and  sympathy  of  her  whole  family.  It  is  a  terrible 
disease. 

Until  after  the  discovery  of  the  germ  character  of  many  diseases, 
this  feai'ful  scourge  was  only  suspected  by  medical  men  to  be  con- 
tagious. It  has,  however,  long  since  been  found  to  be  highly  conta- 
gious and  propagated  by  the  ordinary  routes  of  travel  by  physician, 
nurse,  friend,  etc.,  who  come  in  contact  with  women  about  to  be 
confined  or  with  people  who  have  open  wounds. 

We  know  that  when  a  woman  is  confined  the  germs  which  natur- 
ally belong  on  the  skin  and  in  the  vagina,  if  introduced  into  the 
little  lacerations  and  wounds  which  are  liable  to  ensue  during  labor, 
set  up  a  violent  form  of  blood-poisoning,  which,  for  its  severity, 
rapidity  of  development,  and  direful  consequences,  surpasses  all  other 
infectious  diseases.  Child-bed  fever  is  purely  and  simply  a  germ- 
disease,  caused  by  unclean  hands,  unclean  instruments,  unclean  nap- 
kins, or,  in  fact,  anything  which  contains  germs,  being  brought  in 
contact  with  the  mother.  For  a  further  understanding  of  this  cau- 
sation, see  articles  on  Asepsis,  Antisepsis,  etc. 


■iiMMWMteiWMMn 


■■f*»S»r«iS*l* 


— ■ 


1 


FRMALE   DISEASES. 


489 


says  an  old 
-  and  dip  it 
d  (!OV«r  I  he 
t  over  it  to 
,  up  for  six 
it,  and  batlu; 
me  part,  and 
lie  first  appli- 
or  six  hours, 
18  pa«8  from 
18  Dr.  Meigs 

^ed  by  some 

11  be  proper 

3  tincture  of 

mmation  has 
the  groin, 
with  rubber 
3  leg. 

ticcemia.  — 


3  practitioner 
,n  least  of  all 
len  she  most 
is  a  terrible 

[lany  diseases, 
to  be  con- 
highly  conta- 
by  physician, 
about  to  be 

which  natur- 
uced  into  the 
during  labor, 

its  severity, 
asses  all  other 
mply  a  germ- 
unclean  nap- 
y  brought  in 

of  this  cau- 


Tt  becomes  quite  necessary  for  a  woman  to  regard  liei-self  as  about 
1<)  undergo  a  surgical  operation  when  she  is  to  be  .ioniined,  for  the 
simple  reason  that  she  should  be  pn^parcd  for  the  labor  just  as  the 
piitient  is  for  tlie  operation,  that  she  nia^  have  all  the  advantivges  of 
skilled  nui'sing  and  the  many  little  antiseptic  precautions  which  ren- 
der not  only  operations  but  labor  itself  safe. 

Symptoms. —  The  train  of  symptoms  Iwlonging  to  this  dreadful 
iiiidady  are  too  well  known  to  many  to  repeat  them  in  much  detail. 
Tlie  first  that  one  carefully  observant  of  the  sick  one  notices,  is  a 
slijrlit  rise  of  temperature,  then  perhai)s  follows  a  chill,  sweating  and 
liuiidache  ;  discharges  begin  to  smell  badly,  the  bowels  enlarge  from 
the  formation  of  gas  ;  the  stomach  is  upset,  and  finally,  if  the  diseiise 
is  not  checked,  the  infection  spreads  to  the  tulxis  and  ovaries  and 
into  the  general  abdominal  cavity,  when  death  soon  steps  in  to  end 
tlie  frightful  scene. 

Treatment. —  The  nurse  should  always  be  on  the  alert  to  discover 
the  least  rise  in  temperature  or  any  beginning  odor ;  it  is  just  here 
that  valuable  time  is  often  lost.  The  womb  has  become  infected, 
but  as  yet  the  septic  inflammation  is  only  on  the  inside  of  the  organ. 
At  this  point  vigorous  measures  must  be  at  once  inaugurated  and 
tlie  womb  thoroughly  irrigated  with  some  disinfectant  solution,  like 
thecorroiive  sublimate  solution,  with  carbolic  acid  solution  or  sul- 
pho-naphLlu)l  solution.  If  this  measure,  rejjeated  every  eight  to  twelve 
hours,  doei  not  speedily  correct  the  odor,  lower  the  tempeiature  and 
improve  afifairs  at  once,  a  thorough  curetting  of  the  entire  lining  of 
the  womb  must  bs  made,  as  described  under  womb-diseases  (page 
399)  and  the  organ  daily  irrigated  or  packed  with  iodoform  gauze. 

In  many  cases  the  womb  and  its  l)elonging8  may  have  to  be  re- 
moved entirely.  Blood  tonics  must  be  employed  from  the  first,  and 
the  infection  thoroughly  removed  lest  subsequent  womb  troubles 
'insue. 

The  chief  preventive  of  this  disease  is  extreme  cleanliness  and  care 
in  warding  off  its  causes. 

Puerperal  Convulsions.  —  Eclampsia. 

During  the  latter  part  of  pregnancy,  and  even  during  the  lying-in 
period,  a  pregnant  woman  may  be  suddenly  seized  with  a  convulsion 
from  which  she  may  never  recover  consciousness.  These  fits  gener- 
ally last  a  few  minutes,  and  complete  consciousness  follows  with  a 
terrific  headache ;  from  one  to  a  hundred  more  attacks  may  ensue. 
The  urine  usually  is  found  heavily  loaded  with  albumen,  and  contains 
all  the  evidences  of  serious  kidney  disease. 

Causes.  —  These  disorders  are  supposed  to  be  due  to  the  pressure 
on  the  kidneys  and  its  vessels  by  the  increasing  growth  of  the  child. 
Some  cases,  however,  remain  still  unsatisfactorily  explained. 


I  III'  I 
I 


I 


440 


FEMALE   DISEASES. 


the   womb   must   be    immediately 
pressure  thus  moved  from  the  kidneys. 


To  avoid  any  such  sudden  nurprisea  women  should  have  their 
urine  examined  every  week  or  two  in  the  luttyr  part  of  pregnancy. 

Symptoms.  —  The  disease  is  usually  ushered  in  by  some  slight 
frontal  hoadache,  by  swelling  of  the  feet,  ankles  and  eyelids ;  these 
are  symptoms  of  impending  trouble,  and  precautions  should  at  once 
be  taken  to  ward  off  tue  consequent  disease.  The  urine  becomes 
scanty,  thick  and  smoky ;  the  face  or  eyelids  twitch,  and  soon  the 
fit  comes  on,  superinduced  by  the  large  amount  of  urea  retained  in 
the  blood  in  consequence  of  the  crippled  condition  of  the  kidneys, 
which  normally  throw  off  these  poisonous  products. 

Treatment.  —  In   most  cases 
emptied  of  the  child  and 

which  are  stimulated  to  secrete  freely.  The  fits  are  for  the  time 
being  controlled  by  tlio  inhalation  of  ether  or  chloroform.  Bleeding, 
the  free  use  of  veratrum  viride,  and  the  use  of  chloral  or  even  mor- 
phine will  materially  aid  the  case  toward  recovery. 

It  is  a  very  fatal  disorder  if  left  to  itself,  the  patient  not  infre- 
quently dying  in  tlie  first  convulsion,  after  prolonged  unconsciousness. 

Here  again  the  early  discovery  of  the  disease  will  often  be  sufficient 
to  tui-n  the  tide  in  a  favorable  direction. 

Flooding  and  Hemorrhage. — Placenta  Praevia. 

Sometimes  during  the  latter  months  of  pregnancy  quite  a  little 
hemorrhage  starts  up  from  the  fact  that  the  afterbirth,  which  normally 
is  attached  to  the  side  of  the  womb,  becomes  engrafted  into  the  lower 
segment  so  as  to  cover  the  opening  into  the  womb.  This  latter  is 
often  separated  from  its  moorings  and  considerable  hemorrhage  en- 
sues, which  may  vary  from  a  small  to  an  extremely  large  and  fatal 
amount.  The  physician  should  be  summoned  immediately  and  labor 
induced  at  once,  if  this  condition  is  really  found  to  exist. 

Flooding  after  labor  is  due  to  a  relaxed  womb  or  some  open  blood- 
vessel. The  womb  is  to  be  seized  and  squeezed  together  into  a  small 
mass,  driving  out  clots;  one  teaspoonful  of  ergot  in  a  little  hot  water 
is  to  be  taken,  and  the  foot  of  the  bed  elevated  till  the  arrival  of  the 
doctor. 

Nursing  Sore  Mouth. 

NxTRSiNG  women  sometimes  suffer  terribly  with  this  complaint.  It 
begins  with  a  scalding  sensation  upon  the  tongue,  a  pink  color  in  the 
roof  of  the  mouth,  and  a  hot,  watery  discharge  from  the  mouth. 
After  a  few  days,  small  ulcers  appear  on  the  tongue,  and  in  the 
throat.  Costiveness  is  generally  present ;  but  when  the  ulceration 
extends  to  the  bowels,  diarrhoea  occurs.  It  comes  to  an  end  upon 
weaning  the  child. 

Treatment.  —  To  relieve  costiveness,  give  some  gentle  cathartic 
(12),  (15),  (25),  (84),  (36). 


FKMALE   DISEASES. 


441 


Id  have  their 
i  pregnancy. 

)y  some  slight 
eyelids ;  these 
ihould  at  once 
urine  becomes 
and  soon  the 
ea  retained  in 
f  the  kidneys, 

8  immediately 
n  the  kidneys, 
e  for  the  time 
:m.  Bleeding, 
i\  or  even  mor- 

ient  not  infre- 
nconsciousness. 
^n  be  sufficient 


I  Praevia. 

y  quite  a  little 
which  normally 
I  into  the  lower 
This  latter  is 
hemorrhage  en- 
large and  fatal 
[lately  and  labor 
xist. 

[)me  open  blood- 
ther  into  a  small 
,  little  hot  water 
ae  arrival  of  the 


B  complaint.  It 
)ink  color  in  the 
rom  the  mouth, 
gue,  and  in  the 
1  the  ulceration 
to  an  end  upon 

gentle  cathartic 


Iron  in  some  of  iU  forms  and  combinations  is  hiehlv  necessary 
((il),  (71),  (73),  (849). 

Gargles  will  frequently  do  much  good  (227),  (229),  (230),  (236), 
(243),  (244),  (347),  (350).  ^       ^       '^       ^ 

The  diet  must  l>e  simple,  nourishing,  and  dit  'istible,  consisting  of 
stale  bread,  tender  beefsteak,  broths,  etc. 

Inflammation  of  the  Breast.  —  Broken  Breast.— 

Mammary  Abscess. 

The  mammary  gland,  or  gland  which  secretes  milk  in  the  human 
breast,  coiisists  of  a  number  of  ducts,  passing  inward  from  their  tei> 
mination  in  the  nipple,  and  then  spreading  around 
like  the  roots  of  a  tree,  and  terminating  in  minute 
glands.  The  mammillary  tubes  are  straight  ducta, 
ten  or  twelve  in  number,  having  their  mouths  at 
the  centre  of  the  nipple,  dilating  at  ita  biuso  into 
larger  reservoirs,  which  extend  some  distance  into 
the  gland.     (Fig.  146.) 

When  milk  is  first  formed,  after  confinement, 
these  tubes  and  reservoirs  sometimes  get  so  full 
and  hard  that  they  crowd  and  compress  each  other, 
making  it  difficult  to  remove  the  milk,  and  under 
these  circumstances,  the  breast  will  inflame. 

Symptoms The  inflammation  generally  begins  with  a  chill,  fol- 
lowed by  fever,  and  pain  of  a  shooting  kind,  which  is  much  increased 
by  pressure.  An  examination  will  generally  reveal  a  circumscribed, 
hard,  and  painful  tumor,  even  before  there  is  any  redness  on  the  sur- 
face. After  a  time,  the  swelling  spreads,  the  skin  becomes  of  a  dusky 
red,  is  hot  and  shining,  will  frequently  pit  a  little  on  pressure,  and 
soon  gives  a  sense  of  fluctuation.  TTpon  the  formation  of  matter,  the 
breast  is  enlarged,  and  there  is  local  tenderness  and  throbbing  pain. 

This  complaint  may  be  caused  by  taking  cold,  irregularities  in 
diet,  or  by  mental  emotion  ;  but  more  commonly  it  is  caused  by  ac- 
cumulation of  milk  within  the  ducts  ;  still  more  commonly  by  septic 
matter  from  the  uterus  entering  the  circulation  and  causing  a  local- 
ized blood-poisoning. 

Treatment.  —  These  afflictions  may  generally  be  prevented  by 
keeping  the  breasts  well  drawn.  It  is  the  duty  of  a  nurse  to  look 
well  after  this  matter,  and  see  that  the  breasts  do  not  get  l\rd  and 
distended  with  milk. 

But  when  the  inflammation  has  fairly  set  in,  the  first  aim  should 
be  to  prevent,  if  possible,  the  formation  of  matter. 

Active  purging  should  be  resorted  to  at  once  (29),  (32).  Sweating 
should  be  encouraged  by  the  tincture  of  veratrum  viride.  If  the  ob- 
ject be  to  prevent  the  formation  of  matter,  cold  lotions,  or  cold  water 
compresses  should  be  used  freely  j  but  if  two  or  three  days  have  passed 


FIO.  140. 


•iji; 

lit 


J 


442 


FKMALR   DISEASES. 


before  active  treatment,  tlie  Hiippuration  will  go  on,  and  it  is  better  to 
UHO  warm  upplicutioMt;.  Dewees  nays  wann  vinegar  is  the  most  liene- 
ficial  as  woll  as  the  most  comforting.  Poultices  and  warm  fomentji- 
tions  are  much  used.  Some  apply  Htimulating  linimentH,  made  of 
essential  oils,  etc.  (195),  (198).  Leeches  are  often  used  with  advan- 
Uige.     They  should  he  applied,  not  upon  the  breast,  hut  just  l)elow  it. 

Ddriug  the  2)rogre8s  of  the  disease,  especially  after  the  alwc'ss  is 
opened,  the  breast  should  be  supported,  and  prevented  fiom  hanging 
down,  by  long  strips  of  adliesive  plaster  carried  below  and  around  it. 
liy  this  means  a  gentle  pressure  is  kept  up  by  which  the  matter  is 
more  easily  evacuated. 

The  breast  should  be  opened  with  a  lancet  as  soon  as  the  abscess 
points,  or  fluctuation  is  discovered.  Should  the  ulcer  not  heal,  an 
astringent  wash,  such  as  a  weak  solution  of  nitrate  of  silver  (211), 
may  be  applied  to  it  once  or  twice  a  day. 

During  the  discharge  of  matter,  the  system  of  the  patient  should 
be  supported  by  a  nourishing  diet,  wine,  tonics,  etc.  To  lift  up  the 
breasts,  and  at  the  same  time  gently  compress  them  with  a  gauze  or 
thin  flaimel  bandage,  is  one  of  the  best  methods  of  treatment. 

Sore  Nipples. 

Women  suffering  from  excoriated  nipples  are  apt  to  keep  the  infant 
chiefly  to  the  healthy  breast,  and  only  to  apply  it  to  the  tender  side 
for  the  purpose  of  obtaining  present  ease  from  the  pain  of  over-dis- 
tension. In  this  way  the  ducts  remain  alwa}^  full,  and  are  apt  to 
get  inflamed.  Sore  nipples,  therefore,  are  to  be  attended  to  as  much 
on  account  of  the  evils  to  which  they  lead,  as  of  the  suffering  they 
directly  occasion. 

The  excoriation  of  the  nipples  begines  as  a  chap.  This  shows  no 
tendency  to  heal;  and  the  child's  mouth  being  often  applied,  rubs 
off  the  skin  around  the  crack,  and  this  naked  surface  soon  becomes 
an  ulcer.  These  ulcers  are  sometimes  only  on  the  surface ;  at  other 
times  they  are  profound,  going  deep  into  the  substance  of  the  nipple. 

Treatment.  —  These  excoriations  and  ulcers  might  be  easily  healed, 
were  it  not  that  the  newly-formed  skin  is  apt  to  be  continually  rubbed 
off  by  the  child's  mouth  in  the  act  of  nursing.  Two  things  are  there- 
fore to  be  done,  —  to  favor  the  healing,  and  to  protect  the  tender  part 
from  renewed  injury. 

For  the  first  object,  a  strong  infusion  of  green  tea  or  port  wine  may 
answer  very  well  in  ordinary  cases.  A  little  alum  or  borax,  dissolved 
in  rosewater,  or  water  (201),  (202),  is  often  used.  A  weak  solution 
of  sulphate  of  zinc,  or  sulphate  of  copper,  or  nitrate  of  silver  (209), 
(211).  But  one  of  the  very  best  articles  is  composed  of  glycerine 
and  tannin  (306). 

To  protect  the  nipple  from  injury  in  the  act  of  sucking,  use  a  shield 
made  of  India-rubber.  When  the  infant  is  not  at  the  breast,  the 
nipple  should  be  covered  by  a  shield. 


t  is  better  to 
e  most  bene- 
irin  fomentii- 
iitH,  luiulu  of 
I  with  lulvivn- 
just  ImjIow  it. 
lie  ul)H(""S8  is 
lom  hanging 
ml  around  it. 
the  matter  is 

18  the  abscess 

not  heal,  an 

silver  (211), 

atient  should 
I'o  lift  up  the 
til  a  gauze  or 
tmeut. 


eep  the  infant 
le  tender  side 
n  of  over-dis- 
ind  are  apt  to 
ed  to  as  much 
iufiering  they 

rhis  shows  no 

applied,  rubs 

soon  becomes 

face ;  at  other 

of  the  nipple. 

e  easily  healed, 
inually  rubbed 
lings  are  there- 
bhe  tender  part 

port  wine  may 
QFdx,  dissolved 
L  weak  solution 
if  silver  (209), 
jd  of  glycerine 

ng,  use  a  shield 
the  breast,  the 


MARRIED  LADIES'  PERPETUAL  CALENDAR. 


TiiK  utility  of  those  tablcH.  servinp  us  n  faithful  and  conflrtentinl  friend  in 
matters  <if  urgent  interent,  cannot  fail  of  lieing  perceived.  The  young  and 
newly-married  might  be  spared  an  unpieaHant  amount  of  embarrasHment  by 
consulling  the  Calendar  as  to  the  time  of  conttnement,  which,  in  nclconing 
the  full  period  of  gestation  "280  days  from  conception,  may  be  very  nearly  ap- 
l)roximated;  or,  in  tiio  event  of  the  time  of  conception  l)eing  uncertain,  from 
the  period  of  quickening,  whicli  she  can  usually  note,  she  may  reclton  140 
(lays.  It  will  be  perceived  that  the  Calendar  luus  three  colunuis  of  Hgures,  de- 
noting tlie  days  of  the  months  noted  at  the  head  of  each.  The  first  column 
;^ive9  the  date  of  conception;  the  second,  that  of  the  period  of  quickening; 
and  the  third,  that  of  delivery.  Thus,  if  a  lady  dates  the  period  of  conception 
.lanuary  1,  189((,  quickening  will  occur  May  20,  and  confinement  about  the  8th 
of  October  following;  or,  if  she  is  ignorant  of  the  time  of  conception,  by  con- 
sulting the  middle  column  as  to  the  time  of  quickening,  if  it  occurs  May  20, 
she  may  expect  her  confinement  to  occur  about  the  8th  of  October  following, 
or  140  days  afti^r  tlie  period  of  <|uickening.  The  date  in  the  first  column  is 
that  of  Cvfuception;  the  corresponding  date  in  the  second  column  is  that  of 
quickening;  and  the  corresponding  date  in  tho  third  column  that  of  contine- 
ment. 


Jastjaey. 

Pkbruart. 

March. 

April. 

Vonetp- 

^uut- 

Jkliv- 

Conetp- 

Quiek- 

Veliv- 

Concep- 

Quick- 

Deliv. 

CoKCtp- 

Quick- 

Deliv- 

tim. 

eninQ. 

try. 

tion. 

ening. 

try. 

tion. 

ming. 

try. 

titm. 

ning. 

try. 

•Tan. 

May 

Oct. 

Feb. 

June 

Nov. 

March 

July 

•Dec. 

April 

^?f 

Jan. 

1 

20 

8 

1 

20 

8 

1 

18 

6 

1 

6     . 

2 

21 

9 

2 

21 

9 

2 

19 

7 

2 

19 

7 

3 

22 

10 

3 

22 

10 

3 

20 

8 

3 

20 

8 

\ 

23 

11 

4 

23 

11 

4 

21 

<) 

4 

21 

9 

6 

24 

12 

6 

24 

12 

6 

22 

10 

5 

22 

10 

6 

26 

13 

6 

26 

13 

6 

23 

11 

6 

23 

11 

7 

26 

14 

7 

26 

14 

7 

24 

12 

7 

24 

12 

8 

27 

18 

8 

27 

15 

8 

25 

13 

8 

26 

13 

9 

28 

16 

9 

28 

16 

9 

26 

14 

9 

26 

14 

10 

29 

17 

10 

29 

17 

10 

27 

15 

10 

27 

15 

11 

30 

18 

11 

.30 

18 

11 

28 

16 

11 

28 

16 

12 

31 

19 

July 

12 

29 

17 

12 

29 

17 

June 

12 

1 

19 

13 

30 

18 

13 

30 

18 

i:< 

1 

20 

13 

2 

20 

14 

31 

19 

14 

31 

19 

14 

2 

21 

14 

3 

21 

Aug. 

Sept. 

15 

3 

22 

15 

4 

22 

15 

■ 

20 

16 

20 

10 

4 

23 

16 

6 

23 

16 

2 

21 

16 

2 

21 

17 

5 

24 

17 

6 

24 

17 

3 

22 

17 

3 

23 

18 

6 

26 

18 

7 

25    . 

18 

4 

23 

18 

4 

23 

19 

7 

26 

19 

8 

26 

19 

5 

24 

19 

5 

24 

ao 

8 

27 

20 

9 

27 

20 

6 

26 

20 

6 

26 

21 

9 

28 

21 

10 

28 

21 

7 

26 

21 

7 

26 

22 

10 

29 

22 

11 

29 

22 

8 

27 

22 

8 

27 

23 

11 

30 

23 

12 

30 

23 

9 

28 

23 

9 

28 

24 

12 

31 

Dec. 

24 

10 

29 

24 

10 

29 

Nov. 

24 

13 

1 

26 

11 

30 

26 

11 

30 

25 

13 

1 

26 

14 

2 

26 

12 

31 

26 

12 

31 

26 

14 

2 

26 

16 

3 

Jan. 

Feb. 

27 

16 

3 

27 

16 

4 

27 

13 

1 

27 

13 

1 

28 

l(i 

4 

28 

17 

5 

28 

14 

2 

28 

14 

2 

29 

17 

5 

29 

16 

3 

29 

16 

3 

30 

18 

6 

30 

16 

4 

30 

16 

4 

31 

19 

7 

31 

17 

6 

■m. 


MAKKIKD   LADIR8'    PEBI'KTUAL  CALKNUAK. 


Oaiictp- 
Him 

M«y 

3 
3 
4 

6 

6 

7 

H 

1) 
10 
11 
12 
13 
14 

16 
16 
17 
18 
19 
20 
21 
22 
23 
24 

2fi 
26 
27 
28 
29 
30 
31 


Mat. 

tning. 
Sent. 

17 

18 

19 

20 

21 

22 

23 

24 

25 

2(i 

•n 

28 
29 

:io 

Oct. 
1 
2 
3 
4 
5 
6 
7 
8 
9 
10 

11 
12 
13 
14 
10 
16 
17 


Othr- 
try. 

Fob. 

ft 

6 

7 

H 

9 
10 
11 
12 
13 
14 
IS 
16 
17 
IH 

19 
20 
21 
22 
23 
24 
20 
20 
27 
28 
March 

1 

2 

3 

4 

0 

6 

7 


JUNB. 

Jdlt. 

AUODIT 

Cotiffih 

Quick- 

Dtliv- 

Coticrp- 

Qairt- 

Otlir- 

Conetp- 

(JHiell- 

DtHr. 

ti.m 

minff. 

try. 

lion. 

mlng. 

try. 

lian. 

thinf. 

'•y. 

June 

Oct. 

Marnh 

July 

Nov. 

April 

Aug. 

Deo. 

May 

I 

IH 

H 

1 

17 

7 

1 

IH 

H 

2 

19 

9 

2 

IH 

8 

2 

19 

9 

3 

20 

10 

3 

19 

9 

3 

20 

10 

4 

21 

11 

4 

20 

ao 

4 

21 

11 

0 

22 

12 

0 

21 

11 

0 

22 

12 

6 

23 

13 

6 

22 

12 

6 

23 

13 

7 

24 

14 

7 

23 

13 

7 

24 

14 

8 

20 

10 

8 

24 

14 

8 

20 

10 

9 

26 

16 

9 

20 

10 

9 

26 

1» 

10 

27 

17 

10 

2»i 

16 

10 

27 

17 

11 

2H 

18 

11 

27 

17 

11 

28 

IH 

12 

29 

19 

12 

28 

18 

12 

29 

19 

13 

;«) 

20 

13 

2f» 

19 

13 

30 

20 

14 

31 
Nov. 

21 

14 

30 
Deo. 

20 

14 

31 
Jan. 

21 

1ft 

1 

22 

\li 

1 

21 

10 

1 

22 

16 

2 

23 

16 

2 

22 

16 

2 

23 

17 

8 

24 

17 

3 

23 

17 

3 

24 

18 

1 

20 

18 

4 

24 

18 

4 

20 

19 

0 

26 

19 

0 

2ft 

19 

0 

26 

20 

6 

27 

20 

6 

26 

20 

6 

27 

21 

7 

28 

21 

7 

27 

21 

7 

2H 

22 

H 

29 

22 

8 

28 

22 

8 

29 

23 

9 

30 

23 

» 

29 

23 

9 

;«) 

24 

10 

31 
April 

24 

10 

■M 
May 

24 

10 

31 
June 

2fi 

11 

1 

20 

11 

1 

20 

11 

1 

26 

12 

2 

26 

12 

2 

26 

12 

2 

27 

13 

3 

27 

13 

3 

27 

13 

3 

28 

14 

4 

2H 

14 

4 

28 

14 

4 

'A) 

10 

0 

29 

in 

:, 

29 

15 

5 

30 

16 

6 

30 

16 

6 

■M 

16 

6 

31 

17 

7 

31 

17 

7 

Skptkmbier. 


:.\ 


Conetp- 
tion. 

Sept. 

2 
3 
4 
0 
6 
7 
8 

g 

10 

11 

12 
13 
14 

15 
16 
17 
18 
19 
20 
21 
22 
23 

24 
26 

20 
27 
28 
29 
30 


Quick- 
ning. 

Jan. 

18 

19 

20 

21 

22 

23 

24 

20 

26 

27 

28 

29 

30 

31 

Feb. 
1 
2 
3 
4 
6 
6 
7 
8 
9 

10 
11 
12 
13 
14 
15 

ir> 


Dtlif. 
try. 

June 
8 
9 
10 
11 
12 
13 
14 
10 
16 
17 
18 
19 
20 
21 

22 

23 

24 

20 

26 

27 

28 

29 

30 

July 

1 

2 

3 
4 
0 


T)CTOBKR. 


Conetp- 
lion. 

Oct. 

1 

2 

3 

4 

0 

6 

7 

8 

9 
10 
11 
12 

13 
14 
15 

16 
17 
18 
19 
20 
21 
22 
23 
24 

25 
2() 
27 

;> 

29 
30 
31 


Quick- 
ening. 

Feb. 
17 
18 
19 
20 
21 
22 
23 
24 
26 
26 
27 
28 
March 

1 

2 

3 

4 

0 

6 

7 

8 

9 
10 
U 
12 

13 
14 
15 
16 
17 
18 
19 


Dtliv- 
ery. 

July 

8 

9 
10 
11 
12 
13 
14 
10 
16 
17 
18 
19 

20 
21 
22 
23 
!k 
2-5 
2(5 
27 
28 
29 

;« 

31 
Aug. 
1 
2 

3 
4 
0 
6 

7 


NOVKMBBR. 


Conetp-    Quick- 
lion,      tning. 

Nov.  March 
20 


2 
3 
4 

0 

6 

7 

8 

9 

10 

11 

12 

13 
14 
10 
16 
17 
18 
19 
20 
21 
22 
23 
24 


26 
27 
28 
29 
30 


21 
22 
23 
24 
20 
26 
27 
28 
29 
.30 
31 
April 

1 

2 

3 

4 

5 

6 

7 

8 

9 
10 
11 
12 

13 
14 
15 
16 
17 
18 


Velir- 
try. 

Aug. 

8 

9 

10 

11 

12 
13 
14 
10 
16 
17 
18 
19 

20 
21 
22 
23 
24 
25 
26 
27 
28 
29 
30 
31 
Sept. 

2 
3 
4 
5 
6 


Drcembbr. 


Conctp- 
lion, 

Dec. 

1 

2 

3 

4 

5 

)> 

7 

8 

9 
10 
11 
12 

13 
14 
16 
16 
17 
18 
19 
20 
21 
22 
AS 
24 

25 
2(i 
27 
28 
29 
30 
31 


Quid- 
<nif.(;. 

April 
19 
20 
21 
22 
23 
24 
20 
26 
27 
28 
29 
30 
May 

1 

2 

3 

4 

6 

6 

7 

8 

9 
10 
11 
12 

13 
14 
15 
16 
17 
18 
19 


Driir- 
try. 

Sept. 

8 

9 
10 
11 
12 
13 
14 
16 
16 
17 
18 

19 
20 
21 
22 
23 
24 
25 
26 
27 
28 
29 
30 
Oct 
1 
2 

3 
4 
0 
6 
7 


ammmamttmim^smsaiissnits 


Avovwt. 

etp- 

OMift- 

tUtir- 

an. 

aiiint. 

fy. 

UK- 

Dec. 

May 

1 

18 

H 

a 

19 

9 

a 

ao 

10 

4 

31 

11 

S 

32 

12 

6 

33 

13 

7 

24 

14 

H 

2n 

15 

« 

•ifi 

16 

10 

27 

17 

[1 

28 

18 

12 

29 

19 

[a 

30 

20 

14 

31 
Jan. 

21 

Ifi 

1 

22 

IB 

2 

23 

17 

3 

24 

18 

4 

25 

to 

5 

26 

20 

6 

27 

21 

7 

28 

22 

8 

29 

2S 

9 

;» 

24 

10 

31 
June 

25 

11 

1 

26 

12 

2 

27 

13 

3 

28 

14 

4 

29 

15 

5 

:» 

16 

6 

31 

17 

7 

Drcembbr. 

nrep- 

Qiiirl- 

Driiv- 

ion. 

enihg. 

*ry. 

)eo. 

1 

A)rll 
9 

Sept. 

2 

20 

8 

3 

21 

9 

4 

22 

10 

B 

23 

It 

)> 

24 

12 

7 

25 

13 

8 

26 

14 

9 

27 

IB 

10 

28 

16 

11 

29 

17 

12 

30 
May 

18 

13 

1 

19 

14 

2 

20 

15 

3 

21 

16 

4 

22 

17 

5 

23 

18 

(> 

24 

1!) 

7 

25 

20 

8 

26 

21 

9 

27 

'*•» 

10 

28 

■J.'< 

11 

29 

24 

12 

30 
Oct 

2ri 

13 

1 

26 

14 

<> 

27 

15 

3 

28 

16 

4 

29 

17 

5 

;» 

18 

6 

31 

19 

7 

CAKE  OP  CHILDREN  AND  THEIR 
DISEASES. 


Pure  Air. — The  first  want  of  a  child  is  a  plenty  of  fresh  air;  and 
this  want  never  ceases  to  the  end  of  life.  Impure  air  kills  thousands 
of  infants.  Out  of  7,660  born  in  the  lying-in  hospital  of  Dublin, 
2,944  were  destroyed  by  impure  air  within  two  weeks  after  birth. 

Children  should  be  kept  in  the  open  air  as  muoh  as  possible,  and 
ill  well-ventilated  rooms  when  indooi-s.  It  is  wrong,  when  infants  are 
sleeping,  to  cover  their  faces  with  bedclothes,  or  draw  curtains  around 
their  cots,  or  to  envelop  their  heads  in  blankets  and  shawls  when 
curried  in  the  open  air. 

The  Skin.  —  The  health  of  infanta  requires  that  their  skin  should 
ba  kept  clean.  Unless  this  is  done  they  are  liable  to  suffer  much 
from  cutaneous  and  other  diseases.  The  skin  of  a  new-bom  child 
is  cover:  with  a  white,  unctuous  matter,  called  the  vernix  caseosa. 
It  is  injurious  to  let  this  remain  for  any  length  of  time  after  birth. 
To  remove  tliis,  Dr.  Dewees  recommends  that  the  child  be  smeared 
with  hog's  lard,  and  then  washed  with  soap  and  water.  Dr.  Eberlp 
says,  smear  with  yolk  of  egg,  and  then  wash  with  simple  warm 
water. 

The  young  child  should  be  washed  every  day  with  warm  water,  — 
then,  after  a  time,  with  tepid  water,  then  with  temperate,  and  finally, 
after  it  is  some  months  old,  with  cold  water.  This,  if  persevered  in 
through  childhood  and  youth,  will  ward  off  a  thousand  ills  and  sick- 
nesses to  which  the  young  are  liable. 

The  Clothing:  of  Children  should  be  so  adjusted  as  to  give  their 
limbs  ample  play,  and  should  be  thick  enough  to  keep  them  warm. 
They  ought  to  have  flannel  next  the  skin  in  winter,  and  cotton  in 
summer.  At  the  risk  of  wounding  some  nice  people's  feelings,  I 
must  add  that  the  fashion  of  a  child's  clothes  is  not  important. 

The  Food.  —  The  natural  and  proper  food  of  a  young  child  is  its 
mother's  milk.  To  this  it  should  be  confined,  unless  prohibited  W 
imperative  circumstances,  until  a  portion  of  the  teeth  are  cut.  WL  .. 
the  mother  cannot  nurse  her  child,  the  breast  of  a  suitable  nurse 
should,  if  possibio,  be  supplied.     If  the  infant  need  any  more  food 

445 


11 


StSSSS^^ 


1 


446 


CAUE   OF   CHILDREN    AND   THEIR   DISEASES. 


than  is  supplied  by  the  breast,  give  cow's  milk  and  water,  sweetened 
with  a  little  loaf  sugar.  The  nursing  bottle,  if  used,  must  never  U 
permitted  to  get  sour. 

Health  of  a  Nursing  Woman.  —  During  nursing  the  greatest  at- 
tention  to  health  is  required  by  the  mother  or  the  nurse.  A  woman 
of  a  consumptive  constitution  should  never  nurse  an  infant.  Nour- 
ished at  the  breast  of  such  a  mother,  the  child,  who  has  inherited  her 
constitution,  will  be  the  more  likely  to  fall  a  victim  to  her  disease. 

Passions  of  a  Nursing  Woman.  —  Let  the  woman  who  nurses  a 
young  child  be  careful  of  iier  passions.  An  irritable  disposition,  giv- 
ing rise  to  gusts  of  violent  passion,  may  so  alter  the  character  of  thu 
milk  as  to  throw  the  child  into  convulsions.  Grief,  envy,  hatred,  fear, 
jealousy,  and  peevishness,  unfit  the  milk  for  nourishing  the  child,  and 
often  cause  the  child's  stomach  to  be  much  disordered. 

Tlie  Diet  of  the  Nurse  shouhl  receive  strict  attention.  It  should 
be  plain  and  wholesome,  and  the  amount  should  never  be  excessive. 
Her  drink  should  be  simply  water  and  non-stimulating  and  nourisli- 
ing  drinks  such  as  the  various  preparations  of  cocoa,  etc.  She  should 
take  gentle  daily  exercise  in  the  open  air. 

Wet  Nurses.  —  If  for  any  reason  it  should  be  necessary  to  wean 
the  baby,  or  the  mother  cannot  nurse  the  child,  then  we  must  select 
a  food  the  most  like  that  of  the  mother. 

Wet-nurses  formerly  were  quite  popular  among  the  well-to-do  t« 
supply  this  food ;  but  as  in  her  selection  there  are  so  many  exacting 
requirements,  she  is  fast  becoming  obsolete.  There  are  three  requi- 
sites for  a  good  wet-nurse :  she  must  be  of  good  health,  of  good  moral 
character,  and  be  able  to  supply  plenty  of  good  healthy  milk. 

If  she  has  any  tubercular,  scrofulous,  syphilitic,  insane  or  osseous 
history;  if  she  is  menstruating,  or  pregnant,  or  is  in  anywise  below  par 
in  health,  she  is  necessarily  disqualified  as  a  nurse  for  any  child ; 
only  your  phjreician  may  be  able  to  detect  these  evidences  and  per- 
haps not  even  he.  If,  on  the  other  hand,  she  is  occasionally  given 
to  blues,  has  a  violent  temper,  is  jealous,  or  fretful,  or  worries  about 
har  own  child,  or  goes  into  dangerous^  company  when  away  fi'om  the 
house,  then  you  have  added  a  second  disqualification.  Again,  her 
supply  of  milk  must  be  good  as  shown  by  an  analysis  and  the  healtli 
and  growth  of  her  own  child.  A  nurse  may  pass  muster  to-day  in 
reference  to  this  third  requisite,  but  perhaps  not  in-  a  week  from  to- 
day. 

Seeing  that  the  average  wet-nurse  comes  from  a  lower  stratum  of 
society,  even  if  not  from  the  criminal  class,  that  she  is  in  consequenci; 
more  liable  to  fcquired  disease  and  contagion,  that  she  is  more  than 
likely  to  bring  trouble  into  the  household  rather  than  to  relieve  the 
household  of  it,  it  will  be  extremely  difficult  for  you  to  find  such  a 
person  as  can  furnish  all  the  required  conditions  of  a  safe  wet-nurse. 


mmtMimtm-mimeim 


-t^S;::a;'uj-^Jt.^->i^4-,.^„ 


ESS. 

water,  sweetened 
d,  must  never  be 

[  the  greatest  at- 
lurse.  A  woman 
m  infant.  Nour- 
has  inherited  her 
I  to  her  disease. 

lan  who  nurses  a 
ie  disposition,  giv- 
e  character  of  the 
envy,  hatred,  fear, 
ling  the  child,  and 
fed,  I    ^ 

ntion.  It  should 
iver  be  excessive. 
ting  and  nourisli- 
,,  etc.     She  should 


necessary  to  wean 
3n  we  must  select 

T  the  weil-to-do  to 
so  many  exacting 
re  are  three  requi- 
alth,  of  good  moral 
althy  milk. 
,  insane  or  osseous 
anywise  below  par 
rse  for  any  child; 
jvidences  and  per- 
occasionally  given 
il,  or  worries  about 
hen  away  from  the 
ation.  Again,  her 
ysis  and  the  health 
3  muster  to-day  in 
in-  a  week  from  to- 

a  lower  stratum  of 
le  is  in  consequence 
it  she  is  more  than 
than  to  relieve  the 
you  to  find  such  a 
jf  a  safe  wet-nurse. 


CARE   OF   CHILDREN   AND  THEIR   DISEASES. 


447 


It  has  been  found,  therefore,  that  artificial  feeding  gives  better  satis- 
faction and  is  quite  as  safe. 

Nursing  Bottles.  —  There  are  nursing  bottles  innumerable,  few  of 
which  are  of  practical  value.  A  simple  bottle  with  plain  black  nij)- 
ple  is  all  that  is  requi8\te  for  successful  feeding  cA  the '  hands  of  a 
careful  and  cleanly  mo^Jier  or  nm-se.  The]  •  should  be  several  bottles 
and  several  nipples,  the  latter  to  be  kept  in  soda  water  or  other  sim- 
ple alkaline  solution  when  not  in  use.  A  pinch  of  soda  to  a  cup  of 
water  is  of  sufBcient  strength.  After  a  bottle  lias  been  used  it  should 
be  thoroughly  scalded  with  hat  water  and  soda  and  finally  set  away 
tilled  to  the  brim  with  thi,3  sam'^  solution,  till  later  in  the  day. 
Meanwhile,  a  fresh  bottle  and  /esh  nipple  is  used,  they  having 
tirst  been  cleansed  with  the  above  solution.  The  best  bottle,  how- 
evei,  for  nursing  in  those  cases,  where  for  want  of  time  and  means 
the  bottle  cannot  be  held  by  mother  or  nurse,  is  one  called  "  The 
Best."     See  Figs.  147  and  148,     This  bottle,  like  many  others,  al- 


Fia.  148. 


FlO.  147. 

lows  of  its  resting  on  the  bed;  but,  unlike  many  others,  it  ic  very 
readily  cleansed,  is  of  easy  suction  and  has  a  nipple  which  does  not 
collapse.  The  »  jompanying  cuts  and  description  are  worthy  of  at- 
tention. The  pec'iliar  feature  of  the  bottle  is  a  valve  or  air-inlet 
in  the  end  admitting  air  back  of  the  food,  thus  rendering  suction 
easy.  This  valve  does  not  leak  and  cannot  be  pulled  off  by  the  baby, 
but  is  easily  cleansed  and  adjusted.  Whatever  else  you  may  do  with 
the  bottle,  above  all  things  keep  it  clean,  not  only  to  outward  ap- 
pearances, but  by  actually  scalding  and  soaking  in  soda  solution  up 
to  the  very  time  of  its  use. 

Food  for  Infants.  —  It  has  been  found  that  mother's  milk,  which 
of  course  is  the  best  food  for  babies,  is  composed  on  the  average  of 
the  following  ingredients:  water  87,  fat,  4,  casein  1,  sugar  7,  ash  1, 
and  slightly  alkaline  in  reaction. 

Now,  c'dinary  cow's  milk  has  the  following  composition :  water 
87,  fat  H.  r,  casein  2.9,  sugar  4.9,  ash  .4 ;  it  is  slightly  acid. 


*6^, 


teiiiSwSES 


448 


CARE   OF  CHILDREN  AND  THEIK  DISEASES. 


We  car  therefore  see  that  if  we  take  cow's  milk  and  dilute  it  with 
water  sufficiently,  we  diminish  the  amount  of  caaein  to  that  of 
mother's  milk,  and  by  the  addition  of  cream,  milk,  sugar  and  lime- 
water,  we  raise  these  constituents  to  the  standard  found  in  human 
milk.  This  mixture,  known  among  medical  men  as  the  "Meigs' 
Cream  Mixture,"  is  the  basis  of  all  modern  compouiuls  for  artificial 
feeding. 

Milk,  as  ordinarily  received  from  the  milkman,  swarms  with  bac- 
teria and  germ-life  which,  under  favorable  conditions,  quickly  changes 
the  milk  and  renders  it  unfit  for  easy  and  proper  digestion.  Milk 
from  the  mother  is  devoid  of  these  germs,  or,  as  medical  men  say, 
it  is  sterile.  This  attribute  then  is  in  reality  quite  as  important  as 
the  proper  constituency  of  milk.  The  process  of  making  cow's  milk 
sterile  is  called  sterilization^  of  which  we  will  speak  shortly. 

Temperature  of  Milk. —  Mother's  milk  is  of  the  same  heat  as  the 
body,  or  nearly  so ;  hence  common  sense  dictates  that  the  artificial 
food  must  be  of  that  degree  of  heat,  or,  about  98°  Farenheit. 

Quantity  and  Interval  of  Feedings.  —  The  capacity  of  a  baby's 
stomach  and  the  length  of  time  food  remains  in  it  are  matters  of  ex- 
perience. Herewith  is  appended  a  table  covering  the  general  rules 
of  feeding  infants  and  especially  adapted  to  milk  and  cream  mixture 
of  which  we  will  now  speak. 


GENEEAL  RULES 

FOE  FEEDING. 

aob. 

Inte*val. 
Hours. 

Feedings  in 
24  Hours. 

Amount  at 

each  Feeding. 

Ounces. 

Amount  in 

'2A  Hours. 

Ounces. 

Istweek 

Ist  to  6th  week     .... 
6th  week  to  6th  month  .    . 

At  6  months 

At  10  months 

2 

2i 

3 

3 

3 

10 
8 
6 
6 
5 

1 
lJto2 
3to4 

6 

8 

10 
12  to  Ifi 
18  to  24 

36 

40 

—Dr.  F.  M.  Eotch,  Heating's  Cyc.  Dis,  Children. 

Based  on  the  average  analysis  of  mother's  milk,  i.  e.,  7  parts 
sugar,  4  of  fat,  and  1  of  albuminoids,  we  must  take  :  cream  1 J  ounces, 
milk  1  ounce,  water  6  ounces,  lime-water  ^  ounce,  sugar  of  milk  3 
to  84  drachms. 

The  milk-sugar  is  to  be  obtained  at  the  druggist's.  This  gives  an 
eight-ounce  mixture,  so  that  for  a  baby  four  weeks  old  (see  table) 
we  need  to  take  about  one-half  or  three-fourths  more  of  this  mixture ; 
for  a  baby  six  months  three  times  this  amount,  and  so  on.  For  a 
child  newly  born,  after  the  first  few  days,  when  only  a  little  should 
be  -given,  only  slightly  more  of  these  ingredients  should  be  used  than 
in  above  formula. 

Of  course,  plain  cow's  milk  one-third  part,  with  boiled  wal  r  twn- 
thirds,  will  answer  well  for  many  babies,  if  the  milk  is  steriliztd  and 


CAKK  OF   CHILDREN   AND   THEIR   DISEASES. 


440 


[id  dilute  it  with 
jein  to  that  of 
3ugar  and  linie- 
oiind  in  human 
as  the  "Meigs' 
uls  for  artificial 

warms  with  bac- 
quickly  changes 
iigestion.  Milk 
nedical  men  say, 
as  important  as 
iking  cow's  milk 
shortly. 

same  heat  as  the 
lat  the  artificial 
arenheit. 

icity  of  a  baby's 
re  matters  of  ex- 
he  general  rules 
d  cream  mixture 


nnt  at 

Amonnt  In 

'eeding. 

24  Honra. 

ICM. 

Ouncea. 

1 

10 

to  2 

12  to  Ifi 

»4 

18  to  24 

6 

36 

8 

40 

!yc.  Dis.  Children. 

.k,  i.  e.,  7  parts 
cream  1 J  ounces, 
sugar  01  milk  3 

.  This  gives  an 
s  old  (see  table) 
Bof  this  mixture; 
d  so  on.  For  a 
ly  a  little  should 
>uld  be  used  than 

xtiled  water  twn- 
t  is  sterilizt'd  and 


a  little  sugar  of  milk  and  lime-water  be  added  just  before  feeding ; 
but  tliis  simple  mixture,  while  quite  sufficient  for  the  average  baby, 
will  not  answer  for  all,  nor  is  it  as  good  for  any  as  the  cream  mixture 
given  above.  Should  the  former  cause  green  stools  or  curdy  masses, 
the  latter  must  be  substituted.  This  mixture  is  very  easy  to  prepare, 
as  the  process  of  making  it  sterile  is  very  simple,  and  any  woman  of 
ordinary  care  and  intelligence  can  successfully  carry  on  this  kind  of 
feeding  till  the  eruption  of  the  second  or  fouith  tooi.h,  when  plain 
cow's  milk  diluted  with  an  equal  quantity  of  oatmeal  jelly  and 
sweetened,  may  be  substituted.  This  food  should  be  given  at  fii-st 
once  daily ;  and  later,  twice,  thrice,  and  finally  it  may  be  fed  alto- 
gether on  mi'       'd  oatmeal. 

When  the  <.  teeth,  or  molars,  have  come  through,  then,  for  the 
fu-st  time,  breau,  rice,  and  soft-boiled  egg  may  be  added. 

Oatmeal  jelly  may  be  prepared  by  boiling  a  quarter  of  a  pound  of 
oatmeal,  in  a  quart  of  water,  down  to  one  pint.  This  mixture  is  then 
to  he  diluted  with  an  equal  quantity  of  boiled  water  and  strained 
through  a  cloth.  Should  the  oatmeal  prove  too  laxative  for  the 
child,  barley  jelly  may  be  made  in  the  same  way. 

Sterilization  of  Millc. — We  have  seen  how  much  more  important 
than  the  kind  of  nursing-bottle  that  may  be  selected  is  the  kind  and 
quality  of  food  put  into  that  bottle.  To  complete  our  consideration 
of  the  best  artificial  food,  we  meat  know  how  to  render  the  milk  free 
from  bacterial  life ;  this  process  is  called  sterilization,  and  may  be 
accomplished  in  a  simple  way  as  follows :  into  as  many  bottles,  which 
have  been  previously  scalded  and  cleansed,  as  there  are  to  be  feed- 
ings in  the  twenty-four  hours,  pour  that  quantity  of  the  milk  mixture 
which  is  to  be  given  at  a  feeding;  place  these  bottles,  with  al)sorbent 
cotton  in  the  mouths,  into  a  kettle  filled  with  water  up  to  the  level 
of  the  milk  in  the  bottles,  and  allow  the  water  to  rise  to  170°  Faren- 
heit,  when  the  kettle  is  removed  to  a  warm  part  of  the  stove  and 
covered  for  about  half  an  hour.  The  bottles  should  then  be  kept  in 
a  cold  place  till  used,  when  they  are  to  be  heated  just  sufficiently  to 
correspond  to  the  body  heat.  These  bottles  come  ready  made, 
also  a  rack  in  which  to  rest  them  in  the  kettle.  They  should  be,  in 
reality,  specially  made  bottles,  and  are  to  be  obtained  at  any  drug- 
store. They  are  ready  for  the  baby's  use  after  removing  tlie  cotton  and 
attaching  the  nipple.  One  may,  however,  sterilize  the  entire  feeding 
of  the  twenty-four  hours,  or  for  twelve  hours,  as  thought  best,  in  any 
clean,  thin  bottle  or  jar,  and  pour  out  the  given  amount  required  at 
each  feeding ;  but  there  is  some  danger  of  spoiling  the  st«rilization  by 
so  much  handling.  Should  it  be  desirable  to  prepare  milk  t4)  keep  for  a 
longer  time,  it  will  then  be  necessary  to  sterilize  at  a  greater  heat 
(212°),  and  to  repeat  the  process  two  or  three  times.  Such  milk  is 
supplied  nowada)r8  in  the  larger  cities  by  companies  whn  will  express 
it  daily  to  one's  address.  By  giving  the  age,  quantity  and  kind  of 
feeding  the  baby  ueeds,  these  companies  send  to  you  in  neat  straw 


450 


CARE   OF  CHILDREN   AND   THEIR  DISEASES. 


baskets  the  number  of  bottles  the  baby  will  use  in  the  next  twenty- 
four  hours,  containing  the  quantity  required,  and  of  the  composition 
found  to  agree  best  with  the  baby.  The  Walker-Gordon  Laboratory, 
203  Clarendon  St.,  Boston,  perhaps  is  the  best  known  of  these  insti- 
tutions, as  it  sends  milk  even  to  remote  parts  of  the  country,  and  in 
sufficient  quantities  to  last  for  a  voyage  to  Europe,  and  even  further 
if  needed. 

To  summarize,  then,  in  reference  to  infant  feeding,  first  in  impor- 
tance is  the  mother's  milk ;  second,  the  sterilized  cream  mixture ; 
third,  the  sterilized  milk  and  water;  and  in  later  months,  the  addition 
of  oatmeal  jelly. 

Weaning. — At  the  end  of  twelve  months,  the  first  set  of  teeth  are 
generally  so  far  cut  that  the  child  can  manage  most  kinds  of  plain 
food ;  and  it  may  now  be  taken  from  the  breast.  Should  the  teeth 
appear  earlier,  and  the  infant  be  healthy,  it  may  be  weaned  even  at 
the  end  of  the  tenth  month.  Never  take  the  child  from  the  breast  in 
the  midst  of  summer  heat.  A  disordered  state  of  the  bowels,  or 
cholera  infantum,  would  be  likely  to  be  the  result.  The  spring  and 
the  autumn  are  the  proper  periods  for  weaning. 

If  for  some  months  it  has  been  accustomed  to  other  food  besides 
the  milk  of  the  mother,  it  may  be  taken  suddenly  from  the  breast. 
It  must  not  have  any  amount  of  solid  food  it  may  crave  immediately 
after  weaning.  It  should  still  be  kept,  for  some  time,  upon  a  simple, 
bland,  half-fluid  aliment,  taken  in  moderate  quantities,  and  at  proper 
intervals.  At  first,  the  food  should  be  bread  and  milk,  boiled  rice  and 
milk,  soft-boiled  eggs,  oatmeal  gruel,  plain  rice-pudding,  preparations 
of  arrowroot,  tapioca  and  sago,  simple  meat-broths,  mixed  with 
crumbs  of  bread  or  grated  crackers,  or  in  which  rice  or  barley  has  been 
well  boiled.  From  this  it  may  pass  gi-adually  to  a  more  solid  diet ; 
though,  until  the  age  of  puberty,  the  principal  part  of  the  diet  should 
be  milk,  the  farinaceous  articles,  and  vegetables.  Sugar  has  been 
thought  to  be  injurious  to  children.  It  is  not  so.  If  taken  moder- 
ately, at  meal-times,  it  is  wholesome.  Lately  a  new  form  of  choco- 
late has  come  into  use,  called  Kraft-chocolate,  made  in  Germany.  It 
is  prepared  with  cocoa-butter  and  comes  in  small  cakes,  is  easily  di- 
gested, nourishing,  and  supplies  sweets  in  a  very  acceptable  and 
strengthening  form. 

Whatever  be  the  food  allowed  to  children,  it  should  never  be  taken 
in  excess ;  and  to  prevent  this,  they  ought  not  to  take  their  meals 
alone ;  for  they  have  very  keen  appetites,  and  if  permitted  to  do  so, 
they  will  generally  form  habits  of  gluttony.  Three  or  four  light 
meals  a  day  is  enough. 

Their  drink  should  be  water  simply,  —  nothing  else. 

If  parents  would  observe  these  rules,  and  enforce  them  strictly,  they 
would  confer  blessings  upon  their  children  greater  than  riches.  They 
would  send  them  into  the  world  with  health  and  good  constitutions, 
and  would  save  them  from  untold  misery  and  an  early  death.     Such 


•mm 


illlHll1ll«i,!l)».»WlW 


H!Hiiim.iii'iii<l»»tliHiW»illM>IHiiii 


^■«*t'l»-^ftlH^W  Ki.   iHi  ■^b'Mil 


CARE   OF   CHILDRRN    AND   THEIR   DISEASES. 


4r.i 


!  next  twenty- 
le  composition 
on  Laboratory, 
of  these  insti- 
)untry,  and  iu 
[I  even  further 

first  in  impor- 
eam  mixture; 
18,  the  addition 

set  of  teeth  are 
kinds  of  plain 
)uld  the  teeth 
eaned  even  at 
m  the  breast  in 
bhe  bowels,  or 
"he  spring  and 

r  food  besides 
)m  the  breast, 
^e  immediately 
upon  a  simple, 
,  and  at  proper 
boiled  rice  and 
g,  preparations 
J,  mixed  with 
)arley  has  been 
3re  solid  diet; 
the  diet  should 
ugar  has  been 

taken  moder- 
"orm  of  choco- 

Germany.  It 
3S,  is  easily  di- 
icceptable  and 

never  be  taken 
ke  their  meals 
litted  to  do  so, 
I  or  four  light 


m  strictly,  they 
I  riches.  They 
1  constitutions, 
y  death.     Such 


a  course  would  evince  more  love  for  their  children  than  those  weak 
concessions  which  allow  tea  and  coffee,  and  all  sorts  of  food,  in  quan- 
tities to  suit,  which  occasion  early  disorders  of  the  stomach  and 
bowels,  and  bring  later  derangements  of  the  nervous  system,  with 
all  its  regrets  and  horrora. 

Sleep  of  Children.  —  During  the  first  period  of  its  existence,  an 
infant  sleeps  a  large  portion  of  the  time.  This  is  a  wise  provision  of 
nature.  It  withdraws  the  young  child,  for  a  time,  from  those  outward 
exciting  agents,  which  would  too  nmch  disturb  the  nervous  system 
of  so  tender  a  being.  Whenever  a  young  infant  is  restless  or  wakeful 
much  of  the  time,  we  may  feel  sure  it  has  had  too  much  food,  or  is 
in  some  way  disturbed  by  it,  or  by  tight  clothes,  or  that  some  other 
cause  is  giving  it  uneasy  sensations.  Do  not  make  the  mistake  of 
thinking  the  child  is  hungry  because  it  cries. 

Its  sleep  should  be  the  promptings  of  nature,  and  should  never, 
except  iu  rare  instances,  be  brought  about  by  opiates.  It  is  wrong 
and  sinful  for  a  mother  or  nui-se  to  put  an  infant  to  sleep  with  an 
opiate,  merely  that  she  may  gain  time  for  pleasure,  or  even  for  other 
duties. 

The  Infant  should  be  kept  Warm  while  Sleeping. —  During  the 
fii-st  few  weeks  it  should  '^leep  with  its  mother,  especially  if  the 
weather  be  cold.  After  that,  it  may  be  in  a  cradle  or  cot.  The 
covering  should  be  warm,  but  light,  so  as  not  to  press  heavily  upon 
its  tender  limbs.  If  laid  upon  its  back,  the  fluid  of  its  mouth  and 
throat  may  get  into  the  windpipe,  and  obstruct  the  breathing,  or 
produce  coughing.  It  is  better,  therefore,  to  lay  the  infant  upon  its 
side,  —  taking  care  not  to  produce  distortion  of  the  spine  or  limbs 
by  always  laying  it  upon  the  same  side. 

Children  should  not  be  allowed  to  sleen  either  with  the  aged,  or 
with  siok  persons.  It  is  not  healthful  for  them  to  breathe  the  exhala- 
tions from  the  bodies  of  such.  For  a  somewhat  similar  reason,  some 
kinds  of  plants,  and  flowers  generally,  should  be  excluded  from  their 
sleeping-rooms.  Their  beds  should  be  so  placed  as  to  turn  their 
faces  away  both  from  the  sunlight  which  comes  in  at  the  windows, 
and  from  the  artificial  light  in  the  room. 

They  should  be  taught  to  retire  early  at  night,  and  to  rise  imme- 
diately after  waking  in  the  morning.  This  habit  will  be  worth  much 
to  them  through  life.  Do  not  form  the  habit  of  rocking  the  child  to 
sleep.  After  the  meconeum  has  passed,  the  bowels  of  an  infant 
should  be  opened  from  two  to  four  times  in  twenty-four  hours.  If 
the  stools  are  less  frequent  than  twice  a  day,  or,  if  they  are  lumpy, 
some  gentle  cathartic  is  called  for.  From  one-quarter  to  one-half 
teaspoonful  of  castoria,  or  a  dessert-spoonful  of  mixture  (24),  an- 
swers a  good  purpose.  During  childhood,  the  bowels  should  lie 
moved  once  or  twice  a  day.  When  a  cathartic  is  required,  a  table- 
spoonful- of  mixture  (25),  or  a  teaspoonful  of  (17),  will  be  found 
excellent. 


452 


CARK    OF  CTIILPRFN    ANP   TIIF.IIl   DISEASKS. 


Exercise.  —  During  tho  first  few  weeks  of  an  infiuit's  lifd  it  i'0(iiiircH 
but  little  exeroist; ;  indeed  its  organization  is  not  sufficiently  suttlod 
and  compacted  to  j)ermit  much  without  injury.  A  little  gentle  rul>- 
bing  with  the  hand  over  the  whole  body  is  about  all  it  needs  or  will 
bear.  To  dandle  and  toss  it  about,  and  especially  to  set  it  upright, 
is  injurious  and  wrong.  Its  bones  arc  all  soft,  and  will  not  endure 
to  be  much  twisted  about,  and  its  spine  is  not  stiff  enough  to  bear 
up  the  weight  of  its  head. 

After  a  few  months,  riding  in  a  carriage,  by  a  careful  and  trusty 
nurse,  is  both  a  healthful  and  pleasurable  exercise  for  children. 

Learning  to  Walk.  —  At  the  end  of  the  ninth  or  tenth  month,  a 
child  may  begin  to  learn  to  walk.  It  is  not  safe  to  teach  it  this 
exercise  much  earlier  than  this,  as  the  bones,  being  soft,  may  be 
bent  by  the  weight  of  the  body,  and  the  limbs  be  permanently 
deformed. 

As  soon  as  the  child  has  learned  to  walk  alone,  it  should  be  allowed 
perfect  freedom  of  exercise.  Thenceforward,  the  open  air  is  its  proper 
place  during  the  day ;  and  such  an  unrestrained  use  of  its  limbs  as 
its  own  instincts  may  dictate,  is  its  proper  calling.  For  five  yeara 
after  it  has  learned  to  walk,  it  should  do  little  else  than  to  use  its 
limbs  out  of  doors,  as  it  pleases.  The  books  and  the  school-room 
will  be  in  season  after  that.  First  compact  the  body,  then  bring  out 
the  mind.  The  mind  is  of  no  use  without  the  body, —  the  body  must 
be  developed  first,  or  never. 

Moral  Treatment.  —  We  charge  upon  nature  many  of  the  bad 
passions  which  we  ourselves  implant  in  children.  The  moral  treat- 
ment of  children  is  generally  bad.  We  are  apt  to  begin  by  either 
making  them  our  masters  or  our  slaves.  Sometimes  we  do  both,  — 
allowing  them  to  govern  us  for  a  time,  and  then,  getting  into  a  pas- 
sion, or  a  mood  for  playing  the  tyrant,  we  turn  upon,  and  govern 
them  as  if  we  were  autocrats.  We  submit  to  their  whims  until  we 
grow  irritable,  and  then,  by  way  of  retaliation,  we  compel  them  to 
submit  to  ours. 

This  is  all  wrong.  Children  should  be  governed  always,  but  with 
an  even,  a  gentle,  and  a  loving  hand.  They  should  early  be  sulv 
jected  to  habits  of  self-control,  and  of  regularity  in  eating  and  sleep- 
ing ;  and  should  be  taught  absolute  and  continued  obedience.  All 
this  can  be  brought  about  only  by  firmness,  self-control,  and  great 
gentleness  on  the  part  of  the  parents..  If  they  would-  make  a  child 
cheerful  and  happy  in  its  disposition,  they  must  themselves  be  cheer- 
ful, and  never  let  it  see  anger,  passion,  and  fretfulness,  marring  their 
conduct.  Nothing  is  more  injurious  to  the  health  of  a  child  than  a 
peevish,  complaining,  and  soured  disposition ;  and  these  vices  are 
seldom  acquired,  unless  seen  in  the  lives  of  parents. 


s 


nmmrn 


MH 


■ 


CARE   OF   CHILDREN    AND   THEIR   DISEASES. 


463 


life  it  ro(|niioK 
ciently  sotthid 
tie  gentle  riil>- 
;  needs  or  will 
set  it  upright, 
ill  not  endiue 
nongh  to  bear 

ul  and  trusty 
shildren. 

x;nth  month,  a 
)  teach  it  this 
;  soft,  may  be 
i  permanently 

uld  be  allowed 
air  is  its  proper 
of  its  limbs  as 
For  five  yeai-s 
;han  to  use  its 
lie  school-room 
then  bring  out 
-  the  body  must 

my  of  the  bad 
he  moral  treats 
)egin  by  either 
we  do  both,  — 
ting  into  a  paa- 
on,  and  govern 
vhims  until  we 
ompel  them  to 

Iways,  but  with 
i  early  be  suli- 
iiting  and  sleep- 
jbedience.  All 
itrol,  and  great 
Id-  make  a  child 
selves  be  cheer- 
9,  marring  their 
E  a  child  than  a 
these  vices  are 


How  to  Nurse  Sick  Children. 

As  the  education  of  the  young,  whether  religious,  moral,  or  intel- 
lectual, is  more  important  than  that  of  adults,  so  is  the  care  of  their 
physical  life  of  more  importance.  Death  aims  to  "  out-Herod  Herod," 
and  seeks  the  life  of  all  infants,  male  and  female,  and  in  fact  destroys 
one-half  of  all  below  the  age  of  five  years. 

But  few  know  how  to  train  and  take  care  of  children.  It  is  a  still 
more  rai-e  gift  to  know  how  to  nurse  them  when  sick.  No  person 
can  properly  nurse  sick  children  who  is  in  feeble  health,  or  has  a 
fretful  temper,  or  is  low-spirited:  for  she  can  neither  endure  the 
fatigue,  nor  bear  the  trials,  nor  hear  the  prattle  which  such  a  respon- 
sibility would  bring.  Som^  will  manage  a  well  child  very  well,  who 
are  not  fit  to  have  the  care  of  a  sick  one  ;  for  there  is  a  great  differ- 
ence between  a  child  when  well,  and  the  same  child  when  sick. 
When  well,  and  full  of  fun  and  frolic  and  life,  laughing  and  jump- 
ing and  shouting  aloud  for  very  joy  at  being  alive,  it  is  an  easy  thing 
for  a  person  of  even  a  morose  temper  to  attend  upon  them.  But 
when  sickness  comes,  and  the  child's  playfulness  is  all  laid  aside ; 
when  it  becomes  so  fretful  that  nothing  goes  right  with  it ;  when  it 
cries  to  be  laid  down,  and  then  cries  to  be  taken  up ;  stretches  out  its 
hand  for  drink,  and  pushes  away  the  cup  when  it  is  presented,  — 
apparently  made  more  angry. by  your  attempts  to  serve  it;  — when 
these  things  are  repeated  day  and  night,  until  the  nurse  is  weary  and 
exhausted,  and  even  a  change  of  disease  and  amendment  only  brings 
a  cross  and  fractious  temper,  it  is  only  by  possessing  peculiar  qualifica- 
tions that  the  nurse  can  maintain  an  even  and  unruffled  disposition. 

While  passing  through  such  scenes,  it  is  hard  for  the  nurse  to  re- 
member that  sickness  does  not  destroy  the  little  loving  heart,  but  only 
hides  its  affection  for  a  short  time. 

Signs  of  Disease  in  Cliildren.  —  It  is  important  that  the  nurse  of 
sick  children  should  know  what  to  observe,  and  the  meaning  of  the 
signs  of  disease.  A  baby  has  only  cries  to  express  its  sick  feelings. 
To  one  person,  these  cries  mean  no  more  than  that  the  baby  has  some 
sort  of  illness.  To  another,  with  more  experience  and  better  powers 
of  observation,  they  point  to  the  head,  or  chest,  or  stomach  as  the  dis- 
order. A  baby  with  the  stomach-ache  utters  long,  loud,  and  passion- 
ate cries,  and  sheds  tears  plentifully.  Suddenly  it  stops  for  a  moment, 
and  then  begins  again,  drawing  up  its  legs  to  the  stomach,  and  as  the 
pain  passes  off,  stretching  them  out  again,  and  with  many  sobs,  pass- 
ing off  into  a  gentle  sleep. 

If  there  be  inflammation  in  the  chest,  it  neither  cries  loud,  nor  sheds 
tears,  but  after  every  long  breath  or  hacking  cough,  it  utters  a  short 
cry,  which  is  cut  off  before  it  is  half  finished,  —  apparently  because 
crying  is  painful. 

If  the  disease  be  in  the  head,  the  cries  will  be  sharp,  piercing  shrieks^ 


454 


OARK   OV  CHILDREN    AND   THEIR   DISEASES. 


with  low  monnit  and  tvaih  between.  Or,  there  will  lie  (juiet  dozing', 
inten'upted  by  stiirtliiig  jmuiih. 

When  a  child  is  Uiken  ill,  whatever  the  diHoiuso  which  is  impending, 
there  is  always  a  change  of  some  sort,  whicii  soon  attnicts  attention. 
It  eitlu'i"  loses  its  apj)etitc,  or  is  fretful,  or  soon  tired,  or  sleepy,  or 
restless,  or  thii-sty,  or  has  a  hot  skin,  or,  rather,  has  a  number  of  i\\v.w 
symptoms.  It  vomits,  or  is  purged  or  lx>und  in  its  bowels.  It  loses 
its  merry  laugh  and  cheerful  look ;  it  no  longer  watches  its  mother's 
or  its  nuree's  eye,  as  before,  but  clings  to  her  more  closely,  and  will 
not  be  out  of  her  arms  a  moment.  If  lulled  to  sleep  in  her  arms,  it 
wakes  immediately  on  being  placed  in  its  cot. 

Such  symptoms  often  continue  a  day  or  two  before  it  can  be  de- 
termined what  disease  is  impending.  An  intelligent  nurse  may  do 
much  towards  8olving*the  question.  It  is  frequently  proper  at  such 
times  to  place  the  child  in  a  warm  bath.  When  stripped  for  IIk; 
bath,  it  should  be  carefully  examined  to  see  if  there  is  any  rash  upon 
its  body.  If  it  be  a  rash  from  which  it  is  about  to  suffer,  the  bath 
•will  help  bring  it  out.  The  rash  should  be  looked  for  at  least  every 
twelve  hours,  until  the  nature  of  the  disease  is  determined. 

The  Appearance  of  the  Different  Rashes  may  be  distinguished 
with  a  little  care  and  experience.  Measles  has  a  number  of  (lark-red 
spots,  in  many  places  running  into  each  other,  and  is  generally  seen 
first  about  the  face  and  on  the  forehead,  near  the  roots  of  the  hair, 
and  is  preceded  by  running  at  the  eyes  and  nose,  and  all  the  signs  of 
a  severe  cold.  Scarlet  fever  does  not  show  separate  3pots,  but  pre- 
sents a  general  bright  red  color  of  the  skin,  much  like  a  boiled  lobster. 
At  first  there  is  more  of  it  about  the  neck  and  chest  than  on  the  face, 
and  it  is  preceded  by  a  sore  tlu-oat.  Chicken-pox  is  .attended  by 
fever,  but  not  so  much  running  at  the  nose  and  eyes  as  in  meaales, 
nor  is  there  so  much  cough.  The  spots,  too,  ar.  smaller,  and  are  not 
so  much  run  together ;  and  they  come  out  more  over  the  whole  body. 
They  appear  a  few  hours  earlier  on  the  body  than  elsewhere  ;  and  in 
a  day  or  two  they  are  found  to  be  enlarged,  and  turn  into  little  blad- 
ders of  water  as  big  aa  the  head  of  a  shawl-pin.  (See  table  of  com- 
parison of  these  diseases.) 

And  now  a  few  Words  as  to  what  should  be  Done  in  the  sick- 
room of  a  child.  The  room  should  be  kept  cool^  and  its  temperature 
should  be  measured  by  a  tliermometer.  This  instrument,  when  hung 
away  from  the  fire,  should  show  a  temperature  of  about  60°.  That 
is  about  the  right  degree  of  warmth.  Sick-rooms  are  generally  kept 
too  hot.  The  room  should  be  darkened ;  not  made  totally  dark,  but 
its  light  shaded  down  by  closing  the  outside  blinds,  or  by  dropping 
the  curtains,  so  as  to  give  a  kind  of  twilight ;  and  the  cot  should 
always  be  so  placed  as  to  turn  the  little  one's  face  away  from  the 
light.  The  room  should  be  kept  quiet;  and  this  requires  attention 
in  the  whole  house,  as  well  as  among  the  persons  in  the  room.    Those 


WHiHJ.IUI'1 


CARB  OP  CHILDREN  AND  THETR  lUSEASKa 


455 


e  quiet  doziiip, 

h  is  impending, 
nicttt  iittciition. 
d,  or  sleepy,  or 
lumber  of  these 
)wel8.  It  loHeH 
lies  it8  mother's 
losely,  and  will 
)  in  her  arms,  it 

re  it  can  be  de- 
t  nurse  may  do 
•  proper  at  siuli 
itripped  for  the 
i  any  rash  upon 
suffer,  the  biitli 
)r  at  least  every 
tuined. 

le  distinguished 
iber  of  <lark-red 
8  generally  seen 
lots  of  the  hair, 
[  all  the  signs  of 
I  jpots,  but  pre- 
I  a  boiled  lobster. 
;han  on  the  face, 

is  .attended  by 
es  as  in  measles, 
Her,  and  are  not 

the  whole  body, 
lewhere ;  and  in 

into  little  blatl- 
lee  table  of  coni- 


one  in  the  sick- 
its  temperature 
lent,  when  hung 
bout  60°.  That 
•e  generally  kept 
totally  dark,  but 
,  or  by  dropping 
the  cot  should 
e  away  from  the 
equires  attention 
the  room.    Those 


present  should  never  whisper,  but  speak  in  low  and  gentle  tones, — 
.sliDiild  not  walk  on  .tip-toe,  !)ut  move  about  carefully.  There  is  a 
fi(»Hi/  ({uietnens  wliich  disturbs  the  sick  far  more  than  noise.  The 
child  must  be  spoken  to,  and  roused  from  its  slumbers,  and  turned 
from  side  to  side,  and  raised  for  its  food  or  medicine,  with  a  soothing 
lenderness,  and  a  delicacy  which  never  forgets  itself. 

In  applying  leeches  or  cold  to  a  child,  judgment  is  needed  to  suc- 
ceed well.  The  leeches  should  be  put  either  behind  the  ear  or  on  top 
of  the  head,  so  that  the  child  cannot  see  them.  Cold  is  best  applied 
by  means  of  a  couple  of  ice-lmgs,  half  filled  with  powdered  ice,  and 
wrapped  in  two  large  napkins ;  one  of  them  should  be  placed  under 
the  child's  head,  the  corner  of  the  na{)kin  being  pinned  to  the  pillow- 
case to  prevent  its  being  disturbed,  while  the  other  is  allowed  to  rest 
upon  tlie  head,  with  the  corner  of  the  napkin  again  pinned  to  the 
pillow,  to  take  off  the  greater  part  of  its  weight.  In  this  way  the  child 
will  not  be  wetttid,  or  irritated,  as  by  the  changing  of  wet  cloths, 
nor  will  the  cold  applications  get  displaced  by  its  movements. 

A  word  should  be  said  respecting  the  nurping  of  children  in  cases 
of  lung-inflammation,  —  an  affection  from  which  they  often  suffer. 
The  lungs  are  much  like  two  large  sponges,  and  the  air  enters  them 
tlirough  the  windpipe  ;  and  passing  through  smaller  and  yet  smaller 
tul)es,  it  comes  at  last  into  tiny  cells,  so  small  that  they  can  only  be 
seen  by  a  magnifying  glass.  When  the  lungs  are  inflamed,  some  of 
the  tubes  become  stopped  up;  and  the  very  small  cells  are  pressed 
on  by  the  flow  of  more  blood  than  natural  to  the  part ;  and  so  the 
air  enters  less  easily,  and  in  smaller  quantities,  than  it  should.  If 
now  you  let  the  child  lie  flat,  it  is  not  only  less  able  to  draw  a  deep 
breath,  and  fill  the  lungs,  but  the  blood  also  flowing  to  the  inflamed 
portion  of  the  lung,  returns  less  easily  than  if  the  child  were  propped 
up  in  bed.  When  a  whitlow  is  on  the  finger,  if  the  hand  be  hung 
down,  the  inflamed  finger  will  become  redder,  and  will  beat  and 
throb  so  as  hardly  to  be  endured,  while,  if  the  hand  be  raised,  the 
pain  will  abate.  The  same  increase  of  pain  does  not  foUov,"  an  accu- 
mulation of  blood  in  an  inflamed  lung,  because  the  lung  is  not  as 
sensitive  as  the  finger ;  but  the  consequences  are  very  serious.  The 
air-cells  being  more  and  more  pressed  upon,  the  admission  of  air  is 
more  and  more  difficult,  until,  at  length,  a  large  part  of  the  lungs  is 
rendered  useless,  and  the  child  dies. 

In  this  disease,  the  temperature  of  the  room  needs  attention.  The 
air  should  not  be  quite  so  cool  as  in  other  diseases.  From  60°  to  65" 
is  about  rig'nt. 

Of  course  crying  will  irritate  inflamed  lungs,  and  it  is  all  important 
that  a  child  sick  with  this  disease  should  be  soothed  and  quieted  as 
much  as  possible.  Every  good  nurse  knows  how  to  do  this  better 
than  any  rules  can  teach  her. 

Sometimes  sickness  and  vomiting,  from  which  a  child  may  suffer, 
are  increased  by  want  of  judgment  in  giving  food  and  drink.     When 


i; 

i'i 

?! 


466 


CARE  OF  CIianRKN    AND    THEIR   DIHRASER. 


there  in  niuisea,  the  HtomiK^h  will  licnr  only  very  Hiinll  qitaiititioH  of 
food  at  a  time,  while  cold  drinks  are  alnioHt  always  lK>rn(!  niU(;h  IhiI- 
ter  than  warm.  When  there  is  nausea,  it  is  In^st,  for  an  hour  or  two, 
not  to  attempt  to  give  any  food  or  drink.  After  the  Htomach  has  iHtuu 
thus  completely  rested,  give  a  single  teaspoonful  of  cold  water.  If 
this  is  not  thrown  up,  it  may  Ik<^  succeeded,  in  ten  or  fifteen  minutes, 
by  n  second  or  a  third.  If  this  is  Imrne,  give  a  little  water  thickened 
with  isinglass,  or  cold  barley-water,  or  cold  milk  and  water;  and 
then,  with  the  same  precautions,  and  in  very  small  quantities,  beef 
tea,  or  chicken  broth,  or  whatever  else  the  doctor  in  attendance  nmy 
direct.  The  small ness  of  quantity,  the  coldness  of  the  articles,  and 
the  giving  it  without  moving  or  disturbing  the  child,  if  possible,  are 
the  important  points  to  he  attended  to. 

It  is  of  great  consequence  that  children  suffering  from  diarrlia;a 
should  have  their  skin  kept  very  clean.  The  pores  should  Ikj  kept 
well  open,  so  that  the  fluid  matter  which  is  passing  off  by  the  bowels, 
and  through  the  mucous  membrane  or  inner  skin,  may  be  diverted  to 
the  outer  skin.  In  this  disease,  the  skin  of  children  is  apt  to  become 
irritable,  or  even  sore.  In  these  cases,  soap  and  water  are  quite  apt 
to  increase  the  soreness,  while  a  little  starch,  made  as  for  use  upon 
clean  clothes,  though  much  thinner,  will,  if  used  in  place  of  soap, 
very  much  soothe  the  inflamed  skin. 

A  child  much  exhausted  by  diarrhoea,  or  other  disease,  should  Iw 
moved  or  lifted  out  of  its  cot  or  cradle  as  little  as  possible.  Sud- 
denly, moving  it  when  very  weak  may  cause  fainting,  or  even  con- 
vulsions. Let  it  bo  sponged  and  cleaned  by  merely  turning  it,  with 
great  gentleness,  from  side  to  side. 

In  such  cases,  too,  the  child  should  be  supported  with  proper  nour- 
ishment. When  worn  down  by  diarrhoea,  its  desire  for  food  may  l)e 
nearly  lost.  Though  at  one  time  it  cried  much,  ar  1  seemed  to  suffer, 
it  will,  in  this  condition,  grow  quieter,  and  doze,  and  even  sleep  on 
for  hours,  appearing  fretful  only  when  roused.  If,  in  such  canes,  the 
child  be  allowed  to  go  without  food  because  it  does  not  seek  it,  or 
declines  it  when  offered,  it  will  sink  into  a  deeper  and  deeper  sleep, 
and  finally  into  a  stupor  which  will  end  in  death.  To  give  a  little 
arrow-root,  or  broth,  may  now  require  trouble  and  perseverance  ;  but 
it  must  be  done,  for  upon  it  depends  the  child's  life.  The  effort  to 
administer  food  must  not  be  abandoned  because  once  or  twice,  or 
several  times  unsuccessful,  for  the  food  which  is  refused  one  minute 
may  be  accepted  five  minutes  after. 

In  the  various  rashes  from  which  children  suffer,  there  is  a  very 
general  fear  of  washing  the  surface  lest  the  rash  be  driven  in.  There 
is  no  ground  for  this  fear,  unless  it  be  in  measles ;  and  even  in  this 
complaint  there  is  no  danger  if  lukewarm  water  be  used.  If  only  a 
small  part  of  the  body  be  sponged  at  a  time,  there  is  nothing  to  fear 
even  from  frequent  washing ;  and  the  passing  of  a  wet  sponge  fre- 
quently over  the  surface  is  a  great  comfort  when  the  skin  is  burning 


wmawjawaw  iiiwMi'>iy<Muua 


OARR    OF  CHII.nRRN    AND   TIlRIIl    niHRARK8. 


487 


quiuititicH  of 
rn!  nuu!h  1h;1- 

lutur  or  twn, 
iDich  hiis  been 
>ld  water.  If 
teen  tninuteH, 
iter  thickeiu;(l 
d  water;  and 
lantities,  Ix'of 
tendance  may 
9  articles,  and 
f  possible,  are 

;rom  diarrhoea 
lould  he  kept 
by  the  Ixiwels, 
be  diverted  to 
apt  to  become 
•  are  quite  apt 
for  use  upon 
place  of  soap, 

lase,  should  be 
jossible.  Sud- 
,  or  even  con- 
uming  it,  with 

;h  proper  nour- 
)r  food  may  be 
emed  to  suffer, 
even  sleep  on 
such  caitcs,  the 
not  seek  it,  or 
1  deeper  sleep, 
0  give  a  little 
severance ;  but 
The  effort  to 
ce  or  twice,  or 
jed  one  minute 

there  is  a  very 
riven  in.  There 
id  even  in  this 
led.  If  only  a 
nothing  to  fear 
vet  sponge  fre- 
skin  is  burning 


willi  fever.  Tlu)  sanio  remark  applies  to  the  changing  of  tlm  linen. 
■|"ht'  Hiimt'  kind  of  objoction,  and  witli  no  lHitt4T  reason,  is  ofU'n  urged 
against  cohl  water  in  feveix,  tliough  it  is  nioht  refresliing,  and  if 
taken  in  small  <juantities,  and  often,  never  does  harm,  Init  often  much 
good. 

The  Warm  Bath.  —  The  In^st  method  of  giving  a  child  a  warm 
liiitli  is  a  nuitter  of  importance.  There  should  Iw  as  little  parade 
iilK)ut  it  as  possible.  If  the  child  sees  the  batl<  prepared,  is  taken  out 
of  k'd,  undressed  and  put  into  it  smoking  l)efore  its  eyes,  it  may  Im) 
imich  alarmed,  and  cry  so  passionately  as  to  bo  really  injured  by  it. 
Tlio  bath  should  be  prepared  out  of  its  sight,  and  brought  to  tlie  bed- 
side with  a  blanket  spread  over  it  to  liide  the  steam.  The  child 
should  then  be  laid  upon  the  blanket,  and  gently  let  down  into  tlio 
water,  and  then  set  to  play  witli  a  couple  of  corks  with  feathera  stuck 
in  them. 

Inflammation  of  the  Mouth. — Ery thematic  Stomatitis. 

This  is  a  simple  inflammation  of  the  mucous  membrane  of  the 
mouth,  and  is  very  common  during  infancy.  It  may  l)e  confined  to 
the  tongue,  or  spread  over  the  whole  mouth.  It  is  sometimes  very 
severe,  going  down  into  the  gullet  and  stomach,  and  into  the  wind- 
pipe. It  occasions  redness  and  pain  in  the  mouth  and  fretfulness  of 
the  infant,  causing  it  to  quit  the  nipple  suddenly  when  nui-sing.  A 
frequent  result  of  tliis  inflammation  is  the  secretion  and  exudation 
upon  the  surface  of  a  white,  matter-like  curd.  It  appears  in  small 
points  and  patches.  This  is  the  thrush,  or  what  nurses  call  children's 
sore  mouth.     It  is  commonly  confined  to  the  period  of  suckling. 

Treatment. —  For  the  simple  inflammation  of  the  mouth,  a  wash 
made  by  infusing  the  inner  bark  of  slippery  elm  in  water  answers  a 
good  pui-pose ;  and  .n  more  severe  caDos,  a  wash  made  of  sugar  of 
lead  (227)  will  hp  found  useful. 

In  some  mild  cases  of  curdy  exudation,  this  last  wash  will  do  well, 
if  united  with  the  daily  use  of  the  warm  Imth,  and  i)roper  care  of  the 
diet.  But  in  the  more  severe  cases,  a  little  pulverized  borax  and 
white  sugar  or  honey  (274),  (275),  placed  occasionally  on  the  in- 
fant's tongue,  will  do  good  service.  A  decoction  of  equal  parts  of 
hlue  cohosh  and  golden  seal  is  a  good  remedy.  When  the  curdy 
patches  are  large,  touch  them  with  a  mixture  of  hydrochloric  acid 
and  honey  (276).  If  the  exudation  have  a  look  as  if  mortification 
were  taking  place,  use  a  wash  of  chloride  of  lime  (228),  or  chloride 
of  soda,  etc.  (229),  or  creosote  and  mucilage  (230),  or  alcohol  and 
vinegar  (231),  or  nitrate  of  silver  (211).  When  diarrhoea  is  present, 
with  acidity,  give  (26).  In  tl.  ~  more  severe  cases,  when  appearances 
of  mortification  are  seen,  quinine  (69)  should  be  administered. 


468 


CARK   OF   CiilLUKKN    AND   THKIK   DIHKAMKH. 


Follicular  Inflammation  of  the  Mouth. —  Aptlmr. 

This  diHoiwe  iittiickH  tlio  little  glantlH  of  the  mouth,  eiilleil  I'oUich'H, 
and  nppeai-s  alK)Ut  the  time  of  cutting  teeth.  Small  white  HpeclcH,  a 
little  elevated,  lirat  show  themselves  on  the  lip8,  iiwides  of  the  cheek.s, 
and  under  side  of  the  tongue,  etc.  The  specks  enlarge,  a  whitish, 
curdy  matter  flows  out  from  their  centre,  and  ulcers  are  formed,  witli 
elevated  edges,  surrounded  hy  a  red,  inflamed  circle.  Sometiiiics, 
instead  of  curdy  matter,  a  bloody  exudation  takes  place,  and  dark- 
colored  crusts  are  formed  which  are  mistaken  for  mortiflcation.  In 
bad  cases,  there  is  great  restleHHiiesH,  with  hot  mouth,  dry  skin,  thirst, 
and  diarrhcea,  with  green  stools,  and  sometimes  salivation. 

Treatment.  —  The  milder  forms  of  this  disease  are  treated  like 
simple  inflammation  of  the  mouth.  If  there  is  thirst,  give  several 
times  a  day,  a  spoonful  of  cold  water,  with  a  little  gum  arable  dis- 
solved in  it.  If  the  child  Iw  weaned  at  this  time,  its  food  sliould  Im 
barley  or  rice-water,  sweetened  with  white  sugar.  An  occasioniil 
dose  of  magnesia,  with  or  without  a  little  rhubarb,  will  remove  the 
acid  wluch  alxjunds  in  the  bowels.  After  ulceration  has  taken  place, 
l)orax  (274)  wi''  do  well.  When  watery  discharges  from  the  bowels 
and  griping  pains  appear,  preparation  (28)  should  be  used.  If  the 
strength  be  reduced,  give  (69). 

Inflammation  of  the  Qums. —  Gengivitis. 

During  the  cutting  of  teeth,  the  gums  are  apt  to  be  inflamed,  red 
or  livid,  swelled  and  painful.  The  child  is  languid,  with  a  hot  and 
dry  skin,  small  and  quick  pulse,  little  appetite,  much  thirst,  and  a 
tongue  covered  with  a  thick,  yellowish  fur.  When  ulceration  takes 
place,  and  is  allowed  to  go  on,  the  teeth  become  loose,  black,  and 
rotten,  and  often  soft  and  pulpy;  a  flow  of  fetid  spittle  takes  place, 
the  breath  of  the  child  becomes  offensive,  and  its  countenance  pale 
and  callow.  The  gums  bleed  under  the  least  pressure,  and  a  profuse 
diarrhoea  fills  up  the  list  of  ills. 

Treatment. — In  the  first  stages,  mild  washes  to  the  gums,  such  as 
(^227),  will  do  well.  Clear  out  the  bowels  at  once  with  magnesia  and 
rlmbarb  (26).  After  ulceration  has  taken  place,  use  oak-bark  (232), 
or  chloride  of  lime  (227),  or  diluted  hydrochloric  acid  (233).  A 
daily  tepid  bath.  If  the  strength  be  reduced,  use  an  infusion  of 
Peruvian  bark,  or  quinine  (69). 

Qcngrene  of  the  Mouth.  —  Canker.  —  Cancrum  Oris. 

This  disease  attacks  weakly  childi-en,  of  a  lymphatic  temperament, 
and  having  inflamed  gums.  It  often  follows  intermittent,  reiriittent, 
or  bilious  fever,  and  is  also  frequently  connected  with  disease  of  the 
stomach  and  bowels. 


,;?fes;»Lia»iK-*»»,(Sfft%;it?A>w-.j%«i(n.i^^ 


■.IVi    I  I 


CAUK   OF   CIIILDRKN    AND   THKIK    DIHKASKH. 


460 


I. —  Aptlini\ 

called  foUic'li'K, 
white  HptickH,  a 
i  of  the  cheeks, 
trge,  a  whitish, 
10  formed,  with 
0.  SometimcH, 
lace,  and  dark- 
irtiflcution.  la 
dry  skin,  thinit, 
,tion. 

tre  treated  like 
8t,  give  several 
fum  arabi(!  dis- 
tood  sliould  liu 
Au  occaHional 
will  rwmove  the 
las  taken  place, 
rom  the  bowels 
9  UBed.    If  the 


Symptoms. —  It  is  attended  with  languor,  listleHsncHS,  indispoHition 
to  play  or  move  alH)ut,  thirHt,  1oh8  of  apiMJtito,  peevishncHH,  and  ina- 
hility  to  Hleep.  The  countenance  Ih  pale  and  Hunken,  and  there  in  a 
peculiar  puckering  of  the  checks  about  the  corneni  of  the  mouth. 
The  breath  is  bad,  the  gums  have  the  app(;amnce  of  Halivation,  the 
teeth  jjccome  loose  and  fall  from  their  sockets,  or,  if  they  remain,  they 
h(M:ome  covered  witli  a  thick  coating  of  a  dirty  white  o.  ash  coloi-. 
A  few  ash-colored  water-pimples  apjxMir  upon  the  gums,  whifsh  en- 
large, »un  together,  and  finally  break,  presenting  a  black  appearance 
of  mortification.  The  gangrene,  sooner  or  later,  goes  to  the  lips  and 
cheeks. 

Treatment. — When  bowel  complaints  exist,  the  re  to  lie  treated 
with  *ho  usual  -emedies,  such  as  (70)  or  (16(J).  If  there  be  active 
inflammation  Ci  the  gums,  at  first,  leeches  may  l>e  applied,  after 
which,  the  inflammation  being  subdued,  a  wash  of  oak-bark  (232) 
will  be  in  place,  with  quinine  given  internally  (Olt)  to  ward  off  the 
mortification.  As  a  wash,  too,  a  strong  solution  of  sulphate  of  cop- 
per (284)  is  excellent;  so  is  white  vitiiol  (285),  and  nitrate  of  sil- 
ver (219),  and  creosote  (28(5). 

The  diet  should  bo  beef-tea,  plain  beef  or  mutton  broth,  with  rice, 
milk  and  rice,  tapioca,  sago,  and  the  like. 


xgwitis. 

be  inflamed,  red 
with  a  hot  and 
3h  thirst,  and  a 
ulceration  takes 
oose,  black,  and 
tie  takes  place, 
(untenance  pale 
a,  and  a  profuse 

e  gums,  such  as 
h  magnesia  and 
oak-bark  (232), 
acid  (233).  A 
an  infusion  of 


"Hancrum  Oris. 

ic  temperament, 
ttent,  reiTiittent, 
h  disease  of  the 


Difficult  Teetli-Cutting. 

Tbeth<!U  f TING  generally  begins  between  the  ages  of  five  and 
seven  months.  It  is  indicated  by  redness,  heat,  and  tenderness  of 
the  gums,  an  increase  ol  oaliva,  and,  occasionally,  redness  of  the 
cheeks,  watering  of  the  eyes,  thirst  and  fever,  with  fretfulness,  dis- 
turbed sleep,  and  more  frequent  motions  of  the  bowels,  a  little  more 
fluid  than  usual,  and  sometimes  of  a  greenish  hue.  As  the  tooth 
comes  near  the  surface,  the  child  holds  its  fingers  in  its  mouth  and 
presses  the  gums  harder  upon  the  nipple  when  nursing.  Beside 
these  milder  symptoms,  there  are  sometimes  ulceration  of  the  mouth, 
gangrene,  extensive  and  long-continued  diseases  of  the  bowels,  and 
even  disorders  of  the  brain,  convulsions,  and  palsy. 

Treatment.  —  Watch  the  gums,  and  the  moment  they  are  swollen 
by  the  teeth  pushing  them  up,  lance  them  at  the  elevated  points,  cub- 
ting  entirely  down  to  the  advancing  teeth,  —  so  that  no  tough  mem- 
brane  shall  cause  pain  by  impeding  their  growth.  These  incisions 
often  prevent  fatal  disease  of  the  brain,  and  sometimes  almost  in- 
stantly relieve  the  most  threatening  symptoms.  Before  the  teeth 
are  far  enough  advanced  for  lancing,  some  soothing  wash  may  be 
applied  to  the  gums,  or  a  leech  or  two  to  the  angle  of  the  jaw.  For 
obstinate  diarrhoea,  with  watery  .'itools  and  griping,  use  prescription 
(157).  If  the  child  be  drowsy  and  starts  from  sleep,  .and  has  heat 
and  redness,  with  enlargement  of  the  blood-vessels  about  the  head, 


■Hri 


460 


CAKE   OF  CHILDREN    AND   THEIR   DISEASES. 


put  three  or  four  leeches  behind  the  ears,  and  make  cold  applications 
to  the  head.  At  the  same  time,  open  the  bowels  with  castor-oil  (17). 
When  there  is  difficulty  of  passing  the  water,  give  flax-seed  tea ;  and 
if  the  pain  be  considerable,  a  sedative  (351) ;  one  half  teaspoonful 
in  as  much  water,  every  hour  till  quiet. 

Croup. 

This  is  one  of  the  scourges  of  childhood.  Croup  is  an  inflamma- 
tion of  the  mutious  membrane  of  the  laiyug.  and  windpipe.  It  causes 
a  peculiar  fluid  to  flow  out  upon  the  surface  of  the  membrane,  which 
stiffens  into  a  membrane,  or  skin-like  substance  and  adheres  to  the 
inner  surface  of  the  windpipe,  and  sometimes  extends  through  the 
whole  of  the  bronchial  tubes.  This  is  membranoua  croup,  —  the  worst 
and  most  fatal  form  ot  the  disease.  The  ordinary  form  of  croup  con- 
sists in  a  congestion  of  the  vocal  chords  with  oedema  and  swelling,  so 
that  the  voice  is  very  husky  and  the  cough  very  much  like  a  hoarse, 
tight  bark.  This  form  is  the  result  of  cold,  and  is  usually  quickly 
amenable  to  treatment,  although  it  is  really  quite  frightful  for 
parents  to  hear. 

The  Symptoms  of  croup  are,  difficulty  of  breathing,  hoarseness, 
and  a  peculiarly  loud  and  ringing  cough,  with  fever.  In. the  mem- 
branous and  worst  form  of  the  disease,  the  breathing  is  not,  at  first, 
so  laborious,  and  the  symptoms  generally  not  so  violent  and  alarm- 
ing as  in  the  less  fatal  but  more  inflammatory  type.  This  latter  kind, 
though  generally  causing  great  alarm,  like  a  highway  robber,  by  the 
sudden  fierceness  with  which  they  seize  the  throat,  are  yet  much 
less  fatal,  and  of  course  less  to  be  feared,  than  the  membranous  form. 
The  disease  is  pretty  much  confined  to  children  between  the  ages  of 
^  one  and  eight  years. 

Treatment  — The  mild  and  ordinary  form  of  croup,  so  frequently 
experienced  by  young  children  at  night  time,  is  usually  much  allevi- 
ated by  small,  oft-repeated  doses  either  of  the  syrup  or  of  the  wine 
of  ipecac,  say  five  drops  (for  a  >hild  two  years  old)  every  fifteen 
minutes,  till  nausea,  and  even  vomiting  ensue,  then  much  less  often. 
The  inhalation  of  steam,  and  of  many  of  the  medicated  vapors,  is  an 
excellent  method  of  treatment  for  the  older  children.  One  tea- 
spoonful  of  the  compound  tincture  of  benzoin  in  a  bowl  of  boiling 
water  inhaled  through  a  tin  funnel  is  a  very  simple  thing  and  a  very 
efficacious  one;  this  is  to  be  repeated  every  twenty  minutes.  In 
cases  which  do  not  yield  to  this  treatment  at  once,  the  employment 
of  turpeth  mineral,  in  one-half  to  one-grain  doses  every  half-honr  till 
the  child  vomits,.will  clear  up  almost  any  severe  case.  The  accom- 
panying bronchitis  which  often  follows  is  to  be  treated  as  laid  down 
for  that  disease.  Membranous  croup  is  in  reality  diphtheria,  and  is 
to  be  so  treated,  the  exudation  being  in  the  windpipe  rather  than  m 


"'^'^?a''^'i''?i5f'VS-'^'Si#'i-'-^iti^'j'^^ 


-^mt 


CARE   OF   CHILDUEN    AND    THEIR  DISEASES. 


4t>l 


old  applications 
castor-oil  (17). 
x-«eed  tea ;  and 
lalf  teaspoonful 


is  an  inflamma- 
pipe.  It  causes 
lembrane,  which 
adheres  to  the 
ds  through  the 
>up,  —  the  worst 
•m  of  croup  con- 
and  swelling,  so 
jh  like  a  hoarse, 
usually  quickly 
»   frightful   for 

ling,  hoarseness, 
.  In. the  niem- 
g  is  not,  at  first, 
)lent  and  alarm- 
rhis  latter  kind, 
y  robber,  by  the 
t,  are  yet  much 
3mbranous  form, 
iveen  the  ages  of 

ip,  so  frequently 
illy  much  allevi- 
3  or  of  the  wine 
id)  every  fifteen 
much  less  often, 
ted  vapors,  is  an 
dren.  One  tea- 
,  bowl  of  boiling 
thing  and  a  very 
ity  minutes.  In 
the  employment 
ery  half-hour  till 
se.  The  accom- 
ited  as  laid  down 
iphtheria,  and  is 
pe  rather  than  in 


the  throat.  As  soon  as  the  case  is  diagnosed,  the  child  is  to  be  quar- 
antined in  a  room  by  itself,  and  all  the  precautions  taken  against 
spreading  the  disease  that  would  be  employed  in  diphtheria  proper. 
The  newly-discovered  antitoxin,  with  which  the  world  has  now  been 
blessed  for  a  year  or  two,  has  already  saved  hundreds  and  thousands 
of  lives  by  its  timely  use.  Nothing  is  simpler,  nothing  more  effica- 
cious, and  nothing  less  deleterious.     (See  Diphtheria,  pagb  485.) 

The  inhalation  of  the  vapor  of  water-slacked  lime  softens  the 
membrane  and  causes  the  little  one  to  breathe  with  more  ease. 
Place  a  bucket  under  a  tent  made  with  a  sheet  spread  over  the  crib, 
into  this  bucket  put  a  piece  of  lime  the  size  of  a  turnip,  and  gradu- 
ally add  a  Uttle  water.  The  fumes  produced  are  not  hard  to  bear, 
but  an  adult  should  also  get  under  the  tent,  so  that  the  little  one 
will  not  be  frightened.  Keep  the  room  warm,  with  plenty  of  moisture 
in  the  air.  Liquid  diet  which  is  very  concentrated,  like  beef-extracts, 
milk  and  egg,  etc.,  with  stimulants,  should  be  given  every  two  houi-s. 
Support  the  strength  and  heart  by  simple  tonics  like  quinine,  one- 
half  grain  in  powdered  sugar,  or  in  a  tiny  pill,  every  two  hours. 

Spasm  of  the  Glottis.  —  Laryngismus  Stridulus. 

This  disease  consists  in  a  sudden  shutting  up  of  the  glottis,  or 
passage  to  the  windpipe,  which  creates  a  feeling  of  strangulation, 
/ind  a  difficulty  of  breathing-  so  great  that  the  drawing  in  of  the 
breath  causes  a  peculiar  crowing  sound.  There  is  no  fever.  The 
child,  upon  taking  food  or  drink,  or  upon  being  irritated  or  teased,  is 
taken  suddenly  with  an  impossibility  of  drawing  in  its  breath.  After 
struggling  convulsively  for  a  time,  its  head  thrown  back,  its  nostrils 
dilated,  its  mouth  open,  its  eyes  rolled  up,  its  face  pale,  its  legs  and 
arms  stiff,  it  begins  to  breathe  with  a  shrill  crowing  sound.  The 
disease  is  sometimes  mistaken  for  croup,  and  for  hoopmg-cough.  It 
is  strictly  spasmodic  in  its  nature. 

Treatment.  —  During  the  paroxysm,  set  the  child  in  an  upright 
posture,  with  the  head  leaning  foi-ward,  exposed  to  a  full  draft  of 
cool,  fresh  air,  and  sprinkle  cool  water  upon  the  face.  Let  nothing 
be  tight  about  the  neck.  Slap  the  child  slightly  on  the  lt?-ck,  and 
apply  friction  along  the  spine.  If  these  means  do  not  succeed,  place 
it  in  a  warm  bath ;  while  in  the  bath,  sprinkle  cold  water  on  the  face. 

When  the  fit  is  over,  examine  the  gums.  If  they  are  swollen,  lance 
them  down  to  the  coming  teeth.  The  bowels  should  be  moved  daily 
with  some  gentle  physic,  but  not  irritated  by  severe  purging.  If  the 
stools  are  light-co:..jd,  use  the  following  prescription:  Podophyllin, 
one-half  grain,  alcohol,  one  ounce,  elixir,  one  ounce,  and  take  a  tea- 
spoonful  in  a  teaspoonful  of  water,  three  times  daily. 


mamssssBoassm 


tssisssms^memmsiimmi 


462 


CARE   OF  CHILDREN   AND   THEIR   DISEASES. 


^  Whooping  Cough. — Purtussis. 

This  is  a  contagious  disease,  peculiar  to  childhood,  and  occurring 
but  once  in  the  same  individual.  It  is  characterized  by  a  convulsive, 
paroxysmal  cough,  which  is  attended  by  long-continued  hissing,  con- 
vulsive breathing,  with  rattling  in  the  windpipe,  which  is  succeeded 
by  several  short  efforts  to  expel  the  breath,  following  each  other  in 
quick  succession.  The  long,  convulsive  breathing,  attended  by  the 
whooping  sound,  is  immediately  repeated ;  and  these  paroxysms  con- 
tinue unJl  a  quantity  of  thick,  slimy,  ropy  mucous  is  thrown  up,  by 
expectoration  or  vomiting,  when  the  breathing  is  again  free.  These 
paroxysms  have  all  the  appearance  of  impending  suffocation,  redness 
of  the  face,  shedding  of  teara,  sweating  about  the  head  and  forehead, 
and  such  agitation  of  tlie  whole  body  that  the  child  lays  hold  of 
something  for  support.  Blood  sometimes  stjirts  from  the  nostrils, 
and  the  child  involuntarily  passes  water  or  evacuates  the  bowels.  In 
spring  and  autumn  the  disease  most  prevails.  It  is  not  generally 
dangerous. 

Treatment.  —  First  give  an  emetic,  —  say,  two  drams  of  wine  of 
ipecac.  Afterwards,  give  small  doses  of  ipecac  and  sulphur  (277). 
From  six  to  fifteen  grains  of  sulphur  alone,  three  times  a  day,  is  an 
excellent  remedy,  A  liniment  of  olive  oil,  oil  of  amber,  etc.  (193), 
applied  to  the  spine,  is  useful.  Belladonna  (278)  is  a  good  remedy. 
Prussic  acid  (96)  is  strongly  recommended  by  many,  and  is  worthy 
of  a  trial.  Lobelia  (106)  is  a  valuable  remedy.  Alum  (279)  is  well 
recommended.  Sulphuric  ether,  a  little  being  spilled  in  the  nurse's 
hand  and  held  to  the  child's  nose,  generally  shortens  the  paroxysm, 
and  frequently  abridges  the  disease.  A  solution  of  nitric  acid  in 
water,  as  strong  as  lemon-juice,  and  sweetened,  is  a  very  valuable 
remedy,  breaking  up  the  disease  in  two  or  three  weeks;  The 
child  may  drink  it  freely,  a  little  further  reduced  with  water.  In- 
halations of  cresoline  are  the  most  useful  to  abridge  aftd  soften  the 
paroxysms. 

There  are  remedies  by  the  legion  that  have  from  time  to  time  been 
used  against  whooping  cough,  but  few  of  them  have  survived  their 
infancy.  Among  the  more  modern  drugs  bromoform  still  holds  a 
prominent  place.  Given  in  one  to  six-drop  doses  in  a  tablespcwnful 
of  water,  three  times  a  day,  and  gradually  increased  to  five  and  ten 
drops,  respectively,  the  drug  exerts  a  marked  impression  on  the 
duration  and  severity  of  the  disease.  Antipyrin,  in  five-  to  ten-gi-ain 
doses,  according  to  age  of  child,  given  three  or  four  times  daily, 
mitigates  the  paroxysm  and  shortens  the  disease.  The  burning  of 
cresoline,  a  coal-tar  product  obtainable  at  all  drug-stores,  is  a  most 
valuable  means  of  cutting  short  the;  disease.  This  liquid  should  l)e 
put  in  a  tin  box-cover  and  set  over  a  lamp  with  very  small  blaze,  — 
just  sufficient,  in  fact,  to  evaporate  the  cresoline.     A  lamp  for  the 


1 


CAKE   OF  CHILUUKN  AND   TIIEIK   UISKASES. 


463 


and  occuriinp 
r  a  convulsive, 
i  hissing,  cnn- 
h  is  succeeded 
each  oilier  in 
tended  hy  the 
laroxysms  con- 
thrown  up,  hi- 
ll free.  These 
ication,  redness 

I  and  forehead, 
id  lays  hold  of 

II  the  nostrils, 
;he  bowrels.    In 

not  generally 

anis  of  wine  of 
sulphur  (277). 
nes  a  day,  is  an 
ber,  etc.  (193), 
a  good  remedy. 
r,  and  is  worthy 
m  (279)  is  well 
I  in  the  nurse's 
s  the  paroxysm, 
f  nitric  acid  in 
a  very  valuable 
le    weekSi     The 
ath  water.     In- 
i  and  soften  the 

me  to  time  been 
e  survived  their 
rni  still  holds  a 

a  tablespoonful 
to  five  and  ten 

)ression  on  the 
five-  to  ten-grain 
our  times  daily, 

The  burning  of 
jtores,  is  a  most 
liquid  should  he. 
Y  small  blaze,  — 

A  lamp  for  the 


purpose  comes  with  the  cresoline,  but  any  ordinary  lamp  with  ser- 
rated lamp-chimney  may  just  as  conveniently  be  used.  The  odor 
is  strongly  tarry.  The  vapor  should  be  confined  in  the  sleeping 
chamber  at  night,  but  may  also  be  burned  both  night  and  day. 

Looseness  of  the  Bowels. — Diarrhea. 

Infants  and  children  are  more  liable  to  diarrlupa  than  adults,  and 
this  is  the  reason  for  speaking  of  the  disease  here  as  well  as  else- 
where. It  may  be  caused  by  inflammation  of  the  stomach  and 
bowels,  by  irritation  produced  by  too  much  or  improper  food,  by  cold 
and  damp  weather,  or  by  teething.  The  discharges  from  the  bowels 
may  be  more  or  less  thin,  of  a  dirty  white  color,  of  a  curdled  appear- 
ance and  acid  smell,  or  they  may  be  watery,  yellow  or  green  in  color, 
and  often  mixed  with  blood.  Sometimes  they  are  mixed  with  por- 
tions of  undigested  food,  are  very  acid,  and  when  the  looseness  has 
been  caused  by  unripe  vegetables  and  fruit,  in  a  state  of  fermentation, 
like  yeast.  At  other  times,  especially  while  teething,  they  are  a  kind 
of  thick  mucus,  like  jelly. 

If  pressure  on  the  bowels  causes  pain,  the  diarrhoea  is  the  result  of 
inflammation.  When  the  disease  has  become  chronic,  the  skin  is  dry, 
harsh,  and  discolored,  the  face  wrinkled,  looking  yellowish,  dirty, 
and  old. 

Treatment.  — First,  regulate  the  diet.  This  is  very  important. 
In  the  case  of  older  children,  take  away  every  kind  of  solid  food,  as 
well  as  pastry,  confectionery,  sweetmeats,  and  fresh  vegetables.  Give 
plain  boiled  rice  and  milk,  —  sometimes  boiled  milk,  —  water  gruel, 
crackers  and  milk,  tapioca,  etc.  At  the  beginning  of  the  attack,  give 
some  mild  physic,  as  ct..  "^or  oil,  or  syrup  of  rhubarb.  A  warm  bath 
at  this  period  is  excellent.  If  the  discharges  are  very  sour,  dissolve 
a  teaspoonful  of  bicarbonate  of  soda  in  half  a  tifmbler  of  water,  and 
give  a  teaspoonful  every  hour,  or  the  same  amount  of  lime-water, 
mixed  with  an  equal  quantity  of  new  milk,  or  prepared  chalk  and 
ipHcac  (158),  some  slight  astringent  being  used  also  (159).  But 
better  than  all  other  astringents  for  this  complaint  is  a  decoction  of 
tlie  eranesbill  or  spotted  geranium  with  milk,  or  of  the  bark  from 
the  root  of  the  common  blackberry,  which  is  armed  with  strong 
prickles. 

The  Summer  Complaint  of  Infants.  — Cholera  Infantum. 

This  is  confined  to  the  North  American  continent.  It  occurs  in 
large  cities  during  the  hot  season.  Its  subjects  are  infants  between 
the  ages  of  four  and  twenty  months,  —  occurring  most  frequently 
about  the  time  of  cutting  the  fii-st  teeth.  It  is  one  of  the  most  fatal 
diseases  of  infants. 

Symptoms.  —  It  begins  with  a  profuse  dian'ha>a, — the  stools  being 


HW 


MMIMBMBiiBMfhmgiafiii«»w.1f-W«BSS« 


464 


CABE   OF  CHILDREN  AND   THEIR  DISEASES. 


green  or  yellow,  or  more  often  light  colored,  and  very  thin.  The 
stomach  soon  becomes  very  imtable,T-  rejecting  everything  with 
violence.  In  some  cases,  vomiting  and  purging  set  in,  —  the  dis- 
charges from  the  bowels  being  without  color  or  smell.  The  infant 
rapidly  loses  flesh,  and  is  soon  reduced  to  great  languor  and  prostra- 
tion. The  pulse  in  the  beginning  is  quick,  small,  and  often  tense. 
The  tongue  is  covered  with  a  white,  slimy  mucus.  The  skin  is  dry 
and  harsh.  The  head  and  belly  are  hot.  The  feet  and  hands  are 
either  of  the  natural  temperature,  or  cold.  There  is  great  thirst,  and 
towards  evening,  fever.  The  belly  is  .-iten  a  little  swollen,  and 
tender  to  the  touch.  Occasionally  there  is  delirium,  as  indicated  by 
wild  and  bloodshot  eyes,  violent  tossing  of  the  head,  and  attempts  to 
bite  and  scratch  the  nurse. 

Treatment.  —  If  possible,  remove  the  child  at  once  from  the  im- 
pure and  heated  air  of  the  city  to  the  cooler  and  purer  air  of  the 
country.  Or  better,  take  it  to  the  seashore  or  a  short  trip  on  the  salt 
water.  This  will  often  give  immediate  relief.  Be  careful  the  child 
does  not  take  cold.  If  this  cannot  be  done,  keep  it  in  as  large  and 
dry  a  room  as  can  be  had,  and  take  it  often  into  the  open  air  in  clear 
weather.  Confine  the  infant  entirely  to  the  breast,  or,  if  weaned,  let 
its  food  be  tapioca,  pure  arrow-root,  rice  flour  and  milk,  and  put  it 
daily  in  a  warm  or  tepid  bath,  according  as  the  skin  is  hot  or  cold. 
Give  it  gum-water,  or  rennet  whey,  with  a  little  gum-arabic  added 
to  it. 

These  measures,  if  used  early,  will  often  cure  the  disease,  without 
medicine.  If  the  vomiting  be  obstinate,  camphor  and  sulphuric 
ether  (280)  will  generally  give  relief.  When  everything  else  fails, 
in  relieving  the  sickness,  sugar  of  lead  (160)  is  generally  successful. 
When  the  vomiting  is  stopped,  the  most  prompt  remedy  for  the  dis- 
ordered bowels  is  the  compound  syrup  of  rhubarb  and  potassa. 
When  the  disease  has  become  chronic,  treat  it  the  same  as  children's 
diarrhoea.  But  if  the  discharges  are  sour,  offensive  and  dark  colored, 
pulverized  charcoal  (42),  with  tartrate  of  ivon  (71),  will  be  suitable 
remedies.  Rhubarb,  lept  ^diin,  etc.  (28),  will  often  answer  a  good 
purpose.  4 

Colic. 

Infants  are  very  much  subject  to  colic,  from  over-feeding  and 
consequent  acidity  of  the  stomach,  from  giving  them  solid  food  at 
too  tender  an  age,  and  from  some  improper  thing  eaten  or  drunk  by 
the  mother  or  nurse.  They  often  suffer  intensely  from  these  pains, 
tossing  their  legs  up  and  down,  and  screaming  vehemently.  When 
it  arises  from  costiveness,  the  bowels  are  often  hard  and  swollen. 

Treatment. — When  it  arises  from  costiveness,  give  an  injection 
of  a  tablespoonful  of  castor-oil,  and  a  half-ounce  of  warm  infusion  of 
peppermint  or  spearmint.  At  the  same  time,  administer  internally 
an  infusion  of  one  of  the  same  herbs,  with  a  small  portion  of  bicar- 


S8. 


CAKE   OF   CHILDREN   AND   THEIR   DISEASES. 


406 


very  thin.  The 
Dverything  with 
et  in,  —  the  dis- 
lell.  The  infant 
juor  and  prostra- 
and  often  tense. 
The  skin  is  dry 
it  and  hands  are 
great  thirst,  and 
tie  swollen,  and 
,  as  indicated  by 
,  and  attempts  to 


bonate  of  soda  dissolved  in  it,  and  sweetened  with  loaf  sugar.  Or, 
if  the  bowels  need  to  be  acted  upon,  the  syrup  of  rhubsirb,  ir  the 
sweet  tincture  of  rhubarb,  with  a  little  soda  in  it,  will  do  well.  Para- 
goric  generally  brings  relief,  but  should  not  be  used,  if  simple  car- 
minatives will  answer  tlie  purpose.  Children  are  often  relieved  by 
covering  them  with  a  hot  flannel,  laying  them  upon  the  belly  on  the 
knee,  and  trotting  them,  at  the  same  time  tapping  them  gently  upon 
the  back.  This  should  be  done  cautiously ;  for  if  unsuccessful,  it 
might  increase  the  suffering ;  and  the  infant  has  no  language  but 
screams  to  tell  its  distress.  Five  drops  of  aromatic  spirits  of  ammo- 
nia, with  same  amount  of  spirits  of  lavender,  in  warm  water,  relieve, 
if  often  repeated,  most  cases. 


nee  from  the  im- 

purer  air  of  the 
rt  trip  on  the  salt 

careful  the  child 
t  in  as  large  and 

open  air  in  clear 
or,  if  weaned,  let 

milk,  and  put  it 
in  is  hot  or  cold, 
jum-arabic  added 


e  disease,  without 
)r  and  sulphuric 
rything  else  fails, 
lerally  successful, 
smedy  for  the  dis- 
arb  and  potassa. 
same  as  children's 
and  dark  colored, 
),  will  be  suitable 
en  answer  a  good 


over-feeding  and 
bhem  solid  food  at 
saten  or  drunk  by 
from  these  pains, 
hemently.  When 
d  and  swollen. 
,  give  an  injection 

warm  infusion  of 
ninister  internally 
11  portion  of  bicar- 


Falling  of  the  Bowel.  —  Prolapsis  Ani. 

In  cases  of  long-continued  looseness,  the  lower  bowel  of  children 
sometimes  gets  so  weakened  that  it  drops  down,  and  projects  through 
the  fundament.  Occasionally,  only  the  mucous  membrane  which 
lines  it  comes  down,  in  the  shape  of  a  small  tumor,  causing  a  sense 
of  bearing  down  and  smarting.  These  fallings-down  occur  when  the 
child  goes  to  stool.  Whether  it  be  the  bowel  or  the  lining  membrane 
which  has  come  down,  if  it  be  allowed  to  remain  long  down,  inflam- 
mation will  take  place,  and  to  return  it  will  then  be  very  diflicult. 

Treatment.  —  Place  the  child  upon  his  back,  and,  having  smeared 
the  thumbs,  or  forefingers,  with  lard  or  sweet  oil,  press  them  gently 
upon  the  tumor  in  such  direction  as  shall  t(Mid  to  return  it  within  the 
body.  If  this  does  not  succeed,  push  the  forefinger  into  the  gut,  so 
as  to  relax  the  circular  muscle  which  contracts  upon  and  holds  it.  If 
the  falling  is  caused  by  straining  at  stool,  made  necessary  by  costive- 
ness,  some  ripe  fruit  stewed  in  molasses,  or  rye  hast3'-pudding  and 
molasses,  should  be  given  to  the  cliild  daily,  and  it  should  be  caused 
to  empty  the  bowels  while  standing  up.  To  strengthen  the  bowel, 
few  things  are  better  than  cold  water,  applied  to  the  fundament 
several  times  a  day.  An  astringent  wash  of  oak-bark  (232 )  is  also 
valuable.  Should  the  bowel  become  so  much  relaxed  that  these 
means  fail,  a  tight  bandage  must  be  applied  to  support  the  funda- 
ment. Be  careful  that  some  ignorant  pretender  does  not — as  has 
happened  —  apply  the  ligature  or  the  knife,  and  cut  off  the  tumor, 
instead  of  returning  it  into  the  body.  Feed  upon  the  simplest  of 
liquid  food. 

Qastric  Fever  of  Infancy. 

The  inflammatory  affections  of  the  bowels,  which  happen  after 
teeth-cutting,  are  frequently  accompanied  by  remittent  fever,  —  the 
fever  showing  itself  very  distinctly  towai'ds  evening,  and  subsiding, 
or  nearly  disappearing,  in  the  morning.     It  is  a  sympathetic  fever, 


466 


CARK   OK   t!llll,l)KKN    ANI»   THKIk    DISKASES. 


and  is  generally  the  result  of  a  reaction  produced  by  inflammation  of 
the  stomach,  or  ileum,  or  colon.  The  attack  is  sometimes  siifkleii, 
though  generally  gradual. 

Symptoms. — For  several  days,  the  child  will  be  languid  and 
fretful,  with  loss  of  appetite,  increased  thirst,  and  some  heat  of  skin. 
Towards  night  these  symptoms  are  more  intense ;  the  skin  is  more 
hot,  the  thirst  and  restlessness  ai"e  greater,  the  pulse  more  rapid.  In 
the  morning,  the  skin  is  more  moist  and  cool,  and  the  child  falls  into 
a  short,  disturbed  sleep.  Early  in  the  attack,  the  bowels  are  consti- 
pated, —  though  there  is  sometimes  diarrhtea,  or  a  frequent  desire  to 
go  to  stool  without  mucli  being  passed.  The  evacuations  are  always 
umiatural  and  very  offensive.  They  are  dark-colored,  or  clay-like,  or 
of  the  consistency  of  tar,  —  sometimes  mixed  with  mucus,  and  occa- 
sionally with  blood.  There  is  tenderness  of  the  belly,  and  pressure 
upon  it  causes  pain.  It  is  also  hot  to  the  touch,  while  the  feet  aie 
cold.  The  face  is  flushed,  and  the  breath  has  a  decidedly  sickly 
smell.  The  stomach  is  irritable,  and  vomiting  is  frequent.  The 
tongue,  after  a  time,  becomes  coated,  diy,  and  pointed. 

In  the  chronic  form  of  the  disease,  there  is,  frequently,  diarrhea, 
the  passages  being  unhealthy  and  fetid  ;  the  tongue  is  covered  with 
a  brownish-yellow  mucus,  the  gums  with  sores ;  the  lips  are  parched 
and  cracked ;  the  urine  is  scanty  and  high-colored,  with  a  white  sedi- 
ment; the  skin,  dry,  harsh,  and  dirty-looking;  the  countenance  con- 
tracted and  wrinkled ;  and  there  is,  frequently,  a  dry,  hacking  cough. 

Treatment.  —  Regulate  the  diet.  This  is  important.  In  recent 
and  acute  cases,  withhold  all  food,  except  some  cold  mucilaginous 
fluid  to  drink,  as  rice-water,  gum-water,  infusion  of  slippery-elm  bark, 
or  milk  diluted  with  baiiey-water.  Give  a  warm  or  tepid  bath  daily. 
Purgatives  should  be  used  iparingly.  The  bowels,  when  costive,  had 
better,  generally,  be  opened  by  injections  of  tepid  water,  or  thin 
gruel.  If  any  laxative  be  used,  let  it  be  the  compound  rhubarh 
powder,  or  either  of  the  following  (28),  (281).  When  the  discharges 
have  become  healthy,  and  the  tongue  clean  and  moist,  some  light 
bitter,  as  the  infusion  of  Peruvian  bark,  or  calumba,  in  combination 
with  diluted  sulphuric  or  hydrochloric  acid,  may  be  given.  These, 
carefully  given,  with  the  daily  tepid  bath,  and  exercise  in  the  open 
air  will  soon  restore  the  strength. 


Mesenteric  Disease. 

This  attacks  scrofulous  children  between  the  ages  of  three  and 
ten  years.  Its  symptoms  are  a  prominent  belly  and  loss  of  flesh,  — 
particularly  upon  the  arms  and  legs.  To  be  able  to  feel  the  enlaigi'l 
and  hardened  glands  through  the  walls  of  the  belly  is  the  surest 
sign  of  this  disease.  When  the  complaint  is  long-continued,  the 
child  loses  all  its  flesh,  and  dies  in  almost  a  complete  skeleton  state. 


DARK   OF  CHILDREN   ANP   THEIR   DISEASES. 


467 


nflammatiDii  of 
letimes  sudden, 

be  languid  and 
me  heat  of  skin. 
he  skin  is  more 
more  rapid.    In 
5  cliild  falls  into 
jwels  are  consti- 
■equent  desire  to 
itions  are  always 
id,  or  clay-like,  or 
mucus,  and  occur 
Uy,  and  pressure 
vhile  the  feet  are 
decidedly  sickly 
I  frequent.     The 

,ed. 

uently,  diarrhoea, 
.e  is  covered  with 
B  lips  are  parched 
with  a  white  sedi- 
countenance  con- 
i-y,  hacking  cough. 

prtant.     In  recent 
3old  mucilaginous 
slippery-elm  bark, 
r  tepid  bath  daily, 
when  costive,  hiui 
id  water,  or  thin 
ompound  rhubarb 
len  the  discharges 
moist,  some  hght 
ba,  in  combination 
)e  given.     These, 
ercise  in  the  open 


ages  of  three  and 
md  loss  of  flesh,  — 
to  feel  the  enlargv-'l 

belly  is  the  surest 
long-continued,  the 
ilete  skeleton  state. 


Treatment.  —  If  there  is  inflammation  or  other  disorder  in  tlie 
Htomach  or  bowels,  attend  to  this  fii-st.  Tlicn  put  the  patient  on  a 
generous  diet,«ach  as  meat-broths,  etc.  Give  bicarbonate  of  potassa, 
dissolved  in  the  infusion  of  calumba  or  (luivssia,  and  when  there  is 
costiveness,  add  rhubarb  to  the  preparation.  For  tlio  enlargement 
of  the  glands,  apply,  externally,  an  ointment  (1^-^)  of  the  iodide  of 
lead,  or  of  the  iodide  of  potsissium  (185).  Give  an  ioduretted  bath, 
daily,  which  is  formed  by  adding  one  grain  of  iodine  and  two  grains 
of  iodide  of  potassium  to  each  gallon  of  warm  water. 

The  syrup  of  iodide  of  iron  should  be  given,  internally,  three  times 
a  day,  in  a  little  water,  or  the  iodide  of  p()t4is8ium,  and  compound 
infusion  of  gentian.  Daily  sponging  the  body  in  salt  and  water,  and 
exercisL  in  the  open  air,  are  important. 

Rickets. 

This  is  also  a  disease  of  scrofulous  children.  By  some  defective 
process  of  nutrition  in  such  children,  there  does  not  enter  into  the 
hones  enough  phosphate  of  lime  to  harden  them,  and  the  weight  of 
the  body,  or  the  pulling  of  the  muscles,  o\  the  pressure  of  the 
clothing,  bends  and  distorts  them  in  all  manner  of  ways.  The  heads 
of  the  thigh-bones  are  pushed  nearer  together,  making  the  lower  belly 
narrow;  the  backbone  is  so.  curved  as  to  lessen  the  height;  the 
slioulder-blades  stand  up  like  wings  when  flying  is  contemplated  j 
and  the  shoulders  are  so  lifted  up  that  the  head  seems  only  a  little 
higher  than  the  elevations  on  each  side. 

Treatment.  —  A  good,  generous,  wholesome  diet,  properly  regu- 
lated ;  out-door  exercise ;  the  tepid  or  cold  salt-water  sponge-bath, 
with  friction,  and  but  little  medicine.  The  hypophosphite  of  lime, 
in  two-grain  doses,  given  in  a  little  sweetened  water,  three  times  a 
day,  or  the  syrup  of  the  hypophosphites,  in  half-teaspoonful  doses, 
three  times  a  day,  may  be  given  with  advantage.  The  pyrophosphate 
of  iron,  combined  with  the  lime,  makes  a  good  tonic  for  scrofulous 
cliildren. 

The  Blue  Disease.  —  Cyanosis. 

This  disease  is  known  by  a  blue,  purple,  or  leaden  tinge  over  the 
whole  body.  The  warmth  of  the  body  is  reduced,  there  is  difficult 
breathing,  which  is  increased  by  quick  motion  or  by  crying.  The 
disease  is  generally  fatal.  The  blueness  is  occasioned  either  by  the 
passage  between  the  right  and  left  side  of  the  heart  remaining  open 
after  birth,  so  as  to  let  the  blue,  venous  blood  run  through  and  mix 
with  the  red  arterial  blood,  thus  making  the  whole  blue,  or  by  the 
obstruction  of  the  pulmonary  artery,  which  withholds  the  blood  from 
the  lungs,  and  does  not  allow  it  to  be  arterialized  and  reddened.  This 
latter  opinion  is  the  more  general  one  now. 


468 


CARK    OF   ClIlLnKKN    AND   THEIU    PIRKASES. 


Treatment.  —  Keep  the  patient,  as  muoh  as  jioHHible,  in  a  Htatt'  of 
rest,  HO  that  the  circuhition  may  not  Ik;  hniried.  Allovv  pure,  frcsl. 
air,  easily-digested  food,  and  protect  the  bn.ly  fron.  c^old  and  damp- 
ness.  Hold  the  infant  near  the  fire,  and  apply  gentle  friction  over 
the  head  and  body  with  a  warm,  soft  cloth. 

Fits. 

Most  persons  have  seen  a  baby  in  fits;  anr^.  it  is  a  sad  sight,— its 
little  face  all  distorted  and  livid,  its  eyes  rolling  and  squinting  fright 
fully ;  its  hands  clenched,  arras  bent,  legs  drawn  up,  body  arched 
backward,  and  limbs  twitching  violently,  —  itself  insensible  and  un- 
able to  see  or  swallow  or  move.  After  a  time,  tlie  fit  cetvses,  some- 
times by  degrees,  at  other  times  suddenly,  the  child  fetching  a  deep 
siffh,  and  then  lying  quiet  and  pale,  as  if  it  had  fainted.  From  this 
state  it  passes  into  a  sleep,  and,  on  waking,  some  hours  after,  seems 

quite  well.  ,         „  •       i  -i 

Fits  may  attack  a  child  which  is  apparently  well,  occurring  daily, 
or  even  several  times  a  day,  and  it  may  linger  on  for  weeks.  A 
child  may  have  fits  from  a  great  variety  of  causes ;  they  theretore, 
have  a  different  meamng  in  different  cases.  But  they  ahvayB  show 
that  the  brain  has  in  some  way  been  disturbed. 

Treatment.  —  As  fits  are  not  a  disease  in  themselves,  but  only  a 
Bymptom  of  some  disease,  the  treatment  must  have  reference  to  the 
cause.  Sometimes,  while  the  fit  lasts,  it  is  wise  to  do  nothing.  But, 
if  a  fit  come  suddenly,  in  the  case  of  a  child  previously  healthy,  it  is 
aenerally  safe  to  place  it  in  a  hot  bath,  and  at  the  same  time  to  dash 
cold  water  on  its  face,  or  to  pour  cold  water  on  its  head,  or  hold  on 
it  a  large  sponge  dipped  in  cold  water.  The  hot  bath  will  draw  the 
blood  to  the  skin,  and  away  from  the  overloaded  brain.  It  will  quiet 
the  disturbance  of  the  system,  and  if  scarlet-fever  or  measles  are 
about  to  appear,  it  will  bring  them  out. 


cs. 


ble,  in  a  Htatt'  of 

lUow  pure,  fresli 

cold  and  dainp- 

itle  friction  over 


a  sad  sight, — its 
squinting  fright- 
up,  body  arclied 
isensible  and  un- 
fit ceases,  some- 
i  fetching  a  deep 
nted.  From  this 
lours  after,  seems 

,  occurring  daily, 
n  for  weeks.  A 
I ;  they  therefore, 
they  always  show 

selves,  but  only  a 
reference  to  the 
lo  nothing.  But, 
usly  healthy,  it  is 
same  time  to  dash 
.  head,  or  hold  on 
)ath  will  draw  the 
vin.  It  will  quiet 
Br  or  measles  are 


DISEASES  OP  THE  GENERAL  SYSTEM 

AND  MISCELLANEOUS  DISEASES. 


Having  now  treated  of  those  disorders  which  affect  the  skin,  the 
brain  and  nerves,  the  throat,  the  lungs  and  their  appendages,  the 
lieart  and  its  covering,  the  abdominal  cavity  and  its  lining  membrane, 
the  sexual  organs,  and  those  complaints  peculiar  to  females  and  chil- 
dren, it  remains  to  speak  of  those  others  —  fewer  in  number  —  which 
are  not  specially  developed  in  any  particular  part,  but  disturb  the 
whole  system. 

Fever. 

Fever  is  a  disease  which  affects  the  system  generally,  and  is  char- 
acterized by  more  or  less  excitement  of  the  circulation,  increased 
heat,  diminished  strength,  and,  oftentimes,  unnatural  thirst.  The  de- 
gree of  excitement  is  measured  by  the  state  of  the  pulse.  Of  this 
state,  there  are  two  characteristic  indications :  namely,  frequency  and 
hardness.  A  pulse  is  frequent  when  its  rapidity  exceeds  that  of 
health ;  it  is  hard  when  its  stroke  resists  the  pressure  of  the  finger 
with  unusual  force. 

In  health,  the  pulse  of  an  adult  beats  from  sixty  to  eighty  times  in 
a  minute ;  that  of  children  is  more  frequent.  The  pulsations  of  the 
heart  of  the  unborn  infant,  as  heard  through  the  body  of  the  mother, 
are  one  hundred  and  fifty  in  a  minute.  After  birth,  the  pulse  varies 
from  one  hundred  and  forty  down  to  the  standard  of  adult  age.  To 
appreciate  hardness  of  pulse,  experience  is  absolutely  necessary. 

The  great  activity  of  the  circulation,  in  fever,  is  intimately  con- 
nected with  the  heat  and  thirst,  and  tends  directly  to  waste  the  ener- 
gies and  consume  the  strength  of  the  patient.  The  heat  of  fever 
lessens  or  dries  up  the  secretions,  or  different  fluids  of  the  body, 
which,  in  a  state  of  health,  are  separated  from  the  blood  for  various 
purposes.     This  is  the  cause  of  the  dry  skin,  scanty  urine,  etc. 

A  crisis  of  fever  is  that  period  in  its  course  when  unfavorable 
symptoms  give  place  to  those  of  returning  health. 

A  course  of  fever,  or,  in  common  language,  a  run  of  fevr,  is  dis- 
tinguished by  a  great  variety  of  symptoms,  which. will  be  more  par- 
ticularly spoken  of  in  the  pages  which  follow. 

469 


470 


I»I8KA8K8   OK   THK   QFNRKAL   8YSTKM. 


Typhoid   Fever. 

Ok  tho  (liffon^nt  kiiKls  of  ftivcr,  tliia  is  oiu)  ot  t!"'  most  coiuiunii 
and  widely  prevahait.  Tho  niuno  fi//>hoii/  is  from  two  Greek  words 
which  iiR'iin  like  ti/phuM,or  similar  to  typhim.  Tlio  word  ti//>hus,  fmiii 
a  Greek  word  signifying  ntupor,  moans  stupiil^  dull  or  line  ;  :uid,  when 
applied  to  a  fever,  imi)lieH  that  is  /ow,  or  characterized  by  great  neri'- 
oua  depreanihn. 

Tyjjlius  and  typhoid  fevers,  if  not  identical,  are  ho  siniiLir  in  IiIh- 
tory  and  treatment  as  to  make  unnecessiiry  their  consideration  under 
separate  heads.  The  following  is  one  of  the  differences  claimed  to 
exist  between  the  two :  namely,  in  typhus  fever,  the  belly  is  flat ; 
there  is  no  marked  disease  of  the  bowels,  and  gcncjrally  no  diarrhd'ii 
until  the  second  or  third  week.  In  typhoid  fever,  on  tiio  coiitniiy, 
some  small  glands,  called  y'eyer'*  ^^a7trf«,  situated  i;;  the  lower  part 
of  the  small  intestines,  are  always  inflamed,  and  sometimes  ulcer- 
ated ;  and  consequently,  among  the  symptoms  most  frequently  no- 
ticed, are  diarrhoea,  and  drum-like  swelling  of  the  'jelly,  called  tym- 
panites. 

Symptoms.  —  The  disease  often  lias  precursory  symptoms.  For 
several  days  before  its  actual  beginning,  tlie  patient  droops.  He  may 
attend  to  liis  various  duties,  but  does  not  seem  well ;  he  is  low-8j)ir- 
ited  and  Lmguid ;  is  indisposed  to  any  exertion  of  body  or  mind  ;  has 
pains  in  the  head,  back,  and  extremities ;  loses  his  ajjpetito  ;  and 
although  dull  and  perhaps  drowsy  in  the  daytime,  his  sleep  is  inter- 
rupted and  unrefreshing  at  night.  The  immediate  harbinger  of  the 
fever  is  a  chill,  often  so  marked  as  to  cause  violent  shiveri  ig. 

The  history  of  the  first  week  shows  increased  heat  of  the  surface ; 
frequent  pulse  ranging  from  eighty  to  one  Inmdred  a'ld  twenty; 
furred  tongue ;  restlessness  and  sleeplessness  ;  headache  and  pain  in 
the  back;  sometimes  diarrhoea  and  swelling  of  the  belly  ;oid  some- 
times nausea  and  vomiting. 

The  second  week  is  frequently  distinguished  by  an  eruption  of 
small,  rose-colored  spots  upon  the  belly,  and  by  a  crop  of  little  watery 
pimples  upon  the  neck  and  chest,  having  the  appearance  of  minute 
di'ops  of  sweat  standing  on  the  skin,  and  hence  called  sudamina,  or 
sweat-drops  ;  the  tongue  is  dry  and  black,  or  red  p.nd  sore,  the  teeth 
are  foul ;  there  may  be  delirium  and  dullness  of  hearing ;  and  the 
symptoms  generally  aie  more  serious  than  during  the  first  week. 
Occasionally,  at  this  period,  the  bowels  are  perforated  or  eaten 
through  by  ulceration,  and  the  patient  suddenly  sinks. 

If  the  disease  proceeds  unfavorably  into  the  third  week,  there  is 
low  muttering  and  delirium;  great  exhaustion;  sliding  down  of  the 
patient  towards  the  foot  of  the  bed  ;  twitching  of  the  muscles  ;  bleed- 
ing from  the  bowels ;  and  red  or  purple  spots  upon  the  skin. 

If,  on  the  other  hand,  recovery  takes  place,  the  countenance  briglit- 


DI8EA8ES   OF   THF,  OENRIIAL  8YHTKM. 


471 


mOHt    UUUlllKlll 

(>  Greek  wnnls 
nl  ti/}ihis,  fi'iiii 

I  by  great  iien'- 

1  similar  in  liis- 
ndenition  under 
iiicert  clanued  to 
10  belly  i»  flat; 
[illy  no  diiirrlui'ii 
on  the  contnuy, 
the  lower  part 
ionietiines  uleer- 
^t  frequently  iio- 
H-Uy,  called  tyiii- 

symptoms.  For 
,  droops.  He  may 
I;  he  is  low-Bpir- 
Kjdy  or  mind  ;  has 
Ins  appetite  ;  ami 
bis  sleep  is  inter- 

barbinger  of  tlie 
shiveri ig. 
at  of  the  surface ; 
.red  a'ld  twenty; 
kdaclie  and  pain  in 

belly;  01' dsome- 

jy  an  eruption  of 
[op  of  little  watery 
karance  of  minute 
filled  sudamina,  or 
]nd  sore,  the  teeth 
bearing;  and  the 
g  the  first  week, 
[rforated   or  eaten 
Mks. 

lird  week,  there  is 
Jiding  down  of  the 
[be  muscles  ;  bleed- 
t  the  skin, 
fountenancc  bright- 


cuh;  th(!  pulse   nioderatcH ;  tlie  tongue  cleans,  and  the  (lischargcH 
iisNunie  the  apjM'uraniM^  they  have  in  health. 

Treatment.  —  (iiv(^  tiie  patient  good  air,  and  frequent  s[)ongingM 
with  water,  cohl  or  tepid,  as  Hhall  Im!  most  agreeable  to  his  feelings. 
Keep  the  IkjwcIh  in  order;  h\  which  is  meant,  Ik)  more  afmid  of 
diarrliu'a  than  of  costiveness.  Diarrhwa  should  Ih)  restrained  by  a 
little  lirimdy. 

For  costiveness,  give  injections,  or  the  mildest  aperients  (7), 
(10),  (12). 

To  lessen  the  frequency  of  the  pulse,  reduce  the  fever,  and  pro- 
duce perspiration,  give  from  three-  to  ten-tlrop  doses  of  the  tincture  or 
fluid  extract  of  veratrum  virido  every  hour.  This  remedy  has  great 
power  in  fever. 

(Jreat  wind-swelling  of  the  bowels  may  he  relieved  by  fomentii- 
tiuns,  or  hot,  steaming  ap})lications.  Sometimes  the  wind  may  be 
let  off  by  introducing  into  the  bowels  a  long  India-rubber  tulxi,  — 
thus  reducing  the  swelling,  and  greatly  promoting  the  patient's  com- 
fort. 

If  pain  in  the  head  be  severe  and  constant,  let  the  hair  be  cut 
short,  and  the  head  l)e  frequently  bathed  with  cold  water. 

Let  the  strength  1h)  supported  by  light  nourishment ;  and  in  case 
of  bleeding  fiom  the  bowels,  or  great  debility,  by  broth  and  wine. 

For  foul  mouth,  the  weakest  possible  infusion  of  old  hyson  tea  is 
valuable.     Good  nursing  is  eminently  desirable. 

If  the  fever  runs  a  low  course,  the  patient  being  much  prostrated, 
quinine,  even  in  large  doses,  may  be  given  from  the  beginning. 

Be  very  sure  the  patient  has  absolutely  no  solid  food  during  the 
fever  and  for  five  days  after.  There  is  nothing  so  good  as  milk  for 
typlioid  fever,  —  a  glassful  every  two  to  three  hours  will  be  all  the 
food  required. 

Bilious  Remittent  Fever. 

There  are  three  principal  varieties  of  periodical  fever,  which, 
though  varying  considerably  from  each  other  in  several  particulars, 
are  yet  essentially,  in  their  substance,  but  one  disease.  These  are 
Bilious  Remittent  Fever,  Pernicious  Intermittent  or  Conyestive  Fever, 
aiul  IrUermittent  Fever  or  Fever  and  Ague.  According  to  the  custom 
of  most  writers,  I  shall  treat  them  separately,  beginning  with  Bilious 
Remittent  Fever. 

Symptoms.  —  The  attack  is  generally  sudden  and  well  marked. 
Some  writers  say  it  has  no  premonitory  symptoms ;  others  that  it 
lias.  The  more  general  understanding  is,  that  for  a  day  or  two,  or 
even  longer,  liefore  the  onset,  there  is  a  sense  of  languor  and  debility, 
slight  headache,  lack  of  appetite,  furred  tongue,  bitter  taste  in  the 
mouth  in  the  morning,  pains  in  the  joints,  and  general  uneasiness. 

The  formal  onset  is  nearly  always  marked  by  a  distinct  chill  or 


472 


DI8EABKB  OP  THK  OF.NBRAL  8Y8TRM. 


rigor,  —  HoraetimoH  Hlight  hikI  lu'iof;  at  othjr  timeH  Hev(!ru  iind  |irn- 
longed.  The  chill  may  begin  at  tho  f«et,  or  al)out  the  Hhniildci- 
bludeH,  ur  in  the  buck,  and  thoncc  run  liko  hiiiuII  Mtruums  of  cdid 
water  poured  in  every  direction  through  the  whole  lM)dy.  There  is 
(jcnerally  but  one  well-marked  chill,  the  niturns  of  the  paroxyHins  (if 
fever  being  Meldom,  after  the  linit,  precieded  by  the  cold  Htage. 

At  certain  periodH  of  the  day  there  is  an  increased  intensity  in  the 
Hymptoms  of  the  disease,  occasionally  i)receded,  though  generally 
not,  by  the  cliill.  Between  this  period  of  severity  in  the  feverish 
symptoms,  and  a  similar  period  which  follows  it,  there  is  generally  a 
decrease  in  tlie  violence  of  the  symptoms,  during  which  the  fjivtr 
moderates,  but  does  not,  as  in  fever  and  ague,  entirely  go  off ;  hius 
distinct  remisaions,  but  not  complete  intermianionf. 

During  the  liot  stage,  the  pulse  is  up  to  one  hundred  and  twenty, 
or  one  hundred  and  thirty.  There  are  pains  in  the  head,  back,  and 
liml)B,  of  a  most  distressing  kind. 

The  tongue  is  generally  covered  with  a  yellowish  or  a  dirty-white 
fur ;  and  in  bad  cases  in  the  advanced  stage  is  frequently  parched, 
brown  or  nearly  black  in  the  centre,  and  red  at  the  edges.  There  is 
no  appetite  for  food,  and  generally  nausea  and  vomiting ;  and  usu- 
ally there  is  pain  and  tenderness  in  the  epigastrium.  The  bowels  are 
at  first  costive,  but  afterwards  become  loose,  and  there  are  frequent 
evacuations  of  dark,  offensive  matter. 

Causes.  —  This  disease  is  produced  by  malarial  exhalations  from 
the  decomposition  of  vegetable  matter.  It  is  most  prevalent  in  hot 
climates,  and  in  the  summer  and  autumn. 

Treatment.  —  If  the  fever  be  in  the  formative  stage,  and  have  not 
fully  developed  itself,  give  an  emetic  (1),  (2),  and  follow  it  with  a 
mild  cathartic  (7),  (18). 

If  the  disease  be  already  developed,  sponge  the  body  all  over  sev- 
eral times  a  day,  with  cold  or  tepid  water,  according  to  the  feelings 
of  the  patient^  and  give  cooling  drinks  (132),  (133),  (298),  (299). 
To  moderate  the  fever,  give  three-  to  ten-drop  doses  of  tincture,  or 
fluid  extract  of  veratrum  viride.  The  compound  powder  of  ipecac  and 
opium  is  a  valuable  preparation  for  the  same  purpose.  Give  cold 
water  as  drink  if  desired  by  the  patient,  or  let  him  eat  ice. 

When  fhe  headache  is  very  severe,  let  wet  cups  be  applied  upon 
the  temples  or  behind  the  ears  ;  and  the  same  remedy  to  the  pit  of 
the  stomach,  when  there  is  great  tenderness,  is  often  desirable  ;  though 
a  mustard  poultice  will  sometimes  do  better. 

During  the  remissions  of  the  fever,  quinine  and  other  tonics  are  to 
be  given,  as  in  fever  and  ague.  Quinine,  in  large  doses,  acts  almost 
as  a  specific  for  these  diseases. 


gevore  and  jiro- 
it  the  Hhouldci- 
Htrtiums  of  colli 
Ixxly.  Thero  in 
he  piiroxyHiiiH  of  • 
old  Htage. 
1  intensity  in  llic 
hougli  generally 

in  the  fevisrisli 
ire  is  genei'iilly  a 
which  the  fnvor 
irely  go  off ;  has 

Ired  and  twenty, 
head,  hack,  and 

I  or  a  dirty-whito 
quently  parched, 
edges.  There  is 
niting;  and  nsu- 
,  The  bowela  are 
here  are  frequent 

exhalations  from 
,  prevalent  in  hot 

age,  and  have  not 
1  follow  it  with  a 

3ody  all  over  sev- 
ig  to  the  feelings 
8),  (298),  (299). 
les  of  tincture,  or 
vder  of  ipecac  and 
rpose.  Give  cold 
eat  ice. 

9  be  applied  upon 
tnedy  to  the  pit  of 
desirable ;  though 

sther  tonics  are  to 
doses,  acts  almost 


DT8KA8ER   OF   THK   ORNKRAL   HY8TKM.  478 


Malarial  or  Cons:estive  Fever. 

This  is  the  jxjrniciouH  or  malignant  form  of  malarial  fever.  It  is 
marked,  either  in  the  earlier  or  later  stage,  by  a  rush  of  blood  towards 
one  or  more  organs,  by  which  they  are  crowded  full  and  conyented, — 
lience  its  title  of  congestive  fever. 

Symptoms.  —  It  may  l)e  intermittent  or  remittent,  —  more  com- 
monly, it  is  the  former.  It  may  assume  any  of  the  types  of  period- 
ical fever,  but  it  is  most  frequently  quotidian  or  tertian. 

The  first  attack  does  not  differ  very  materially  from  a  common 
attiick  of  simple  intermittent.  The  first  paroxysm  is  simple,  exciting 
l)iit  little  attention.  The  second  is  always  severe,  producing  great 
coldness,  and  a  death-like  hue  of  the  face  and  extremities.  The  ad- 
vancement of  the  disease  brings  dry,  husky,  parched,  and  pungency 
hot  skin,  followed,  after  a  time,  by  a  cold  clammy  sensation.  Tise 
eyes  are  dull,  watery  and  sometimes  glassy ;  the  countenance  dull, 
sleepy,  distressed ;  the  tongue,  at  first  white,  changes  to  brown  or 
l)laok,  and  in  usually  tremulous;  the  breathing  is  hurried  and  diffi- 
cult. Pressure  over  the  liver,  stomach  or  bowels  produces  pain. 
The  mind  is  often  disturbed,  and  falls  into  lethargy  and  stupor,  or  is 
delirious. 

Treatment.  —  This  should  be  very  much  like  the  treatment  of  the 
bilious  remittent  fever. 

While  getting  up  from  the  fever,  the  diet  must  be  light  and  nutri- 
tious at  first,  but  may  be  increased  in  quantity  as  the  strength  re- 
turns. Exercise  out  of  doora  must  not  be  omitted.  If  recovery  be 
slow,  some  mild  tonic,  or  a  little  wine,  or  ale,  or  brandy  may  be  taken 
two  or  thi'ee  times  a  dsvy.  Ten  grains  of  quinine,  taken  four  hours 
before  the  expected  chill,  will  put  a  stop  to  these  attacks  like  magic. 
After  a  day  or  two  the  dose  may  be  diminished. 


Fever  and  Ag^ue. —  Intermittent  Fever. 

This  is  a  kind  of  fever  in  which  there  is  a  succession  of  attacks 
with  equal  intervals  and  intermissions  that  are  complete  but  unequal, 
on  account  of  the  uncertain  duration  of  each  fit. 

An  interval  is  the  period  of  time  between  the  beginning  of  one  fit 
and  the  beginning  of  the  next. 

An  intermission  is  the  period  of  time  between  the  close  of  one  fit 
and  the  beginning  of  the  next. 

The  different  varieties  of  ague  take  their  designation  from  the 
length  of  the  interval  in  each  case. 

The  interval  of  a  quotidian,  or  daily  ague,  is  twenty-four  hours. 

The  interval  of  a  tertian,  or  third-day  ague,  is  forty-eight  hours. 

The  interval  of  a  quartan,  ov  fourth-day  ague,  is  seventy-two  hours. 


_  ^aWtHnssrsKr. 


474 


DISEASES   OF  THE   GENERAL   SYSTEM. 


Symptoms.  —  The  disease  first  develops  itself  by  an  ague-fit.  This 
luis  three  stages,  the  .cold,  the  hot,  and  the  sweating.  The  cold 
stage  is  very  marked.  The  patient  has  a  sense  of  debility,  yawns, 
stretches,  has  no  appetite,  and  does  not  wish  to  move.  The  face  and 
extremities  become  pale,  the  skin  shrinks,  causing  universal  horripi- 
lation, or  goose-flesh  ;  the  patient  shakes,  and  his  teeth  chatter. 

After  a  time,  these  symptoms  decline,  and  the  hot  stage  comes  on, 
which  is  characterized  by  high  fever,  with  its  various  uncomfortable 
sensations. 

When  this  fever  passes  off,  it  is  followed  by  the  sweating  stage, 
during  which  a  moisture  breaks  out,  which  increases,  frequently,  to  a 
profuse  sweat ;  the  body  returns  to  its  natural  temperature,  the  pains 
and  aches  disappear,  and  a  feeling  of  health  comes  back. 

During  the  cold  stage,  the  ''ood  is  driven  inward  from  the  sur- 
face, and  particularly  oppresses  the  spleen,  which,  in  cases  of  long 
standing,  becomes  swelled  and  permanently  enlarged.  This  swelling 
may  be  plainly  felt,  and  is  often  quite  pei*ceptible  to  the  eye.  It  is 
called  ague-cake. 

Ague-fits  begin  at  different  hours  of  the  day,  and  generally  termi- 
nate in  the  evening. 

A  quotidian  usually  begins  in  the  morning;  a  tertian  at  noon ;  and 
a  quartan  in  the  afternoon. 

The  cold  stag  a  is  shortest  in  the  quotidian,  and  longest  in  the 
quartan. 

Thus  the  longest  fit  has  the  shortest  interval,  and  the  shortest  cold 
stage  ;  while  the  shortest  fit  has  the  longest  interval,  and  the  longest 
cold  stage. 

There  are  also  double  tertians  and  double  quartans,  wherein  the 
fits  repeat  themselves,  —  sometimes  the  same  day,  at  other  times  on 
alternate  days. 

To  these  varieties,  the  terms  postponing  and  anticipating  are  ap- 
plied, according  as  the  intervals  are  growing  longer  or  shorter. 
When  a  person  is  recovering  from  ague,  the  interval  may  gradually 
grow  longer,  the  attack  being  put  off,  or  postponed.  But  if  the  dis- 
ease be  increasing  in  severity,  the  attack  may  anticipate  its  usual  pe- 
riod, making  the  interval  shorter. 

Tertians  are  more  common  than  either  qilotidians  or  quartans. 

Agues  are  more  prevalent  in  spring  and  autumn.  Fall  agues  are 
most  severe  and  dangerous. 

Causes.  —  Exhalations  from  the  soil,  called  malaria,  arising  from 
decomposition  of  vegetable  matter  in  new  countries,  or  from  low  and 
marshy  districts  in  which  tlie  land  is  alternately  covered  with  water, 
and  again  left  dry  and  exposed  to  the  sun. 

In  districts  where  it  prevails,  high  hills  are  exempt,  and  even  the 
upper  stories  of  houses  are  more  healthy  than  the  lower. 

Treatment.  —  Frnt  clear  the  bowels  with  the  fluid  extract  of 


DI8KA8E8  OF  THR   Qr>EBAL   SYSTEM. 


475 


II  ague-fit.  Tliis 
ng.  The  cold 
lebility,  yawns, 
The  face  and 
ihereal  horripi- 

chatter, 
stage  comes  on, 

uncomfortable 

sweating  stage, 
frequently,  to  a 
uture,  the  pains 
ck. 

■  from  the  sur- 

I  cases  of  long 

This  swelling 

the  eye.     It  is 

generally  terrai- 

m  at  noon ;  and 

longest  in  the 

;he  shortest  cold 
and  the  longest 

ns,  wherein  the 
p  other  tinjes  on 

Icipating  are  ap- 
yer  or  shorter, 
may  gradually 
But  if  the  dis- 
ate  its  usual  pe- 

or  quartans. 
Fall  agues  are 

•ia,  arising  from 
or  from  low  and 
red  with  water, 

pt,  and  even  the 
ver. 

fluid  extract  of 


senna  (15),  or  the  preparation  (21).  Then,  in  the  cold  stage,  give 
hot,  and  in  some  cases,  stimulating  drinks.  Administer  hot  foot- 
baths, and  putting  the  patient  in  bed,  apply  bottles  filled  with  hot 
water  to  the  feet,  sides,  and  back,  and  in  every  way  try  to  excite 
warmth  and  comfort. 

In  the  hot  stage,  give  cooling  drinks,  and  camphor  (117),  (118) 
in  decided  doses;  or,  what  is  better,  quinine  (67)  in  two-teaspoon- 
ful  doses  every  half  hour,  at  tiie  same  time  giving  five-drop  doses  of 
tincture  or  fluid  extract  of  veratrum  viride  every  hour. 

During  the  sweating  stage,  stop  the  veratrum,  and  rub  the  patient 
with  dry  towels. 

In  the  intermission,  give  quinine  (62),  in  three-grain  doses  once  in 
three  or  four  hours,  and  continue  it,  gradually  decreasing  the  dose,  a 
fortnight  after  the  cessation  of  the  attacks.  The  following  is  a  good 
preparation :  quinine,  one  scruple ;  elixir  of  vitriol,  one  dram ;  dis- 
solve the  quinine  in  the  elixir,  and  add  tincture  of  black  cohosh, 
fourteen  drams.  Twenty  drops  aie  to  be  given,  in  a  little  water,  o^ce 
an  hour. 

Quinine  is  the  one  medicine  which  surely  relieves  and  cures  this 
disease. 

It  is  important,  in  fever  and  ague  districts,  to  avoid  the  hot  sun, 
and  the  damp  evening  and  morning  air. 

Yellow  Fever. 

This  disease  belongs  to  warm  climates,  being  most  prevalent  in 
Southern  cities.  It  makes  its  appearance  chiefly  in  the  latter  part  of 
summer,  and  disappears  upon  the  approach  of  frosty  weather. 

Symptoms.  —  The  complaint  begins,  generally,  with  a  chill,  which 
is  sometimes  severe,  though  commonly  moderate,  of  short  duration, 
and  rcvrely  repeated. 

Following  this  chiU,  there  is  moderate  fever  and  a  little  heat  of 
surface ;  but  this  rarely  rises  to  any  considerable  height,  and  only 
continues  to  the  second  or  third  day,  when,  in  fatal  cases,  it  gfives 
place  to  coldness  of  surface,  etc.     In  many  cases  there  is  sweating. 

The  pulse  is  peculiar,  —  not  easily  described,  —  generally  not  rising 
above  one  hundred  in  a  minute,  —  a  kind  of  bubble  under  the  finger, 
which  breaks  and  vanishes  before  it  can  be  fairly  felt. 

The  tonguf  is  moist  and  white  in  the  first  and  second  days,  but 
red,  smooth,  shining,  and  dry,  as  the  disease  advances  towards  the 
closp  having  a  d^y,  black  streak  in  the  middle. 

The  most  st  iking  symptoms  are  nausea  and  vomiting.  The 
vomiting,  in  fatal  cases,  is  generally  very  persistent,  and  towards  the 
termination,  the  yellowish  o:  greenish  matters  thrown  up  give  place  to 
a  thin  and  black  fluid,  having  a  sediment  looking  like  coffee  grounds. 
This  is  called  the  black  vomit. 

The  bowels  are  generally  costive,  with  frequent  epigastric  tender- 


DISEASES  OF  THE   GENERAL  SYSTEM. 

ness  and  distress.  There  is  generally  severe  headache,  and  a  peculiar 
expression  of  countenance,  in  which  the  lips  smile,  but  the  rest  of  the 
face  is  fixed  and  sad,  sometimes  wild.  The  patient  continues  wake- 
ful night  and  day.  There  are  discharges  of  blood,  often,  from  tlie 
nose,  the  gums,  the  ears,  the  stomach,  the  bowels,  and  the  urinary 
passages. 

Treatment.  —  First,  move  the  bowels  with  some  mild  physic  (40), 
(18),  (19),  (41),  (37).  ,         ^       . 

During  the  chill,  put  the  feet  in.a  mustard  bath  (242),  give  warm 
cordial  drinks,  and  apply  hot  bottles,  etc.,  externally. 

Cups  may  be  applied  to  the  back  of  the  neck,  or  over  the  stomach, 
according  to  circumstances. 

During  the  second  stage,  or  %tage  of  calm,  nothing  is  to  be  done 
but  give  some  light  stimulants,  and  to  promote  sweating  by  warm 
drinks  and  tincture  of  veratrum  viride;  and  also  quinine  (62). 

The  third  and  severest  stage  is  to  be  met  by  stimulants,  as  bfandy, 
freely  given,  with  a  continuartce  of  the  quinine. 

During  the  fever  stage,  and  for  the  vomiting,  give  creosote,  twenty 
drops  to  six  ounces  of  spirits  of  Mindererus,  and  alcohol  enough  to 
dissolve  the  creosote.  The  dose  is  half  an  ounce  every  two  hours. 
Said  to  be  excellent  for  putting  a  stop  to  the  retching  and  vomiting. 
Cleanliness,  temperance,  and  cheerfulness  are  essential  in  warding 
off  the  disease  when  one  is  exposed  to  its  causes. 

Rheumatism. 

This  is  an  inflammation  of  a  peculiar  character,  being  caused  by 
acid  or  poisonous  matter  in  the  blood,  and  having  for  its  seat  the 
fihrou%  tissue,  or  that  thready  texture  which  enters  largely  into  the 
composition  of  the  cords  and  muscles  of  the  human  body.  The 
synovial,  or  lining  membrane  of  joints,  is  also  peculiarly  subject 
to  rheumatic  inflammation.  Hence  the  terms,  muscular  rheumatism, 
and  synovial  rheumatism.  There  are  also  acute  and  chrome  rheu- 
matism. 

Acute  Rheumatism 

Is  a  very  painful  affection.  It  is  most  frequently  brought  on  by 
exposure  to  wet  and  cold  after  violent  and  fatiguing  exercise  of  the 
muscles. 

Symptoms.  —  Its  principal  characteristics  are,  high  fever,  with  a 
full,  bounding  pulse;  furred  tongue;  profuse  sweat,  which  has  a 
sour  smell,  and  seems  to  increase  the  weakness  without  relieving  the 
pain;  scanty  and  high-colored  urine,  with  brick-dust  settlings;  and 
swelling  of  the  joints,  with  slight  redness,  great  tenderness,  and 
severe  pain,  which  is  particularly  agonizing  when  the  patient  attempts 
to  move. 


DISEASES   OF  THE   GENERAL  SYSTEM. 


477 


3,  and  a  peculiar 
t  the  rest  of  the 
jontinues  wake- 
often,  from  the 
md  the  urinary 

ild  physic  (40), 

!42),  give  warm 

irer  tho  stomach, 

ig  is  to  be  done 
eating  by  warm 
nine  (62). 
lants,  as  bfandy, 

creosote,  twenty 
cohol  enough  to 
ivery  two  hours. 
[g  and  vomiting, 
ntial  in  warding 


being  caused  by 
for  its  seat  the 
largely  into  the 
man  body.  The 
eculiarly  subject 
"ular  rheumatism^ 
tid  chronic  rheu- 


y  brought  on  by 
I  exercise  of  the 

igh  fever,  with  a 
3at,  which  has  a 
LOUt  relieving  the 
ist  settlings;  and 
tenderness,  and 
3  patient  attempts 


This  affection  often  changes  suddenly  from  one  part  of  the  body  to 
another,  or  from  one  set  of  joints  to  another.  This  sudden  shifting, 
termed  metaataaig,  is  peculiarly  dangerous  ;  for  sometimes  the  inflam- 
mation, seeming  to  regard  the  constantly  moving  heart  as  a  large 
central  point,  suddenly  seizes  upon  its  lining  membrane  and  occasion- 
ally proves  speedily  fatal. 

Treatment.  —  It  is  well  first  to  open  the  bowels  freely  with  the 
oompound  powder  of  leptandrin,  or  the  compound  powder  jalap. 
Tlien  give  tincture  of  black  cohosh  and  tincture  of  veratrum  viride 
(124),  and  push  the  preparation  to  the  extent  of  producing  sweating. 
This,  if  no  evil  effects  seem  to  result  from  it,  that  is,  no  prostration 
or  bad  feelings  in  the  head,  may  be  kept  up  till  the  violence  of  the 
disease  abates. 

Sometimes  opium,  nitrate  of  potash,  etc.  (127),  administered  one 
or  more  times,  will  have  a  g^^od  effect. 

The  tincture  of  black  cohosh  root,  two  parts,  and  the  tincture  of 
colchicum  root,  one  part,  and  given  in  dbsos  of  forty  drops,  is  a  valu- 
able remedy. 

For  articular  rheumatism,  some  form  of  the  salicylates  must  be 
used  and  continued  till  all  pain  and  soreness  have  entirely  ceased  for 
several  days.  Omit  all  sweets,  condiments,  and  much  meat  from  the 
diet. 

It  is  a  valuable  treatment,  -after  clearing  the  bowels  with  salts  and 
senna,  to  give  equal  parts  of  wine  of  colchicum  and  spirits  of  turpen- 
tine in  doses  of  ten  drops  every  two  or  three  hours;  and  after  a  day 
or  two  to  give,  in  connection  with  the  above,  at  intervals  of  five 
hours,  tincture  of  chloride  of  iron,  ten  drops,  with  ten  to  twenty  drops 
of  laudanum. 

Fomentations  of  hops  and  cicuta,  or  stramonium  leaves,  placed 
upon  the  inflamed  and  swollen  joints,  will  have  a  good  effect  in  re- 
lieving the  pain.  The  recent  leaves  of  stramonium  pounded,  mixed 
with  a  little  water,  and  laid  upon  the  joints,  are  said  to  act  very 
favorably. 

Salicylic  acid  and  its  salts,  or  salicin,  the  active  principle  of  the 
willow  bark,  when  given  at  the  commencement  qf  an  attack,  often- 
times arrests  the  course  of  the  malady  as  effectually  as  quinine 
arrests  the  intermittent  fever,  or  as  opium  and  ipecacuanha  arrest 
dysentery.  It  exerts  such  a  beneficial  influence  that  it  is  recognized 
by  the  profession  as  a  specific.  From  ten  to  fifteen  grains  of  salicylic 
acid,  or  the  salicylate  of  soda  should  be  given  every  two  hours  until 
relief  is  obtained.  This  usually  takes  place  in  from  twelve  to  thirty- 
six  hours.  In  most  cases  the  fever  and  swelling  will  abate  within 
the  above  time.  If  not  entirely  arrested,  the  disease  is  very  much 
shortened. 

When  the  specitic  effect  is  produced  on  the  sysleui,  it  causes  ver- 
tigo, headache,  ringing  in  the  ears.     These  symptoms  indicate  that 


,-*iW"' 


478 


DISEASES   OF  THE   GENERAL  SYSTEM. 


the  medicine  should  Vie  given  in  smaller  doses  and  with  longer  intor- 
vals.  For  chronic  rheumatism,  Seawright's  Lithia  Water,  drunk 
in  large  quantities,  is  one  of  the  best  remedies. 


IV 


Chronic  Rheumatism. 

The  chronic  form  of  rheumatism  may  follow  the  acute  as  its  con- 
sequence, but  is  more  often  an  independent  disease.  It  is  seldom 
attended  by  fever,  and  in  this  differs  from  the  acute  rheumatism. 
It  often  lasts  a  long  time,  and  causes  much  suffering. 

Symptoms.  —  These  are  various,  but  are  generally  understood, 
even  by  the  common  people,  to  consist  of  pain,  lameness,  stiffness, 
etc.,  in  the  joints  and  other  parts.  The  joints  are  often  swollen,  but 
not  as  much  as  in  the  acute  disease.  It  is  peculiar  to  this  form  of 
the  complaint,  that  when  the  patient  remains  at  rest  for  a  time,  he 
will  have  pain  and  stiffness  in  the  affected  part  on  beginning  to  move, 
but  as  he  grows  warm  both  will  disappear. 

Treatment.  —  This  complaint  is  often  palliated,  and  sometimes 
cured,  by  passing  a  current  of  electro-magnetism  through  the  affected 
part.  The  diet  is  all-important;  no  sweets  nor  fats  should  be  allowed, 
nor  spices  and  other  rich  condiments  are  to  be  taken ;  meat  is  to  be 
eaten  but  once  a  day. 

The  tincture  or  the  fluid  extract  of  black  cohosh,  taken  in  full 
doses,  is  one  of  the  best  remedies.  It  may  be  taken  alone  or  mixed 
with  the  tincture  of  poke-berries,  and  a  tincture  of  prickly-ash  bark, 
if  convenient. 

Opium  and  nitre  (127)  form  a  valuable  remedy.  Colchicum  is 
much  used,  and  has  a  deservedly  high  reputation  (292),  (301)  . 

Liniments  often  have  a  good  effect  (190),  (195),  (196),  198).  It 
is  well  to  wear  a  piece  of  oiled  silk  over  the  affected  pait.  It  keeps 
up  a  gentle  perspiration  from  the  rheumatic  surface,  and  materially 
hastens  a  cure.  Iodide  of  potash  in  ten-  to  thirty-grain  doses,  with 
one-third  glass  of  water,  after  food,  three  times  daily,  is  an  old  hut 
very  efficacious  lemedy.  The  salicylates  in  this  form  are  not  without 
their  special  value,  but  are  not  so  useful  as  in  the  acute  form.  The 
"  Wonderful  Wintergreen,"  lodia,  Tongalin,  are  a  few  of  the  well- 
known  reliable  preparations  that  may  be  found  on  the  market,  each 
of  which  well  deserve  a  trial  in  chronic  rheumatism. . 

To  bathe  the  affected  joint  at  bed-time  with  hot  sweet  oil,  and 
then  envelop  it  in  cotton  batting,  to  be  kept  on  through  the  night, 
will  often  give  much  relief.  Oil  of  cajeput  relieves  a  largo  propor- 
tion of  cases. 

The  bowels  must  be  kept  regular,  and  all  exposure  to  wet  feet  or 
clothes,  and  to  currents  of  cool  air  whe  i  sweating,  must  be  carefully 
shunned. 


DISEASES   OF   THE   CJENEKAL   SYSTEM. 


479 


th  longer  iiiter- 
Water,  drunk 


icute  as  its  con- 
B.  It  is  seldom 
lite  rheumatism. 


ally  understood, 
meness,  stiffness, 
'ten  swollen,  but 
,r  to  this  form  of 
t  for  a  time,  he 
ginning  to  move, 

,  and  sometimes 
3Ugh  the  affected 
lould  be  allowed, 
n;  meat  is  to  be 

sh,  taken  in  full 
n  alone  or  mixed 
prickly-ash  bark, 

Colchicum  is 

92),  (301). 

(196),  198).  It 

part.     It  keeps 

e,  and  materially 

Train  doses,  with 

y,  is  an  old  but 

n  are  not  without 

cute  form.     The 

ew  of  the  well- 

the  market,  each 

ot  sweet  oil,  and 
irough  the  night, 
!S  a  largo  propor- 

ire  to  wet  feet  or 
must  be  carefully 


Qout 

Gout  is  rheumatism's  cousin ;  the  parentage  of  l)oth  belong  to  the 
brotherhood  of  the  acids. 

A  very  acid  state  of  the  biood,  or  a  state  favorable  to  the  forma- 
tion t  f  acid,  is  supposed  to  be  tlie  cause  of  the  inflammation  peculiar 
to  both  these  disorders.  In  rheumatism,  an  acid  wliich  exists  i:i  sour 
milk,  and  in  cider,  called  lactic  acid,  is  thought  to  be  the  disturbing 
element.  In  gout,  lithic  or  uric  acid  is  known  to  be  uncommonly 
abundant,  and  to  form  a  principal  ingredient  of  those  concretions 
found  in  gouty  joints  and  familiarly  called  chalk-atones. 

The  larger  joints  are  most  often  affected  by  rheumatism  ;  while 
gout  prefers  the  smaller  ones.  In  rheumatism,  the  pain  is  excrur 
dating ;  in  gout,  it  is  intolerable.  There  is  truth  in  the  hiimorous 
Frenchman's  description  of  the  pains  of  these  two  complaints,  whicli 
is,  in  substance,  as  follows :  Place  your  joint  in  a  vice  ;  turn  the 
screw  till  you  can  bear  it  no  longer ;  that  gives  you  an  idea  of  rheu- 
matism ;  now  give  the  instrument  one  more  turn,  and  you  have  gout. 

Symptoms.  —  A  fit  of  the  gout,  as  it  is  called,  generally  makes  its 
attack  in  the  night.  Its  unsuspecting  victim  is  first  awakened,  per- 
haps an  hour  or  two  after  midnight,  by  an  intensely  burning,  wrench- 
ing pain  in  the  ball  of  the  great  toe,  or  some  other  small  joint.  This 
pain,  with  its  accompanying"  symptoms  of  fever,  continues  with  little 
abatement  for  twenty-four  hours.  There  is  then  a  distinct  remission, 
when  the  sufferer  may  get  some  sleep.  He  has  a  similar  experience 
during  several  succeeding  days  and  nights,  when  the  disease,  which 
has  been  growing  milder,  leaves  him. 

After  a  considerable  interval,  there  is  likely  to  be  another  similar 
visitation.  The  length  of  this  interval  is  inversely  as  the  number  of 
attacks,  —  that  is,  it  diminishes  in  length  as  the  attacks  increase  in 
number ;  in  yet  plainer  and  more  homely  terms,  the  attacks  come 
"  thicker  and  faster  "  ;  the  space  between  them  gradually  shrinking 
from  three  or  four  years  to  one  or  two  months. 

Recovery  fron  he  first  attack  may  be  complete, — the  skin  peeling 
off  from  the  red  and  swollen  joint,  and  leaving  it  strong  and  supple 
iis  ever.  But,  after  several  repetitions  of  the  in- 
flammation, the  joint  becomes  stiff,  its  motions 
being  obstructed  by  the  deposit  of  lithic  acid  con- 
cretions, or  chalk-stones,  the  limbs  are  sometimes 
actually  frosted  over  with  crystals  of  urate  of  soda 
(Fig.  149).  Tliis  form  of  urate  of  soda  crysbvls 
differs  very  materially  from  Fig.  124.  Wlien  these 
cryst}\ls  appear  upon  the  surface,  and  deposits  are 
made  in  the  joints,  uric  acid  is  not  secreted  as 
usual  by  the  kidneys,  but  accumulates  in  the  blood. 

But  gout  is  a  disease  by  no  means  entirely  local  in  its  character. 


FIO.  149. 


4«0 


D18KA8KS   OK   TIIK   GENERAL   SYSTEM. 


i^ll 


H^ 


It  vitiates  the  blood,  affects  the  system  generally,  and  is  often  lic- 
trayed  by  general  symptoms  long  before  the  loiuil  mischief  is  indi- 
cated by  one  of  the  attacks.  Irritability  of  temper,  unpleasant 
sensations  in  the  stomach  and  head,  and  various  ur.comfortable  feel- 
ings of  body  and  mind,  have  been  considered  iis  premonitory  of  this 
disorder.  Many  other  organs  also,  besides  joints,  are  subject  te  tlie 
gouty  inflammation.  The  stomach,  heart,  lungs,  head,  and  even  the 
eyes,  are  known  to  have  been  thus  affected. 

Causes.  — Luxury  and  indolence  —  particularly  the  former  —  are 
regarded  .as  the  principal  causes  of  gout.  But  poverty  and  activity 
will  not  always  kec->  the  disease  away.  Probably  an  improper  diet 
has  more  to  do  with  the  creation  of  gout  than  all  else.  Starchy  fofxl, 
sweets,  etc.,  which  cause  an  acid  fermentation,  are  most  likely  to  set 
up  the  trouble. 

Treatment.  —  Colchicum  is  the  remedy  for  gout.  It  removes  tlie 
disease  by  exciting  the  kidneys  to  action,  so  that  the  poison  is  con- 
veyed away  in  the  urine.  Perhaps  it  acts  in  some  other  unexplained 
way  as  an  antidote  to  the  disease.  One  teaspoonful  of  the  wine  of 
colchicum  may  be  taken  two  or  three  times  a  day,  until  relief  is  ex- 
perienced. It  should  then  be  continued,  in  ten-drop  doses,  for  a  few- 
days  longer,  to  prevent  a  relapse.  The  colchicum  may  be  taken  in 
the  form  of  prescription  (301). 

Coffee,  d-unk  freely  every  day,  is  said  to  be  a  sovereign  remedy 
for  gout. 

The  bowels  must  be  kept  in  order,  but  not  actually  purged  (34), 
(40).     The  diet  must  be  simple  and  unstiraulating. 

Let  the  inflamed  joint  be  bathed  often  in  a  saturated  solution  of 
bicarbonate  of  soda  in  soft,  warm  water.  Cold  applications  should 
not  be  made,  as  there  is  danger  of  provoking  a  sudden  change  of  the 
inflammation  to  some  internal  organ. 

A  regulation  of  the  diet  and  open  air  exercise  are  the  best  meth- 
ods of  fighting  the  disease. 


Scrofula.  — King's  Evil. 

This  disease  was  once  thought  to  be  peculiar  to  swine,  and  hence 
derived  its  name  from  acrofu,  a  sow.  It  shows  itself  in  various  forms, 
—  as  hip-disease,  white  swelling,  rickets,  salt-rheum,  etc.  Pei-sons 
affected  by  it  are  subject  to  swelling  of  the  glands,  particularly  those 
of  the  neck. 

Symptoms.  —  In  the  beginning  of  the  disease,  small,  hard,  movable 
kernels  appear  about  the  neck,  just  undf  the  skin.  These  are  lym- 
phatic glands,  and  the  swelling  generally  takes  place  long  before  there 
is  any  soreness,  or  perceptible  redness.  They  may  be  felt  under  the 
skin,  and,  ,in  the  course  of  six  months  or  a  year,  may  grow  to  the 
size  of  a  filbert,  or  even  a  hen's  egg.     Sometimes  they  are  much 


IF" 


DISEASES  OF   THE   OENEUAL   SYSTEM. 


481 


mil  is  often  bo 
niachief  is  indi- 
per,  unpleiusaiit 
omfortable  feel- 
iionitory  of  this 
3  subject  to  tlic 
kd,  and  even  the 


he  former  —  are 
rty  and  activity 
n  improper  diet 
!.  Starchy  food. 
lost  likely  to  set 

It  removes  the 
,e  poison  is  con- 
ther  unexplained 
,1  of  the  wine  of 
in  til  relief  is  ex- 
p  doses,  for  a  few- 
may  be  taken  in 

sovereign  remedy 

ally  purged  (34), 

rated  solution  of 
(plications  should 
den  change  of  the 

re  the  best  meth- 


swine,  and  hence 

in  various  forms, 

am,  etc.     Pereons 

particularly  those 

nail,  hard,  movable 
These  are  lym- 

e  long  before  there 
be  felt  under  the 
may  grow  to  the 

les  they  are  much 


larger  even  than  this,  and  very  hard.  They  may  appear  in  many 
other  parts  besides  the  neck. 

After  a  time,  though  very  slowly,  they  come  to  a  head  and  break, 
—  discharging  a  watery  fluid,  or  a  mixture  like  whey  and  curd. 
They  are  seldom  very  sore.  When  they  heal,  they  are  apt  to  leave 
a  puckered  condition  of  the  skin,  and  ugly  scars. 

The  scrofulous  humor  may  sometimes  affect  the  eyes,  when  the 
lids  will  become  red  and  thick,  and  discharge  mucus  and  water ;  — 
the  under  lid  sometimes  turning  out,  and  presenting  a  shocking 
spectacle. 

The  scrofulous  condition  is  generally  supposed  to  be  indicated  by 
a  white,  delicate  skin,  thick  lips,  light  hair,  and  a  delicate  constitu- 
tion ;  but  these  signs  are  not  worthy  of  much  confidence. 

Tlie  disease  often  attacks  the  cellular  tissue,  causing  numerous 
suppurations  and  abscesses.  It  also  affects  the  bones,  producing 
caries,  necrosis,  and  other  affections.  It  shows  itself  in  certain  in- 
flammations of  the  eyes,  in  the  formation  of  running  sores  in  the 
ears,  and  in  various  other  ways. 

Causes.  —  It  is  contended  by  some  that  scrofula  is  in  all  cases 
inherited ;  that  we  receive  it  from  our  progenitors,  as  we  do  their 
other  constitutional  peculiarities ;  that  the  disease  is  everywhere,  and 
in  all  time,  one  and  the  same,  which  shows  it  to  come  from  within, 
and  not  from  without ;  that  w«re  it  dependent  on  external  causes  for 
its  existence,  it  would  be  greatly  modified  by  temperature,  climate, 
and  the  peculiarities  of  the  races  affected  by  it. 

They  assert  that  though  the  causes  which  are  usually  assigned 
for  scrofula,  such  as  living  in  cold,  damp,  and  impure  air,  and  the 
lack  of  sufficient  food,  connected  with  filthy  habits,  often  have  a 
powerful  effect  in  developing  scrofula  already  existing  in  the  con- 
stitution, and  of  aggravating  it  when  already  developed ;  it  never 
produces  it. 

How  far  these  statements  are  to  be  received,  I  will  not  undertake 
to  judge.  It  is  certain  that  the  disease  is  often  inherited ;  and  if  we 
admit  that  the  other  causes  named  have  some  share  in  its  production, 
it  is  possible  we  may  not  go  entirely  astray.  Yet  my  own  strong 
suspicion  that  scrofula  arises  from  the  animal  poison  of  syphilis,  fil- 
tered through  the  blood  of  many  generations,  inclines  me  to  the  adop- 
tion of  the  above  views. 

Treatment.  —  In  olden  times  of  superstition,  this  disease  was  be- 
lieved to  be  cured  by  the  patient  coming  into  the  presence  of  the 
king,  and  being  touched  by  his  royal  hand.  The  ceremony  was 
called  the  "sacred  touch,"  It  was  from  this  that  the  disease  took 
its  name  of  "  king's  evil."  This  superstition  reached  its  height  in 
the  reign  of  Charles  II.  After  the  Restoration,  the  numbers  who 
flocked  to  Whitehall  and  Windsor  to  receive  the  "  touch,"  are  said  to 
have  been  immense,  —  no  less  than  ninety-two  thousand  in  twelve 


r«.^ 


482 


DISEASES  OF  THE   OENKEAL  8Y8TKM. 


years ;  and  the  writers  of  that  day  declare  tlmt  none  failed  to  receiv<! 
benefit. 

In  modern  times,  believing  that  the  ceremony  of  the  touch  was 
best  adapted  to  the  period  when  kings  were  thought  to  have  Hiicied 
persons,  we  rely  for  the  cure  of  this  disease  upon  rational  medicine 
and  hygiene. 

The  medical  treatment  of  it  is  constitutional  and  local. 

Iodine  is  the  great  remedy  for  scrofula.  Dissolve  one  scruple  of 
iodine  and  two  scruples  of  iodide  of  potassium  in  seven  teaspoonfuls 
oi  water.  Of  this,  give  ten  drops  three  times  a  day,  in  a  little  water, 
gradually  increasing  the  dose  to  one  aud  a  half  or  twice  that  amount. 
The  iodide  of  potassium,  as  in  prescription  (101),  is  a  good  remedy. 

Where  there  is  considerable  debility,  the  iodide  of  iron,  in  doses 
of  twenty-five  or  thirty  drops,  i?'  water,  three  times  a  day,  is  a  good 
preparation.     The  syrup  of  the  iodide  is  the  most  agreeable  fomi. 

The  compound  syrup  of  yellow-dock  root,  and  the  compound 
syrup  of  stillingia,  taken  sometimes  alone,  and  at  other  times  with 
two  to  five  grains  of  iodide  of  potassium  in  each  dose,  are  both  ex- 
cellent medicines  for  scrofula. 

The  bowels  must  be  kept  open  by  laxative  food,  or  in  the  failure 
of  this,  by  some  gentle  physic  (12). 

Medicinal  springs,  particularly  those  containing  iodine,  are  ex- 
cellent.    Cod-liver  oil  benefits  most  scrofulous  people. 

Before  the  tumors  become  very  sore,  let  them  be  bathed  several 
times  a  day  with  a  solution  of  muriate  of  lime,  or  ammonia,  or  soda, 
two  drams  to  the  ounce  of  water.  When  they  are  inflamed,  apply 
poultices  of  ground  slippery-elm  and  powdered  bayberry,  equal  parts. 
Powdered  poke-root,  or  blue-flag  may  be  substituted  for  the  bayberry. 
If  these  things  are  not  at  hand,  use  white  bread  and  milk,  or  flax-seed 
poultices. 

When  the  tumors  have  opened,  and  ulcers  have  formed,  the  ulcers 
must  be  washed  out  with  soapsuds,  and  dressed  with  salve  made  of 
beeswax  and  swtet-oil ;  or,  when  the  ulcers  are  indolent,  with  the 
red  iodide  of  mercury  ointment.  Let  the  dressing  be  changed  two 
or  three  times  a  day. 

Great  attention  should  be  paid  to  the  improvement  of  the  general 
health.  The  diet  must  be  ample  and  nourishing,  —  consisting  of 
fi-esh  meat,  poultry,  broths,  soups,  milk,  and  wholesome  vegettvbles  in 
such  variety  as  the  season  allows. 

The  skin  must  be  washed  daily  with  cool  water  and  spirit,  or  water 
and  saleratus ;  and  rubbed  to  redness  with  a  coarse  towel  or  flesh- 
brush.  Either  flannel  or  silk  should  be  worn  next  the  skin,  summer 
and  winter. 

Exercise  must  be  regular,  and  cheerfully  performed,  in  the  open 
air.  If  the  residence  be  in  a  damp  and  unhealthy  air,  it  should  lie 
changed  at  once,  if  possible.  In  any  case,  a  change  of  residence,  from 
time  to  time,  when  travelling  is  not  possible,  is  much  to  be  desired. 


DISEASES   OF  THE   GENKKAL   SYSTEM. 


488 


1  failed  to  rcceivt! 

if  the  touch  was 
b  to  have  Hiicved 
•ational  medicine 

local. 

0  one  scruple  of 
3ven  teaspoonfuls 
,  in  a  little  water, 
ivice  that  amount, 
is  a  good  remedy, 

1  of  iron,  in  doses 
!8  a  day,  is  a  good 
igreeable  form, 
id  the  compound 
,  other  times  witli 
dose,  are  both  ex- 

,  or  in  the  failure 

ig  iodine,  are  ex- 

o\)\e. 

be  bathed  several 
ammonia,  or  soda, 

ire  inflamed,  apply 

yl)erry,  equal  parts. 

id  for  the  bayherry. 
d  milk,  or  flax-seed 

formed,  the  ulcers 

ivith  salve  made  of 

indolent,  with  the 

g  be  changed  two 

nent  of  the  general 
ig,  —  consisting  of 
3Some  vegettibles  in 

and  spirit,  or  water 
irse  towel  or  flesh- 
ct  the  skin,  summer 

brmed,  in  the  open 
hy  air,  it  should  be 
re  of  residence,  from 
auch  to  be  desired. 


Scurvy.  — Scorbutus. 

Owing  to  a  better  knowledge  of  this  disease,  and  of  itiii  proper 
treatment,  it  is  much  less  common  than  in  former  years.  It  chiefly 
affects  seamen  who  make  long  voyages  ;  but  is  not  entirely  unknown 
on  land. 

Symptoms.  —  Languor,  loss  of  strength,  and  great  depression  of 
mind,  are  among  the  first  signs  of  scurvy.  To  one  about  being  at- 
tiieked,  work  and  play  are  >  ike  burdensome.  There  is  no  heart  even 
to  move.  The  face  and  th.,  whole  skin  look  pale  and  bloated,  and 
the  breath  has  a  fetid  smell.  The  gums  are  swelled,  soft,  red,  and 
spongy ;  and  they  bleed  upon  the  slightest  touch,  —  sometimes  the 
blood  oozes  from  them  spontaneously.  The  teeth  get  loose,  and 
often  fall  out.  The  skin  becomes  covered  with  bluish  or  purple 
.spots,  —  looking  precisely  like  bruises.  These  spread  and  run  into 
each  other,  forming  large  patches  of  discoloration. 

These  spots  appear  to  be  formed  by  the  bursting  of  the  small  capil- 
laries Ox  the  veins  and  arteries,  which  have  grown  too  weak  and  rot- 
ten to  hold  their  contents,  and  the  infiltration  of  dissolved  blood  into 
the  cellular  substance  under  the  skin. 

Ulcerous  sores  break  out  in  various  parts  of  the  body,  which  smell 
badly,  and  discharge  a  thin  matter.  These  ulcers  are  covered  with  a 
crust.  Various  parts  of  the  body,  the  bones  included,  are  twinged 
with  pains.  The  pulse  is  weak  and  soft.  All  the  secretions,  includ- 
ing the  urine,  have  an  offensive  smell,  —  as  though  the  whole  bocy 
were  approaching  putridity.  In  truth,  the  whole  man  seems  to  be 
disintegrating,  decaying ;  the  flesh  becomes  soft,  and  dwindles ;  and 
the  bones  break  easily,  —  being  afflicted  with  a  decay  approaching  to 
rottenness. 

In  bad  cases,  blood  is  discharged  from  the  bladder,  bowels,  womb, 
nose,  and  mouth ;  and  the  smallest  exertion  is  followed  by  fainting, 
and  in  many  cases,  by  sudden  death. 

Causes.  —  The  disease  is  owing  to  the  use  of  food  and  drink  begin- 
ning to  be  decomposed,  and  to  living  long  at  sea  without  vegetables 
eoutiiining  certain  acids.  Its  attacks  are  likewise  encouraged  by 
whatever  weakens  and  depresses  the  nervous  system,  as  long  expos- 
ure to  a  moist,  damp  aii",  part"  larly  when  this  is  connected  with 
confinement  on  board  a  ship,  unclean  linens,  occasional  loss  of  the 
usual  rest,  and  great  fatigue,  as  in  storms.  The  force  of  these  ^auses 
is  increased  by  the  loneliness,  the  sadness,  and  the  despondency  of 
the  sailor's  life. 

Treatment.  —  Sailors  are  very  much  protected  from  the  disease 
now,  by  frequent  returns  to  land,  during  long  voyages,  to  procure 
fresh  meats,  vegetables,  and  water.  This  practice  is  very  generally 
adopted,   paiticularly  by  whale-ships,  which  make   long  voyages; 


!'  ih 


1 


484 


DIBKASES  OF   THE   GKNEKAL   HY8TKM. 


and  Ihu  reuult  iH,  very  littl»  muirvy,  and  genural  noaltli  iiiiion^' 
the  men. 

One  of  the  best  inedtcint'8  for  tlie  diHcoHo  is  ({uinine;  it  iiiiiy  Im; 
given  in  from  one  to  two-grain  doses  twice  or  thiee  times  a  diiv. 
Gentian  and  qiniBsia  are  also  Huitahle  remedies ;  so  is  the  muriiitic 
tincture  of  iron  ^73). 

But  the  best  of  all  remedies  are  fresh  and  succulent  vegetables,  und 
also  fruits.  Spinach,  lettuce,  dandelion,  sorrel,  cresses,  and  the  like, 
are  among  the  very  best  things  when  they  can  be  had.  Lemon  or 
lime-juice  produces  the  happiest  effects.  Potatoes  are  among  tlio 
very  best  remedies,  —  particularly  if  scraped  and  eaten  raw.  They  are 
also  valuable  when  cooked.  Spruce  beer  is  a  good  antidote ;  luid 
may  be  made  at  sea  from  the  essence.  Many  kinds  of  beer  may  bo 
brewed  at  sea,  which  are  valuable. 

When  the  bowels  are  costive,  cream  of  tartar,  dissolved  in  water, 
and  drunk  freely,  will  be  found  the  best  remedy.  If  there  be  loose- 
ness of  the  bowels,  morphine,  laudanum,  a  tea  made  of  logwood,  or 
geranium,  or  the  tincture  of  catechu,  will  be  suitable. 

For  the  spongy  gums,  a  solution  of  alum  applied  to  them  will  Ik; 
proper,  or  a  mixture  of  equal  parts  of  tincture  of  myrrh,  catechu, 
and  Peruvian  bark  ;  and  ulcers  may  be  washed  with  the  same. 

Vinegfar,  which  is  an  excellent  preventive  in  this  disease,  may  be 
made  at  sea  from  molasses  and  Avater  exposed  to  the  sun.  Two 
ounces  of  nitre  dissolved  in  a  quart  of  vinegar,  and  given  in  table- 
spoonful  doses,  three  times  a  day,  is  said  to  be  an  excellent  remedy. 

Every  ship,  on  going  to  sea,  should  be  supplied  with  dried  fruit,  as 
raisins,  currants,  whortleberries,  prunes,  etc. ;  and  should  have  peas, 
beans,  rice,  flour,  sugar  and  molasses.  Beside  these,  ships  should 
have  essence  of  spruce  and  lemon,  and  dried  balm,  sage,  pennyroyal, 
and  other  herbs. 

Seamen,  when  dowi.  with  this  disease,  should  be  moved  with  care, 
as  the  spark  of  life  ma}  he  easily  extinguished. 

Purple  Disease.  —  Purpura  Hemorrhagica. 

This  has  been  sometimes  ranked  as  an  affection  of  the  skin ;  hut 
it  is  not  such  ;  it  is  rather  a  disease  of  the  general  system. 

Symptoms. — The  complaint  is  known  by  the  appearance  upon  the 
skin  of  two  kinds  of  spots  ;  the  one  kind  are  small,  round,  bright-red 
points  even  with  the  surface,  and  changing  in  a  day  or  two  to  a  pur- 
ple or  livid  color,  which  are  yellowish  brown  when  about  to  disap 
pear.  This  variety  of  the  purples  is  quite  simple,  attacking,  gener- 
ally, young  persons,  and  in  warm  weather.  It  is  sometimes  tedious  in 
its  course,  but  never  dangerous.  It  requires  little  treatment  —  pure 
air,  wholesome  diet,  with  quinia  and  the  mineral  acids,  make  up  the 
chief  part  of  it.  It  may  be  known  by  the  spots  not  disappearing 
when  pressed  upon  by  the  finger. 


DISEASES   OF  THE   r.RNKRAI.   SYSTEM. 


485 


Health  aiwm^ 

line ;  it  miiy  Ui 
iO  times  ii  diiy. 
is  the  niuriiitii! 

,  vegetables,  and 
lea,  and  the  like, 
lad.  Lemon  or 
are  among  the 
^mw.  They  are 
d  antidote ;  ami 
1  of  beer  may  Iw 

jsolved  ill  watei\ 
i  there  be  loose- 
e  of  logwood,  or 

le. 

to  them  will  be 
:  myrrh,  cateclni, 
1  the  same. 
is  disease,  may  be 
D  the  sun.     Two 
id  given  in  table- 
xcellent  remedy, 
rith  dried  fruit,  as 
ihould  have  peas, 
lese,  ships  should 

sage,  pennyroyal, 

moved  with  care, 


rhagica. 

of  the  skin ;  but 
system. 

peanvnce  upon  the 
round,  bright-red 
y  or  two  to  a  pur- 
n  about  to  disap 
.  attacking,  gener- 
netimes  tedious  in 
treatment  — p"i'« 
icids,  make  up  the 
not  disappearing 


Tho  otlirr  and  more  dangerous  variety  of  the  disease  is  attended, 
generally,  by  faintneHS,  wandering  pains,  great  debility,  and  the  ap- 
jiearance  upon  the  legs,  arms,  and  l>ody,  it'  dark-red  spotM,  and  irreg- 
ular, livid  patches,  looking  just  like  the  marks  of  re(!ent  bruises. 
These  marks  ai'e  caused  by  tho  effusion  of  blood  in  patches  under  the 
skin ;  and  in  this  respect  they  are  just  like  bruises,  only  they  are 
produced  by  different  causes. 

In  the  rapid  progress  of  tho  disease,  (link  venous  blood  frequently 
oozes  from  the  tongue,  mucous  nienibraiie  of  the  mouth,  nose, 
breathing  tubes,  ears,  vagina,  wond),  stoniacdi,  etc.  The  other  symp- 
toms vary  in  different  cases  very  much,  but  generally  indicate  great 
disturbance  of  the  system. 

It  often  runs  a  very  rapid  course,  but  sometimc^s  remains  f(»r 
months.  The  disease,  as  seen  in  this  country,  is  oftentimes  jussoci- 
ated  with  rheumatism,  it  not  infrequently  being  the  forerunner  of  a 
long  and  tedious  rheumatic  outbreak. 

Treatment.  —  The  Ix^wels  are  to  be  kept  regular  by  gentle  physjc 
(26),  (21),  (12),  (15). 

Iron  is  a  valuable  remedy  (73). 

Astringents  generally  have  a  good  effect  (156),  (159),  (279), 
(305).  The  best  astringent  in  this  complaint  is  gallic  acid,  taken 
in  tive-grain  doses  every  three  or  four  houi-s. 

The  sponge  bath,  twice  a  day,  with  tepid  or  cool  water,  and  fol- 
lowed with  gentle  rubbing  with  a  coarse  towel,  will  do  much  to 
restore  and  equalize  the  circulation  in  the  skin. 

During  the  active  stage  of  the  disease,  the  diet  should  be  very 
light,  —  simple  toast-water,  rice  and  arrow-root  gruel,  and  either  alum 
or  wine  whey. 

While  gettirig  well,  the  patient  may  have  a  more  nourishing  diet, 
consisting  of  tender  fresh  meat,  brotlis,  etc. ;  and  must  tsike  gentle 
exercise  in  the  the  open  air. 

When  associated  with  rheumatism,  the  latter  disease  should  be 
treated  on  the  same  lines  laid  down  elsewhere  for  rheumatism. 

Iron  usually  is  the  mainstay  for  building  up  the  blood,  and  should 
be  given  in  some  mild,  unstimulating  form,  such  as  Bland's  pills,  or 
pepto-maugau,  peptouate  or  albuminate  of  iron,  etc. 

Diphtheria. 

Diphtheria  is  an  acute,  contagious  and  infectious  disease,  whose 
characteristic  feature  is  the  formation  of  a  pseudo-membrane  upon 
a  mucous  surface.  It  is  a  comparatively  recent  disease  in  this 
country,  and  only  lately  well  understood  as  to  its  origin  and  pathol- 
ogy. The  excessive  mortality  of  this  diser^^e  within  the  last  fifty 
years  has  been  so  gieat  as  to  justly  frighten  all  parents  at  its  ap- 
proach, and  lead  them  to  regard  it  as  the  most  terrible  of  all  modern 
scourges.     In  New  York  city  alone,  over  fifty  thousand  deaths  have 


486 


mSRASKS   OF   TIIK   fiRNERAL   8Y8TKM. 


occurred  in  twenty-llvo  v<'<i'n-  It  ih  oho  of  tlio  nioHt  fatal,  as  well  us 
Olio  of  tlu^  (■oiiiinoncHt  of  children's  (liHiiiiscH.  It  is  iniposHiltlc  to  khv 
at  the  outhiit  wheUicr  tlu;  typi;  will  prove  to  Im)  a  mild  or  kcvch' 
one.  A  cius«!  coinnieiKMng  with  Hudden,  soveni  conHtitntional  .wmp- 
toins  and  liij^h  fever  may  jjo  on  to  recovery;  whiht  ono  with  slow, 
gradual  development,  and  little  Hystemic  disturbanee,  may  proprcsH 
gradua'.ly  and  end  in  death.  Nor  Ih  theamonntof  mcinlmmu  present 
in  any  case  a  guide  as  to  the  final  outeomo  of  the  ease.  Many  very 
mild  cases  may  not  at  first  Ih)  recognized  as  diphtheria  until  later, 
when  some  })ost-<li[)htheritic  paralysis  or  other  complication  ensues. 
These  mild  cases  are  equally  conuigious,  and  often  the  origin  of  a 
severe  and  most  malignant  epidemic. 

Cause.  —  True  diphtheria  is  caused  by  a  germ  known  as  the 
Klelw-Lieftler  i)aeillus,  either  alone  or  in  company  with  other  germs; 
it  is  originally  u  local  disease,  becoming  general  as  the  poisons  ema- 
nating from  these  germs  are  alworbed  into  the  system. 

Thisbifcillus  is  always  present  in  diphtheria,  and  found  only  at  the 
site  of  the  local  infection,  and  when  injected  into  animals  prochutes 
all  the  characteristic  symptoms  of  the  disease. 

In  doubtful  cases,  recourse  is  now  had  to  the  finding  of  these  germs 
by  cultures  made  from  little  particles  taken  from  the  suspected  mem- 
brane. 

There  is,  besides  the  true  diphtheria,  a  pseudo-membranous  inflam- 
mation which  runs  a  mild  course,  but  which  cannot  be  distinguished 
clinically  from  the  real  disease,  except  by  making  these  cultures  in 
the  laboratory ;  in  the  latter  disease,  the  Klebs-Luiffler  bacillus  is 
always  absent.  On  the  other  hand,  there  are  often  seen  cases  of  true 
dij)htheria  so  mild  in  character,  and  showing  so  little  membrane,  as  to 
pass  unnoticed,  but  which  on  bacteriological  examination  prove  to 
be  the  dreaded  disease ;  hence  in  all  doubtful  cases  arises  the  neces- 
sity, in  these  modern  times  of  refinement  in  diagnosis  and  treatment 
of  disease,  of  having  an  examination  made  that  the  exact  disease  may 
be  properly  diagnosed,  and  the  appropriate  treatment  be  speedily  in- 
stituted. The  development  of  bacteriological  science  within  the  last 
few  years  renders  this  a  very  practical  and  sure  test  of  the  presence 
of  the  disease.  Accepting  the  proven  origin  of  the  disease  to  be 
microbic,  still  there  are  many  circumstances  influencing  the  develop- 
ment or  arrest  of  the  germs  when  once  introduced  into  the  throat, 
since  it  is  one  of  the  most  variable  and  uncertain  of  the  contagious 
diseases.  It  is  said  that  a  normal  throat  wli.  not  be  attacked  by  the 
bacillus,  while  one  with  some  slight  abmsion,  inflammation,  or  other 
lesion,  ceilainly  offers  a  fertile  field  for  its  development.  It  is  essen- 
tially a  disease  of  childhood,  although  it  occurs  at  all  ages.  Cold 
and  dampness,  and  all  unsanitary  conditions,  are  knov,'n  to  favor  the 
germ  development. 

It  occurs  mostly  in  cold  weather,  as  at  this  time  catarrhal  con- 
ditions are  present,  favoring  the  rooting  of  the  germ. 


niHKAHKS  OF  TUB  QKNKUAh  HYSTKM. 


487 


vtiil,  as  well  ns 
|i()Ssil»U'  to  Hiiy 
iiild  or  huvere 
utional  Kyiiip- 
)no  with  hIow, 
,  may  pro^nesH 
ubrane  pn'seiit 
a.  Many  very 
iria  until  later, 
icatiou  eiiHiu's. 
till)  origin  of  a 

known  aa  the 
Lh  other  gernirt ; 
he  poisonH  uaia- 

1. 

lund  only  at  the 

iiiraals  proiluoes 

,g  of  these  germs 
suspected  mem-    * 

nbranous  inflam- 
be  distinguished 
ihese  cultures  in 
iiffler  bacillus  is 
leen  cases  of  true 
membrane,  as  to 
lination  prove  to 
arises  the  neces- 
|is  and  treatment 
xact  disease  may 
t  be  speedily  in- 
■e  within  the  last 
v)f  the  presence 
[he  disease  to  be 
ling  the  develop- 
into  the  thioat, 
(f  the  contagious 
attacked  by  the 
iraation,  or  otlier 
lent.     It  is  essen- 
,  all  ages.     Cold 
lovm  to  favor  the 

le  catarrhal  con- 


Propajfatlon.  —  The  gorms  aro  introdncod  for  th((  moflt  part  by 
till'  air,  iilthdiigh  food  may  contain  tliese  bat  illi.  Domcstir  animals 
have  been  known  to  friMiuently  convey  the  poison.  All  articles  of 
fiiriiitur*',  clothing,  the  hands  of  attcndantM,  etc.,  arc  common  carriers 
(if  till)  di[)htlu'ritic  germ,  which  is  very  tenacious  of  life,  unless  pre- 
viously disinfected,  hence  the  alwolnte  necessity  of  the  greatest  caro 
in  tlioronghly  cleansing  everything  which  ha«  come  in  contact  with 
a  (hphtlieritic  patient.  The  writer  once  had  the  diseasn.  The  mat- 
tress on  which  he  :dept  was  put  away,  after  a  simple  cleaning,  in  the 
attic  for  two  years,  luul  when  later  on  it  was  brought  down  to  accom- 
modate his  two  little  brothers  on  one  occasion,  the  disease  wiut  com- 
municated to  them  and  they  both  died. 

Incubation  Period.  —  This  is  quite  uncertain  in  the  ordinary  case 
of  air  inoculation,  depending  on  the  condition  of  the  throat,  but 
probably  it  varies  from  one  to  twenty  days.  In  the  case  of  inoculo- 
ti'"'.  of  the  bacillus  into  the  tissues  of  animals  the  period  is  only  from 
OHO  to  three  days. 

Location  of  Disease.  —  The  tonsils,  uvula,  pharynx,  nasal  pas- 
sages and  the  larynx  are  the  ordinary  locations  where  the  membrane 
is  formed,  but  it  may  be  found  less  commonly  on  the  conjunctivae, 
border  of  the  anus,  vagina,  and  respiratory  tract. 

All  the  internal  organs  may  eventually  become  involved  through 
the  absorption  of  the  germ  poisons,  and  at  the  autopsy  show  marked 
lieiuorrhages,  inflammations,  congestions  or  fatty  degeneration  of  their 
tissues. 

Symptoms  and  Diagnosis.  —  The  characteristic  feature  is  the 
membrane,  which  is  apt  to  be  of  a  dull  gray  color,  firmly  adherent  to 
the  tonsil  or  throat,  spreading  gradually  and  becoming  thicker.  To 
distinguish  it  from  simple  follicular  tonsilitis,  which  is  so  common, 
is  often  difficult  and  frequently  impossible  without  a  bacteriological 
examination.  The  membrane  of  simple  tonsilitis  is  white,  begin- 
ning aa  little  white  specks  like  the  curd  of  milk,  and  is  usually  easily 
removed  without  bleeding.  The  membrane  of  diphtheria  spreads  and 
attacks  the  uvula  and  back  of  the  throat,  the  adjacent  tissues  become 
swollen,  the  neck  increases  in  size,  breathing  becomes  more  difficult, 
tlie  pulse  more  r<ii)id  and  smaller,  and  prostration  with  drowsiness,  as 
a  rule,  more  and  more  marked. 

In  simple  cases,  there  is  usually  not  much  fever,  but  in  severe 
cases  the  temperature  may  run  high,  with  great  prostration  and 
languor;  delirium  and  restlessness  accompany  the  severe  cases  of 
great  absorption  of  poison.  The  heart  usually  is  rapid,  with  feeble 
pulse,  but  many  severe  cases  have  a  very  slow  pulse,  which  ordinarily 
is  a  bad  symptom.  The  heart  in  diphtheria  is  always  the  uncertain 
element,  many  cases  dying  suddenly  and  unexpectedly  from  heart 
paralysis.  Albumen  often  appears  in  the  urine,  and  is  usually  an 
evideuce  of  the  involvement  of  the  kidneys;    this  uephritis  uiay 


488 


DISEASES  OF  THE   GENERAL   SYSTEM. 


become  chronic  iiiul  i^eraist  long  after  the  convalescence  from  (lio 
original  disease,  and  may  even  j)rove  fatal.  When  the  membrane  is 
deposited  in  the  nares,  the  breathing  is  more  labored,  and  bloody 
mucus  may  be  seen  in  the  nostrils,  which  hardens,  forming  crusts, 
or  may  run  down  on  to  tlie  lip  and  cause  sore  places.  As  the  tonsils 
grow  larger  and  the  nose  becomes  plugged,  sleep  is  more  and  more 
disturbed  by  snoring  and  inability  to  properly  inspire  the  air,  so  that 
the  child  tosses  from  one  side  of  the  bed  to  the  other  every  few 
minutes.  Add  to  this  an  encroachment  by  the  membrane  on  the 
vocal  chords  or  the  larynx,  and  one  sees  a  truly  terrible  malady,  dis- 
tressing in  the  extreme.  The  encroachment  into  the  larynx  is 
suspected  when  the  voice  becomes  husky  and  hoarse ;  it  finally  may 
be  reduced  to  a  whisper.  The  membrane  may  be  limited  to  the  larynx 
alone,  as  in  the  so-called  membranous  croup,  which  is  no  more  or  less 
than  diphtheria  of  this  region.  The  symptoms  of  this  affection  are  at 
first  local,  and  'is  the  disease  progresses,  become  more  and  more 
marked  and  distressing  till  death  ensues  from  suffocation.  The  face 
becomes  blue,  the  chest  heaves  with  the  deep,  labored  respirations, 
the  nostrils  dilate,  and  the  little  spaces  below  the  collar-bones  more 
and  more  depressed  and  drawn  in. 

The  severity  of  the  case  depends  much  on  the  amount  of  absorp- 
tion from  the  throat,  nose,  or  pharynx,  of  the  toxines  produced  by  the 
growth  of  the  germs  on  the  one  hand,  and  the  ability  of  nature  on 
the  other  hand  to  resist  the  invasion. 

The  odor  of  the  breath  in  diphtheria  is  characteristic,  and  when 
once  experienced  is  never  forgotten. 

Sequelae.  —  Besides  the  chronic  catarrh  which  is  left  at  the  origi- 
nal site  of  the  membrane,  and  the  anaemia  (or  paleness  consequent 
on  the  impoverished  blood),  the  most  frequent,  and  the  most  charac- 
teristic sequel  of  diphtheria  is  paralysis,  which  comes  on  in  from  one 
to  five  weeks  after  convalescence.  This  paralysis  lasts  from  two  to 
six  weeks,  though  it  may  last  for  months,  and  even  for  a  lifetime. 
It  is  in  no  wise,  apparently,  proportionate  to  the  severity  of  the  dis- 
ease. It  is  seen  in  all  parts  of  the  body,  particularly  the  throat  and 
nose,  causing  a  nasal  twang  to  the  voice,  and  the  regurgitation  of 
food  through  the  nose.  It  may  affect  the  muscles  of  deglutition  and 
speech,  may  attack  the  legs,  arms,  diaphragm,  and  the  sphincter 
muscles  of  the  bladder  and  rectum. 

Prognosis.  —  The  prognosis  varioa  according  to  the  age  and 
health  of  the  patient,  the  severity  of  the  aymptoras,  place  of  attack, 
and  the  character  of  the  epidemic  prevailing ;  nasal  and  laryngeal 
complications,  as  well  as  the  large  area  of  mucous  membrane  in- 
volved, increase  the  risks  of  the  patient.  The  mildest  cases  may  termi- 
nate fatally  from  relapse.  The  heart  may  give  out  at  any  time,  and 
death  may  be  close  at  hand  when  apparently  all  is  going  well.  Un- 
favoaablc  symptoms  are  pallor,  prostration,  vomiting,  and  inability  to 


DISEASKS   OF   THE    GENRRAL   SYSTEM. 


489 


jcence  from  llm 
the  membrane  is 
red,  and  bloody 
,  forming  crusts, 
.  As  the  tonsils 
1  more  and  more 
■e  the  air,  so  that 

other  every  few 
lembrane  on  the 
ible  malady,  dis- 
n  the  larynx  is 
e ;  it  finally  may 
Ited  to  the  larynx 
s  no  more  or  less 
is  affection  are  at 

more  and  more 
jation.  The  face 
)red  respirations, 
joUar-bones  more 

mount  of  absorp- 
s  produced  by  the 
lity  of  nature  on 

eristic,  and  when 

i  left  at  the  origi- 
eness  consequent 
I  the  most  charac- 
es  on  in  from  one 
lasts  from  two  to 
ren  for  a  lifetime, 
verity  of  the  dis- 
rly  the  throat  and 
)  regurgitation  of 
of  deglutition  and 
nd  the   sphincter 

to  the  age  and 
8,  place  of  attack, 
isal  and  laryngeal 
0U3  membrane  in- 
jt  cases  may  termi- 
t  at  any  time,  and 

going  well.  Un- 
ig,  and  inability  to 


take  much  nourishment,  weakness  of  pulse  witli  great  rapidity  or 
slowness,  hemorrhages  into  the  skin,  restlessness  and  delirium. 

Prophylaxis.  —The complete  isolation  of  the  i)atient  in  a  room  of 
the  top  story,  supplied  with  as  little  furniture  as  possible,  is  requisite. 
All  utensils  and  dishes  should  be  thoroughly  disinfected  before  taken 
out  ot  the  room.  All  discharges  received  into  a  vessel  containing 
corrosive  sublimate.     All  clothing  should  be  boiled  when  possible. 

During  the  disease,  some  volatile  oil,  like  eucalyptus,  turpentine, 
carbolic  acid,  etc.,  should  be  vaporized  through  the  rooni.  The 
.  nuree  in  charge  should  not  be  in  communication  with  other  members 
of  the  household,  nor  children  of  the  family  allowed  to  play  with 
others  in  the  neighborhood,  although  hey  should  be  kept  out  of 
dooi^  hbemlly,  but  carefully  fed  and  .u  every  way  protected  from 
catarrhal  disorders.  The  patient  after  convalescence  should  be 
thoroughly  bathed  with  soap  and  water,  and  finally  with  corrosive 
sublimate  so  ution,  including  the  hair.  As  much  as  possible  of  the 
uimture  and  other  equipmenta  that  cannot  be  thorougldy  cleansed 
by  boiling  water,  steam  or  corrosive  sublimate,  should  be  destroyed; 
hnally  the  room  and  its  contents  should  be  fumigated  with  sulphur 
fumes  by  burning  three  pounds  of  sulphur  to  every  thousand  cubic 
leet  of  air  space. 

Members  of  the  family  should  be  kept  from  school  and  church  and 
other  public  places,  and  their. mouths  and  nostrils  daily  washed  with 
some  disinfectant  like  carbolic-acid  gargle.  Only  thin,  washable 
clothing  should  be  worn  in  the  sick  room. 

Treatment.  —From  the  first  the  treatment  should  be  supportive, 
tonic,  and  stimulating.     The  temperature  of  the  room  should  be  kept 
at  abotit  seventy  degrees,  and  plenty  of  fresh  air  and  sunlight  ad- 
imtted.     The  clothing  and  bedding  should  be  changed  frequently, 
and  the  recumbent  position  without  exertion  be  insisted  on.     The 
diet  should  be  liquid,  and  given  every  two  to  four  hours,  in  definite 
quantity,  not  exceeding  what  the  child  can  easily  digest.     Beef-tea 
milk  and  lime-watei-,  egg  and  milk,  Bovox  or  Bovinine  in  milk  or 
water,  are  samples  of  the  class  of  foods  to  be  administered.     Alcohol 
in  the  fonn  of  brandy,  whiskey,  champagne,  etc.,  should   be  given 
ireely ;  there  is  more  danger  of  giving  too  little  than  too  much.    The 
more  septic  or  poisoned  the  patient,  the  more  the  alcohol  will  be 
tolerated  and  required.     Very  large  amounts  are  taken  in  this  dis- 
ease, as  well  as  in  all  sererely  septic  diseases.     A  five-year-old  child 
will  easily  take  from  two  to  fifteen  ounces  of  whiskey  a  day.    Other 
valuable  stimulant*  are  strychnine,  digitalis,  ammonia,  camphor,  etc. 

h«.i,'''^'A  n  u  "  ^'^?  ^^''''^^  ^  ^"^y^*^  ^y  ''Old  sponging  or  the  cool 
„,n  ;  1.     :  ^«™?"'^g«S'  diarrhoea,  or  other  exhausting  complications 
must  be  stopped.     Of  internal  treatment,  perhaps  none  has  stood  the     ' 
test  ot  time  better  than  that  recommended  years  ago  by  Dr.  Jacobi 
of  New  York,  of  which  the  following  is  an  illustration :  L 


490 


niSKASK8  OF   THK   GWNERAI,   SYSTEM. 


Corrosive  sublimate,  one-lialf  grain ;  wine  of  pepsin,  four  ounces. 
Tetispoonful  every  two  lioni-s,  for  a  child  five  yeara  old.  This  is  an 
antiseptic  to  tlie  intestinal  tract,  and  helps  disinfect  the  system. 
Locally,  the  throat  is  to  be  sprayed  with  a  solution  of  peroxide  of 
hydrogen.  If  this  smarts  or  excoriates  the  mouth,  it  may  be  diluted 
even  to  equal  parts  with  lime  water.  This  solution  may  be  injected 
through  the  nose.     It  must  be  used  freely  and  often. 

To  desti'oy  the  bacilli,  a  one  part  to  one  thousand  solution  of 
corrosive  sublimate  in  the  form  of  spray  may  be  used  after  the 
cleansing  with  the  peroxide  of  oxygen  solution,  or  what  has  recently 
been  introduced  as  the  Lceffler  diphtheria  spray,  which  consists  of 
several  antiseptics. 

The  use  of  papoid,  papayotin  and  other  solvents  of  membranes,  is 
frequently  very  beneficial:  they  may  be  sprayed  or  swabbed  on  to  the 
throat.  The  sequelae  are  to  be  treated  on  general  tonic  principles; 
the  catarrh  is  to  be  treated  by  the  application  of  mild  nitrate  of  silver 
solutions,  and  the  paralysis  by  stxychnia,  massage,  electricity,  and 
general  tonics. 

These  measures  constitute  the  main  essential  points  in  treatment 
in  those  cases  which  for  any  reason  do  not  receive  the  modern 
antitoxin  treatment. 

Since  the  better  understanding  of  the  Klebs-Loeffler  bacillus,  at- 
tempts have  constantly  been  made  to  produce  an  antidote  to  the 
diphtheria  poison,  and  it  would  now  seem  as  if  bacteriology  had  at 
last  revolutionized  the  entire  treatment  of  diplitheria,  for  of  late  a 
remedy  called  antitoxin  has  been  found  and  successfully  tested.  The 
death-rate  of  diphtheria  has  been  reduced  nearly  one  half ;  apparently, 
one  of  the  greatest  boons  ever  sent  to  humanity  has  been  realized  in 
antitoxin. 

For  some  time  it  has  been  known  i '«,.  the  serum  of  animals  immune 
from  diphtheria,  when  injected  into  susceptible  animals,  would  prevent 
the  infection  of  cultures  made  from  the  Klebs-Loeffler  bacillus ;  and  at 
last  the  essential  elements,  or  the  antitoxin.,  has  been  isolated. 

Not  only  has  it  been  found  *;hat  the  injection  of  a  given  amount  of 
antitoxin  into  the  human  subject  would  iill  out  the  diphtheria,  but 
also  that,  when  injected  into  ijhildren  not  yet  taken  down  with  the 
disease,  but  who  have  been  subjected  to  it,  this  antitoxin  would 
actually  pr.ivent  the  occuirence  of  the  disease  in  them,  or,  technically 
speaking,  reiider  them  immune. 

For  over  a  year  now  this  modern  blessing  has  been  enjoyed  by 
thousands  of  I'-opl^  a);  over  the  world.  Reports  are  everywhere 
published  bypubi.--.  institutions  and  private  practitioners,  speaking 
in  figures  more  convincing  than  any  statement  could  be,  of  the 
greatest  advance  in  medicine  that  the  last  half  centuiy  has  witnessed. 
It  is  to  diphtheria  what  Listerism  was  to  surgery. 

The  essential  features  of  this  treatment  consist  in  the  injection  into 
some  convenient  part  of  the  lx)dy,  like  the  back,  loins,  or  thigh,  of  a 
certain  amount  of  this  liquid  proportionate  to  the  age  of  the  patient, 


-r-», 


DISEASES   OF   THE   OENEUAL   SYSTEM. 


491 


the  severity  of  the  disease,  and  the  time  elapsed  since  the  outset  of 
the  symptoms. 

The  dosage  varies  with  all  these  conditions,  and  the  particular 
variety  of  antitoxin  employed.  The  repetition  of  the  dose  depends  on 
the  amount  of  improvement  in  the  membrane.  At  first  a  reddening 
about  the  diphtheritic  patch  is  seen,  then  a  thinning  out  of  the  mem- 
brane and  a  general  amelioration  of  the  symptoms.  To  prevent  the 
occurrence  of  the  disease,  only  quite  a  small  amount  ia  required,  and 
it  needs  to  be  injected  but  once.  The  great  advantage  of  this  treat- 
ment, outside  of  its  favorable  statistics,  is  the  comfort  derived  by  the 
patient  in  not  being  so  frequently  disturbed  by  other  auxiliary 
treatment,  as  nothing  else  is  required  -to  be  done  when  the  case  is 
seen  early.  As  a  matter  of  fact,  cases  are  often  seen  so  late,  and  the 
poison  has  so  successfully  invaded  the  system  as  to  render  the  anti- 
toxin treatment  less  potent,  that  medical  men  employ  local  measures 
to  help  out  the  antitoxin.  The  earlier  the  treatment  is  begun,  the 
less  antitoxin  will  be  required,  and  the  surer  the  successful  issue. 

Like  all  great  advances  in  medicine  and  surgery,  this  method  is 
not  without  its  enemies,  who  will  tell  of  the  ill  effects  to  the  blood 
experienced  later  in  life.  The  only  ill  effects  are  certain  rashes 
resembling  hives,  or  urticaria,  situated  generally  near  the  site  of  the 
punctures  and  due  to  local  irritation.  These  all  pass  off  in  a  few 
days,  and  are  only  annoying  at  the  very  worst.  Should  abscesses 
occur  they  may  be  put  down  as  the  result  of  an  unclean  syi'inge,  or 
ascribed  to  the  neglect  of  proper  aseptic  precautions  on  the  part  of 
the  physician. 

This  antitoxin  serum,  taken  from  horses  after  repeated  inoculation, 
may  now  be  obtained  from  local  boards  of  health,  and  other  similar 
authorities,  thus  enabling  the  poor  to  be  able  to  procure  free  of  cost 
this  antidote  against  the  most  ravenous  of  diseases. 

Canker.  —  Aptha  Communis. 

Vert  few,  if  any,  standard  medical  writers  have  treated  of  canker. 
In  truth,  it  is  only  a  symptom  of  various  complaints,  and  not  itself  a 
disease.  It  has  accordingly  been  shut  out  from  medical  books.  It 
afflicts  —  yes,  »orely  afflicts,  numerous  persons,  who,  though  doubt- 
less affected  by  some  constitutional  disturbance  as  its  cause,  are  not 
conscious  of  any  complaint  except  this  single  manifestation  —  canker. 
You  find  not  only  the  disease,  therefore,  but  complaints  respecting  it, 
in  almost  everybody's  mouth;  "What  shall  I  do  for  the  canker?" 
meets  us  at  almost  every  turn.  "  I  am  sorely  aiflicted  with  the 
canker,"  says  one.  "  I  am  literally  sick  with  the  canker,"  says 
another.  And  a  third  says,  "  I  can  neither  eat,  nor  converse,  nor 
take  rest,  I  am  in  such  pain  from  canker  in  my  mouth."  And  these 
complaints  are  not  unnatural,  for  the  sufferings  occasioned  by  this 
affection  are  indeed  terrible. 


f 


492 


DI8KASE8   OF   THE   GENERAL   SYSTEM. 


Canker  begfins  in  the  form  of  small  blisters,  generally  upon  the 
tongue,  or  inside  of  the  cheeks  or  lips,  or  stomach,  which,  after  a 
time,  break  and  form  little  ulcers,  which  are  oftentimes  very  sore 
and  painful.  These  ulcers  will,  at  times,  not  only  multiply,  but 
spread  themselves  to  large  dimensions,  going  deep  into  the  flesh,  and 
becoming  painful  almost  beyond  endurance.  In  many  cases,  tlu; 
parts  swell,  and  become  so  sensitive  and  tender  that  it  is  almost  im- 
possible to  swallow  the  blandest  food.  The  mouth  will  frequently 
become  fiUod  with  saliva,  which  runs  involuntarily  out,  to  the  great 
annoyance  of  the  patient.  , 

Treatment.  —  Canker  is  frequently  dependent  on  a  deranged  state 
of  the  stomach  and  bowels.  When  this  is  the  case  the  treatment 
may  begin  with  a  dose  of  gentle  physic  (12),  (15),  (19),  (26).  If 
the  stomach  be  quite  permanently  deranged,  let  this  be  followed  with 
a  somewhat  prolonged  use  of  preSvription  (28)  or  (37),  or  of  the 
neutralizing  cordial.  If  the  mouth  be  veiy  sore,  use  a  tea  of  slippery 
elm  bark,  or  flax-seed,  or  a  solution  of  gum-arabic ;  and  as  the  in- 
flammation subsides,  touch  the  ulcerated  patches  with  the  stick 
nitrate  of  silver  (lunar  caustic)  ;  or  use  gargle  (201),  (202),  (203), 
(205),  (208),  (209),  (232),  (243),  r244),  or  sulphate  of  copper, 
eight  grains  dissolved  in  two  ounces  of  water.  A  tea  made  of  rasp- 
berry leaves,  or  blackberry  roots,  may  be  freely  used  as  a  drink. 

One  of  the  best  remedies  is  hamamelis.  Of  this  a  dessertspoon- 
ful, may  be  held  for  a  few  moments  in  the  mouth  and  then  spit  out. 
A  teaspoonful  may  be  taken  internally,  once  an  hour  until  relieved. 
Receipe  205  is  not  only  useful  as  a  gargle,  but  may  be  reduced  by 
adding  one  pint  of  water,  and  may  then  be  swallowed  four  or  five 
times  a  day,  in  doses  of  two  tablespoonfuls  at  a  time. 

The  diet  should  always  be  carefully  regulated,  arid  only  the  more 
simple  food  taken,  and  at  regular  meals. 

To  rapidly  heal  a  canker  spot,  touch  it  with  a  wooden  tooth-pick 
which  has  been  dipped  in  a  strong  solution  of  carbolic  acid.  The 
ulcer  turns  white,  and  in  a  few  days  is  completely  healed. 


merally  upon  the 
ih,  which,  after  a 
mtimes  very  sore 
ily  multiply,  but 
nto  tlie  flesh,  and 

many  cases,  tlu; 
it  it  is  almost  iiii- 
h  will  frequently 

out,  to  the  great 

1  a  deranged  state 
Lse  the  treatment 
,(19),  (26).    If 

be  followed  with 
r  (37),  or  of  the 
i  a  tea  of  slippery 

;  and  as  the  in- 
i  with  the  stick 
1),  (202),  (203), 
phate  of  copper, 
tea  made  of  rasp- 
d  as  a  drink. 
\  a  dessertrspoon- 
,nd  then  spit  out. 
ur  until  relieved, 
ly  be  reduced  by 
wed  four  or  five 
e. 
.rid  only  the  more 

/^ooden  tooth-pick 
rbolic  acid.  The 
liealed. 


DISEASES  PECULIAE  TO  MODERN 

TIMES. 


In  so  short  a  space  as  we  liave  at  our  command  the  mere  outlining 
of  this  chapter  is  all  that  can  be  expected  ;  whole  volumes  might  be 
written,  and  that,  too,  much  to  the  reader's  profit  and  interest 

Within  the  last  fifty  years  diseases  have  assumed  different  aspects, 
while  many  actually  new  or  heretofore  unrecognized  diseases  swell 
the  list  of  ailments.  The  "diathesis  "  of  disease  is  the  type  of  con- 
stitution inherited  from  the  parents.  From  time  immemorial,  almost, 
there  have  been  recognized  five  such  types :  the  strumous,  the  ner- 
vous, the  bilious,  the  lymphatic,  and  the  gouty.  Diseases  of  modern 
times  tend  greatly  to  the  nervous  type  ;  not  only  this,  but  individual 
cliaracteristics  are  at  times  so  pronounced  as  to  form  what  are  pro- 
fessionally known  as  "idiosyncrasies."  These  idiosyncrasip  con- 
tinually increase,  —  so  much  so  that  what  may  be  "food  for  one  is 
poison  to  another."  The  causes  of  this  change  of  tendency  in  disease 
are  most  numerous  and  espocially  noticeable  in  young  countries. 

Born  of  busy,  hard-working  parents,  whose  lot  in  life  has  been  to 
struggle  hard  in  new  lands,  or  cast  among  neighbors  whose  life  has 
been  one  of  hurry  and  excitement,  the  child  receives  a  nervous  im- 
petus at  an  early  age,  and  his  precociousness  is  considered  to  be  due 
to  an  inheritance  of  unusual  mental  strength  rather  than  to  an  over- 
strained nervous  system  of  the  parents  and  a  consequent  nerve-debility 
of  the  child.  The  child's  early  training  is  a  rapid  one,  and  at  the 
early  age  of  five  or  six  the  youth  begins  a  course  of  school  instruc- 
tion calculated  to  make  a  man  or  woman  within  a  given  time.  The 
already  frail  nervous  system  is  overtaxed ;  when  he  branches  out  into 
business  life,  he  already  shows  signs  of  mental  feebleness,  which 
should  be  the  concomitant  of  long  years  of  hard  labor  only.  Society, 
too,  claims  so  much  of  young  people  as  unfits  them  for  anything  else 
but  its  own  exactions.  Too  long  waking  hours  and  too  short  sleep- 
ing hours  waste  the  surplus  energy  and  call  on  the  nervous  system  to 
whip  up  the  tired  body.  The  wear  and  tear  of  business  life,  with  its 
constantly  increasing  complications  and  confinement  to  indoor  work, 
only  add  to  the  strain  induced  at  dentition  and  puberty.  In  modern 
times,  when  every  business  in  rapidly  growing  towns  and  cities  is 
being  more  and  more  "cut  up,"  and  when,  consequently,  greater 

493 


m 


;v^PSBRMn 


494 


DISEASES   PECULIAR   TO  MOUEKN   TIMES. 


struggling  for  existence  occui-s,  greater  speed  and  anxiety,  and  more 
frequent  disappointments  are  necessarily  incurred.  We  rush  tlu-ough 
life  nowadays.  Advancing  civilization  is  the  cause  of  much  of  lliis 
extra  speed.  The  press,  telegraph,  telephone,  and  steam  appliances 
enable  us  to  live  faster,  know  and  see  more  in  a  given  time  than  ever 
before.  The  temptation  is  too  great,  and  we  rush  on,  regardless  of 
tired  bodies  and  exhausted  brains,  of  overtaxed  stomaclis  and  sleej)- 
less  nights,  to  keep  up  with  the  times.  Climates  which  are  dry,  with 
extremes  of  heat  and  cold,  also  cause  much  waste  of  nerve-force. 
The  upbuilding  of  a  new  country  has  much  to  do  with  our  discuses. 
At  present  the  West  exhibits  that  feverish  eagerness  for  success  in 
life  once  exhibited  in  the  East.  Europe  has  passed  that  stage  of 
barometrical  change  in  disease,  due  to  advancing  civilization,  while 
the  United  States  is  passing  through  it.  The  faults  of  Europe  lie 
in  the  direction  of  pleasure-excesses ;  ours  is  an  overworked  nervous 
system.  Our  American  liberty,  and  freedom  of  personal  ambition  to 
rise  from  the  lowest  station  in  life  to  the  highest,  from  poverty  to 
riches,  and  from  ignorance  to  intelligence  and  honor,  will  always  act 
as  an  excitant  to  the  nervous  system,  and  is  the  one  cause  of  our 
excessive  activity.  We  must  huny  less ;  give  more  time  for  Dame 
Nature  to  repair  the  waste  of  the  system  and  to  store  up  potential 
energy.  We  must  divide  more  evenly  our  periods  of  sleep,  recrea- 
tion, and  work,  that  our  children  may  become  the  possessors  of  more 
vital  energy.  We  neglect  too  much  old-fashioned  methods  of  strength- 
ening our  bodies,  as  outdoor  gymnastics  and  walks.  Even  our  sports 
tinge  t<io  much  of  speed  and  undue  excitement,  and  partake  too  much 
of  "professional "  knowledge.  Let  us  have  fewer  "  finely-cut "  men, 
and  more  robust  ones. 

Thus  it  is  we  inherit  a  greater  diathesis  to  nerve  disetises.  This 
diathesis  means  a  greater  susceptibility  to  stimulants  and  narcotics, 
social  evils  and  greater  risks.  The  changes  peculiar  to  this  diathesis, 
or  those  much  increased  by  it,  are  the  early  and  rapid  decay  of  teetli, 
neuralgia,  premature  baldness,  and  hay  fever;  nervous  dyspepsia, 
sick  headaches,  short-sightedness,  St.  Vitus's  dance,  sleeplessness, 
hypochondria,  hysteria ;  cerebral,  spinal,  digestive,  and  sexual  ex- 
cesses ;  inebriety,  epilepsy  and  insanity. 

The  first  signs  of  ascension  or  declension  in  the  health  of  a  nation 
are  seen  in  woman.  The  American  woman  of  to-day  offers  a  striking 
contrast  to  the  original  female  inhabitant  of  this  continent.  The 
difference  in  the  mental,  moral,  and  social  types  m.ay  be  well  worth 
the  cost,  but  we  have  sacrificed  too  much  of  the  physical  and  nervous 
strength  to  have  gained  the  most  out  of  our  three  hundred  years  or  so 
of  existence.  Womb  troubles  are  almost  the  birthright  of  every 
woman,  —  so  much  so  that  necessity  has  developed  in  America  a 
science  for  their  relief,  in  a  short  space  of  time,  as  wonderful  aw  the 
telegraph  or  telephone.  The  physician  of  to-day  feels  he  must  have 
at  least  a  knowledge  of  gynaecology,  whatever  else  he  may  or  may 
not  know. 


DISEASES    PECULIAR   TO  MODERN   TIMES. 


495 


mxiety,  and  more 

We  rush  through 
B  of  much  of  this 

steam  appliances 
en  time  than  ever 
I  on,  regardless  of 
omaclis  and  8lee[)- 
diich  are  dry,  with 
te  of  nerve-force, 
with  our  diseiises. 
less  for  success  in 
ised  that  stage  of 
civilization,  while 
iilts  of  Euro[)e  lie 
erworked  nervous 
rsonal  aiuhition  to 
;,  from  poverty  to 
)r,  will  always  act 

one  cause  of  our 
>re  time  for  Dame 
store  up  potential 
is  of  sleep,  recrea- 
possessors  of  more 
ethods  of  strength- 
Even  our  sports 

partake  too  much 
"  finely-cut "  men, 

fe  diseases.  This 
nts  and  narcotics, 
ir  to  this  diathesis, 
pid  decay  of  teeth, 
lervous  dyspepsia, 
nee,  sleeplessness, 
e,  and  sexual  ex- 
health  of  a  nation 
ly  offers  a  striking 
s  continent.  The 
nxay  be  well  worth 
ysical  and  nervous 
lundred  years  or  so 
irthright  of  every 
ped  in  America  a 
,s  wonderful  as  the 
feels  he  must  have 
se  he  may  or  may 


The  terms  nervous  exhaustion,  nervous  prostration,  neurasthenia, 
etc.,  are  of  modern  invention.  Ancients  knew  little  of  the  continual 
noises  of  factories  and  teams,  electric  and  steam  appliances ;  tlieir 
wearied  bodies  were  lulled  to  sleep  by  gentle  sighing  of  the  trees, 
and  refreshed  by  sweet  air.  The  evident  cure  for  these  increasing 
evils  lies  in  a  change  in  our  national  habits.  We  must  cultivate  the 
restful  out-door  recreation  of  the  Indians ;  we  must  go  through  life 
more  slowly,  eat  less  rapidly,  and  sleep  longer.  Cultivate  the  desire 
to  enjoy  nature  and  art  more.  Do  business  only  in  business  hours 
and  on  business  days.  Indulge  more  in  cool  baths,  rides,  walks,  and 
natural  sports.     Learn  to  do  less  in  amount,  but  better  in  quality. 


m 


\: 


^ 


OLD  AGE  AND  ITS  DISEASES. 


Life,  like  the  natural  day,  has  its  morning,  its  noon,  and  its  even- 
ing. Eacli  period  has  its  sunshine  and  its  clouds ;  its  light  and  it« 
darkness  ;  its  fair  weather  and  its  storms ;  its  joys  and  its  sorrows. 
The  old  do  not  feel  the  exhilarating  brightness  of  the  morning  of  life, 
nor  the  fervid  strength  of  its  noon ;  but  they  often  experience  what 
is  better :  a  calm,  quiet  stillness,  and  peaceful  repose,  in  its  evening. 

There  is,  perhaps,  no  one  thing  —  certainly  not  many  things  — 
which  impress  the  reflective  mind  and  tender  heart  with  more  sadness, 
than  to  see  an  old  man,  bending  low  with  years,  with  little  or  no  self- 
restraint  ;  the  passions  all  untamed,  except  so  far  as  age  has  quenched 
their  fires ;  fretful,  peevish,  jealous,  complaining ;  distrustful  of  the 
ways  of  Providence ;  doubting  the  integrity  of  any  human  being ; 
surrounded  by  clouds  and  dsirkness ;  and  stepping  down  gradually 
and  reluctiintly,  amid  a  cold,  drizzly,  sleety,  moral  rain,  into  a  dark, 
uncheered,  and  unillumined  grave. 

On  the  other  hand,  how  unspeakably  pleasant  it  is  to  see  the  silver- 
haired  pilgrim,  in  the  evening-time  of  life,  cheerful,  happy,  trustful 
in  God  and  hopeful  of  men ;  the  winds  and  storms  of  life  bringing 
little  or  no  disturbance  of  his  peace  ;  baring  the  head  reverently  and 
bowing  it  meekly  in  the  presence  of  great  afflictions,  and  lifting  it 
up  rejoicingly  when  blessings  fall  upon  it ;  converting,  by  the  soft, 
subdued,  and  beautiful  sunshine  which  he  spreads  around  him,  the 
very  unpromising  elements  of  the  latest  autumn  into  the  finest  Indian 
summer  of  life  ;  and  finally  sinking  down  peacefully  to  his  rest  amid 
the  golden  evening  sunlight,  and  leaving  the  sky,  long  after,  tinted 
with  colorings  more  beautiful  than  artists  ever  conceived. 

"Why  weep  ye,  then,  for  him  who,  having  won 
The  bound  of  man's  appointed  years,  at  last,  — 
Life's  blessings  all  enjoyed,  life's  labors  done,— 

Serenely  to  his  final  rest  has  passed  : 
While  the  soft  memory  of  his  virtues  yet 
Lingers  like  twilight  hues  when  the  bright  sun  is  set  ? " 

Besides  these  general  reflections,  it  is  proper  in  this  chapter  to 
contemplate  the  old  from  several  points  of  view. 

They  are  experienced  persons,  and  we  may  learn  much  from  them. 
To  be  sure,  they  have,  in  most  cases,  lost  the  acuteness  of  thoir 
senses.     They  do  not  hear,  or  see,  or  taste  as  sharply  as  the  young, 


OLD   AGR   AKD   ITS   DIflRASES. 


497 


.8ES. 


)on,  and  its  oven- 
its  light  and  its 
and  its  sorrows, 
le  morning  of  life, 
1  experience  what 
se,  in  its  evening. 
t  many  things  — 
vith  more  sadness, 
th  little  or  no  self- 
i  age  has  quenched 
distrustful  of  the 
my  human  being; 
ig  down  gradually 
rain,  into  a  dark, 

is  to  see  the  silver- 
•ul,  happy,  trustful 
ns  of  life  bringing 
lead  reverently  and 
ions,  and  lifting  it 
[erting,  by  the  soft, 
Is  around  him,  the 
[to  the  finest  Indian 
illy  to  his  rest  ainid 
r,  long  after,  tinted 
iiceived. 


|un  is  set  ?  " 
in  this  chapter  to 

rn  much  from  tliera. 
[acuteness  of  thoir 
(arply  as  the  young, 


or  even  always  think  as  quickly ;  yet  their  judgments  are  founded 
on  r  large  experience ;  their  decisions,  though  not  as  prompt,  or 
emphacic,  or  brilliant  as  those  of  younger  persons,  are  more  safe  and 
reliable.  They  are  worthy,  therefore,  of  our  respectful  confidence. 
We  may  seek  their  counsel  and  advice,  and  in  most  cases  follow  it 
with  safety.  True,  they  are  apt  to  be  conservative,  and  to  distrust 
new  things  and  ideas ;  but  these  new  things  and  ideas  are  matters  in 
which  they  have  had  no  experience  —  matters  which  belong  to  an 
age  subsequent  to  their  time  —  matters,  therefore,  which  lie  outside 
the  sweep  of  their  active  life,  and  respecting  which  they  should  not 
be  expected  to  judge.  It  is  no  disparagement  to  them  to  say  that 
they  are  not  fitted  to  judge  of  those  new  thoughts  and  discoveries 
which  have  swarmed  upon  the  world  since  the  sun  of  their  life  has 
been  sinking  low  in  the  western  sky.  But  in  all  those  staple  max- 
ims and  ideas  which  underlie  human  duties,  in  all  ages,  the  old  may 
safely  be  taken  as  our  counsellors. 

Depositories  of  Family  History.  —  They  are  the  frail  depositories 
and  keeper's  of  a  vast  deal  of  valuable  family  history,  anecdote,  and 
reminiscences  of  events  fast  fading  from  human  recollection.  Few 
errors  of  my  own  early  life  have  been  so  much  regretted  by  me  as  the 
neglect  to  learn  from  my  aged  relatir  es,  when  I  had  the  opportunity, 
some  of  the  more  important  points  in  the  history  of  my  family.  My 
grandfather,  Col.  Gideon  Warren,  —  a  first  cousin  of  Gen.  Joseph 
Warren,  and  a  personal  friend  of  Ethan  Allen, —  lived  in  some  of  the 
towns  of  southern  Vermont,  and  finally  spent  his  last  days  and  died 
in  Hampton,  N.Y.  There  stands  his  tombstone  to  this  day,  with  the 
following  beautiful  words  from  Young's  "  Night  Thoughts  "  engraved 
upon  it :  — 

<'An  angel's  arm  can't  snatch  me  from  the  grave; 
Legions  of  angels  can't  confine  me  there." 

These  few  facts  are  about  the  substance  of  what  I  know  of  his  his- 
tory. In  what  town  his  father  settled,  who  was  one  of  three  brothers 
who  emigrated  to  this  country,  or  who  were  his  brothers  and  sisters, 
or  what  became  of  them,  I  have  not  been  informed,  simply  because  I 
did  not  obtain  the  information,  now  so  much  desired  by  me,  as  I 
might  ^easily  have  done,  between  thirty  and  forty  years  ago,  while 
spending  a  year  in  Hampton  fitting  for  college.  An  uncle  of  mine, 
Caleb  Warren,  was  then  living  in  Hampton,  an  old  man.  He  had 
learned  from  my  grandfather  the  full  history  of  the  family;  and 
from  him  I  might  have  derived  knowledge  which  I  should  now  value 
above  price  —  knowledge  which  I  intend  yet  to  acquire,  if  the  pres- 
sure of  professional  business  shall  ever  be  so  lifted  from  me  tliat  I 
can  command  time  for  the  investigation.  But  I  shall  never  cease  to 
remeihber  the  fact,  or  to  lament  my  misimprovement  of  it,  that  from 
this  venerable  relative  I  might  have  learned  facts  and  put  them  on 
record  in  one  hour,  which  it  will  cost  me  weeks  and  months  of  cor- 
respondence, travel,  and  the  searching  of  records  to  acquire.     I  say 


:,: 


^rWil 


#^ 


498 


OLD   AOK   AND   ITS  PTflRASKS. 


to  all  young  persons,  value  very  highly  the  knowledge  of  your  family 
history,  which  you  may  easily  learn  from  your  parents,  grandparent, 
uncles,  aunts,  etc.,  and  esteem  those  very  highly  who  are  able  to 
impart  it  to  you.  Soon  these  living  records  will  1x3  suddenly  Wotted 
by  the  hand  of  death ;  and  then  no  regret  for  past  negligence  will 
enahle  you  to  repair  your  loss,  if  you  have  not  improved  your  oppor- 
tunity. 

The  Fathers  of  our  Race  and  the  Founders  of  our  Institutions.— 

The  aged  people  who  yet  linger  among  us  are  our  fathers.  We  have 
our  existence,  through  God,  from  them,  and  from  others  who  have 
preceded  them  to  the  silent  land.  They  educated  the  present  race. 
All  that  is  valuable  in  the  moral  principle  and  mental  culture  of  the 
men  and  women  of  this  genenition,  has  been  derived  from  them. 
Much  of  their  lives  was  spent  in  training  us,  mentally  and  morally, 
and  fitting  us  for  usefulness. 

Not  only  the  fine  moral  and  intellectual  characters  which  are  found 
everywhere,  acting  like  salt  and  leaven  in  human  society,  are  the 
work  of  their  hands ;  but  society,  and  government  itself,  have  been 
handed  down  to  us  by  them,  with  much  valuable  instruction  as  to 
the  means  of  their  preservation.  We  can  scarcely  conceive  the 
amount  of  obligation  our  fathers  have  laid  upon  us  in  giving  us 
these  vast  blessings.  The  men  who  have  been  the  means  of  bringing 
us  into  life ;  who  have  educated  and  trained  us ;  who  have  preserved 
our  government  and  passed  it  into  our  hands  unbroken ;  who  have 
built  and  enlarged  our  colleges,  established  and  improved  our  un- 
equalled common  schools ;  have  founded  and  endowed  our  charitable 
institutions,  and  thus  made  our  land  famous  throughout  the  world, 
are  certainly  worthy  —  those  of  them  who  are  yet  among  us  —  of  our 
constant  regard  and  veneration. 

Loneliness  of  the  Aged.  —  The  old  are  left,  in  some  sense,  alone 
in  the  world.  The  age  in  which  they  have  had  their  active  being 
has  gone  by.  The  world  has  slid  from  under  them  ;  and  they  stand 
far  out,  as  it  were,  on  a  narrow  neck  of  land  between  this  world  and 
the  next,  from  which  they  hear  strange  sounds  doming  to  them  from 
the  moving  mass  of  beings  of  whom  they  are  soon  to  take  leave. 
Most  of  the  companions  with  whom  they  started  in  the  journey  of 
life  have,  one  by  one,  dropped  away  from  their  side,  and  the  younger 
and  stirring  multitude  vho  have  come  after  them  are  moved  by  new, 
and  to  them  strange  thoughts  and  aspirations.  The  throng  of  younger 
men  is  driven  forward  by  impulses  which  they  never  felt,  and  in  paths 
which  they  never  trod.  Manners,  speech,  dress,  modes  of  doing  busi- 
ness—  all  have  changed.  The  old-fashioned  fire-place,  the  stage- 
coach, the  boy's  bow  and  the  girl's  coui-tesy  to  strangers  in  the  street, 
these  all  —  some  of  them  useful  and  some  of  no  further  value  — 
have  disappeared,  never  more  to  be  enjoyed  by  thocv  who  so  much 
prized  them  in  their  day. 


OLD   ACE    AND   ITS   DIBEAaES. 


490 


(Ige  of  your  family 
ents,  grandparents, 
y  who  are  able  to 
K)  suddenly  blotted 
a«t  negligence  will 
proved  your  oppor- 

)ur  Institutions.— 

fathei-s.  We  have 
tn  others  who  have 
)d  the  present  race. 
ental  culture  of  the 
ierived  from  them, 
mtally  and  morally, 

ters  which  are  found 
nan  society,  are  tlie 
snt  itself,  have  been 
(le  instruction  as  to 
arcely  conceive  the 
on  us  in  giving  us 
le  means  of  bringing 
who  have  preserved 
inbroken ;  who  have 
d  improved  our  un- 
iowed  our  charitable 
iroughout  the  world, 
it  among  us  —  of  our 

in  some  sense,  alone 
id  their  active  being 
hem  ;  and  they  stand 
tween  this  world  and 
Coming  to  them  from 

soon  to  take  ^  leave. 
,ed  in  the  journey  of 
side,  and  the  younger 
m  are  moved  by  new, 
rhe  throng  of  younger 
ever  felt,  and  in  paths 
(,  modes  of  doing  busi- 

fire-place,  the  stage- 
strangers  in  the  street, 
I  no  f"rt.her  value  — 
jy  thoi^v  who  so  much 


What  wonder  if  at  times  a  sense  of  loneliness  and  desolation  should 
Kleal  into  the  minds  of  tho  aged?  It  is  not  without  cause  that  they 
often  yield  to  nufluncholy  reflections.  The  young  have  their  com- 
panioas  and  their  sports.  Tho  companions  of  the  old  have  mostly 
gone ;  and  for  sports  they  have  no  agility.  Cut  off  from  the  present, 
they  are  llirowu  upon  the  past,  and  too  often  look  gloomily  to  the 
future.  They  should  be  sympathized  with  and  encouraged.  We 
Hhould  sit  by  their  side,  and  tjvlk  with  them  of  the  manners  and 
events  of  other  days.  Their  convei-sation  is  often  instructive  as  well 
iw  amusing.  Would  we  engage  in  it  with  right  feelings  towards  the 
old,  it  would  be  to  us  a  source  both  of  profit  and  pleasure.  To  a 
right-minded  person,  few  things  are  more  pleasurable  than,  to  sit  by 
intelligent  aged  persons,  cozily  seated  in  a  large  armed-chair,  and 
listen  to  their  tales  of  personal  adventure  and  experience.  They 
enter  upon  such  narratives  with  so  much  animatior  and  live  over 
tiie  past  with  such  evident  satisfaction,  that  the  benevolent  person 
would  find  pleasure  in  engaging  them  in  that  conversation  for  this 
reiifion  alone. 

Helpless  Dependence  of  the  Aged. — No  one  thing  should  tendmore 
to  excite  our  pity,  compassion,  and  kindly  feelings  for  old  people,  than 
tiieir  helplessness  and  dependence.  It  is  one  of  the  best  indications 
of  humanity  to  deal  gently  with  the  weak.  The  old  are  in  their 
second  childhood.  In  their  day,  they  have  been  strong  and  vigorous 
—  laboring,  many  of  them,  in  season  and  out  of  season,  to  support 
their  families  and  gain  a  competence.  They  have  felled  the  primitive 
forests,  and  brought  the  soil  under  the  dominion  of  the  plough  and 
hoe;  they  have  constructed  turnpikes  and  built  bridges;  made  ships 
and  sailed  them  over  stormy  seas,  whitened  every  harbor  with  the 
emblems  of  commerce  ;  filled  every  city  with  the  beautiful  creations 
of  art,  and  the  useful  productions  of  mechanical  handicraft ;  created 
systems  of  education  and  philanthropy ;  framed  strong  governments 
and  worked  them,  —  in  a  word,  have  carried  the  world  upon  their 
shoulders,  without  bending  or  giving  tokens  of  exhaustion.  But  a 
multitude  of  yeara  have  robbed  them  of  the  strength  which  did  all 
these  things.  They  now  totter  like  a  young  child.  The  brain  which 
conceived  and  the  arm  which  executed  are  alike  feeble.  How  proper 
that  much  which  is  kindly  should  now  be  done  for  those  who  have 
done  so  much  for  us  and  for  the  world !  Oh,  let  the  old  have  a 
warm  place  in  the  affections  I  Supply,  as  far  as  possible,  all  their 
wants.  Go  with  them,  in  spirit,  into  the  shadows  of  evening,  within 
which  they  are  retiring,  and  there  hold  them  up.  Be  a  staff  to  them 
in  their  weakness ;  and,  if  it  be  possible,  when  the  shades  deepen 
around  them,  lift  the  curtains  of  the  future  and  let  in  upon  them, 
though  it  be  never  so  few,  some  raj^  of  light  from  the  heavenly  world. 

From  these  general  remarks,  I  pass  to  consider  — 


^vii.^,(;,JiMi,'h:ii'K!jitiJir  ';i.\\-,»KiU'sii 


OLD   AOR   AND   ITS   DI8KA8E8 


The  Changes  occurring  In  Advanced  Life. 

Growth,  maturity,  and  decline  are  tho  threw  periods  which  divide 
and  measure  human  life. 

During  growth,  the  deposit  of  new  matter  takes  place  more  rap- 
idly  than  the  decay  or  waste  which  is  also  going  on. 

During  healthy  maturity,  waste  and  increase  are  exactly  equal, 
the  one  taking  place  just  as  rapidly  as  the  other. 

The  decline  of  old  age  reverses  the  order  of  growth,  and  waste 
outstrips  addition.  The  newly  deposited  matter  comes,  but  not  ho 
rapidly  as  the  old  is  cast  away. 

Declining  Age  may  be  said  to  extend  frorn  fifty  to  sixty. 
Incipient  Old  Age  from  sixty  to  seventy.      ■  ^ 

Ripe  Old  Age  i'om  seventy  to  eighty. 

Decrepitude  or  3econd  Infancy  from  eighty  to  the  end  of  life. 
During  all  these  periods,  particularly  during  the  latter,  important 
structural  and  other  changes  are  occurring  in  the  human  system, 
Piles,  apoplexy,  paralysis,  diseases  of  the  liver,  kidneys,  and  bladder, 
with  organic  changes  of  the  heart,  dropsy,  chronic  affections  of  the 
breathing  organs,  gout,  etc.,  frequently  appear. 

No  fear  of  Death.  —  It  is  a  wise  and  merciful  provision  of  Provi- 
dence, tlmt  as  old  age  advances,  and  the  natural  end  of  life  draws 
near,  the  dread  of  death  diminishes.  As  the  aged  gradually  lose 
their  hold  upon  life,  they  do  so  with  less  and  less  reluctance,  until 
finally  they  let  go  willingly,  and  part  from  it  even  with  ]oy.  Persons 
passing  from  life  at  the  age  of  eighty  or  upwards,  generally  look 
forward  to  death  with  more  of  pleasure  than  of  fear.  It  is  one  good 
reason  why  it  is  desirable  to  live  to  great  age,  that  life  may  come  to 
a  close  without  those  harassing  fears  which  so  many  dread. 

Preservation  of  Old  People's  Health. 

It  is  proper  here  to  speak  of  the  hygiene  of  old  age,  or  the  means  of 

^Til'^tufaftS^desfre  atontinuance  of  life;  and  except  in  the  case 
of  the  extremely  old,  there  is  a  geneial  wish  for  its  prolongation. 
Those  who  are  born  of  parents  who  have  lived  long,  are  more  likely 
to  attain  length  of  days  than  those  who  have  descended  from  short. 
lived  ancestors ;  yet  the  influence  of  correct  habits  may  add  quite  as 
many  years  to  their  lives. 

Reeular  Habits.  — The  old  feel  the  evil  influence  of  irregular 
habits  much  more  than  the  young.  It  is  seldom  that  any  changed 
habit,  long  indulge  s  well  borne  by  the  aged.  So  true  is  this,  tha 
the  attempt  to  correct  some  habits  of  evil  tendency  is  sometimes 


OLD   AOE   AND   ITS   DI8EAHE8. 


r.oi 


need  Life. 

leriods  which  divide 

es  place  more  ta,\)- 
on. 
are  exactly  equal, 

growth,  and  waate 
comes,  but  not  so 

y  to  sixty. 


0  the  end  of  life. 

he  latter,  important 
the  human  system, 
idneys,  and  bladder, 
ic  affections  of  the 

provision  of  Provi- 

1  end  of  life  draws 
aged  gradually  lose 
ess  reluctance,  until 
1  with  joy.  Persons 
ards,  generally  look 
fear.  It  is  one  good 
lat  life  may  come  to 
lauy  dread. 

Health. 

1  age,  or  the  means  of 

,nd  except  in  the  case 
for  its  prolongation, 
long,  are  more  likely 
escended  from  shortr 
aits  may  add  quite  as 

nfluence  of  irregular 

m  that  any  change  of 

So  true  is  this,  that 

indency  is  sometimes 


(langermis  to  tho  old,  ho  mnoh  have  tlioy  lost  tho  power  of  adapting 
ihcnmclvcH  to  clmngt^  Tlio  diHcontinuaiicc  of  tliu  hahilual  uhi;  of 
spirit,  or  tobacco,  or  opium,  l>y  an  old  ptnHoii,  tiiougli  the  itse  of 
eitiuT  is  of  acknowledged  evil  tendency,  will  frucpK^ntly  prove  fatal. 
It  is  ahiKMt  necessary  that  the  habits  of  the  aged  should  remain  as 
they  are.  What  an  impressive  lesson  this  fact  gives  the  young  on 
the  necessity  of  forming  good  habits  in  early  life  ! 

Even  the  hours  of  taking  meals  should  not  be  changed  in  the 
decline  of  life.  Kemoving  to  new  (tlimates,  and  forming  new  social 
relations  by  those  advanced  in  years,  is  not  favorable  to  length  of 
days.  Old  trees  do  not  often  take  root  and  live  long  when  trans- 
ferred to  a  new  soil. 

Diet.  —  The  food  of  old  people  should  of  courae  Iks  easy  of  diges- 
tion. It  is  often  the  case  that  they  bear  made  di.shes  such  as  "  hash," 
so  called,  better  than  plain  boiled  or  roasted  meat.  This  can  only  be 
explained  on  the  ground  that  the  meat  is  ohopped  line,  and  is  more 
thoroughly  cooked. 

node  ot  Cooking  fleatA.  —  Tliis  leads  me  to  speak  of  the  best 
methods  of  cooking  meats  so  that  they  may  be  tender. 

The  flesh  of  all  warm-blooded  animals  is  identical  in  composition 
with  that  of  human  beings.  That  the  flesh  of  animals  used  as  food, 
therefore,  may  form  flesh  in  the  human  body  in  the  easiest  manner, 
none  of  its  essential  constituents  or  parts  should  l)e  taken  from  it 
during  the  process  of  cooking.  If  any  one  of  its  constituents  is 
extracted,  it  will  no  longer  be  like  human  flesh ;  and  that  lost  part 
will  have  to  be  resupplied  before  it  can  become  a  part  of  the  frame 
of  man. 

Flesh  is  composed  of  two  parts — that  which  can  be  dissolved,  and 
that  which  cannot.  The  separation  between  these  two  parts  is  more 
or  less  completely  effected  in  boiling,  according  to  the  amount  of 
water  used  and  the  length  of  time  employed  in  the  process. 

In  making  soup,  we  have  no  objection  to  a  separation  between  the 
hard  and  juicy  parts  of  the  meat,  because  the  latter  passes  ink)  the 
water  and  helps  form  the  eoup.  Hence  the  proper  way  is  to  put  the 
meat  into  cold  water  when  it  is  put  over  the  fire,  and  let  it  come  to 
the  boiling  point  very  gradually ;  during  which  time  the  juicy  part 
lias  a  chance  to  dissolve  out,  and,  uniting  with  the  water,  make  lich 
soup. 

But  when  the  meat  is  to  be  boiled  simply,  and  eaten  as  boiled  meat, 
we  should  aim  to  retain  the  juice  within  it,  that  we  may  retain  the 
whole  of  it.  To  do  this,  we  must  put  the  meat  into  water  which  is 
briskly  boiling  over  the  fire.  The  juice  of  the  meat  contains  a  large 
quantity  of  albumen,  a  substance  just  like  the  white  of  egg;  and 
putting  the  meat  suddenly  into  boiling  water  almost  instantly  hardens 
this  albumen  all  around  the  surface,  just  as  boiling  water  hardens 
white  of  Qgg,  and  this  prevents  all  the  juice  of  the  inner  portion  of 


I 


--m^ssss^s^isiT^smsm^sm^s^m^? 


#' 


502  OLD   AGE   ANT)   ITS   PISEASES. 

the  meat  from  running  out  into  the  water  and  being  lost.  Keep  the 
meat  in  the  briskly-boiling  water  a  few  minutes,  then  pour  in  a  little 
cold  water  to  reduce  the  temperature  slightly,  and  keep  it  in  thi.s 
somewhat  reduced  temperature  until  it  is  done  through. 

Broiling  and  roiisting  are  pretty  generally  undentood,  and  are 
done  well  enough  where  persons  are  disposed  to  take  pains.  Frying 
is  an  abomination,  and  shoiUd  be  banished  from  all  civilized  house- 
holds. 

Milk  is  an  excellent  article  of  diet  for  old  persons.  Except  in  some 
few  cases  where  it  disagrees  with  the  stomach,  it  is  among  the  very 
best.  Sometimes,  when  it  disagreed  with  a  weak  £,tomach,  a  little 
lime-water  added  to  it  will  make  all  right.  Artificial  ass's  milk,  which 
will  generally  sit  well  on  aged  people's  stomachs,  may  be  made  by 
dissolving  one  ounce  of  pulverized  sugar  of  milk  in  one  pint  of 
skimmed  cow's  milk. 

Potatoes,  beets,  carrots,  parsnips,  and  asparagus  are  healthful; 
peas,  beans,  cabbages,  etc.,  had  better  not  be  largely  indulged  in. 

Ripe  Fruits,  taken  in  modeiation,  are  useful;  but  should  be  eaten 
at  meal-time,  not  between  meals.  Among  these,  ripe  apples,  pears, 
peaches,  plums,  strawberries,  currants,  and  grapes  are  luxuries  in 
which  not  even  the  oldest  persons  need  fear  to  indulge  to  a  reason- 
able extent. 

Plain  Puddings  and  Pies  are  not  entirely  objectionable  ;  but  all 
rich  and  high-seasoned  articles  of  pastry  should  be  strictly  rejected 
by  the  old,  as  they  should,  in  fact,  by  all  classes. 

Wine,  etc.  —  If  any  persons  in  the  a\  arid  may  indulge  in  a  little 
wine  for  their  stomach's  sake,  it  is  the  old.  But  even  they,  if  they 
have  not  been  accustomed  to  its  use,  often  get  along  very  well  with- 
out it ;  and  when  they  can  do  so  it  is  better,  for  various  reasons, 
especially  that  their  example  may  have  a  good  influence  with  others. 
When  the  feeble  vitality  of  the  aged  seems  to  require  it,  especially  if 
they  have  been  in  the  habit  of  leaning  upon  it,  they  should  be  en- 
couraged to  use  it.  And  if  they  chance  to  be  poor,  and  cannot  pro- 
cure it  themselves,  for  friends  to  withhold  it  from  them  on  the  ground 
of  economy,. or  from  the  feeling  of  grudging  stinginess,  is  nothing 
less  than  inhumanity  and  cruelty. 

To  these  remarks  upon  diet,  I  add :  the  old  should  never  eat  to 
excess  or  repletion.  They  should  eat  slowly,  and' chew  their  food 
very  thoroughly. 

Susceptibility  to  Cold. — Aged  people  suffer  very  much  from  cold 
hands  and  feet,  and,  indeed,  from  languid  circulation  and  low  tem- 
peratui^  generally.  The  heart,  like  all  their  other  muscles,  has 
become  feeble,  and  sends  the  blood  very  lazily  along  the  arteries. 
The  clothing  of  the  old  should  be  thicker  and  warmer  than  that  of 
younger  people.     We  must  prevent  the  escape  of  what  little  animal 


OLD   AGE   AND   ITS   DISEASES. 


-.03 


g  lost.     Keep  the 
311  pour  in  ta  little 

I  keep  it  in  this 
.ugh. 

leiftood,  and  are 
ce  pains.     Frying 

II  civilized  house- 

Except  in  some 

among  the  very 

stomach,  a  little 

I  ass's  milk,  which 

may  be  made  by 

k  in  one  pint  of 

us  are  healthful; 
J  indulged  in. 

it  should  be  eaten 
dpe  apples,  pears, 
s  are  luxuries  in 
ulge  to  a  reason- 

ctionable ;  but  all 
e  strictly  rejected 

indulge  in  a  little 
jven  they,  if  they 
ig  very  well  with- 
r  various  reasons, 
aence  with  others, 
lire  it,  especially  if 
hey  should  be  en- 
r,  and  cannot  pro- 
hem  on  the  ground 
iginess,  is  nothing 

ould  never  eat  to 
dchew  their  food 

sry  much  from  cold 
tion  and  low  tem- 
ther  muscles,  has 
ilong  the  arteries, 
rmer  than  that  of 
what  little  animal 


heat  there  is  by  flannel  worn  next  to  the  skin,  and  by  woollen  clothes 
(((norally  —  they  being  bad  conductors  of  heat.  Unless  very  fleshy, 
tliey  seldom  suffer  from  heat,  even  when  their  flannels  are  continued 
tlu'ough  the  summer. 

It  is  during  winter  nights  that  the  old  arc  apt  to  suffer  most  from 
cold.  On  going  to  bed,  therefore,  they  should  be  warm ;  and  on  very 
cold  nights  should  have  a  hot-water  bag  at  their  feet.  The  commu- 
nication of  animal  heat,  particularly  from  the  young,  is  better  even 
than  this  to  support  the  vital  energies  of  age;  and  some  writers  have 
recommended  that  the  vital  warmth  of  the  old  should  be  kept  up  by 
letting  the  young  of  our  own  species  sleep  with  them.  The  human- 
ity of  this  suggestion  is  very  questionable  The  aged  would  doubt- 
less be  benefited  by  such  a  proceeding;  but  the  young  would  be 
injured.  Whatever  vitality  should  be  gained  by  one  would  be  lost 
by  the  other.  While  a  few  might  be  added  to  the  limited  days  of 
the  aged,  many  would  be  quite  as  likely  to  be  subtracted  from  those 
of  the  young.  I  would  much  sooner  recommend  that  old  people 
attach  to  themselves,  and  take  to  their  bed,  au  affectionate,  clean,  and 
silken-haired  English  terrier  dog.  Such  an  animal,  usually  as  clean 
as  a  child,  would  impart  warmth  and  vitality  at  night,  and  be  a  +-  ae, 
affectionate,  and  amusing  companion  during  many  a  lonely  hour  of 
the  day.  Whatever  may  be  said  against  this  recommendation, — and 
of  course  some  over-nice  people  will  object,  —  I  insist  that  it  is  in 
every  sense  far  more  proper  than  the  expedient  adopted  with  King 
David,  when  he  "  was  old  and  stricken  in  years,"  and  after  "  they 
covered  him  with  clothes,  but  he  gat  no  heat."     (1  Kings  i,  1.) 

Mortality  in  Cold  Weather.  — Far  more  of  the  old  people  die  in 
wmter  than  in  summer,  or,  indeed,  in  any  other  season.  For  this 
r-^ason,  old  people  should  be  very  careful  how  they  expose  themselves 
auiing  the  coldest  days  of  the  winter. 

If  there  be  any  change  which  the  old  are  likely  to  bear  with  im- 
punity or  advantage,  it  is  from  a  cold  to  a  warm  climate  in  their  lat- 
ter yeara.  The  wealthy  Romans,  when  they  grew  old,  were  taken 
to  Naples. 

Care  of  the  Skin. — Attention  to  the  skin,  always  important  to 
health,  is  very  essentially  so  in  the  latter  years  of  life.  The  scarf- 
skin  of  the  old  tends  to  become  dry,  and  peel  off.  This  may  be  pre- 
vented in  a  great  measure  by  regular  washing  with  tepid  water,  and 
iiibb'<  g.  If  the  bath  cannot  be  endured,  not  even  the  sponge-bath, 
let  friction  alone  be  employed.  For  friction,  either  the  naked  hand, 
a  piece  o*  flar  -il,  or  the  flesh-brusl  may  be  used.  In  rubbir-  the 
belly,  the  land  should  follow  the  course  of  the  large  bowel;  t 
m  the  region  of  the  stomach  pass  across  from  right  to  left,  dow  m 
the  left,  across  on  the  lower  parts  of  the  bowels,  up  on  the  right,  etc. 
oy  this  method,  constipation  and  a  windy  condition  of  the  stomach 
and  bowels  may  frequently  be  removed,  or  rendered  less  distressing. 


504 


OLD   AOB   AND  ITS  DISEASES. 


Exercise.  —  Always  important,  in  all  periods  of  life,  exercise  does 
not  lose  its  advantages  in  old  age.  But  the  aged  should  always  exer- 
cise with  moderation.  The  violence  used  in  youth  would  break  the 
bones,  and  do  various  kinds  of  mischief  were  it  indulged  by  the  old. 
Carriage  exercise  is  very  suitable  for  old  people,  but  the  more  active 
exercise  of  horseback  riding,  walking,  and  even  working  in  the  gar- 
den, should  not  be  omi*ted  —  bearing  always  in  mind  that  great 
fatigue  is  injurious. 

Sleep.  — Aged  people  should  get  about  as  much  sleep  as  nature  asks 
for.  They  should  retire  early,  and  not  be  in  haste  to  rise  with  the 
dawn.  They  require  more  sleep  than  persons  in  middle  life.  Eight 
or  ten  hours  in  the  twenty-four  is  not  too  much. 

Sleeplessness.  —  Though  the  old  require  a  good  deal  of  sleep,  it  is 
unfortunate  that  many  of  them  can  sleep  but  little.  A  large  propor- 
tion of  persons  far  advanced  in  life,  complain  of  inability  to  sleep. 
Many  old  people  deceive  themselves,  and  really  sleep  much  more 
than  they  are  aware.  Yet  they  often  persist  that  they  sleep  none  at 
all,  night  after  night.  Their  case  is  illustrated  by  an  old  lady  whose 
doctor  entered  her  room  arid  found  her  sleeping  very  soundly  and 
comfortably.  The  noise  of  a  person  entering  the  room  awoke  her 
soon  after,  when,  rubbing  her  eyes,  she  turned  to  the  doctor,  and  said 
all  she  wanted  was  sleep,  that  she  had  slept  none  for  a  month ;  and 
unless  he  could  give  her  something  to  bring  sleep,  she  must  die. 

Medical  art,  I  am  sorry  to  say,  frequently  fails  to  bring  relief,  when 
there  is  real  want  of  sleep.  Narcotics  should  always  be  avoided  if 
possible.  They  do  too  much  mischief ;  yet  it  is  necessary,  sometimes, 
to  resort  to  them.  Much  may  be  done  sometimes  by  taking  an  earlier 
or  a  lighter  supper.  Early  rising,  and  exercise  in  the  open  air,  will 
often  bring  sleep  at  night.  Occasionally  a  glass  of  wine,  or  a  little 
spirit  of  any  kind,  taken  just  before  retiring,  will  bring  the  needed 
sleep. 

Electricity.  —  In  connection  with  sleep,  the  disturbing  and  the 
tranquillizing  influence  of  electricity  and  magnetism  has  received  some 
attention  within  a  few  years.  A  German  philosopher  contends  that 
terrestrial  magnetism  exerts  on  perf  .is  of  a  sensitive  organization  a 
very  soothing  influence,  when  placed  in  proper  relations  with  its  cur- 
rents, and  a  disturbing  impression  when  otherwise  situated.  He 
cit«s  cases  to  show  that  lying  from  east  to  west  is  so  intolerable  that 
persons  of  delicacy  cannot  endure  it ;  while  the  horizontal  position 
from  north  to  south,  with  the  head  south,  is  more  agreeable ;  and  most 
agreeable  and  tranquilizing  with  the  head  to  the  north.  A  German 
surgeon  is  mentioned  in  Reichen  back's  Memoirs,  who  always  woke 
early  in  the  morning,  and  turning  his  head  where  his  feet  had  been, 
invariably  fell  into  a  sound  slumber,  which  was  more  refreshing  than 
that  of  the  night.  When  he  chanced  to  omit  this,  he  felt  ill  all  day. 
Observing  that  the  head  of  his  bed  was  directed  to  the  south,  Reich- 


ife,  exercise  does 
ould  always  exer- 
would  break  the 
iilged  by  the  old. 
t  the  more  active 
rking  in  the  gar- 
mind  that  great 

jep  as  nature  asks 
B  to  rise  with  the 
iddle  life.     Eight 

deal  of  sleep,  it  is 
A  large  proper- 
inability  to  sleep. 
sleep  much  more 
hey  sleep  none  at 
an  old  lady  whose 
very  soundly  and 
room  awoke  her 
le  doctor,  and  said 
tor  a  month  ;  and 
she  must  die. 
bring  relief,  when 
lys  be  avoided  if 
essary,  sometimes, 
y  taking  an  earlier 
the  open  air,  will 
f  wine,  or  a  little 
bring  the  needed 

isturbing  and  the 
has  received  some 
)her  contends  that 
live  organization  a 
itions  with  its  cur- 
'ise  situated.  He 
80  intolerable  that 
horizontal  position 
^reeable;  and  mosJ 
lorth.  A  German 
who  always  woke 
his  feet  had  been, 
)re  refreshing  than 
,  he  felt  ill  all  day. 
0  the  south,  Reich- 


IB 


OLD   AGE   AND   ITS   DISEASES. 


505 


enback  persuaded  him  to  turn  it  to  the  north ;  and  ever  after  he  slept 
soundly  till  the  proper  time  to  rise  in  the  mo/ning. 

Without  pronouncing  upon  the  correctness  of  this  theory,  I  will 
simply  say  that  in  my  winter  residence  in  town,  the  head  of  my  bed 
is  to  the  south.  I  sleep  toUrahly  well ;  but  not  m  well  as  at  my 
summer  residence  a  little  out  of  town,  where  the  head  of  my  bed  is 
towards  the  north.  How  much  the  stillness  of  the  country  and  the 
greater  purity  of  its  atmosphere  may  contribute  to  this  difference,  I 
will  not  pretend  to  decide. 

Medical  Treatment  of  the  Old. 

In  prescribing  medicine  for  old  people,  we  should  bear  in  mind  the 
difference  between  the  sexes.  Women  in  advanced  life  are  less  ex- 
citable, and  enjoy  better  health,  frequently,  than  in  early  life.  Old 
men,  on  the  contrary,  are  more  nervous,  in  their  latter  years,  and 
consequently  more  easily  affected. 

The  physician  cannot  rely  on  the  reaction  ot  the  system  in  old  age. 
He  must  do  more  by  his  remedies,  and  depend  less  upon  nature  to 
help  him  out  of  straits. 

The  small  power  of  rallying  in  the  systems  of  the  old,  puts  all 
blood-letting,  severe  purging,  etc.,  entirely  out  of  the  question.  The 
man  is  near  enough  to  insanity  who,  except  in  some  very  rare  case, 
bleeds  the  young.  He  who  takes  a  drop  of  blood  from  the  old,  should 
be  put  in  a  straights-jacket  and  sent  to  the  insane  hospital. 

Larger  Doses.  —  The  torpid  condition  of  the  system  in  old  age 
frequently  requires  larger  doses  of  medicine  to  make  an  impression. 

Fluid  Medicines. — Pills  and  powders  sometimes  pass  through  the 
stomach  and  bowels  in  the  same  state  in  which  they  entered.  Fluids 
are  more  readily  appropriated — especially  when  the  more  active  me- 
dicinal ingredient  is  mixed  with  wine,  or  some  stimulating  tincture, 
or  aromatic  water.  These  things  rouse  up  the  torpid  stomach  and 
bowels,  and  cause  the  medicine  to  take  effect. 

Medicine  by  Rectum.  —  When  the  disease  is  situated  in  the  imme- 
diate neighborhood  of  the  lower  bowel,  as  the  bladder,  etc.,  it  is 
sometimes  better  to  administer  the  medicine  by  injection  inu)  the 
rectum. 

Suitable  Medicines  for  the  Old The  acids,  the  alkalies,  and  the 

neutral  salts  are  unsuitable  to  be  administered  much  to  old  people. 
All  metallic  medicines  must  be  given  sparingly,  and  with  caution. 
Iodine  and  iodide  of  potassium  are  not  very  well  borne.  Narcotics 
must  sometimes  be  used  to  some  extent.  Harsh  and  drastic  purga- 
tives are  out  of  the  question,  except  in  some  few  instances  in  which 
they  may  be  given  sparingly  in  connection  with  compound  tincture 
of  gentian,  or  some  other  stimulating  tonic.     Sulphur  is  a  valuable 


MMMMM 


J 


\ 


506  OLD   AGE   AND   ITS   DISEASES. 

remedy  for  aged  people.  So  are  the  stimulant  tonics,  bitters,  astrin- 
gents, gum-resins,  balsams,  etc.,  together  with  the  various  carmina- 
tives, as  anise,  coriander,  fennel,  uascarilla,  ginger,  etc. 

Surgical  Operations.  — Some  of  the  smaller  operations  in  surgery 
need  not  be  forbidden  in  the  case  of  the  old ;  but  great  operations  are 
not  to  be  thought  of.  There  is  not  recuperative  power  enough  to 
bear  them. 

Diseases  of  the  Old. 

Most  of  the  diseases  which  afflict  aged  people  are  of  course  much 
the  same  as  those  which  come  upon  people  at  all  periods  of  life. 
These  having  all  been  treated  of  in  the  previous  pages  of  this  book, 
do  not  require  to  be  gone  over  particularly  again.  There  are  a  few 
complaints,  however,  which  are  peculiar  to  the  old,  of  which  I  must 
briefly  speak. 

Bronchial  Flux.  —  Bronchorrhoea. 

A  MORE  than  usual  amount  of  mucous  expectoration,  accompanied 
with  cough,  is  very  common  with  old  people  —  so  common  that  in 
many  cases  they  think  very  little  of  it,  even  when  the  expectoration 
becomes  very  profuse.  This  discharge,  however,  from  the  mucous 
surface  of  the  bronchial  tubes,  is  very  apt  to  be  attended  by  shortness 
of  breath  on  making  even  very  slight  exertion  ;  and  the  whole  trouble 
is  aggravated  in  damp  weather,  and  by  constipation,  and  the  stoppage 
of  leucorrhoea  in  females,  or  the  interruption  of  insensible  perspiration 
through  the  skin. 

Slow  progress.  —  This  complaint  makes  very  slow  progress,  as  a 
general  rule,  often  continuing  many  years  without  doing  any  great 
mischief.  It  is  apt,  however,  to  degenerate  into  a  mischievous  con- 
dition in  the  end ;  and  should,  therefore,  as  a  general  thing,  receive 
some  attention. 

Treatment. — Attend  carefully  to  the  skin.  Keep  it  in  as  healthy 
a  condition  as  possible,  by  regular  and  faithful  bathing  and  friction. 
This  is  of  prime  importance. 

Care  must  be  had  not  to  suppress  the  discharge  too  suddenly.  It 
may  be  necessary,  at  times,  to  use  some  expectorant  (see  expectorants 
among  the  prescriptions)  to  make  the  raising  easier.  But  when  it  is 
thoroughly  loosened  up,  we  should  begin  to  suppress  it  by  astringent 
inhalations.  For  this  purpose  Inhalant  No.  4  is  excellent.  It  might 
be  well,  however,  to  begin  with  the  Inhalant  No.  6,  which  is  slightly 

styptic.  ,,11  1 

'if  ulcers  on  the  legs  have  recently  healed,  they  should  be  opened, 

or  blisters  applied  in  their  vicinity. 

Removal  to  a  dry  climat«  is  a  valuable  i-emedy,  provided  tlxe  ch- 
mate  is  not  too  hot,  and  is  healthful  in  every  other  respect. 


wumfiiaii 


,-s 


OLD   AGE   AND   ITS   DISEASES, 


507 


s,  bitters,  astrin- 
irarious  carmina- 
tc. 

itions  in  surgery 
sat  operations  are 
ower  enough  to 


I  of  course  much 
[  periods  of  life, 
ges  of  this  book, 
There  are  a  few 
of  which  I  must 


oea, 

ion,  accompanied 
common  that  in 
the  expectoration 
Tom  the  mucous 
ided  by  shortness 
the  whole  trouble 
and  the  stoppage 
isible  perspiration 

ow  progress,  as  a 
doing  any  great 
mischievous  con- 

ral  thing,  receive 

ep  it  in  as  healthy 
liing  and  friction. 

too  suddenly.  It 
(see  expectorants 
r.  But  when  it  is 
3S  it  by  astringent 
cellent.  It  might 
,  which  is  slightly 

should  be  openetl, 

,  provided  tlxe  cU- 
•  respect. 


Other  Diseases.  -—  The  other  diseases  with  which  old  persons  are 
afflicted  are  so  common  to  all  ages,  that  I  do  little  more  than  name 
them,  adding  a  few  general  remarks.    . 

Asthma.  —  The  asthma,  or  intermittent  difficulty  of  breathing  of 
the  old,  is  connected  with  various  other  troubles,  as  chronic  inflamma- 
tion of  the  bronchial  tubes,  air  in  the  lung-tissue,  swelling  of  the 
lungs,  enlargement  and  dilatation  of  the  heart,  and  diseases  of  its 
valves,  etc.  It  is  also  dependent  on  impurities  of  the  blood,  and  is 
connected  with  torpid  action  of  the  kidneys.  It  is  impossible,  some- 
times, to  say  which  of  these  conditions  it  is  dependent  upon.  As  far 
as  may  be,  however,  the  cause  must  be  searched  out;  and  then,  while 
the  general  remedies  for  asthma  must  be  employed,  the  particular 
tiling  with  which  it  is  connected  must  also  receive  attention,  especially 
if  it  be  connected  with  derangement  of  the  kidneys. 

Asthmatic  old  people  are  almost  always  dyspeptics.  The  stomach 
and  bowels,  therefore,  require  particular  attention.  The  warm  pur- 
gatives, combined  with  alkalies,  are  generally  useful :  aa  rhubarb  and 
soda,  equal  parts,  or  Mettauer's  Aperient,  with  a  little  tincture  of 
ginger  or  tincture  of  cayenne  in  it.  A  very  valuable  preparation  is 
compound  tincture  of  gentian  and  tincture  of  calumba,  two  ounces 
each,  one-half  ounce  of  tincture  of  ginger,  and  half  an  ounce  of  bi- 
carbonate of  soda.  Mix,  and  take  a  teaspoonful  as  occasion  may 
require. 

Apoplexy  and  Paralysis.  —  The  nervous  system  being  weakehed 
iu  aged  people,  the  way  is  opened  for  greater  frequency  of  attack 
from  apoplexy  and  paralysis.  The  exciting  cause  may  be  hypersemia, 
too  much  blood ;  or  anaemia,  too  little  blood.  It  may  be  general 
debility,  or  gout,  or  a  poisoned  state  of  the  blood. 

The  treatment  is  to  be  conducted  much  on  the  same  principles  as 
when  these  diseases  occur  in  younger  subjects. 

I  pass  over  numerous  complaints  which  may  be  said  to  be  somewhat 
more  common  in  advanced  life  than  at  earlier  periods.  They  are  so 
fully  treated  in  previous  pages  of  this  book,  that  it  is  deemed  needless 
even  to  name  them  here.  There  is,  however,  one  other  class  of  dis- 
eases occurring  so  very  often  in  old  age,  and  in  so  many  cases  mak- 
ing advanced  life  a  burden,  that  I  cannot  pass  them  wholly  in  silence. 
I  refer  to 

A 

Diseases  of  the  Urinary  Organs^  —  These  afflict  the  old,  not  only 
very  commonly,  but  very  severely.  A  man  who  reaches  the  age  of 
seventy  or  eighty  without  experiencing  some  serious  trouble  from 
deranged  kidneys,  diseased  bladder  or  prostate  gland,  or  gall-stones, 
or  giavel,  or  unliealthy  urinary  deposits  of  some  s.ort,  may  think  him- 
self greatly  favored. 

Treatment.  —  It  is  not  necessary  here  to  go  over  the  whole  ground 
of  treatment.     That  is  done  in  other  parts  of  the  book.     I  will  say, 


[ 


508 


OLD    AGE  AND  ITS   DISEASES. 


however,  that  a  surgical  operation  for  stone  in  the  bladder  is  not  often 
to  be  thought  of  in  the  ca^e  of  old  people.  Other  remedies  must  be 
sought  And  among  these,  none  hold  out  so  good  a  chance  of  rehef 
as  the  free  drinking  of  the  alkaline  bicarbonates  dissolved  in  water 
This  will  frequently  dissolve  stones  formed  of  unc  acid,  urate  of 
ammonal  and\riple  phosphates.  Poland  water  in  large  quantities 
is  good.  _  -  ; 


1  •■ 


'■■>''<ll|-|ti     |IIT>|„.. 


adder  is  not  often 
remedies  must  l)e 
a  chance  of  relief 
issolved  in  water, 
ic  acid,  urate  of 
large  quantities 


ACCIDENTS. 


Apparent  Death  from  Noxious  Vapors. 

When  persons  become  insensible  from  breathing  foul  air  in  a  deep 
well  or  other  place  where  it  collects,  let  them  be  immediately  exposed 
to  the  open  air,  cold  water  be  sprinkled  upon  the  face  and  head, 
and  strong  vinegar  be  rubbed  about  the  nostrils.  As  soon  as  there  is 
ability  to  swallow,  give  some  drinks,  as  lemonade,  or  a  few  drops  of 
aromatic  sulphuric  acid,  dropped  into  a  tumblerful  of  water,  and 
slightly  sweetened.    A  stimulating  injection  (246)  may  be  given. 

Apparent  Death  from  Burning  Charcoal. 

Some  persons  very  thoughtlessly  attempt  to  warm  their  sleeping  or 
sitting  rooms  with  a  portable  furnace,  or  open  pan  filled  with  burning 
charcoal,  or  live  coals  from  a  wood  fire.  This  is  very  wrong,  as  such 
coals  while  burning  throw  off  large  quantities  of  carbonic  acid  gas,  a 
deadly  poiaon.  This  being  heavier  than  atmospheric  air,  falb  to  the 
bottom  of  the  room,  and  for  a  tim«  may  do  no  damage  ;  but,  if  there 
be  no  chimney-draught,  or  open  door  or  window,  it  will  rise  above 
the  heads  of  those  in  the  room,  and  bring  on  asphyxia  and  death. 

Let  such  cases  be  treated  the  same  as  the  preceding,  with  the  ad- 
ditional measure  of  attempting  to  excite  breathing,  as  in  the  case  of 
persons  apparently  dead  from  drowning. 

To  Recover  Persons  Apparently  Drowned. 

Of  all  the  sad  accidents  that  may  often  be  avoided  jby  a  knowledge 
of  their  prevention,  drowning  seems  the  most  lamentable.  Its  oc- 
currence, too,  is  the  most  frequent.  A  knowledge,  then,  of  how  to 
restore  the  drowning  to  life,  and  to  renew  the  suspended  animation, 
is  equally  important  to  people  as  a  knowledge  of  how  to  swim. 

Drowning  persons  die  by  what  is  called  asphyxia.  The  air  being 
sluit  off  from  the  lungs,  breathing  stops,  and  the  immediate  accumu- 
lation of  carbonic  acid  in  the  blood  paralyzes  the  nervous  system,  and 
insensibility  immediately  follows.  The  heart  continues  to  beat,  how- 
ever, from  five  to  twenty  minutes  after  the  occurrence  of  insensibility 
and  apparent  death. 

'   „.-■■■         509  .      ■  -•.■■.^: 


MMIAiMIH^rJili. 


510 


ACCIDENTS. 


Recoveiy  may  take  place  at  any  time  before  the  heart  ceaaes  to 
beat,  and  has  been  brought  about  in  some  casea  even  after  this  organ 
has  become  still.  It  has  taken  place,  ir.  some  few  instances,  as  late 
as  an  hour  after  Ixiing  under  water,  but  it  can  scarcely  be  expected, 
even  under  the  best  treatment,  later  than  twenty  minutes  from  i\w 
time  of  submersion ;  and  even  as  late  as  this,  the  chances  are  nnich 
against  restoration. 

Several  main  facts  should  never  be  lost  sight  of :  remember,  fii-st. 
to  empty  the  water  out  of  the  person's  stomach  and  lungs  ;  second, 
to  remove  the  patient  as  little  away  from  the  spot  where  rescued  as 
possible  ;  third,  to  go  to  work  at  once,  unless  the  atmosphere  of  winter 
prevent ;  remember,  finally,  to  keep  at  work  long  after  hope  seems 
gone,  to  many,  of  restoring  the  person  to  life. 


PlO.  160. 

Roll  the  patient  over  on  to  his  stomach,  with  a  parcel  of  clothing 
(see  Fig.  150),  a  barrel  or  box  under  him,  and  press  firmly  on  his 
back,  while  au  assistant  pulls  forward  the  tongue  and  clears  the 
mouth  of  mucus.  Repeat  the  pressure  once  or  twice,  and  then  roll 
the  patient  on  to  his  back  (Fig.  151)  with  the  clothes  rolled  up 
resting  under  his  lowest  ribs.     Loosen  all  clothing  about  the  neck, 

chest,  and  waist.  c    x,    x.  a 

Let  the  assistant  extend  the  arms  in  the  direction  of  the  body 
above  the  head,  bringing  them  as  near  together  as  possible,  while 
you  blow  into  the  patient's  mouth.  Now,  straddling  the  body,  re- 
place the  arms  and  press  firmly  with  your  own  weight  upon  the 
sides  and  front  of  the  lower  chest,  as  if  to  press  out  something  from 


ACCIDENTS. 


511 


»e  heart  ceaaea  to 
m  after  this  organ 
T  instances,  as  late 
rcely  be  expected, 
minutes  from  i\w, 
chances  are  nuK^li 

E:  remember,  fii-st, 
ad  lungs ;  second, 

where  rescued  as 
[iiosphere  of  winter 

after  hope  seems 


a  parcel  of  clothing 
press  firmly  on  his 
gue  and  clears  the 
;wice,  and  then  roll 
e.  clothes  rolled  up 
ng  about  the  neck, 

rection  of  the  body 
ir  as  possible,  while 
ddling  the  body,  re- 
m  weight  upon  the 
out  something  from 


the  lungs ;  suddenly  let  go.     Repeat  these  motions  of  the  arms  and 
uhest  peraeveringly,  ten  or  fifteen  times  a  minute. 

While  thus  engaged,  assistants  should  remove  the  wet  clothing, 
wipe  the  body  dry,  and,  by  vigorous  friction  of  the  skin,  endeavor 
to  restore  warmth  to  the  surface.  Hot-water  bottles,  if  they  can  be 
[iiocured,  are  very  serviceable  in  securing  this  result.  Neither  the 
weather  nor  place  may  allow  of  this  warmth.  When,  however,  the 
iwphyxia  has  been  relieved,  warmth  should  be  abundantly  supplied 
and  light  stimulants  given.  Avoid  the  warm  bath.  Rubbing  with 
coarse  cloths  answers  well  in  the  absence  of  hot-water  bottles. 


Ito.  iM. 

As  soon  as  the  patient  can  swallow,  give  warm  milk,  beef  tea,  or 
coffee  with  a  tablespoonful  of  some  spirit.  Volatile  stimulants  like 
ammonia,  held  before  the  nose,  are  very  serviceable,  even  before  the 
patient  breathes. 

Sleep  should  now  be  encouraged,  but  a  watch  must  be  kept,  in 
cases  of  prolonged  asphyxia,  lest  a  relapse  occur. 

How  long  a  person  may  be  under  water  and  yet  recover,  is  not 
definitely  known,  although  the  duration  depends  on  the  amount  of 
air  confined  in  the  chest  just  prior  to  the  immersion. 

Unlesi  you  are  well  acquainted  with  heart  or  lung  action,  you 
may  be  deceived  as  to  the  existence  of  life  ;  persevere,  therefore,  in 
the  worst  oases,  fully  an  hour,  sinoo  the  heart  may  beat  so  feebly  as 
to  escape  your  notice,  and  yet,  finally,  rally. 

It  is  doubtful  if  a  heart  that  has  actually  stopped  for  five  minutes 
can  be  resuscitated. 


512  AccmKNTS. 

Apparent  Death  from  Lightning. 

A  axnoKK  of  lightning  will  frequently  produce  asphyxia  by  par- 
alyzing the  muscles  of  respimtion.  In  such  ca  e,  the  same  nicaiis 
for  locovery  should  be  used  as  in  apparent  death  from  drowning.  Or, 
the  apparently  dead  penson  may  be  placed  in  a  current  of  fresh  air, 
and  cold  water  dashed  upon  the  face,  neck,  and  breast,  and  warm 
frictiou  be  ai)pliod  if  the  body  is  cold. 

Apparent  Death  from  Hanging. 

Persons  found  hanging,  who  have  committed  suicide,  are  to  ho  nit 
down  instantly,  and  the  same  means  employed  to  re-establisli  Inoath- 
ing  as  in  cases  of  drowning.  It  may  help  to  restore  the  breathin<r.  to 
bathe  the  forehead  and  face  with  vinegar,  or  tincture  of  camphor,  and 
to  pass  hartshorn  frequently  uuder  the  nostrils. 

Clothes  Catching  Fire. 

It  is  perhaps  unreasonable  to  look  for  presence  of  mind  when  tliis 
frightful  accident  occure,  yet  it  is  never  more  needed  than  at  such  a 

tiine.  ' 

The  instant  a  lady  perceives  her  clothes  to  be  on  fire,  and  in  a  bme, 
she  should  seize  the  nearest  large  rug,  cloak,  blanket,  coverlet,  or  any 
equivalent  article,  and,  wrapping  it  tight  around  her,  throw  heitielf 
flat  upon  the  floor,  taking  care  to  keep  the  protecting  covenng  dom 
to  her  until  the  fire  is  completely  smothered.  If  she  does  this  with 
energy,  and  effectually,  she  will  put  out  the  fire  instantly. 

If  she  continue  on  her  feet,  the  blaze  will  rapidly  ascend,  and  burn 
her  vital  parts.  If  she  run  to  seek  relief  from  others  not  present,  the 
motion  of  the  air  will  fan  the  flame  into  a  swifter  work  of  destruc- 
tion. 

If  it  be  a  child  that  is  on  fire,  let  any  person  present  treat  it  as 
above.  If  it  be  badly  burned  before  the  fire  is  extinguished,  put  it 
instantly  into  a  tub  of  cold  water,  or  dash  cold  water  upon  it,  to 
prevent  the  burn  from  becoming  deep. 

■•'it-     ; 

r  Accidents  on  the  Water. 

Ip  upset  in  a  boat,  or  otherwise  thrown  into  the  water,  ftnd  not 
able  to  swim,  draw  the  breath  in  well,  and  keep  the  mouth  shut  tight. 
Do  not  struggle  and  throw  the  arms  up ;  but  yield  quietly  to  the 
water,  hold  the  head  well  up,  and  stretch  out  the  hands  only  below 
"the  water.  To  throw  the  hands  or  the  feet  up,  will  pitch  the  head 
down,  and  cause  the  whole  person  to  go  immediately  under  water. 
Keep  the  head  above,  and  everything  else  under  water. 


W'  ,.^..^  -  ir BirJUi'iifHi'iirtitiiii 


AOOIDENT& 


613 


tning. 

;e  asphyxia  by  par- 
e,  tliri  siiniu  iiicans 
OTi  (Irowninf?.  Or, 
iirrt'iit  of  frosli  iiir, 
.  broaat,  and  warm 


ging. 

luicido,  are  to  ho  rut 

re-establisli  broatli- 

ire  the  breathiii<,',  to 

ure  of  camphor,  and 


)  of  nrinrt  when  tliis 
sded  than  at  such  a 

n  fire,  and  in  a  blaze, 
iket,  coverlet,  or  any 
I  her,  throw  hei'HeU' 
cting  covering  done 
I  she  does  this  with 
instantly. 

lly  ascend,  and  burn 
hers  not  present,  the 
«r  work  of  destruc- 

present  treat  it  as 
extinguished,  put  it 
Ld  water  upon  it,  to 

I  r' 

)  the  water,  ftnd  not 
;he  mouth  shut  tight. 
yield  quietly  to  the 
he  hands  only  helm 
will  pit<}h  the  head 
idiately  under  water. 
water. 


Poisoning  Accidents.  —  Antidotes  of  Poisons. 

AcciDENTH  from  poiaons  are  of  such  common  occurrence,  that 
every  person  should  know  the  proper  remedies,  and  not  be  obliged  to 
wait  the  arrival  of  a  physician  before  the  proper  corrective  is  applied. 
The  most  common  remedies,  with  aq  methods  of  applying  themi 
will  i)e  given  under  the  proper  heaud  bfc.'ow. 

Poisons  may  be  claasified  under  two  hmc'ji :  viz.,  mineral  and  vetre- 
tahle.  ** 

In  the  treatment,  three  objects  are  to  be  kept  in  view :  first,  to  get 
rid  of  the  poison ;  second,  to  stop  ita  action ;  and  third,  to  avert  its 
tendency  to  death. 

The  first  indication  is  accomplished  by  the  administration  of  eme- 
ticH  to  cause  vomiting,  or  by  the  use  of  a  stomach  pump.  The 
simplest  way  to  provoke  vomiting  is  to  give  large  draughts  of  luke- 
warm water,  and  to  thrust  a  finger  down  the  throat. 

A  teaspoonful  or  two  of  mustard  in  warm  water  is  oftentimes  an 
effectual  emetic.  Some  of  the  emetics  are  ipecacuanha,  tartar  emetic, 
sulphate  of  zinc,  and  sulphate  of  copper.  Sulphate  of  zinc  in  twenty- 
grain  doses  is  about  the  best. 

The  second  indication  is  to  use  an  antidote.  The  third  '  ^dication 
IS  fulfiUdd  by  palliating  the  symptoms,  and  neutralizing  U  after- 
effects on  the  constitution. 

After  copious  vomiting,  soothing  liquids  should  be  given,  such  as 
oil,  milk,  beaten-up  raw  eggs.  These  are  useful  when  the  poison 
has  been  of  an  irritating  character. 

If  the  patient  be  much  depressed  in  mind  or  body,  the  hands  and 
feet  cold,  the  lips  blue,  the  face  pale,  a  cold  perspiration  oi.  the  fore- 
head and  about  the  mouth,  some  stimulant  may  be  administered, 
strong,  hot  tea  is  the  best,  because  it  is  a  chemical  antidote  to  many 
poisons.  Strong  coffee  is  a  good  stimulant.  Brandy  and  other 
spints  are  sometimes  necessary.  Sometimes  when  the  powers  of  life 
are  much  depressed,  artificial  heat  also  is  necessary. 

;     Mineral  Poisons. 

Poisoning  by  Ammonia. 

Water  of  ammonia,  or  hartshorn,  if  taken  in  an  undiluted  state, 
acts  as  a  violent  poison. 

When  this  accident  happens,  give  vineffar  instantly,  mixed  with  a 
little  water.  Vinegar  is  an  acid,  and  ammonia  is  an  alkali ;  acids  and 
alkalies  neutralize  each  other. 

Poisoning  by  Antimony. 

Tartar  emetic,  and  wine  of  antimony,  are  sometimes  taken  by 
accident  in  large  doses,  so  as  to  act  as  poisons,  and  cause  dangerous 
vomiting  and  prostration. 


MWaaiMM 


mM 


j.'j<i.nijnwiij^unin)i»uTu»i|ii.jffiKmmj.i.n.ni  I 


muiuMitmMmm 


J 


f 


514  ACCIDENTS. 


nlsd 


Give  a  tea  of  slippery  elm,  flax-Heed,  marshmallow,  etc 
syrup  of  poppies,  paregoric,  or  laudanum  in  twenty-drop  doses.  To 
neutralize  the  poison,  give  a  strong  solution  of  tannin,  or  an  infusion 
of  oak-bark,  or  nutgalls. 

Poisoning  by  Arsenic. 

Use  the  8tv'>mach-pump  instiintly,  if  onb  is  to  be  had ;  if  not,  give 
twenty  grains  of  sulphate  of  zinc  (white  vitriol)  in  a  little  warm 
water;  and  pron  tte'the  vomiting  by  tilling  the  stomach  with  liiige 
di-aughts  of  warm  or  cold  milk,  sweetened  water,  or  flax-seed  tea. 
Or,  vomiting  may  be  induced  still  more  quickly,  by  giving  a  large 
tablespoonful  of  strong  ground  mustard,  mixed  with  a  teacupful  of 

water. 

but  the  best  antidote  for  arsenic  is  hydrated  sesquioxide  of  iron. 
Mix  a  Ublespoonful  of  this  with  water,  and  give  this  amount  every 
five  or  ten  minutes,  until  half  a  dozen  doses  are  taken. 

Treat  the  inflammation  of  the  stomach  which  follows,  by  blisters, 
a  bland  liquid  diet,  mucilaginous  drinks,  etc. 

Poisoning  by  Verdigris,  or  Acetate  of  Copper. 

Cooking  utensils  made  of  copper  never  ought  to  be  tolemted; 
yet  they  are  used ;  and  it  is  from  the  verdigris  which  forms  upon 
them  that  most  of  the  casjs  of  poisoning  by  copper  happen. 

Give  an  emetic  instantly,  and  then  two  teaspoonfuls  of  carbonate 
of  soda  (baking  soda)  in  a  tumblerful  of  water,  to  be  repeated  in  ten 
minutes.  White  of  eggs  diffused  in  wat«r,  and  mucilaginous  dnnks, 
are  proper. 

Poisoning  by  Corrosive  Sublimate. 

This  is   the   common   bed-bug   poison,  and  is  often   taken  by 

mistake.  e     u 

Mix  up  quickly  the  whites  of  a  dozen  eggs,  with  two  pints  ot  cold 
water,  and  give  a  glassful  of  the  mixture  every  two  minutes  till  the 
stomach  can  contain  no  more.  If  there  are  not  eggs  enough  at  hand, 
take  what  there  are,  and  make  up  the  deficiency  with  milk.  Wheat 
flour,  mixed  with  water,  is  a  good  remedy.  Use  the  stomach-pump, 
if  it  is  at  hand.  Treat  the  resulting  inflammation  with  leeches  and 
fomentations. 

Poisoning  by  Sugar  of  Lead,  or  Acetate  of  Lead. 
Give  a  ground-mustard  or  a  sulphate  of  zinc  emetic;  then  give 
diluted  sulphuric  acid,  or  either  epsom  or  glauber's  salts. 

Poisoning  by  Strong  Lye. 

Strong  lye  is  sometimes  swallowed  by  children.  The  remedy  is 
vinegar,  or  oil.  Vinegar  will  convert  the  lye  into  acetate  of  potash, 
and  any  of  the  oils  will  unite  with  it  and  form  soap ;  and  neither 
the  acetate  of  potash  nor  soap  will  materially  injure  the  stomach. 


,--  ,iiiiii"i>"<fe"r.  TiitrririWiijiiaaiiiiaiiaM-'  » ■» '  «■""— <■*— b— ibm 


,y.^-.-,    _L,.->.--..A.'A*jaL-..f\.  u 


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Sciences 
Corporation 


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CIHM/ICMH 

Microfiche 

Series. 


CIHM/ICMH 
Collection  de 
microfiches. 


Canadian  Institute  for  Historical  Microreproductions  /  Institut  Canadian  de  microreproductions  historiques 


IS 

h, 
er 


ACCIDENTS. 


515 


Poisoning  by  Nitric,  Muriatic,  or  Sulphuric  Acid. 

When  either  one  of  these  acids  is  swallowed,  not  a  moment  of 
time  is  to  be  lost.  Fill  the  patient /m«  of  calcined  magnesia  stirred 
up  in  water.  This  is  the  best  remedy ;  but  if  it  is  not  to  be  had, 
give  half  an  ounce  of  soap  in  a  pint  of  water.  If  neither  are  at 
hand,  give  chalk,  or  whiting,  in  water,  or  even  pound  fine  some  of 
the  plastering  of  the  room,  and  give  it  in  water. 

Poisoning  by  Nitrate  of  Potash,  called  Nitre,  or  Saltpetre. 

Induce  vomiting  by  lukewarm  water,  and  by  tickling  the  throat 
with  a  feather :  but  avoid  irritating  the  stomach  with  the  ordinary 
emetics. 

Poisoning  by  White  Vitriol. 

Provoke  vomiting  by  warm  drinks,  and  by  tickling  the  throat, 
and  give  freely  carbonate  of  soda,  in  water. 

Poisoning  by  Oxalic  Acid. 

This  resembles  epsom  salts,  and  is  liable  to  be  taken  for  salts  by 
mistake.  The  two  can  always  be  distinguished  by  touching  a  little 
to  the  tongue.     Epsom  salts  taste  bitter;  oxalic  acid,  very  sour. 

In  cases  of  poison  from  oxalic  acid,  give  magnesia  in  water  as 
quickly  as  possible.  When  this  is  not  at  hand,  give  chalk,  or  lime, 
or  saleratus.     Use  the  stomach-pump,  if  it  is  ta  be  had. 

Vegetable  and  Other  Poisons. 

The  vegetable  poisons  are  quite  numerous,  and  many  of  them 
quite  as  virulent  and  rapid  as  any  in  the  mineral  kingdom. 

Poisoning  by  Aconite. 
Give  an  emetic  of  ground-mustard  or  sulphate  of  zinc,  or  use  the 
stomach-pump  instantly,  and  then  give  stimulants,  as  brandy,  gin, 
whiskey,  rum,  etc. 

Poisoning  by  Opium,  Morphine,  and  laudanum. 

Use  the  stomach-pump,  if  at  hand ;  if  not,  a  powerful  emetic  of 
sulphate  of  zinc,  or  sulphate  of  copper ;  or,  if  these  are  not  at  hand, 
a  tablespoonful  of  ground  mustard  in  a  teacupful  of  warm  water. 
If  vomiting  is  not  induced  at  once,  tickle  the  throat  with  a  feather, 
or  with  the  finger.  If  sleep  is  impending,  take  the  patient  into  the 
open  air,  and  keep  him  walking;  dash  water  upon  his  face.  etc.  If 
he  still  falls  into  sleep,  and  appears  to  be  near  dying,  apply  means 
for  artificial  breathing  as  for  persons  apparently  daad  from  drowning. 

Poisoning  from  Belladonna,  Hyoscyamus,  Stramonium,  and  Conium. 
These  are  all  narcotics,  and  when  accidentally  taken  in  poisonous 
doses,  the  treatment  is  to  be  the  same  as  for  poisoning  by  opium. 
Strong  coffee  is  said  to  counteract  the  effect  of  these  articles. 


aavi 


5ie  ACCIDENTS. 


I- 


f'. 


Poisoning  by  Dogwood,  Ivy,  etc. 
Give  some  of  the  salts  as  a  cathartic,  and  apply  to  the  skin  a  solution 
of  sugar  of  lead,  or  still  better,  a  decoction  of  witchhazel-haik  or 
lime-water. 

Poisoning  by  Prussic  Acid. 

This  is  the  most  deadly  of  all  known  poisons.  One  drop  of  the 
pure  acid  will  cause  immediate  death.  Give  water  of  ammonia  or 
hartshorn,  one  part  dUuted  with  six  parts  of  water,  freely. 

Poisoning  by  Strychnine. 

The  same  treatment  as  for  poisoning  by  opium,  excepting  that 
sweet  milk  should  be  freely  admini.iered.  This  has  been  recom- 
mended by  one  respectable  physician,  at  least,  who  says  he  has  found 
it  to  be  a  specific.  Camphor,  two  ounces  dissolved  in  a  quart  ot 
whiskey,  and  given  freely,  is  also  said  to  be  an  antidote. 
Poisoning  by  Spanish  Flies. 

Give  large  draughts  of  sweet  oil,  sugar  and  water,  milk,  or  flax- 
seed tea.  For  the  inflammation  of  the  bladder  which  is  produced 
by  it,  apply  leeches,  and  a  liniment  composed  of  camphor  and  sweet 
oil.  To  relieve  the  strangury  or  scalding  of  the  water,  give  camphor 
internally. 


skill  a  solution 
bhazel-bark  or 


ne  drop  of  the 
if  ammonia  or 
jely. 


excepting  that 
18  been  recom- 
s  he  has  found 
in  a  quart  of 

te. 

',  milk,  or  flax- 
3h  is  produced 
phor  and  sweet 
r,  give  camphor 


SUBGICAL  DISEASES. 


Modern  Surgery. 

To  one  educated  in  surgery  a  quarter  of  a  century  ago,  the  cus- 
toms and  theories  of  to-day  must  seem  very  odd,  and  the  results  of 
to-day's  surgical  science  must  seem  truly  miraculous.  Formerly  pus 
formation  in  a  healing  wound  was  regarded  not  only  as  unavoidable, 
but  really  beneficial.  Pus,  or  matter,  was  known  as  laudable  or  good 
pus,  and  diseased,  or  bad  pus.  Wounds  only  occasionally  healed  by 
primary  union  or  first  intention,  —  that  is  to  say,  skin  growing  to  skin 
and  muscle  to  muscle  as  sewn,  but  they  rather  healed  by  a  long,  slow 
process  of  granulation  attended  with  pus-formation,  called  second  in- 
tention. The  various  surgical  epidemics  of  contagious  diseases  were 
extremely  common  in  the  very  best  hospitals  under  the  guidance  of 
the  very  best  men ;  tliey  wfere  thought  unavoidable.  Hospital  gan- 
grene, erysipelas,  and  the  various  forms  of  blood-poison  diseases,  were 
so  common  and  spread  so  rapidly  as  often  to  render  it  necessary  to  close 
a  hospital.  Major  operations  were  attended  by  a  mortality  that  now- 
adays seems  almost  incredible.  To  amputate  a  leg,  except  under 
the  most  favorable  circumstances,  meant  almost  sure  death.  The 
late  Dr.  Pasteur  of  France  first  made  known  to  the  world  that  there 
were  such  things  as  germs,  or  microscopic  life,  capable  of  transmitting 
themselves  and  their  spores  almost  ei-'dlessly.  These  germs  were 
soon  found  to  be  the  outcome  of  dirt  and  disease,  and  that  possibly 
in  their  extermination  lay  a  great  future  for  surgery.  It  was  Sir 
Joseph  Lister,  of  England,  who  first  discovered  the  fact  that  certain 
medicines,  like  carbolic  acid,  would  kill  these  germs,  and  that  in  so 
doing  wounds  would  uu'te  by  first  intention  in  the  majority  of  cases. 
This  was  the  first  great  step  toward  the  realization  of  the  dreams  of 
our  forefathers. 

The  study  of  bacteriology  was  then  commenced,  and  it  has  pro- 
gressed rapidly  ever  since,  till  to-day  it  has  become  a  marvelous 
science  unfolding  the  life,  nature  and  propagation  of  all  sorts  of 
bacteria. 

We  now  know  that  on  the  living  skin  there  exist  normally  certain 
germs  whose  function  apparently  is  to  use  up  the  waste  products  of 
the  economy,  but  which,  when  introduced  into  the  flesh,  produce  most 
deleterious  effects. 

517  '     . 


'wm 


518 


SURGICAL    DISEASES. 


Germ-lifc  is  found  everywhere,  —  on  our  hands  and  clothes,  in  tlu- 
dust  of  tlu!  air  and  in  the  water  we  drink.  So  long  as  the;/  keep  to 
their  natural  abodes  no  mischief  is  done.  It  is  this  germ-life  wliicli 
causes  wounds  to  suppurate,  erysipelas,  blood-poisoning  and  gangrene 
to  occur.  It  is  the  annihilation  of  these  germs  about  all  wounds, 
and  on  all  objects  which  come  in  contact  with  wounds,  that  (Hstin- 
guishes  the  newer  from  the  older  surgery.  To-day  the  mortality 
figures  are  revised  as  regards  all  important  operations.  Regions  of 
the  body  are  invaded  which  fifteen  or  twenty  years  ago  w  ere  thought 
to  be  inviolate  to  the  scalpel.  Thousands  of  lives  are  now  saved  and 
thousands  of  people  rescued  from  becoming  invalids. 

The  methods  of  treating  germs  have  changed  very  materially  since 
Sir  Joseph  Lister  first  announced  his  antiseptic  treatment  and  showed 
the  way  to  a  new  ei-a  in  surgeiy ;  but  the  principles  are  much  the 

same. 

Some  germs  have  been  found  to  be  innocuous,  even  on  wounded 
surfaces  ;  others  are  deadly  poisons.  Some  germs  cause  one  kind  of 
disease,  some  another ;  some  are  even  antagonistic  to  others.  They 
are  all  endowed  with  great  resistance  to  ordinary  medicines  and  are 
capable  of  propagation  under  adverse  circumstances ;  they  are  con- 
tagious and  infectious,  and  when  carried  from  one  person  to  another 
cause  their  specific  disease  to  start  up.  The  so-called  blood-poison 
is  a  general  name  for  many  distinct  varieties  of  germ-disease. 

It  matters  not  whether  a  simple  wound  is  to  be  dressed,  a  leg  am- 
putated or  a  woman  delivered,  the  one  essential  thing  above  all  else 
which  protects  life  and  allows  the  wounded  surface  to  heal  is  to 
make  a  clean  field,  to  render  the  surfaces  aeeptic. 

Aseptic.  Septic.  —  These  are  two  terms  which  are  daily  becoming 
the  common  property  of  the  laity :  the  former  means  without  poison, 
germ-frei,  or  surgically  clean  ;  the  latter  means  poisonous,  germ-laden, 
surgica]  iy  dirtg.  Let  it  not  be  supposed  that  the  flesh  looks  to  the  eye 
differently  in  these  two  conditions,  —  it  is  not  so  necessarily.  These 
bacteria  are  so  minute  that  if  a  single  rod-bacillus  were  enlarged  fif- 
teen hundred  times  it  would  then  only  reach  across  the  head  of  a 
pin.  Nor  is  their  virulence  in  proportion  to  their  apparent  numbers, 
for  in  twenty-four  hours  a  single  germ  may  multiply  to  sixteen  and 
one-half  millions  1 

Surgical  cleanliness  is  surgical  morality,  and  consists  not  merely  ni 
washing  off  the  rough,  visible,  outside  dirt,  but  in  rendering  every- 
thing which  can  possibly  touch  the  wound,  directly  or  indirectly, 
germ-free.  This  condition  is  called  asepsis;  when,  however,  germs 
have  entered  the  wound  and  the  consequent  changes  due  to  germ 
life  have  developed,  then  the  condition  is  called  sepsis. 

Antiseptics.  —  The  important  and  practical  question  then  is,  ho^y 
are  these  germs  killed  and  how  is  the  wound  rendered  aseptic? 
Lister  discovered  in  carbolic  acid  a  germicide  of  no  mean  power,  and 


■ 


SURCICAI,    DISKASES. 


51fl 


I  cloihos,  ill  tlic 
118  thtr','  kct'])  to 
gerni-lifi!  wliicli 
ig  and  gangrene 
DUt  all  wounds, 
(ids,  that  distin- 
yr  the  mortalitj' 
[IS.  Regions  of 
go  w  ere  thought 
B  now  saved  and 

materially  since 
neat  and  showed 
s  are  much  the 

ven  on  wounded 
Yuse  one  kind  of 
o  others.  They 
edicines  and  are 
8 ;  they  are  con- 
erson  to  another 
led  blood-poison 
n -disease, 
ressed,  a  leg  am- 
ig  above  all  else 
,ce  to  heal  is  to 


B  daily  becoming 
18  without  poison, 
inou8,  germ-laden, 
1  looks  to  the  eye 
jessarily.  These 
/ere  enlarged  fif- 
is  the  head  of  a 
jparent  numbers, 
y  to  sixteen  and 

sts  not  merely  in 
rendering  every- 
,ly  or  indirectly, 
,  how  over,  germs 
ret,  due  to  germ 
sis. 

tion  then  is,  how 
endered  aseptic? 
mean  power,  and 


oven  lo-diiy  this  acid  is  most  (^xfensivtdy  used  for  the  clcanHing  of 
wouikIs  and  instruments.  'I'his  pnxiess  of  killing  germ-life  is  called 
stcrUiztttion. 

After  carbolic  acid  came  numberless  other  ilrugs,  such  as  corrosive 
sublimate,  phenyl,  sulpho-naphthol,  etc.  Of  this  group  corrosive 
sublimate  is  by  far  the  most  potent :  it  may  be  used  in  very  weak 
solutions  as  one  part  to  three,  five,  or  even  ten  thousand  of  water. 

Heat.  —  By  far  the  sim.plest,  safest,  and  most  economical  method 
of  sterilization  is  by  means  of  heat,  either  in  the  form  of  lioiling 
water,  dry  oven-heat,  or  steam.  Whatever  can  be  baked  lor  an  hour 
at  140°  of  heat,  or  whatever  can  be  steamed  for  an  hour,  and  what- 
ever can  be  boiled  five  minutes  without  impairing  the  integrity  of 
the  object  sterilized,  can  be  rendered  absolutely  sterile.  Germs  and 
their  spores,  which  latter  are  more  tenacious  of  life  than  the  former, 
yield  readily  to  boiling  water  in  a  few  minutes;  while  some  germs 
of  the  most  virulent  type  may  soak  for  houi-s  in  a  tolerably  strong 
solution  of  the  chemical  sterilizers  without  being  killed.  The  ten- 
dency of  the  present  is  to  substitute  these  natural  means  of  steriliza- 
tion for  the  chemical  germicides. 

Preparation  for  Operation.  —  Nothing  withstands  boiling;  but 
as  the  flesh  cannot  be  baked,  boiled,  or  steamed,  it  is  the  custom  be- 
fore an  operation  to  make  free  use  of  green  soap  and  a  brush  to  scrub 
off  the  external  superficial-  dirt  and  then  to  give  the  skin  a  good 
scrubbing  and  soaking  in  corrosive  sublimate,  in  the  strength  of 
aljout  one  part  to  two  thousand.  This  prepares  the  skin  antiseptically 
for  the  operation.  The  instruments  and  apparatus  likely  to  touch 
the  flesh  are  boiled ;  the  hands  and  arms  of  the  surgeon,  assistant 
and  nurse  are  rendered  sterile  by  repeated  scrubbing  with  soap  and 
brush  and  some  one  of  the  several  antiseptic  processes  in  vogue. 
This  requires  fifteen  to  twenty  minutes.  All  dressings  such  as  gauze, 
cotton,  etc.,  are  steamed  and  neatly  done  up  air-free  and  germ-free 
ready  for  use.  Sponges,  generally  made  of  gauze,  have  been  sterilized 
by  steaming  previous  to  the  operation.  Sutures,  etc.,  have  been  boiled' 
or  steamed  or  soaked  in  some  suitable  disinfectant.  The  neighbor- 
hood of  the  wound  is  covered  with  steamed  towels  or  sheets,  the 
clothes  of  the  operator  covered  with  some  sterilized  coat,  and  in  fact 
everything  and  everybody  that  is  likely  to  approach  the  wound  is 
fir.st  thoroughly  rendered  aseptic. 

In  the  subsequent  dressing  of  a  wound,  and  for  all  time  till  the 
wound  is  healed,  similar  precautions  are  taken.  Thus  it  is  that  by 
shutting  out  all  germ-life  one  succeeds  in  securing  primary  union,  a 
quick  convalescence  and  a  freedom  from  the  risks  of  septicaemia  and 
other  blood-poisoned  diseases. 

The  change  from  the  old-fashioned  soap-and-water  cleanliness  to 
the  new  antiseptic  cleanliness  has  wrought  marvellous  results. 
Brains  are  exposed,  gall-bladders  incised  and  stones  removed,  kidneys 


11 HW 


,  ■•* 


"^ssiti- 


wmmm 


mmd 


520  SUROICAL    DISEASES. 

removed,  wombs  and  ovaries  and  huge  tumors  taken  out  witli  a  small 
mortality  rate.  These  same  operations  were  but  dreams  in  the  pro 
Listerian  days. 

.  Inflammation. 

On  this  pathological  basis  much  of  surgical  disease  rests.  Surgical 
inflammation  is  due  in  a  great  mecasure  to  tlie  introduction  into  tlu' 
tissues  of  germs  which  there  multiply  with  great  activity,  forniiuir 
as  a  result  certain  poisonous  products  called  toxines.  These  toxines 
are  deadly  poisonous  to  the  system,  and  when  absorbed  cauae  high 
fever,  chills  and  sweats,  loss  of  appetite  and  strength,  and  generally 
undermine  the  strength.  It  is  as  if  so  much  mineral  or  vegetable 
poison  had  been  introduced  into  the  stomach.  Their  activity  is 
astonishingly  rapid  when  they  are  situated  in  tissues  favorable  to 
their  development,  like  the  peritoneum  and  other  serous  membranes, 
richly  supplied  with  lymphatic  vessels  to  convey  the  poison  from  one 
point  to  another. 

There  are  several  conditions  favorable  to  the  development  of  germs 
when  introduced  into  the  body,  chief  among  wluch  is  moisture  ;  hence 
to  keep  the  wound  dry  and  well  drained  is  the  constant  aim  of  the 
surgeon.  When  bacteria  are  introduced  into  the  system  through  a 
wound,  they  begin  at  once  to  put  on  their  activity,  and  the  produc- 
tion of  toxines  commences.  Nature  rushes,  so  to  speak,  to  the  field 
of  the  enemy,  and  a  great  fight  at  once  occui-s.  She  throws  out  a 
mass  of  lymph  about  the  invaded  portion  of  the  flesh  to  surround  the 
enemy  and  cut  off  his  base  of  supplies.  She  forms  out  of  her  ovi 
blood  antitoxines.,  so  called.  It  soon  becomes  a  question  of  which  is 
the  stronger  form,  —  the  toxines  of  the  germs,  or  the  antitoxines  of 
the  serum.  This  battle  results  in  a  thickened,  congested,  painfully 
swollen  and  reddened  area,  which,  if  nature  conquers,  softens  and 
melts  away,  but  which,  if  the  enemy  is  victorious,  breaks  down  and 
forms  pus.  The  result  depends  largely  on  the  location  of  the  strug- 
gle, the  strength  of  the  patient,  and  the  virulence  of  the  germ.  If 
it  be  in  a  part  poorly  supplied  with  lymphatic  vessels  and  soft  struc- 
tures, nature  has  the  advantage,  because  the  enemy  cannot  find  easy 
access  to  structures  beyond  the  field  of  battle;  but  if  the  neighbor- 
hood of  the  invasion  is  in  soft  structures,  the  enemy  quickly  seizes 
on  some  short  route  to  a  neighboring  lymphatic  station  and  there 
deposits  its  poison  and  thus  extends  its  field  till  nature  is  over- 
whelmed. The  ability  of  nature  to  manufacture  antitoxines  quickly 
and  mobilize  her  forces  to  the  rescue  on  the  one  hand,  and  the  viru- 
lence of  the  germ  or  its  capability  to  develop  its  poison  quickly,  on 
the  other,  are  always  deciding  elements  in  the  preservation  or  de- 
struction of  the  part  attacked.  Much  is  now  being  accomplished 
toward  eradicating  germ-diseases  and  germ-inflammation  by  the  cul- 
tivation of  this  natural  antitoxine.  Its  special  victory  is  seen  j in  the 
diphtheritic  antitoxine  with  which  that  disease  is  now  so  succeisfully 


SW.-v^itffrt.M  :\  ■  ^-tif  flfe^iw  .tivwl.  \ 


SURGICAL   DI8EA8KS. 


521 


out  with  a  smiiU 
iams  in  the  pro 


rests.  Surgical 
luction  into  the 
ictivity,  foiiuiuLf 
These  toxines 
rbed  cauae  liigh 
h,  and  generally 
ral  or  vegetabh; 
'heir  activity  is 
les  favorable  to 
"ous  membranes, 
poison  from  one 

jpment  of  germs 
moisture  ;  hence 
jtant  aim  of  the 
?^stem  through  a 
md  the  produc- 
»eak,  to  the  field 
le  throws  out  a 
to  surround  the 
out  of  her  ovi 
ition  of  which  is 
e  antitoxines  of 
yested,  painfully 
3rs,  softens  and 
reaks  down  and 
ion  of  the  strug- 
f  the  germ.  If 
s  and  soft  struc- 
cannot  find  easy 
if  the  neighbor- 
ly quickly  seizes 
ation  and  there 
nature  is  over- 
itoxines  quickly 
d,  and  the  viru- 
ison  quickly,  on 
servation  or  de- 
ig  accomplished 
ition  by  the  cul- 
ry  is  seenun  the 
f  so  8ucce| sfully 


fought.  This  antitoxine  wliich  naturt;  throws  out  is  cultivated  in 
iiorses  till  such  an  amount  is  stored  up  that  against  it  diphtheria  no 
longer  has  any  influence  ;  this  serum,  so  ricli  in  antitoxine,  is  then 
introduced  into  the  human  subject  as  an  antidote  to  the  forming 
toxines  of  the  diphtheria. 

And  so  it  is  with  lockjaw,  labies,  and  many  other  germ-diseases. 
This  therapeutic  agency  is  yet  in  itw  infancy,  but  much  may  be  ex- 
pected of  it  in  the  future. 

But  not  all  inflammation  is  necessarily  of  bacterial  origin,  at  least 
HO  far  as  is  yet  proven. 

Every  part  of  the  body  which  lias  vessels  and  nerves  is  liable  to 
inflammation.  Where  there  are  no  nerves,  it  cannot  exist.  Many 
diseases  are  caused  by  it.  Mechanical  injuries,  such  m  cuts,  bruises, 
and  fractures,  produce  it.  And  many  other  disorders,  not  caused  by 
or  causing  it  in  the  beginning,  become  entangled  with  it  in  their 
progress.  It  is  very  important,  therefore,  to  understand  the  nature 
and  management  of  inflammation.  It  is  not  always  to  l)e  looked  upon 
iiH  a  disease ;  it  is  frequently  a  simple  process  of  repair,  whereby 
nature  restores  injured  parts  to  health,  in  wliich  there  is  no  germ-life 
present. 

The  Signs  of  Inflammation  are  redness,  pain,  heat,  swelling  and 
loss  of  function,  though  in  some  cases  these  do  not  all  appear. 

Acute  Inflammation.  —  When  the  redness,  the  pain,  the  heat,  and 
the  swelling  are  clearly  marked,  and  the  infl'iramation  is  so  rapid 
that  it  either  subsides  in  a  few  days,  or  quicklj^  brings  on  suppuration, 
or  ulceration,  or  mortification,  it  is  said  to  be  acute. 

Chronic  Inflammation.  —  When  it  is  less  painful,  and  flower  in 
its  progress,  beginning  very  gradually,  and  lingering  a  long  time,  it 
is  then  chronic. 

Common,  or  Simple,  or  Healthy  Inflammation,  is  that  which  is 
not  mixed  up  with  any  disease,  but  is  established  by  nature  for  some 
salutary  purpose,  and  is  generally  germ-free. 

Unhealthy  Inflammation  is  that  which  has  been  caused  by  some 
other  disease,  like  the  poison  from  germ  life,  and  is  under  its  control. 

Specific  Inflammation  is  that  which  seems  to  vary  from  all  ordi- 
nary cases,  being  dependent  on  a  particular  state  of  the  system,  on  an 
animal  poison,  or  a  principle  of  contagion  or  infection,  and  a  power 
of  propagation  from  one  person  to  another,  such  as  all  germ-poisons. 

Some  of  these  produce  such  permanent  effects,  that  those  having 
them  are  not  liable  to  a  second  attack. 

Inflammation  is  Primary,  or,  as  the  doctors  say,  idiopathic,  when 
it  is  the  original  disease. 

Inflammation  is  Secondary,  or  Sympathetic,  when  it  is  tho  re- 
sult of  some  other  disorder,  which  goes  before,  and  produces  it. 


J 


'rrr 


522 


8UR01CAL    1)I8EA9K8. 


V 


It  haH  lieen  explained  clsewlicre  that  tlie  different  pails  of  tlic 
body  are  connected  l)y  little  threads  or  nervous  strings  which  run 
from  one  to  the  other.  If  one  jjart  of  the  body  iKieonie  injured  or 
disordered,  it  u os  these  nervous  threads  as  telegraphic  wires,  to  k'il 
other,  part-s  of  its  misfortune  ;  and  it  sometimes  happens  that  when  the 
intelligence  conveyed  is  of  a  8ad  and  alarming  character,  the  part  re- 
ceiving the  news  is  so  excited  and  distressecl  as  to  become  inflamcii 
Nothing  can  be  more  proper  than  to  call  this  aympathetic  inflannmi- 
tion. 

When  the  inflammation  is  violent,  and  is  seated  upon  some  impor- 
tsint  part,  the  sympathetic  action  is  so  great  as  to  disturb  the  wliolu 
(!onstitution  ;  and  this  general  disturbance  is  sympathetic  or  symptom- 
atic inflammatory  fever  On  the  other  hand,  it  more  frequently  hap- 
pens, especially  in  the  light  of  modern  surgical  pathology,  that  the 
lymphatic  system,  which  is  in  reality  a  delicate  railroad  system  for 
ihe  economy,  leading  toward  the  great  citadel  A  life,  the  heart, 
carries  over  its  tracks  to  the  nearest  station  some  of  these  germs  or 
germ-poison  from  the  primary  wound  or  inflamed  spot,  thus  spread- 
ing the  contagion  to  whatever  lymphatic  station  the  vessel  happens 
to  run. 

The  Symptoms  are  quick  and  strong  pulse,  dryness  and  heat  of 
skin,  parched  mouth,  great  thii-st,  scanty  and  high-colored  urine,  cos- 
tiveness,  disordered  nervous  system,  loss  of  appetite,  anxiety,  restless- 
ness, sleeplessness,  headache,  wandering  and  confusion  of  mind,  and 
sometimes  delirium.  This  fever  John  Hunter  called  a  univeraal 
sympathy  of  the  body  with  the  disturbed  condition  of  a  part  of  it. 

It  is  only  by  inflammation  that  a  wound  is  healed,  or  a  broken  bone 
repaired. 

Upon  the  surface  of  a  wound  nature  pours  out  a  fluid  called  plas- 
tic lymph.  This  is  composed  of  fibrin,  —  the  material  of  which  flesh 
is  made,  —  united  with  a  little  of  the  watery  part  of  the  blood,  chiefly 
albumen.  The  watery  part  disappeai-s  soon  after  it  is  poured  out, 
and  the  fibrin  hardens  into  a  kind  of  membrane.  Through  this, 
nature  sends  small  nerves,  arteries,  and  veins,  which  she  uses  as 
threads  to  sew  up  the  womid.  Fibrin  being  the  chief  material  with 
which  nature  constructs  our  bodies,  she  of  course  uses  it  to  repair 
them  when  wounded,  just  as  a  carpenter,  who  constructs  a  floor  with 
planks,  uses  planks  to  mend  it  when  it  is  broken  through.       , 

Buffy  Coat  of  the  Blood.  —  The  effects  of  inflammation  extend  to 
the  blood.  This  fluid,  when  draw  n  from  the  veins  of  a  person  suffer- 
ing from  an  inflammation  active  enough  to  disturb  the  constitution, 
forms  a  clot  in  the  basin  more  slowly  than  usual,  but  the  clot  is 
harder ;  and  a  layer  of  fibrin  is  left  upon  the  surface,  of  a  yellowish 
buff-color,  looking  like  size  or  glue,  and  called  the  buffy  coat.  The 
clot  is  also  scooped  out  in  the  centre,  and  the  blood  is  said  to  be 
cupped.  .      • 


•^aaiaaMlWaK 


'  ^1 


SUIUilCAIi    MSKAHKS. 


523 


•ent  parts  of  I  he 
triiij^s  \vlii(^li  run 
oonio  iiijiinMl  or 
i)liic.  wiroH,  to  k'll 
ens  that  when  the 
icter,  the  part  rc- 
hecomo  inflamed, 
mthetic  inflamiiia- 

ipon  some  impor- 
iisturb  the  whoh; 
thetl<y  or  »ymptom- 
e  frequently  hap- 
thology,  that  tlie 
ilroad  system  for 
f  life,  the  heart, 
if  these  germs  or 
ipot,  thus  spread- 
le  vessel  happens 

yrness  and  heat  of 
!olored  urine,  cos- 
,  anxiety,  restless- 
iion  of  mind,  and 
ailed  a  univeraal 
of  a  part  of  it. 
,  or  a  broken  bone 

I  fluid  called  pla»- 

ial  of  which  flesh 

the  blood,  chiefly 

it  is  poured  out, 

3.     Through  this, 

hich  she  uses  as 

ief  material  with 

uses  it  to  repair 

tracts  a  floor  with 

irough.       , 

(imation  extend  to 
of  a  person  suffer- 
b  the  constitution, 
al,  but  the  clot  is 
ace,  of  a  yellowisli 
e  buffy  coat.  The 
>lood  is  said  to  be 


Coin  Discs.  —  It  is  another  i)eculiarity  of  inflamed  blood,  that  if  a 
(hop  of  it  1)6  examined  under  a  powerful  microscope,  it«  globules,  or 
(lisi's,  which  are  very  numerous,  will  be  found  .standing  on  their 
edges,  and  leaning  against  each  other,  like  a  row  of  copper  or  silver 
coins.     (F'ig.  152.) 

Inflammation  may  end  in  one  of  four  different  ways. 

I.  By  Resolution.  — Suppose  a  large  splinter  of  wood  be  ptuck  into 
Iho  liand  of  a  healthy  man.  It  causes  rcidness,  lieat,  swelling,  and 
j)ain  ;  and  these  combined  are  inflammation.  The  splinter  is  pulled 
out,  and  the  hand  well  done  up  with  a  disinfectant  dressing,  and 
[)roperly  cared  for.  The  redness  fades,  the  heat  declines,  the  swelling 
subsides,  and  the  pain  disappeai-s ;  the  inflammation  is  ended,  and  the 
hand  is  well.  Coming  to  a  fortunate  end  in  this  way,  iuflammatiou 
is  said  to  be  resolved.,  or  terminated  by  resolution. 


O    O 


q  o       « 


FlO.  1B2. 


FIO.  163. 


II.  By  Suppuration.  —  It  does  not  always  end  so  happily.  The 
splinter  may  be  broken  off  below  the  skin,  and  not  pulled  out ;  or,  even 
if  removed,  germs  may  have  been  introduced  from  the  splint  or  from 
ill!  skin  of  the  hand;  these  germinate  rapidly  and  form  pus,  and 
i!i  lead  of  the  inflammation  abating,  it  will  increase,  and  the  centre 
of  the  injured  part  will  begin  to  rise  up  to  a  point,  and  grow  white 
oil  the  top.  This  shows  that  there  is  matter  formed  underneath, 
wliich  is  lifting  up  the  scarf-skin,  and  seeking  to  come  through.  Fig. 
153  is  a  microscopic  view  of  pus  ooipuscles. 

The  pain  is  now  very  throbbing  and  pulsating  —  keeping  time  with 
the  beats  of  the  heart.  When  the  scarf-«kin  can  hold  out  no  longer, 
it  breaks,  and  yellow,  cream-like  fluid  runs  out,  ^v^hich  we  call  pus. 
The  redness,  pain,  etc.,  now  subside.  This  process  we  call  suppuror 
lion. 

At  this  time,  if  the  wound  have  been  a  severe  one,  attended  by 
sympathetic  fever,  and  the  discharge  of  pus  be  now  large,  there  may 
be  a  change  in  the  fever,  marked  by  frequent  shiverings  and  chilli- 
ness, followed  by  flushes  of  heat,  which  ends  in  sweating.  We  call 
this  heatie  fever. 

III.  By  Ulceration,  or  the  formation  of  open,  running  sores. 


iiil 


mm 


mM» 


D24 


8UK0ICAI.   DIHKAHKH. 


IV.  By  Mortification.  — If  tho  wounded  part  have  l)eon  bo  mnoh 
injured  m  gradually  to  destroy  its  vitality,  it  dies.  The  vivid  red 
of  the  inflammation  changes  to  a  purplish,  or  livid,  or  hlaek  hiu'. 
The  strained  condition  of  tho  skin  ceases,  a  bloody  fluid  liftH  up  tiu- 
cuticle,  the  pain  and  feeling  are  all  gone, —  tho  part  is  dead  and 
putrid,  and  gives  out  a  peculiarly  offensive  smell.  This  process  is 
called  mortification. 

The  mortified  and  dead  part  is  called  a  dowjh;  and  it  is  seijarated 
from  the  living  parts  l)y  a  peculiar  vital  i)rocess  whi'jh  has  the  name 
of  ulceration. 

Treatment  of  Inflammation.  —  Though  inflammation  sometinies 
ends  kindly  by  resolution,  and  though  it  is  often  a  salutary  process, 
yet  it  is  frequently  very  destructive,  ending  in  suppuration,  uhsem- 
tion,  and  mortification,  thickening,  hardening,  soi'tening,  and  en- 
larging parts  affected  by  it;  and  doing  these  things  in  textures  of 
great  delicacy,  and  of  vital  importance  in  tho  economy  of  life.  It 
calls,  therefore,  for  judicious,  and,  often,  for  very  active  treatment. 

There  are  tliree  principal  things  to  be  done,  —  to  remove  the  cause, 
if  it  be  still  active,  to  take  the  blood  away  from  the  inflamed  part, 
and  to  render  the  part  aseptic,  if  possible. 

If  a  bullet  be  lodged  in  the  flesh,  or  a  thorn,  or  a  splint  of  wood, 
or  a  piece  of  glass,  it  is  the  exciting  cause  of  the  inflammation  whuli 
follows,  and  little  can  be  done  to  advantage  till  the  offending  sul)- 
stance  is  extracted.  If  inflammation  be  excited  in  the  bladder  by 
the  irrittvting  presence  of  urine  which  cannot  be  passed,  this  must  be 
drawn  off  with  the  catheter  before  relief  can  be  had.  If  thestomacli 
be  inflamed  by  improper  food,  or  too  much  of  it,  the  diet  nuist 
cease  to  follow  appetite,  and  ttike  reason  for  its  master.  If  ladies 
have  excited  -nflammation  in  the  bowels,  or  any  of  the  internal  or- 
gans, by  a  dragging  weight  of  skirts,  they  must  either  put  off  the 
burden,  or  hang  it  upon  tlie  shoulders  with  straps. 

The  blood  is  removed  from  the  inflamed  part  in  two  ways :  — 

Cupping  and  Leeching. —  It  is  done  directly  by  cupping  and  leech- 
ing. These  methods  take  the  blood  out  of  the  small  vessels,  which 
are  so  full  and  crowded  as  to  produce  pain.  Cold  water,  ice,  etc., 
applied  to  the  part  cause  these  little  vessels  to  contract,  and  squeeze 
the  blood  out  of  themselves.  These  are  very  useful  applications; 
and  they  are  to  be  pursued  as  long  as  there  is  any  hope  of  breaking 
up  the  inflammation,  or  causing  it  to  end  by  resolution.  But  when 
this  is  no  longer  to  be  expected,  and  it  is  found  that  it  will  go  on  to 
suppuration,  then  apply  warm  fomentations  and  poultices.  These 
will  mollify  and  soften  the  parts,  and  cause  the  suppurating  to  go  on 
more  rapidly  and  with  less  pain. 

Counter-Irritation.  —  The  other  method  of  removing  the  blood 
from  the  inflamed  part  is  by  what  is  called  counter-irritation. 

People  are  apt  to  think  it  very  absurd  that  inflammation  fhould  be 


.  ^.,.iij.ji.ji;.;iL»'-i^:a.-..J.:^.',  . — j:aa._a^..iA.^ — —f^^ — ^-^ 


-  .  r^' 


wo  l)een  ho  mnrli 
Tho  vivid  rcil 
id,  or  black  hiK;. 
fliiitl  lifts  up  tJH' 
part  is  dead  uiul 
Thia  piocetw  is 

iiid  it  is  separated 
lich  has  tho  name 

■nation  sometimes 
I  salutary  j)rocoHs, 
ppuration,  uUieni- 
nttoning,  and  eii- 
igs  in  textures  of 
noniy  of  life.  It 
ctive  treatment, 
remove  the  cause, 
bhe  inflamed  part, 

a  splint  of  wood, 
iflamraation  whiili 
ihe  offending  sub- 
n  the  bladder  by 
issed,  this  must  be 
I.     If  theBtomach 

it,  the  diet  must 
master.  If  ladies 
of  the  internal  or- 
either  put  off  the 

two  ways :  — 

Rupping  and  leech- 
lall  vessels,  which 
Id  water,  ice,  etc., 
tract,  and  squeeze 
eful  applications; 
hope  of  breaking 
ution.  But  when 
at  it  will  go  on  to 
poultices.  These 
)purating  to  go  on 

moving  the  blood 
-irritation, 
amation  phould  be 


8UUUI0AL  DIHKAHKS. 


625 


induced  in  one  place  to  relieve  or  cure  it  in  another.  But  it  is  not 
iibsurd.  It  relieveH  or  cures  on  the  principle  of  synipathy,  wiiicli  1 
have  already  explained.  Wo  put  croton  oil,  or  tartar  emetic,  or 
Spanish  flies,  or  cayenne  jjep/ier,  or  mustard,  tipon  tlie  surface  of  the 
bowt'l.s  wlien  tho  internal  ps  rts  are  dangerously  inflamed,  and  what 
is  the  result?  Why,  the  terrible  smarting  >..ul  pain  alarms  nature, 
mid  she  ruslies  up  to  the  surface  with  a  large  amount  of  the  blood 
iiroiind  the  inflamed  parts,  and  there,  for  hours,  perhaps  for  days, 
struggles  to  l)eat  down  tlio  new  mischief  at  the  surface  ;  and,  in  tho 
mean  time  tho  internal  partw,  relieved  by  the  removal  to  the  surface 
of  so  largo  a  quantity  of  hot  blood,  make  a  long  stride  towards  re- 
covery. 

A  popular  orator  is  speaking  to  a  multitude  in  a  hall,  which  is 
thronged  to  excess,  and  a  few  feeble  persons  faint,  and  are  lik(dy  to 
be  suffocated  and  trodden  ui)on  in  the  dense  mass.  A  person  at  the 
door,  seeing  what  luis  happened,  cries  "/re."  The  crowd  rush  out ; 
the  fainting  persons  get  breath,  and  are  saved.  So,  when  the  thou- 
sand streams  of  blood  rush  througli  their  channelH  upon  an  inflamed 
and  fainting  internal  organ,  crowding  and  oppressing  it,  we  set  the 
skin  on  fire  wi*^h  some  inflammatory  sul)stance  ;  the  blood  rushes  to 
tho  now  point  of  excitement,  and  the  oppressed  and  fainting  organ 
recovers. 

Cupping  and  leeching,  which  are  often  necessary,  are  not  to  be  re- 
Hoi'tefl  to  in  very  debilitiited  constitutions.  In  some  persons,  leeching 
produces  erysipelas. 

Costiveness  is  always  produced  by  the  symptomatic  fever  which 
often  results  from  inflamnuition.  This  should  be  removed  by  saline 
purgatives,  such  as  Rochelle,  Ejwom  or  Glauber's  salts,  salts  of  tar- 
tiir,  tartrate  of  potassa,  and  the  tartrate  of  soda  (9),  (7),  (12),  (14), 
(18),  (20),  (25),  (27),  (41).  So:  itimes  more  active  purgatives 
are  required,  and  then  the  compound  extract  of  colocynth,  etc.  (29), 
will  Ije  excellent,  or  two  compound  cathartic  pills,  at  night,  followed 
by  (299)  may  be  used. 

As  a  drink,  cream  of  tartar  (298)  will  be  found  cooling  and  re- 
freshing. In  all  inflammations,  the  diet  must  be  light  and  unstimu- 
lating. 

To  allay  the  excessive  fever  and  pain  of  inflammation,  some  of  the 
coal-tar  products  may  h3  used,  like  ammonol  or  phenacetine,  in  ten- 
grain  doses,  every  two  to  four  houra ;  but  it  must  be  remembered 
that  inflammation  is  the  result  of  poisons  and  not  the  cause  of  them, 
hence  these  remedies  are  but  temporary  and  palliative,  and  must  be 
used  while  the  real  cause  is  being  fought  by  removal  of  the  original 
source  of  the  trouble. 

The  third  method  of  treating  inflammation  is  the  most  important, 
because  generalu  it  str"  i  home.  Inasmuch  as  most  inflammation 
which  comes  from  outs  j  causes  is  the  result  of  the  introduction  of 
bacteria  into  the  body,  che  most  natunl  thing  to  do  is  to  disinfect 


526 


SURGICAL   DISEASES. 


at  once  the  injured  or  diseased  part.  The  bruised  finger,  the  hole 
made  by  the  bullet,  or  the  cut  by  the  knife,  all  need  to  be  bathed  in 
some  antiseptic  solution  to  kill  all  germ-life  and  arrest  the  develop- 
ment of  their  poisons,  which  inevitably  cause  inflammation.  Such 
solutions  should  be  injected  into  the  vs^ound  or  freely  bathed  over 
the  surface.  They  are  legion  in  number,  but  only  a  few  may  be 
mentioned,  such  as  corrosive  sublimate,  wliich  one  can  buy  in  tablet 
form  of  the  druggist,  and  of  which  one  is  taken  dissolved  in  two 
quarts  of  water;  strong  carbolic  acid  is  another  disinfectant,  and 
may  be  used  in  strength  of  one  teaspooiiful  of  the  ninety-five  \m- 
cent  acid  to  a  pint  of  water.  Sulpho-naphthol  or  oil  of  milk,  is  still 
a  third  disinfectant,  and  is  used  in  strength  of  one-half  teaspoonful 
to  a  quart  of  water ;  this  latter  turns  the  water  milk-color.  Carbolic 
acid  on  standing  long  or  being  exposed  to  the  light  turns  reddish, 
but  is  not  impaired  in  efficacy.  The  sulpho-naphthol  is  the  least 
expensive,  and  may  be  used  for  sinks,  drains,  etc.  It  is  perhaps  the 
safest  and  best  to  have  in  the  house. 

Suppuration  and  Abscess. 

An  abscess  is  the  collection  of  pus  or  matter  in  the  substance  of 
some  part  of  the  body.  When  the  matter  is  poured  out  from  some 
part,  the  process  is  said  to  be  suppuration  ;  when  it  collects  in  a  tissue, 
it  is  an  abscess.  When  the  matter  collecting  in  some  organ  conies 
towards  the  surface,  and  a  place  in  the  centre  rises  above  the  sur- 
rounding skin,  and  turns  white,  the  abscess  is  said  to  point.  Some 
abscesses  point  and  break  in  a  week ;  others  of  a  more  chronic  char- 
acter vi'ill  linger  on  for  months. 

Fluctuation.  —  Before  an  abscess  points,  a  fluctuation  may  gener- 
ally be  felt  in  the  swelling,  which  is  one  of  tiie  surest  signs  that  it 
contains  pus.  Sometimes  this  fluctuation  may  be  felt  even  when  the 
matter  lies  very  deep  in  the  flesh.  And  when  it  is  so  deep  that  tt 
cannot  be  felt,  if  a  sudden  cessation  of  the  symptomatic  fever  should 
occur,  and  shiverin^s  or  rigors  should  come  on,  attended  by  coldness 
in  the  affected  part,  we  may  reasonably  suspect  that  pus  is  formed. 
It  is  not  easy,  at  times,  to  say  whether  matter  is  really  present ;  and 
great  care  should  be  used  not  to  plunge  in  a  lancet  where  none 
exists.  Chills  and  fever  due  to  pus  formation  are  caused  by  the 
absorption  into  the  system  of  the  poisons  of  ptomaines,  which  are  the 
result  of  germ-life,  and  their  propagation. 

Treatment.  —  When  the  abscess  is  completely  formed,  and  there 
is  no  longer  any  doubt  of  the  presence  of  matter,  it  should  be  opened 
at  once.  To  let  out  the  confined  pus  alleviates  the  pain  and  lessens 
the  inflammation.  If  the  matter  lie  close  to  a  bone,  the  openiiit,' 
should  be  made  without  delay.  The  opening  should  lie  large  enough 
to  let  the  matter  out  freely.     It  is  a  rule  to  keep  the  incision  open 


TTil: 


SURGICAL  DISEASES. 


627 


[  finger,  the  hole 
d  to  be  bathed  in 
■rest  the  develoi)- 
immation.  Such 
eely  bathed  over 
ly  a  few  may  be 
jan  buy  in  tablet 
dissolved  in  two 
disinfectant^  and 
e  ninety-five  per 
il  of  milk,  is  still 
-half  teaspoonful 
c-color.  Carbolic 
ht  turns  reddish, 
ithol  is  the  least 
It  is  perhaps  the 


the  substance  of 
}d  out  from  some 
ollects  in  a  tissue, 
ome  organ  conies 
}S  above  the  sur- 

to  point.  Some 
lore  chronic  char- 

uation  may  gener- 
jrest  signs  that  it 
3lt  even  when  the 
is  so  deep  that  \i 
natic  fever  should 
nded  by  coldness 
at  pus  is  formed, 
ally  present ;  and 
incet  where  none 
ire  caused  by  the 
les,  which  are  the 

ornied,  and  there 
should  be  opened 
i  pain  and  lessens 
)one,  the  openiiit,' 
\  lie  large  enough 
the  incision  open 


till  the  cavity  of  the  abscess  is  so  far  filled  up  that  another  collection 
of  pus  is  not  likely  to  occur. 

If  the  matter  do  not  readily  get  to  the  surface  through  the  opening, 
it  may  burrovr  itself  in  the  flesh,  in  a  long  narrow  channel  called  a 
sinm.  To  relieve  this,  the  opening  must  be  extended  in  such  a  way 
as  to  give  vent  to  the  new  collection. 

An  abscess  is  sometimes  indisposed  to  heal  at  the  bottom,  and  pus 
continues  to  be  formed  a  long  time,  pud  is  discharged  through  an 
opening  smaller  than  the  sack  whicn  contains  it.  This  is  a  fistula, 
and  tlie  opening  to  it  should  be  enlarged  so  as  to  let  out  the  matter 
more  fre  ly.  A  little  soft  lint  may  then  be  gently  pressed  into  the 
wound  to  prevent  its  healing  before  tlie  cavity  below.  The  cavity 
should  be  freely  scraped  out  to  remove  all  germ-life,  and  then  thor- 
oughly disinfected  and  kept  clean  and  aseptic  by  aseptic  gauze  pack- 
ings, and  in  this  way  nature  is  bound  to  heal  the  wound. 

Au  abscess  from  acute  inflammation  requires  to  be  poulticed  for  a 
time  after  it  has  been  opened.  When  the  swelling  and  inflammation 
are  gone,  the  poultices  are  to  be  laid  aside,  and  a  bandage  put  on. 
When  the  inflammation  is  gone,  let  the  diet  be  improved;  and  if  the 
lUscharge  of  matter  be  large,  give  wine  and  tonics. 

Mortification. 

The  complete  death  of  a  part  of  the  body,  and  its  change  into  a 
black,  stinking,  cold,  and  insensible  mass,  with  which  the  other  parts 
of  the  system  have  discontinued  all  organic  connection,  is  what  we 
call  mortification.  That  form  of  it  which  is  most  common  is  said  to 
be  humid,  on  account  of  the  moisture  of  the  dead  pai-ts.  It  is  the 
result  of  nature  having  walled  oft"  by  her  antitoxin  the  scene  of  the 
battle,  and  while  she  has  lost  the  original  battle  and  the  original 
field,  has  nevertheless  succeeded  in  keeping  out  the  enemy  from  the 
remainder  of  the  system.  The  enemy  feeds  on  the  dead  tissue,  set- 
ting up  a  putrid,  stinking  cesspool  of  filth. 

Gangrene.  —  Before  the  mortified  part  is  completely  dead,  and, 
consequently,  while  its  recovery  is  supposed  to  be  possible,  the  con- 
dition of  the  part  is  called  gangrene. 

Sphacelus  is  the  name  given  to  it  after  its  entire  death. 

Sloughing  is  the  process  of  separating  the  dead  matter,  and  the 
susbtance  separated  is  a  slough. 

The  causes  of  mortification  are  quite  numerous.  The  most  com- 
mon are,  stoppage  of  the  circulation  by  inflammation,  by  mechanical 
causes  which  obstruct  the  passage  of  the  blood,  by  chemical  agents 
and  poisons,  and  by  local  or  general  debility. 

In  a  bad  constitution,  which  l)ears  diseiuse  poorly,  mortification  is 
vei-i/  dangerous. 


I 


'I 


528 


SURGICAL  DISEASES. 


Treatment.  — In  treating  mortification,  three  things  are  to  be  aimed 
at,  —  to  stop  its  progress,  to  promote  the  separation  of  the  dead  from 
the  living  parts,  and  to  heal  tlie  ulcer  which  is  left  after  the  separa- 
tion. 

To  stop  the  progress  of  mortification,  we  must  remove  its  cause. 
If  it  be  inflammation,  treat  that  according  to  the  principles  laid  down, 
though  leeching,  purgatives,  etc.,  should  be  used  sparingly,  as  mor- 
tification reduces  the  constitution  so  rapidly  that  it  does  not  bear 
reducing  well,  and  sometimes  not  at  all.  As  soon  cas  the  inflamma- 
tion has  subsided,  particularly  if  the  system  be  weakened,  tonic  bit- 
ters and  a  nourishing  diet  must  be  had.  When  there  is  fever,  with 
great  excitement  of  the  nervous  system,  delirium,  picking  of  the 
bed-clothes,  etc.,  the  patient  should  have  anodynes  (1^1)  and  anti- 
spasmodics (87),  (91),  (90),  drafts  upon  the  feet,  and  such  other 
local  remedies  as  the  case  may  require.  Here  opium  and  stimulants 
are  of  paramount  importance. 

It  is  of  little  use  to  pat  anything  upon  the  mortified  part,  except 
with  a  view  of  lessening  the  stench.  For  this  purpose,  lay  upon  the 
part  lint  soaked  in  a  solution  of  chloride  of  lime  or  soda,  or  a  solution 
of  pyroligneous  acid,  or  of  creosote. 

Very  little  can  be  done  to  hasten  the  separation  of  the  dead  part 
from  the  living ;  but  while  it  is  taking  place,  a  common  flax-seed 
poultice,  mixed  with  a  little  powdered  charcoal,  may  be  kept  on  it. 

The  ulcer  left  after  the  separation  is  to  be  treated  like  other 
ulcers.  A  dressing  of  bovinine  and  five  per  cent  solution  of  carbolic 
acid,  equal  parts,  will  be  found  to  hasten  the  granulation. 


Pyaemia. 

This  frightful  afPection  has  been  called  the  bane  of  surgery.  It 
is  caused  by  a  peculiar  poison,  resulting  from  the  fermentation  and 
disintegration  of  the  tissues  of  a  wound,  which  is  taken  into  the 
system  either  by  the  veins  or  absorbents,  and  is  usually  accompanied 
by  the  formation  of  collections  of  pus  in  the  various  tissues  and 
organs  of  the  body.  It  follows  very  trifling  as  well  as  severe  injuries, 
and  it  is  a  frequent  sequela  of  surgical  operations,  oftentimes  of  a 
very  slight  character.  The  only  tenable  theory  which  can  explain 
the  different  phenomena  of  this  diseah'e  is,  that  the  pysemic  condition 
is  caused  by  the  absorption  of  septic  material,  sometimes  in  a  fluid, 
sometimes  in  a  gaseous  state,  which  unfits  the  blood  for  the  processes 
of  healthy  nutrition,  induces  capillary  stagnation  and  its  conse- 
quences, low  forms  of  inflammation  in  different  parts  of  the  body,  as 
in  the  joints  and  serous  cavities,  and  may  finally  produce  those  sec- 
ondary deposits  of  pus,  in  any  or  all  parts  or  organs  of  the  body, 
called  metastatic  abscesses. 

When  an  internal  organ  is  involved,  the  result  is  generally  fatal. 
When  suppuration  attacks  the  integuments  or  the  extremities,  there 
is  a  fair  chance  of  recovery. 


SURGICAL   DISEASES. 


629 


are  to  be  aimed 

the  dead  from 

ter  the  separa- 

love  its  cause. 

pies  laid  down, 

.ringly,  as  mov- 

does  not  bear 

the  inflamma- 

ened,  tonic  bit- 

J  is  fever,  with 

picking  of  the 

;^l£t)  and  anti- 

md  such  other 

and  stimulants 

ed  part,  except 
se,  lay  upon  the 
da,  or  a  solution 

I  the  dead  part 
mmon  flax-seed 
be  kept  on  it. 
ated  like  other 
ution  of  carboUc 
Eition. 


of  surgery.    It 
jrmentation  and 

taken  into  the 
lly  accompanied 
LOUS  tissues  and 
,s  severe  injuries, 

oftentimes  of  a 
lich  can  explain 
ysemic  condition 
Avaes  in  a  fluid, 
for  the  processes 
and  its  conse- 
s  of  the  body,  as 
oduce  those  sec- 
ins  of  the  body, 

generally  fatal, 
ixtremities,  there 


Thence  the  disease  ntvs  been  divided  into  two  classes  :  the  internal 
or  acute,  the  external  or  clironic  pyaemia.  When  pyaemia  involves 
the  internal  organs  the  coui-se  is  usually  rapid  and  fatal.  When  it 
attacks  the  external  parts,  it  is  slow  in  its  course  and  may  be  recov- 
ered from. 

Duration  of  the  Disease.  —  Sometimes  its  course  is  so  rapid  that 
the  patient  may  die  in  two  or  three  days  after  the  appearance  of  the 
Hymi)toms.  As  a  rule,  however,  bad  cases  terminate  during  the 
second  week.  Some  go  on  for  six  or  seven  weeks.  In  cases  which 
recover,  the  patient  jjoes  through  a  long  illness  and  may  be  left  per- 
manently crippi.  by  secondary  affections  of  the  joints.  As  a  rule, 
tlie  longer  a  patient  lives  the  better  the  hopes  of  a  successful  ending. 

Pyaimic  symptoms  generally  make  their  ai)pearance  after  the  fourth 
day.  The  first  symptom  is  a  chill ;  this  is  repeated  at  irregular 
intervals,  and  is  followed  by  profuse  and  exhausting  sweats. 

The  hot  stage  which  characterizes  the  malarial  paroxysms  of  inter- 
mittent fever  is  usually  absent  or  but  slightly  marked.  During  the 
course  of  the  attack,  the  temperature  of  the  body,  which  is  naturally 
98^°  Fahrenheit,  may  rise  six  or  eight  degrees,  and  in  ordinary  cases 
its  fall  is,  as  a  rule,  gradual.  The  greatest  elevation  of  temperature 
corresponds  witli  the  period  of  rigor.  During  the  sweating  stage  the 
temperature  falls  again.  Should  the  fall  be  sudden,  a  general  break- 
down of  the  powers  of  the  patient  is  indicated.  The  pulse  rate  varies, 
according  to  the  violence  of  the  attack,  from  ninety  to  one  hundred 
and  thirty.  The  respiration  is  usually  rapid,  from  forty  to  fifty  a 
minute,  and  in  many  cases  a  hay-like  odor  of  the  breath  is  present, 
which  is  considered  pathognomonic  of  the  disease.  The  countenance 
is  flushed,  the  skin  dusky,  sallow,  sometimes  jaundiced  and  marked 
with  sudamina. 

The  tongue  is  coated,  and  there  is  a  complete  loss  of  appetite,  and 
often  nausea  and  vomiting.  The  urine  is  frequently  albuminous. 
When  the  brain  is  involved  there  will  be  sleeplessness,  or  delirium 
of  a  low,  muttering  kind ;  some  unconsciousness,  from  which  the 
patient  can  be  aroused  only  to  relapse. 

Intense  pain  usually  attends  the  secondary  complications,  though 
it  is  sometimes  remarkable  how  slight  the  symptoms  often  are  when 
severe  local  disease  exists. 

The  wound  becomes  sauious,  serous,  and  fetid ;  sometimes  the 
secretions  are  arrested  and  the  surface  becomes  dry  and  glazed; 
sometimes  absolute  sloughing  occurs.  Union,  if  progressing,  will 
become  disunion,  and  all  reparative  action  ceases.  As  the  disease 
progresses,  the  symptoms  become  profoundly  typhoidal,  and  the 
patient  may  die  comatose  or  from  exhaustion. 

The  exciting  causes  of  pyaemia  are  very  obscure.  It  attacks  the 
healthy  as  well  as  the  feeble,  those  surrounded  by  perfect  hygienic 
influences  as  well  as  those  who  are  exposed  to  deleterious  influences. 
It  is  found  not  only  in  hospitals  but  in  private  practice;  but  it  is 


l-l::  ^ 


M   -H) 


530 


SURGICAL   DISEASES. 


more  prevalent  in  unhealthy  places,  in  the  overcrowded  wards,  and 
in  those  spots  where  ventilation  and  drainage  is  bad.  It  lurks  among 
the  poorly  housed  and  poorly  fed  and  clad,  and  wherever  those  in- 
fluences exist  which  are  depressing  to  the  vital  powers. 

The  general  treatment  in  these  cases  is  of  paramount  importance. 
It  is  the  duty  of  the  surgeon  to  see  that  the  patient's  room  is  well 
ventilated,  and  that  it  ii5  frequently  purified  by  cleansing  and  tUsin- 
fectants. 

Tlie  wound  is  to  be  kept  clean  and  well  -drained. 
The  dressings  should  be  changed  as  often  as  four  times  a  day,  and 
saturated  with  disinfectant  lotions. 

When  sloughing  exists  the  charcoal  poultice  should  be  applied,  and 
every  measure  pursued  which  will  insure  the  utmost  cleanliness  of 
the  patient  and  his  surroundings. 

The  curative  treatment  is  to  be  conducted  on  the  same  principles 
which  guide  the  surgeon  in  the  management  of  all  cases  of  atyphoid- 
al  character. 

The  bowels  if  constipated  are  to  be  opened  hy  a  gentle  laxative, 
and  the  different  secretory  organs  restored  to  a  healthy  action  as  far 
as  possible. 

The  vital  energies  of  the  patient  are  to  be  maintained  or  stimu- 
lated, and  everything  that  tends  to  lower  them  must  be  warded  off. 
Quinine  is  the  most  valuable  remedy  we  have  for  the  treatment  of 
pyaemia.  Some  su'geons  give  it  in  large  doses  and  speak  highly  of 
its  effects.  It  is  valuable  in  doses  of  four  or  five  grains  every  three 
or  four  hours.  It  may  be  combined  with  iron  advantageously  in 
some  cases.  Tl  ^lest  combination  is  with  the  citrate  of  iron.  Four 
grains  of  each  are  lo  be  given  four  or  five  times  a  day. 

Stimulants  are  also  of  great  importance  to  maintain  the  powers  of 
life.  In  some  cases  it  is  necessary  to  employ  them  freely  to  keep  up 
the  waning  strength. 

The  diet  should  be  as  nutritious  as  the  patient's  assimilative  powers 
will  bear.     Milk  and  the  animal  broths  are  the  best. 

When  the  stomach  rejects  nourishment  it  must  be  given  by  the 
rectum,  enema  of  beef-tea  and  milk  with  brandy  being  administered 
every  four  houre. 

When  the  nervous  system  is  disturbed  by  pain  and  want  of  rest 
and  sleep,  some  of  the  forms  of  opiates  or  anodynes  are  to  be  given, 
small  doses  frequently  repeated  being  better  than  large. 

Should  diarrhoea  exist  it  is  to  be  kept  under  control.  It  should 
not  be  checked  suddenly,  as  it  appears  to  have  an  eliminative  ten- 
dency in  cases  of  blood-poison. 

Carbonate  of  ammonia  in  ten-grain  doses  five  or  six  times  a  day 
is  a  valuable  remedy  when  other  tonics  cannot  be  tolerated. 

When  secondary 'abscesses  fonn,  they  should  be  opened  and  kept 
cleansed  by  some  disinfectant  fluid,  such  as  carbolic  acid  or  the  solu- 
tion of  the  chlorinate  of  soda,  in  their  proper  strength. 


irhV''lirtitii(iiViirf"i''lr ' 


wded  wards,  and 
It  lurks  among 
lerever  those  in- 
ers. 

aunt  importance, 
snt's  room  is  well 
insing  and  tlisin- 


times  a  day,  and 

Id  be  applied,  and 
)st  cleanliness  of 

e  same  principles 
iases  of  a  typhoid- 

a  gentle  laxative, 
Ithy  action  as  far 

atained  or  stimu- 
)t  be  warded  off. 
["  the  treatment  of 
i  speak  highly  of 
rrains  every  three 
.dvantageously  in 
ite  of  iron.  Four 
lay. 

;ain  the  powers  of 
freely  to  keep  up 

ssimilative  powers 

t. 

;  be  given  by  the 

eing  administered 

and  want  of  rest 
38  are  to  be  given, 
large. 

ontrol.     It  should 
n  eliminative  ten- 

r  six  times  a  day 
tolerated, 
opened  and  kept 
c  acid  or  the  solu- 
igth. 


SURGICAL   DISEASES.  581 


Ulcerations  and  Ulcers. 

When  the  small  particles  composing  tlie  body  have  been  used 
a  while,  they  wear  out,  and  become  useless.  Over  the  whole  body 
are  distributed  a  multitude  of  small  vessels,  called  absorbents,  whose 
business  it  is  to  pick  up  these  worn  and  loosened  particles,  aiid  carry 
them  away. 

There  is  another  class  of  small  vessels,  having  just  the  opposite 
duty,  —  namely,  to  bring  new  particles  of  matter,  and  put  in  the 
places  of  those  taken  away.  These  are  arteries.  They  are  the  natu- 
ral artisans,  who  construct  oar  bodies.  The  absorbents  ara  the 
demolishers  who  pull  them  down.  Under  these  two  forces,  our 
existence  is,  for  a  time,  a  drawn  game  between  life  and  death.  The 
absorbents,  like  myriads  of  hungry  insects,  eat  us  up, — the  con- 
structing arteries,  like  faithful  builders,  reconstruct  us.  The  work 
of  the  absorbents,  is  called  absorption  ;  that  of  the  constructing  arte- 
ries nutrition. 

When  nutrition  partially  ceases,  and  absorption  continues  una- 
bated, we  grow  thin,  or  lose  flesh.  This  happens  in  consumption. 
If  nutrition  should  stop  altogether,  absorption  going  on  sii*  usual,  our 
bodies  would  be  quickly  destroyed.  We  should  be  wholly  devoured 
by  these  little  absorbent  vessels.  This  would  be  ulceration  applied  to 
the  whole  body.  But  it  does  not  appear  in  so  gensral  a  form.  It 
confines  itself  to  particular  parts. 

When  nutrition  entirely  ceases  in  any  portion  of  the  body,  the 
absorbents  devour  all  the  skin,  flesh,  and  vessels  of  the  part, — leaving 
an  open  cavity.  The  process  of  taking  away  the  flesh,  etc.,  is  ulcer- 
ation, —  the  cavity  left  is  an  ulcer  or  sore. 

Natural  Surgery.  —  Ulceration  sometimes  acts  the  part  of  a  nat- 
ural surgeon.  When  a  part  dies  from  mortification,  it  is  necessary 
to  have  it  removed ;  so  nature  sets  up,  directly  around  it,  an  acute 
inflammation,  in  which  all  nutrition  stops,  and  absorption  goes  on 
rapidly.  In  this  way,  a  complete  dike  is  in  a  short  time  made  around 
the  dead  mass,  and  it  is  as  handsomely  amputated,  or  cut  off,  as  any 
surgeon  could  do  it. 

When  the  ulceration  is  going  on,  and  the  blood-vessels  are  b3ing 
cut  off  by  it,  the  blood  coagulates  or  curdles  in  them  for  a  short 
distance  back  from  the  breach,  which  prevents  bleeding.  This  is  as 
good  as  tying  the  arteries. 

Some  textures  ulcerate  more  easily  than  others,  —  the  skin  and 
mucous  membranes  most  easily  of  all. 

Ulcers  are  divided  into  healthy.,  unhealthy,  and  specific. 

A  Healthy  ulcer  i.s  a  simple  sore,  not  showing  any  bad  symptoms, 
but  rather  a  kindly  disposition  to  heal.  It  is  generally  small  in  size, 
of  a  florid-red  color,  and  has  upon  its  surface  little  elevations,  pointed 


I 


n 


532  SUKGICAL   DISEASES. 

like  cones,  i;iille<l  (franulations,  vvliioh  are  not  so  apt  as  in  the  ciuto  of 
unhealthy  ulcers,  to  rise  above  the  level  of  the  surrounding  skin. 

Unhealthy  Ulcers  comprise  those  called  irritable,  indolent,  pha- 
gedenic, etc. 

Indolent  Ulcers  are  m  iierous.  The  edges  of  the  skin  around 
them  are  generally  thick,  prominent,  and  rounded.  The  granulatioiiH 
are  pale,  smooth,  large,  and  flabby,  with  a  peculiar  gloss  upon  tliem. 
These  ulcers  form  most  often  on  the  leg ;  and  the  nearer  they  are  to 
the  ankle,  the  harder  they  are  to  cure. 

Phagedenic  Ulcers  are  those  which  look  as  thcagh  they  literally 
eat  away  the  parts.  Their  surface  has  a  livid  appearance.  The 
matter  formed  is  small  in  quantity,  and  is  frequently  tinged  with 
blood. 

Specific  Ulcers  embrace  scrofulous,  cancerous,  venereal,  scarhutic, 
and  others.  They  are  called  specific  because  they  are  produced  by 
particular  diseases  and  states  of  the  system.  , 

Treatment.  —  The  first  thing  to  be  done  is  to  remove  the  exciting 
cause.  A  venereal,  or  a  scrofulous,  or  a  scorbutic  ulcer,  cannot  be 
cured,  unless  we  first  lessen  the  force  of  the  disease  in  the  general 
system.  If  the  continuance  of  a  sore  depends  on  bad  digestion,  we 
cannot  expect  to  cure  it  till  we  put  the  stomach  right. 

Healthy  ulcers  need  no  treatment,  except  some  simple  dressing, 
such  as  oxide  of  zinc  ointment.  It  is  well,  in  some  cases,  to  touch 
the  granulations  near  the  surface  with  lunar  caustic. 

Ulcers  upon  the  legs  and  ankles  do  not  heal  well  if  the  patient 
walks  about  much,  or  even  allows  the  legs  to  hang  down  a  great 
deal.  The  patient  must  be  put  to  bed  and  the  leg  bandaged,  especially 
if  the  ulcers  are  the  result  of  the  breaking  down  of  varicose  veins, 
which  are  so  common  a  cause  of  leg-ulcers. 

Indolent  ulcers  are  to  be  touched  by  lunar  caustic,  or  by  diluted 
nitric  acid.  The  diluted  ointment  of  the  nitrate  of  mercury  is  also 
often  used  with  benefit.  So  is  the  compound  tincture  of  benzoin,  the 
basilicon  ointment,  etc.  Or,  apply  a  bread-and-milk  poultice  to  the 
ulcer,  and  keep  the  patient  twenty-four  hours  in  bed.  Then  apply 
the  lunar  caustic  to  the  whole  sore,  and  to  the  skin  around  it.  After- 
wards cover  the  ulcer  with  sticking  plaster,  and  a  bandage. 

The  following  is  the  best  plan.  Lay  upon  the  sore  a  number  of 
pieces  of  lint,  soaked  in  the  nitric-acid  lotion  (314),  xand  cover  them 
with  a  bread-and-milk  poultice.  Change  these  applications  twice  a 
day,  and  continue  them  till  the  discharge  looks  healthy,  and  the  gran- 
ulations begin  to  appear. 

If  there  is  inflammation  about  tlie  sore,  give  some  of  the  prepara- 
tions of  salts  to  purge  the  bowels,  and  confine  the  patient  to  bed. 
When  the  parts  begin  to  look  healthy,  lay  some  pieces  of  lint  upon 
the  sore,  wet  with  nitric-acid  lotion  (214),  or  zinc  lotion  (216);  and 


SUUGICAL   DISEASES. 


533 


as  in  the  ciwi-  of 
ounding  skin. 

W«,  indolent,  phor 

the  skin  around 
The  granulatioiiH 
gloss  upon  tlieni. 
learer  they  are  to 

agh  they  Uterally 
ippearance.  The 
sntly  tinged  with 

wnereal,  scorbutic, 
are  produced  by 

move  the  exciting 

ulcer,  cannot  be 

le  in  the  general 

bad  digestion,  we 

:ht. 

simple  drcvssing, 
e  cases,  to  touch 

■» 
.>• 

ell  if  the  patient 
ing  down  a  great 
idaged,  especially 
of  varicose  veins, 

itic,  or  by  diluted 
if  mercury  is  also 
ire  of  benzoin,  the 
k  poultice  to  the 
)ed.  Then  apply 
iround  it.  After- 
jandage. 

ore  a  number  of 
,  xand  cover  them 
ilications  twice  a 
thy,  and  the  gran- 

e  of  the  prepara- 
i  patient  to  bed. 
ices  of  lint  upon 
otion  (215);  and 


then  apply  strips  of  adhesive  plaster,  one  and  one-half  inches  wide, 
two-thirds  round  tlie  limb,  and  extending  an  inch  below  the  ulcer 
and  an  inch  above  it, —  at  the  same  time  drawing  the  edges  of  the 
sore  together  with  a  gentle  fonu;,  and  retaining  them  there  with  the 
plaster.  Put  a  compress  of  soft  linen  over  tlie  plaster,  and  ai)ply  a 
bandage  over  the  whole,  making  it  tighter  below  and  a  iittle  looser 
above,  and  extending  to  tlie  knee.     {Vig,  164.) 


Surgeons  frequently  snip  out  little  pieces  of  healthy  skin  from 
some  adjacent  part  and  graft  onto  the  ulcer,  thus  shortening  the  pro- 
cess of  healing.  A  dressing  of  bovinine  and  water  in  equal  parts 
hastens  the  growth  of  the  flesh  part.  Whenever  the  fleslx  is  even 
with  the  skin  it  should  be  kept  at  this  level  by  some  mild  caustic,  as 
stated  above.  Then  comes  the  time  for  transplanting  skin.  The 
varicosities  of  the  veins  must  be  cured,  or  at  least  improved  before 
the  ulcera  will  remain  healed.     Avoid  the  use  of  pork  or  lard. 

Boils.  —  Ferunculus. 

Underneath  the  skin  is  a  layer  of  tissue  composed  chiefly  of  cells. 
From  this  tissue  there  are  small  elevations,  in  the  shape  of  cones, 
which  rise  up  into  the  substance  of  the  true  skin.  Like  those  papillae 
of  the  skin  which  become  inflamed  and  produce  copis,  these  eleva- 
tions are  subject  to  an  inflammation,  which  causes  boils. 

At  first,  a  tender  knot  or  hardness  is  felt  just  under  the  skin,  which 
soon  begins  to  look  red.  A  painful  tumor  now  begins  to  show  itself, 
of  a  dusky  red  or  purple  color,  which  acquires  the  size  of  a  pea,  a 
hazel-nut  or  a  walnut.  Some  time  between  the  fourth  and  eighth 
day  it  becomes  pointed  and  white  at  the  top,  when  the  scarf-skin 
gives  way,  and  lets  out  a"  little  pus  mixed  with  blood,  and  exposes  to 
view  a  mass  of  dead  matter,  called  a  core,  which  is  too  large  for  the 
opening,  and  is  not  ready  to  come  away,  if  it  were  not.  This  core  is 
a  mass  of  mortified  or  dead  flesh ;  and  nature  is  cutting  a  space 
around  it,  that  it  may  be  thrown  off.  In  two  or  three  more  days,  it 
comes  away,  leaving  a  cup-like  cavity,  which  gradually  fills  up,  and 
the  boil  is  over. 

Some  constitutions  yield  boils  in  successive  crops.  When  this  hap- 
pens they  are  a  terrible  affliction.  There  are  not  many  Jobs  who  can 
bear  them  with  patience.  » 


\ 


534  BURGIOAL  DISEASES. 

Treatment.  —  A  boil  will  generally  run  its  course.  A  five-priiin 
blue-pill,  tiikim  at  bed-time,  wliun  tbe  boil  is  (irHt  .sbowiiig  itHoit',  is 
about  the  only  tbing  I  know  tbat  will  bliust  it.  And  yet,  my  unwil- 
lingness to  encourage  a  general  use  of  mercurials  makes  me  iiesitile 
to  rev'ommend  it.  One  pill,  not  to  be  repeated,  can  do  no  harm,  how- 
ever, and  may  safely  be  tsiken. 

Boils  may  sonietimes  be  stopped  by  touching  them  with  lunar 
caustic.  Water-tlressing,  if  used  early,  and  persevered  in,  will  some- 
times prevent  their  growing  larger  than  a  pea.  After  the  boil  luus 
oi)ened,  apply  poultices  for  a  day  or  two,  then  some  simple,  stimula- 
ting ointment,  as  Ixisilicon  salve,  or  Turner's  cerate,  or  nitric  acid 
lotion  (814).  If  boils  continue  to  come  out  in  successive  crops,  give 
alterative  medicines,  or  sulphurous  mineral  waters,  or  liquor  potassas 
or  bicarbonate  of  soda.  General  tonic  treatment,  with  iron,  quinine, 
etc.,  is  usually  required  (65),  (75).  A  cupful  of  Indian  meal  soaked 
in  a  quart  of  water  for  four  hours,  and  the  water  drunk  freely,  will 
often  stop  a  boil  if  taken  when  it  firat  starts,  and  if  continued  will 
prevent  their  returning.  I  would  advise  its  trial,  as  it  is  often  suc- 
cessful. 

Carbuncle.  —  Anthrax. 

This  is  like  a  boil,  only  much  larger  and  more  painful.  Instead 
of  one  of  the  little  cellular  elevations  being  inflamed,  as  in  the  case 
of  the  boil,  the  carbuncle  begins  with  the  inflammation  of  several. 
Its  surface  is  more  flat  than  that  of  a  boil ;  its  inflammation  more 
violent;  and  the  constitutional  symptoms  excited  more  severe.  It 
has  the  breadth,  sometimes,  of  the  top  of  a  quart  bowl.  Like  the 
boil,  it  appears  most  often  upon  the  neck,  the  shoulders,  the  back,  the 
buttocks,  the  thighs,  etc.  It  goes  through  the  same  process  as  a  boil, 
and  ends  in  the  same  way,  only  discharging  a  vastly  larger  core. 

Carbuncles  most  often  appear  in  persons  above  middle  age,  and 
indicate  an  impaired  and  broken  constitution.  They  occasion  great 
suffering,  and  sometimes  prove  fatal.  Upon  the  head  or  neck,  they 
are  more  dangerous  than  in  other  situations.  They  are  now  con- 
sidered to  be  of  bacterial  origin. 

Treatment.  —  Apply,  constantly,  during  the  formation  of  the  car- 
buncle, either  fomentations  and  poultices,  or  cold-water  dressing.  I 
prefer  the  latter.  To  stop  both  the  local  and  the  constitutional  dis- 
order, make  two  incisions  in  the  form  of  a  cross,  cutting  entirely 
through  the  dead  mass.  Then  apply  a  fermenting  poultice,  or  one  of 
oatmeal,  for  two  or  three  days,  after  which  use  the  basilicon  salve,  or 
apply  daily  a  weak  solution  of  lunar  caustic,  or  the  nitric-acid  lotion 
(314).  During  recovery,  tonics  are  useful,  such  as  quinine,  tincture 
of  Peruvian  bark,  and  sulphuric  acid ;  and  morphine  to  procure  rest, 
at  every  stage  when  it  is  required.  A  piece  of  caustic  potash  the 
size  of  a  pea,  dropped  into  the  middle  of  the  cross-cut,  hastens  the 
suppumtion  and  subsequent  healing  of  the  wound. 


BBilNBMiW^MIIill  I.    mmrvn'WKmnmMaietism'tJ^ti  iiW<iHinmjJl^jfl|jaiJ 


c.  A  five-pniin 
lowing  itHolf,  is 
I  yet,  my  uiiwil- 
ikes  mo  iicsitjvto 
o  no  harm,  liow- 

lem  with  lunar 
id  in,  will  801110- 
ter  tlw  boil  luus 
simple,  stimiilii- 
i,  or  nitric  m'ul 
ssive  crops,  give 
•  liquor  potassa), 
th  iron,  quinine, 
ian  meal  soaked 
•unk  freely,  will 
'  continued  will 
9  it  is  often  sue- 


ainful.  Instead 
,  as  in  the  ciise 
tion  of  several, 
ammation  more 
lore  severe.  It 
)owl.  Like  the 
IS, the  back, the 
»roces8  as  a  boil, 
larger  core, 
[niddle  age,  and 
r  occasion  great 
i  or  neck,  they 
sy  are  now  con- 
ation of  the  car- 
ter dressing.  I 
nstitutional  dis- 
autting  entirely 
lultice,  or  one  of 
isilicon  salve,  or 
litric-acid  lotion 
[uinine,  tincture 
to  procure  rest, 
istic  potash  the 
cut,  hastens  the 


SURGICAL   DISEASES.  635 


Malignant  Pustule. 

Tnia  is  one  of  the  five  diseases  which  man  may  take  from  animals. 
The  other  four  are  the  <;ow-pox,  hydrophobia,  (flandera,  and  vmlignant 
carbuncle.  This  hist  is  what  the  French  call  nharbon,  —  pronounced 
gharbo.  My  own  mother  and  an  elder  brother  came  nb.>r  losing  their 
lives  by  it,  —  having  taken  it  by  handling  the  flesh  and  tallow  of  a 
dead  cow. 

Malignant  pustule  begins  with  a  water-pimple,  not  bigger  than  a 
millet  seed.  Underneath  it  is  a  hard  point,  surrounded  with  redness, 
hke  a  flea-bite.  This  hardneas  is  soon  attacked  by  mortification, 
which  spreads  on  all  sides,  and  kills  everything  as  it  goes.  Next,  in 
fatal  eases,  come  great  restlessness,  faintings,  sunken  countenance, 
dry  skin,  dry  brown  tongue,  despondency,  delirium,  and  death.  It  is 
su[)i)08ed  generally  not  to  arise  from  constitutional  causes,  but  to  be 
produced  by  a  specific  poison  or  bacterium  applied  to  the  skin,  or  by 
eating  the  flesh  of  cattle  which  die  of  gangrenous  diseases.  The  dit 
order  is  probably  the  same  as  the  malignant  carbuncle. 

Treatment. —  Deep  incisions,  and  the  application  of  the  most  pow- 
erful caustics,  as  the  caustic  potash,  etc.,  and  tincture  of  peruvian 
hark,  quinine,  aromatic  sulphuric  acid,  wine,  ether  and  opium.  Prob- 
ably the  best  treatment  is  to  surround  the  pustule  with  a  thick  layer 
of  ointment ;  then  to  fasten  mme  lint  to  the  end  of  a  stick,  wet  it 
with  nitric  acid,  and  press  it  upon  the  pustule.  Now  apply  cloths, 
wet  with  cold  water,  and  when  the  slough  comes  off,  dress  with  sim- 
ple ointment,  or  touch  occasionally  with  weak  solution  of  nitrate  of 
silver  (211).  When  once  opened  it  should  be  thoroughly  irrigated 
with  disinfectants  like  corrosive  sublimate,  in  strength  of  1  part  to 
2000  solution. 

Chemical   Injuries. 

These  are  of  two  kinds,  produced  by  causes  of  an  exactly  opposite 
nature.     The  flret  are 

Burns  and  Scalds. 

A  bum  is  the  effect  of  concentrated  heat  acting  upon  living  tissues. 
The  effects  are  inflammation,  and  sometimes  complete  disorganization 
and  destruction  of  the  parts. 

A  scald  is  an  injury  produced  by  applying  hot  water  or  other  flui  .1, 
to  the  skin  or  mucous  membrane.  The  natural  temperature  of  the 
human  body  is  ninetj^-eight  degrees ;  that  of  boiling  water,  two  hun- 
dred and  tv/elve  degrees.  Bringing  the  skin  in  contact  with  a  fluid 
heated  so  far  above  it,  produces  redness  and  pain  ;  and  when  nothing 
is  done  instantly  to  ward  off  the  injury,  the  scarf-skin  is  raised  from 
the  true  skin  in  the  form  of  a  blister,  filled  with  water. 


-'-«^5(51gS^ 


■^■tt 


586 


SUKQICAL   DISEASES. 


The  degree  of  danger  from  a  burn  or  Hcald  (htpcnds  upon  tlio  ex- 
tent oi  the  injured  Hurfaee,  and  also  u])on  the  depth  ol  the  injury,  aw 
extensive  scahl  or  hum  may  prove  fatal  in  a  few  hours, —  the  padini 
never  i-allying  from  the  first  prostration.  These  injuries  are  most 
dangerous  when  upon  the  head,  neck,  chest  and  belly.  Old  persons, 
and  those  who  are  feeble  and  have  shattered  constitutions,  will  sink 
under  burns  and  scalds  from  which  robust  pereons  will  suft'er  but 
little. 

Treatment.  —  For  slight  burns  and  scalds,  make  cold  applications. 
Put  the  injured  part  in  very  cold  water,  or  lay  upon  it  piecies  of  linen, 
or  lint,  wet  with  vinegar  and  water,  or  rose-water  and  sugar  of  lead 
(288),  or  diluted  solution  of  acetate  of  ammonia.  When  these  are 
not  to  ])e  quickly  had,  lay  on  scraped  raw  potatoes,  which  is  one  of 
the  best  remedies  to  give  immediate  relief.  The  object  is  to  reduce 
the  inflammation,  and  to  prevent  blistering.  They  must,  therefore 
be  put  on  very  soon.  If  the  scald  be  extensive,  and  on  the  body,— 
producing  shivering,  faintness,  paleness  and  coldness  of  the  skin, 
and  a  small  j)ulse,  —  cold  applications  are  not  propor.  In  such  case 
we  may  use  warm  fomentations,  or,  in  the  case  of  a  child,  the  warm 
bath.  A  liniment  of  spirits  of  turpentine,  linseed  oil,  etc.  (194), 
makes  an  excellent  application.     Also  (371). 

Raw  cotton,  spread  out  thin,  and  laid  upon  a  burn,  is  a  good  dress^ 
ing,  and  one  which  is  much  used.  So  is  flour  sprinkled  upon  the  in- 
jured surface  with  a  dredger.  For  loosening  the  flour  when  it  is  to 
be  taken  off,  poultices  are  useful. 

Keep  the  air  from  the  wound  as  much  as  possible.  With  this 
view,  do  not  remove  the  dressing  often,  and  when  a  cold  lotion  is 
used,  merely  pour  it  upon  the  rags,  letting  them  remain  undisturl)ed. 
Stimidate  and  narcotize  the  patient  if  exhausted  by  the  shock  of  the 
burn.  Nothing  is  more  generally  used  than  carron  oil,  which  is  com- 
posed of  equal  parts  of  linseed  oil  and  lime-water.  It  soothes,  heals 
and  promotes  granulation. 

Effects  of  Cold.— Frost-Blte. 

Cold  is  a  relative  term.  The  same  temperature  may  be  called  hot 
or  cold,  according  as  it  is  compared  with  a  hotter  or  colder  tempera- 
ture. If  we  warm  one  hand  by  a  fire,  while  we  lay  the  other  upon 
ice,  and  then  plunge  them  both  into  cold  water,  the  water  will  feel 
cold  to  the  one  which  has  been  by  the  fire,  and  warm  to  the  one  taken 
from  the  ice. 

The  warmth  of  the  body  being  ninety-eight  degrees,  any  tempera- 
ture below  this  may  be  said,  in  a  certain  sense,  to  be  cold.  Yet  a 
temperature  much  lower  than  this,  namely,  from  sixty  to  seventy,  is 
the  most  agreeable  and  invigorating,  because  it  takes  away  the  heat 
just  about  as  fast  as  it  is  produced  in  a  healthy  body. 

The  first  effect  of  cold  applied  to  the  body  is  to  weaken  the  circu- 


■MMMta 


WMMIIIMM 


^^^ 


SURniCAL  PISEASKB. 


687 


lends  upon  the  ex- 
of  tho  injury.  .An 
DUrH, —  the  piiliiiiL 
injuries  uro  iiuxst 
tUy.  Old  persons, 
titutions,  will  sink 
ins  will  suffer  Imt 


)  eold  applications. 
I  it  pieces  of  linen, 

aiul  sugar  of  lend 
When  these  are 
9,  which  is  oiu)  of 
object  is  to  reduce 
ley  must,  therefore 
md  on  the  body, — 
Iness  of  the  skin, 
por.     In  such  case 

a  child,  the  warm 
ed  oil,  etc.  (194), 

rn,  is  a  good  dress^ 
nkled  upon  the  in- 
flour  when  it  is  to 

(ssible.  With  this 
n  a  cold  lotion  is 
smain  undisturlwd. 
)y  the  shock  of  the 
1  oil,  which  is  com- 
It  soothes,  beak 


ite. 

may  be  called  hot 
or  colder  tenipera- 

ly  the  other  upon 
the  water  will  feel 
m  to  the  one  taken 

yrees,  any  tempera- 
lO  be  cold.  Yet  a 
uxty  to  seventy,  is 
akes  away  the  beat 
)dy. 
weaken  the  circu- 


lation in  the  small  l)lood-ves8el8  of  the  skin.  When  applied  with 
Hoino  intctnsity,  tlu;  Ix^art  and  arteries  in  general  an;  weakened;  .'.le 
Iddod  is  delayed  in  tlio  vessels  near  tlie  Hiirface,  and  not  In-in^L,' changed 
to  a  red  color  in  the  lungs  tis  ftust  us  it  should  be,  the  lingei's,  cans, 
etc.,  l)ccomu  blue  or  livid;  and,  if  the  cold  Ih)  continued  sufficiently 
long,  the  circulation  stops  in  these  parts ;  heiit  ceases  to  In;  evolved, 
and  inortiiication  or  death  is  the  consequence.  Parts  killed  in  this 
way  are  said  to  he  froat-bitteii. 

A  free  circulation  of  red  blood  is  essential  to  tlie  continuance  of 
sen.sibility.  Hence,  when  the  circulation  is  seriously  impeded  by  cold, 
the  body  becomes  nuniV), —  it  loses  its  feeling;  the  muscles  act  feebly; 
a  languor  and  torpor  follows ;  drowsiness  comes  on,  followed  by  sleep, 
from  which  there  is  no  waking.  Drowsiness,  during  exposure  to  ex- 
treme cold,  indicates  great  danger. 

Treatment*  —  It  is  a  great  principle  in  restoring  frost-bitten  parts, 
and  pei-sons  benumbed  with  cold,  to  coninmnieate  heat  in  the  most 
gradual  manner.  It  has  been  said  that  the  degree  of  external  heat 
should  be  in  proportion  to  the  quantity  of  life.  When  life  is 
weakened  and  nearly  destroyed  by  frost,  therefore,  the  warmth  must 
he  small,  and  rise  no  faster  than  life  returns. 

To  rectore  a  frozen  limb  or  part,  rub  it  with  snow,  or  place  it  in 
cold  water  for  some  time.  When  feeling  begins  to  return,  still  keep 
it  in  cold  water  and  let  heat  be  added  in  a  very  gradual  manner,  by 
pouring  in,  now  and  then,  a  very  small  quantity  of  warm  water. 

If  a  person  be  nduced  by  cold  to  insensibility,  and  apparently 
frozen  to  death,  take  his  clothes  off,  and  cover  him  all  over  with  snow, 
except  the  mouth  and  nostrils.  If  snow  is  not  to  be  had,  put  him  in 
water  as  cold  as  ice,  and  let  him  lie  for  some  minutes.  Then  rub 
him  with  cloths  wet  with  cold  water.  When  the  body  is  thus  thawed 
by  degrees,  and  the  muscles  begin  to  relax,  dry  the  body,  and  placing 
it  in  a  cold  bed,  rub  with  the  warm  hands,  only  under  the  clotlies. 
Continue  this  for  houra.  If  signs  of  life  appear,  give  a  small  injec- 
tion of  camphor  and  water,  and  put  a  drop  of  spirits  of  camphor  on 
the  tongue.  After  a  time,  rub  with  spirit  and  water,  and  finally 
with  spii'it,  and  give  tea,  or  coffee,  or  brandy  and  water, 

Chilblains. 

These  are  caused  by  exposure  to  cold,  and  affect  the  fingers,  toes, 
and  particularly  the  heels,  with  a  painful  inflammatory  swelling,  of 
a  red,  purple,  or  bluish  color.  The  skin  may  be  red  in  patches,  and 
slightly  swelled,  with  itching,  tingling,  pain,  and  lameness ;  or  there 
may  be  blisters,  around  which  the  skin  is  blue  or  purple  ;  or,  worse 
yet,  there  may  be  ulceration  and  sloughing. 

Treatment-  — Stimulating  Imiments  are  the  remedies  usually  em- 
ployed for  this  complaint.     One  of  the  best  consists  of  six  parts  of 


wmd 


538 


BUKOIOAL   DIHRASKH. 


floiip  linimont,  aiul  ono  piirt  of  tin.-turo  of  SpimiHh  (Hch  ;  im»l  iiiiollicr 
excellent  one  is  prescription  J107.  If  tlioro  is  ulceration,  use  Tuiiht's 
cerate,  or  the  resin  ointment. 

Mechanical  Injuries. 

WouNns  are  divided  into  several  kinds. 

Incised  Wounds  are  very  common.  Heing  made  with  sharp  in- 
struments, they  are  cuts,  and  have  no  laceration  or  tearing  about 
them. 

5tabs,  or  Punctured  Wounds,  form  another  class.  They  are  made 
with  pointed  weapons,  as  bayonets,  lances,  swords,  and  daj^gurs. 
They  are  more  dangerous  than  the  former,  because  they  penetrate 
to  a  greater  deptli,  —  injuring  blood-vessels,  nerves,  bowels,  and 
other  organs. 

Contused  and  Lacerated  Wounds  form  still  another  class.  They 
embrace  gun-shot  wounds,  and  all  those  produced  hy  blunt  instru- 
ments.    They  tear,  and  brui»e,  and  maiih  the  flesh. 

Poisoned  Wound*  form  yet  another  class.  They  are  such  as  are 
united  with  the  introduction  of  some  venomous  p(>ison  into  tlie  in- 
cised, or  punctured,  or  contused  part.  Stings  and  bites  of  venomous 
insects  and  snakes  are  of  this  class,  —  also  the  wounds  made  hy 
poisoned  arrows. 

Simple  Wounds  are  such  as  are  inflicted  on  a  healthy  subject  with 
a  clean,  sharp  instrument. 

Complicated  Wounds  are  those  inflicted  when  the  state  of  the 
whole  system,  or  of  the  wounded  part,  is  such  as  to  make  it  neces- 
sary for  the  surgeon  to  deviate  from  the  treatment  needed  for  a  sim- 
ple wound,  —  as,  for  example,  when  there  is  bleeding,  or  nervous 
symptoms,  or  great  pain,  or  locked-jaw,  or  much  contusion,  or  ery- 
sipelas. 

Lacerated  wounds  are  more  dangerous  than  ircised  ones,  because 
the  parts  are  stretched  and  otherwise  injured,  besides  being  separated. 

A  very  small  wound  upon  the  brain,  the  spinal  marrow,  the  bowels, 
or  the  heart,  will  often  prove  fatal,  because  the  functions  of  these 
parts  are  intimately  connected  with  life. 

Woundb  of  young  persons  heal  much  more  rapidly  and  kindly  than 
those  of  old  persons. 

Septic  Wounds. 

Whenever  a  surface  has  been  cut,  lacerated,  or  in  any  way  in- 
jured, so  that  the  surface  can  absorb  germ-life  from  the  instrument 
inflicting  the  wound,  from  the  dressings  used  to  cover  it  up,  or  from 
the  diit  of  the  skin  itself,  we  are  very  apt  to  get  in  a  few  days  what 
used  to  be  known  as  sympathetic  fever,  but  which  is  no  more  or  less 


/ 


mum 


;>H  ;  iiikI  iiiintlicr 
■»ti,  iiKo  Tuiiht's 


with  Hhar{)  iii- 
r  tearing  about 

They  aro  inadt! 
1,  and  daj^gors. 
I  they  penetrate 
BB,  bowels,  and 


SUROICAL  niBEABRS. 


539 


than  the  neptic  fever,  or  the  HyHteniio  nianifefltation  of  gorm  ubtiorp- 
tion.  Fever,  Iohh  of  appetit(%  hoadache,  Hwelling  and  tunderneHH  of 
tlio  wound,  witli  perhaps  pu«  formation,  are  the  natural  outcome  of 
Huch  abHorption.  Hence  it  will  readily  ho  seen  frotn  what  has  Iwen 
previously  said  alxiut  nrpsis,  that  the  lirst  indication  in  all  cuts  is  to 
disinfect  the  area  injured  witli  some  one  of  the  germicidal  solutioiLs. 
None  is  cheaper  than  (iorrosive  snhlimato  in  the  strength  of  one  part 
to  two  thousand.  This,  in  many  cases,  is  all  that  need  l)o  done.  If 
the  cut  is  to  he  sewn  up,  the  wound  is  fust  cleaned  with  corrosive 
sublimate  or  oil  of  milk  solution  (a  half-teaspoonful  to  one  quart  of 
water),  and  then  sewn  with  needle  ami  thread  that  iiave  been  boiled 
live  minutes.  The  dressingii  or  bandage  should  be  disinfecttid  with 
..jeam  before  being  applied.  Druggists  nowadays  keep  in  stock  I'-sep- 
U'^  gauze  meant  for  precisely  this  class  of  cases,  lacerated  wounds,  etc. 


J  ■ 


ler  class.  They 
)y  blunt  instru- 

■  are  such  as  are 
ison  into  the  iii- 
tes  of  venomous 
ounds  made  by 

thy  subject  with 

he  state  of  the 
a  make  it  neces- 
Beded  for  a  sim- 
ing,  or  nervous 
antusion,  or  ery- 

ed  ones,  because 
being  separated, 
row,  the  bowels, 
nctions  of  these 

and  kindly  than 


•  in  any  way  m- 
1  the  instrument 
er  it  up,  or  from 
a  few  days  what 
I  no  more  or  less 


Incised  Wounds. 

V/hen  the  flesh  is  divided  with  a  cutting  instrument,  the  cut  edges 
separate,  and  the  wound  has  a  gaping  a})pearance.  This  drawing 
apart  happens  in  consequence  of  the  elasticity  of  the  skin.  It  often 
happens  that  vessels  of  considerable  size  are  cut,  so  that  bleeding  is 
the  principal  thing  to  receive  attention. 

Treatment  of  Hemorrhage. — Bleeding  is  stopped  by  the  tourniquet, 
by  the  ligature,  by  compression,  by  the  application  of  cold  water  and 
ice,  and  by  astringents  and  styptics. 

The  Tour  ^uet.  —  This  instrument  consists  of  a  bjind  and  buckle, 
a  pad  and  two  brass  frames,  the 
upper  of  which  is  furnished  with 
two  small  rollers,  and  the  lower 
with  four,  over  all  of  which  the 
band  plays.  When  the  handle  is 
turned  to  the  right  or  left,  the 
band  is  tightened  or  relaxed  to 
just  the  extent  required.  (Fig. 
155.)  The  band  is  buckled  round 
the  limb  in  such  a  manner  that 
the  pad  is  placed  exactly  over  the 
artery.  When  an  artery  is  cut,  it 
is  known  by  the  blood  being  very 
rerf, and  spirting  out  in  jets;  and 
in  this  case,  the  instrument  must 
l)e  placed  upon  the  limb  above  the 
wound,  or  between  it  and  the 
heart.  *"'o-  »»• 

The  Ligature.  —  When  an  artery  is  divided,  the  surgeon  lays  hold 
of  the  end  of  it  with  his  forceps,  and  ties  a  thread  tight  around  it,  or 


K  % 


540 


SURGICAL  DISEASES. 


twists  the  end  of  the  artery.  This  is  called  a  ligature.  By  it,  tlio 
bleeding  is  instantly  stopped,  and  long  before  the  thread  becomes 
loose,  the  opposite  sides  of  the  vessel  have  grown  together,  and  all 
danger  of  a  renewal  of  the  bleeding  is  over.  In  all  these  procedures 
the  careful  surgeon  uses  only  disinfected  instruments  and  ligatures. 

Application  of  Water  and  Ice.  —  This  is  done  by  saturating  witli 
cold  water  several  folds  of  linen  rags,  or  lint  pads,  and  applying  them 
to  the  wound,  remoistening,  and  reapplying  them  as  fast  as  they  be- 
come hot,  till  the  pain  and  inflammation  subside. 

Compression.  —  When  the  blood  does  not  come  from  any  large 
vessel,  but  from  several  small  ones,  compression  is  sufiicient.  It  con- 
sists in  placing  the  opposite  sides  of  the  wound  together,  if  possible, 
and  then  laying  compresses  over,  and  applying  a  bandage  with  mod- 
erate tightness. 

Astringents  and  Styptics. — These  are  spirits,  tinctures  of  myrrh, 
Peruvian  bark,  diluted  mineral  acids,  solutions  of  tannin,  alum,  sul- 
phate of  copper,  decoctions  of  white-oak  bark,  etc.  These  have  the 
po  ^er  to  stop  bleeding  from  small  vessels.  Monsel's  salt  is  soid  to 
have  more  power  than  all  the  above.  It  is  a  preparation  of  iron  and 
nitric  acid,  and  has  been  used  with  great  success  in  stopping  violent 
bleeding.  It  is  not  a  caustic  or  an  irritant ;  but  it  acts  very  power- 
fully upon  albumen  and  blood,  —  producing  with  the  latter  a  large 
clot,  absolutely  insoluble,  which  continues  to  enlarge  for  several  houre 
after  the  application,  and  becomes  quite  hard  and  firm,  so  that  no 
blood  can  get  through ;  but  it  leaves  the  wound  filled  with  clots 
which  afterward  decompose  and  often  give  rise  to  blood-poisoning. 
The  compress  wrung  out  of  some  antiseptic  solution  is  always  the 
best  method  when  practical. 

Beside  these  means,  the  application  of  the  lunar  caustic,  potash,  and 
the  hot  iron,  are  used,  particularly  the  first,  quite  often. 

Union  by  the  First  Intention. 

When  the  bleeding  is  stopped,  all  foreign  substances  removed,  and 
the  wound  properly  cleansed,  the  next  thing  is  to  bring  the  opposite 
sides  c  f  the  cut  evenly  together,  and  to  keep  them  steadily  in  this 
position  till  they  have  healed.  If  this  method  succeeds,  the  healing 
takes  place  without  the  formation  of  any  pus.  This  is  called  healini/ 
by  the  first  intention,  or  adhesion.  The  cut  surfaces  grow  together. 
For  keeping  the  surfaces  together,  straps  of  adhesive  plaster  are  used, 
putting  them  at  right  angles  across  the  cut,  and  leaving  spaces  be- 
tween them. 

Sutures.  —  Incised  wounds  are  sometimes  seived  together  by  what 
is  called  the  interrupted  suture.  After  the  bleeding  is  stopped,  a 
a  curved  needle  is  threaded,  and,  the  liijs  of  the  wound  being  brought 
together,  is  introduced  through  '  "le  right  lip,  and  then,  being  directed 


■vi««iirlwniaiWW>wwKi 


mmm 


i^-l*V^  ^ — — 


•TOKWfJgiBliiV 


ure.  By  it,  tlio 
thread  becomes 
)gether,  and  all 
hese  procedures 
I  and  ligatures. 

saturating  witii 

1  applying  them 

fast  as  they  he- 

from  any  large 
ficient.  It  con- 
ther,  if  possible, 
dage  with  mod- 

ctures  of  myrrh, 
nnin,  alum,  sul- 
These  have  the 
i  salt  is  soid  to 
ition  of  iron  and 
itopping  violent 
lets  very  power- 
e  latter  a  large 
or  several  houre 
irm,  so  that  no 
illed  with  clots 
blood-poisoning. 
1  is  always  the 

Stic,  potash,  and 
en. 

1. 

les  removed,  and 
ing  the  opposite 
steadily  in  this 
eds,  the  healing 
is  called  hcalimj 
3  grow  together. 
plaster  are  used, 
ving  spaces  be- 

ogether  by  what 
g  is  stopped,  a 
d  being  brought 
1,  being  directed 


SURGICAL   DISKASRS. 


541 


across  the  wound,  ia  pushed  through  the  left  lip,  from  within  out- 
ward. It  is  now  cut  off,  and  tied  in  a  bow.  These  stitches  should 
Iw  at  least  an  ijich  from  each  other.  These  needles  and  sutures  are, 
of  course,  to  be  boiled  or  otherwise  rendered  aseptic  before  using,  aa 
well  an  the  hands  of  the  one  doing  the  sewing.  Needles  and  thread 
come  all  ready  i)ut  up  in  glass  tubes,  Imving  been  fii-st  sterilized,  and 
kept  in  alcohol  c  in  a  vacuum  for  any  length  of  time  perfectly  germ- 
free. 

The  first  ]Ai.  ;,ers  and  dressings  should  remain  on  the  parts  at  least 
three  or  four  days,  unless  veiy  great  pain,  bleeding,  or  some  other 
bad  symptom,  should  call  for  their  removal. 

Useful  Rules  for  Examining  and  Dressing  Wounds. 

Neveu  givo  the  patient  more  pain  from  the  mode  of  handling  and 
dressing  the  wound  than  is  necessary  for  liis  present  good  or  future 
safety.  Never  distress  him  by  probing,  squeezing,  etc.,  to  find  things 
diat  will  Ije  of  no  use  when  learned. 

Make  all  examinations  ns  soon  after  the  accident  as  possible ;  for 
l)efore  inflammation  and  swelling  take  place,  the  prol)e  or  finger  in- 
flicts nmch  less  pain. 

In  changing  the  dressing  of  a  wound,  let  all  the  fresh  ont  i  be  ready 
before  the  removing  of  the  old.  The  sponge,  warm  water,  adhesive 
phisUir,  lint,  ointment,  lotions,  bandages,  etc.,  should  all  be  at  hand, 
and  not  have  to  be  looked  after  wlien  the  wound  is  exposed. 

Put  the  patient  in  the  most  easy  position,  that  he  may  not  l)e 
needlessly  fatigued  during  the  dressing. 

If  the  bandage,  plaster,  and  other  dressings,  have  become  hard,  and 
glued  together,  and  to  the  skin,  by  blood  or  matter,  soften  them  with 
warm  boiled  water,  which  is  to  be  pressed  out  of  a  sponge, — a  basin 
being  held  below  the  part  to  catch  the  water  as  it  falls  from  the 
dressing. 

The  strips  of  adhesive  plaster  are  to  be  removed  by  pulling  gently 
at  one  end,  and  then  che  other, — each  to  be  drawn  towards  the 
wound,  so  as  not  to  pull  lus  lips  apart. 

In  large  wounds,  take  off  one,  or  at  most,  two  strips  of  plaster 
at  a  time.  Cleanse,  wipe  dry,  and  again  eupport  this  part  of  the 
wound  with  new  strips  of  plaster,  before  any  more  are  taken  off. 
Tbis  will  prevent  the  wound  being  torn  open  by  the  weight  of  its 
parts. 

If  the  wound  be  large  and  deep,  its  sides  should  be  supported  by 
an  assistant  while  changing  the  dressings. 

If  there  are  several  wounds,  dress  but  one  at  a  time,  that  there 
may  be  no  needless  exposure  to  the  air. 

Pay  the  utmost  attention  to  cleanliness,  asepsis  and  dryness. 

T);a  frequency  of  the  dressing  must  depend  (ju  the  amount  and 
qi'^.uty  of  the  disclutrge,  the  situation  of  the  injury,  the  climate  and 


i,ti  i>wpi.iiff ji^ii  iiia(t»Ji 


542 


SUKGICAL   DISEASES. 


season  of  the  year,  the  effect  produced  by  the  dressing,  and  hy  the 
feelings  of  the  patient- 
Remember  that  the  one  great  desideratum  is  to  keep  away  all 
germs  from  the  wound  and  its  vicinity. 


Antiseptic  Dressings. 

Antiseptics  have  lately  attracted  a  great  deal  of  notice  in  the 
treatment  of  inflammation,  especially  resulting  from  wounds. 

The  article  most  used  at  the  present  time  for  this  purpose  is  car- 
bolic acid.  Lister  is  its  chief  advocate,  and  under  his  authority  it 
has  established  a  position  which  deserves  attention. 

It  is  based  upon  the  germ-theory  of  disease,  which  is  founded 
upon  the  observations  of  Pasteur.  The  theory  supposes  that  animal 
decomposition  is  due,  not  to  the  chemical  action  of  oxygen,  or  any 
other  gas,  but  to  the  presence  of  organic  germs  floating  in  the  atmos- 
phere. Carbolic  acid  is  used  on  account  of  its  known  destructive 
effects  upon  low  forms  of  organic  life. 

These  low  forms  of  vegetable  organisms,  which  float  in  the  air  in 
great  abundance  as  constituents  of  the  dust,  are  called  by  naturalists 
bacteria,  of  which  there  are  many  varieties.  Whenever  they  find 
entrance  into  the  body,  there  putrefaction  is  produced. " 

These  vegetable  parasites  are  capable  of  a  wonderful  power  of 
multiplying  their  species,  —  a  single  germ  producing  in  a  few  hours 
many  thour-nds.  Once  admitted  into  the  body,  they  find  their  way 
everywhere,  —  into  the  muscles,  into  the  blood,  into  the  different 
organs  of  the  body,  —  and  they  spread  destructive  fermentation  and 
putrefaction  wherever  they  go. 

In  accidental  wounds,  it  is  fir»t  necessary  to  kill  any  septic  organ- 
isms which  may  have  been  introduced  from  the  air  or  from  contact 
with  foreign  bodies.  We  do  this  by  thoroughly  bathing  the  surfaces 
with  a  solution  of  carbolic  acid,  of  the  strength  of  one  part  of  the  acid 
to  twenty  of  water. 

When  the  wounds  are  made  by  the  surgeon,  the  germs  are  de- 
stroyed by  means  of  a  spray  imbued  with  the  acid.  This  spray  is 
produced  by  an  atomizer,  of  which  there  are  many  kinds,  and  is 
thrown  continually  on  to  the  surface  of  the  wound,  until  the  comple- 
tion of  the  operation,  including  the  ligaturing  of  the  vessels  and  the 
final  stitching  together  of  its  edges. 

Lister  also  recommends  the  use  of  carbolized  catgut  for  ligatures, 
being  of  an  animal  substance  and  finally  absorbed. 

When  the  operation  is  fully  completed,  the  antiseptic  dressings 
are  applied.  Besides  these  antiseptic  precautions,  in  cases  of  large 
and  deep  wounds  a  drainage  tube  is  introduced  to  allow  for  the 
escape  of  the  serum. 

The  antiseptic  dressings  consist  of  —  first,  the  protector ;  second, 
the  cai'bolized  gauze ;  third,  tlie  mackintosh ;    and  fourth,  another 


SURGICAL   DISEASES 


543 


jssing,  iuul  l)y  the 
to  keep  away  all 


il  of  notice  in  the 
m  wounds, 
lis  purpose  is  car- 
er his  authority  it 
1. 

Avhich  is  founded 
pposes  that  animal 
of  oxygen,  or  any 
ating  in  the  atmos- 
known  destructive 

I  float  in  the  air  in 
ailed  by  naturalists 
i/'henever  they  find 
uced.' 

'onderful  power  of 
cing  in  a  few  hours 
they  find  their  way 
,  into  the  different 
e  fermentation  and 

II  any  septic  organ- 
lir  or  from  contact 
lathing  the  surfaces 
one  part  of  the  acid 

the  germs  are  de- 
Lcid.  This  spray  is 
nany  kinds,  and  is 
d,  until  the  comple- 

the  vessels  and  the 

catgut  for  ligatures, 

antiseptic  dressings 
IS,  in  cases  of  large 
id  to  allow  for  the 

protector;  second, 
iud  fourth,  another 


layer  of  the  gauze,  and  a  bandage  of  tlie  same  to  keep  the  whole  in 
place.  For  the  purpose  of  protecting  the  cicatrizing  parts  from  the 
irritating  effects  of  the  gauze,  a  layer  of  oil-silk  coated  on  both  sides 
with  copal  varnish,  and  afterwards  brushed  over  with  dextrine,  to 
eniihle  it  to  become  uniformly  moistened  when  dipped  into  a  watery 
solution  of  the  acid,  is  applied  directly  over  the  wound,  the  ends  of 
the  drainage  tube  protruding  about  an  inch  from  each  extr»'mity  of 
the  incision.  The  wound  is  then  covered  with  a  layer  of  ar.tiscptic 
gaiixe  dipped  into  a  solution  of  one  to  forty  of  the  acid.  There  are 
then  snperimposed  six  other  layers  of  dry  gauze ;  then  the  mackin- 
tosh or  a  piece  of  rubber  cloth ;  then  an  eighth  layer  of  gauze  large 
enough  to  cover  i  '  the  remainder,  and  finally  a  bandage  of  the 
same. 

When  the  dressings  are  renewed,  it  is  to  be  done  under  the  spray, 
great  care  being  taken  not  to  admit  any  non-carbolized  air. 

The  dressings  are  not  to  be  changed  until  the  discharge  has  begun 
to  soak  through  and  appear  below  the  edge  of  the  rul)l)er  cloth. 

Tlie  antiseptic  gauze  is  made  by  impregnating  cotton  doth  of  open 
texture  with  a  mixture  of  carbolic  acid  one  part,  resin  five  parts, 
paraffine  seven  i>arts.  The  resin  acts  as  a  vehicle  for  the  acid,  while 
the  paraffine  is  added  to  prevent  inconvenient  adhesiveness. 

The  Way  in  which  Wounds  Unite. 

When  the  two  surfaces  of  a  wound  are  brought  togethei",  they  be- 
come impervious  to  the  blood,  but  not  to  coagulable  lymph,  or  fibrin. 
Tliis, —  the  material  of  which  all  flesh  is  made, —  flows  out  upon  the 
two  surfaces,  and  becomes  a  bond  of  union  between  them. 

Into  this  layer  of  fibrin,  the  small  blood-vessels, —  arteries  and  veins, 
—  which  have  been  cut  asunder,  push  themselves  with  open  mouths, 
and,  meeting  in  the  centre,  they  inosculate,  or  grow  together,  and  the 
blood  resumes  its  circulation  through  them. 

By  this  method,  incised  wounds  of  moderate  size  are  often  healed 
in  foity-eight  hours.  This  method  of  healing  by  the  f  rst  intention  is 
always  to  be  brought  about,  if  possible. 

Punctured  Wounds. 

These  are  produced  by  swords,  daggers,  etc. 

Great  swelling  and  inflammation,  large  abscesses,  erysipelas,  the 
wounding  of  large  arteries,  and  the  consequent  extravasation  of  blood, 
symptomatic  fever,  and  lock-jaw,  are  the  frequent  results  of  punctured 
wounds.  They  are,  therefore,  more  dangerous  and  hard  to  cure  than 
cuts.  , 

Treatment.  —  For  the  first  twenty-four  lioui-s,  use  superficial  dress- 
ings of  lint,  wet  with  some  disinfecting  liquid,  and  a  loose  bandage. 
If,  after  this,  pain  and  swelling  should  increase,  leeches  may  be  ap- 


544 


SURGICAI.   mSEASKS. 


IK 


\ 


plied  to  the  neighborhood  of  the  wound,  and  fomentations,  or  poul- 
tices, be  applied,  placing  a  small  linen  rag  or  gauze,  that  has  first  been 
soaked  in  the  disinfectant,  over  the  wound.  When  the  pain  and  in- 
flammation are  great,  saline  purgatives  (7),  (18),  (25),  (27),  and 
opiates  are  often  called  for. 

Contused  and  Lacerated  Wounds. 

These  are  produced  by  cudgels,  stones,  bullets,  or  Avhatever  else 
of  a  blunt  nature  tears  asunder  the  muscular  fibres,  leaving  jagged 
and  uneven  surfaces.  They  are  rarely  healed  without  suppuration, 
and  are  frequently  followed  by  violent  inflammation.  They  suppur- 
ate and  slough,  but  they  do  not  bleed  much,  —  not  even,  sometimes, 
when  large  arteries  are  torn  asunder.  Whole  limbs  are  occasionally 
torn  away  without  hemorrhage.  In  warm  climates,  lock-jaw  is  a  fre- 
quent consequence  of  them. 

Treatment.  —  Draw  the  edges  of  the  wound  loosely  together,  and 
retain  them  with  a  few  strips  of  adhesive  plaster.  Sometimes  a  su- 
ture, here  and  there,  will  be  proper.  If  a  great  deal  of  inflammation 
ensues,  take  away  the  adhesive  plitster  and  the  stitches,  and  apply  a 
poultice,  or  water-dressing ;  and  if  there  be  much  fever,  restlessness, 
or  delirium,  saline  purgatives  (18),  (25),  and  opium  (118),  will  be 
needed ;  but  especially  will  it  be  necessary  to  again  disinfect  the 
wound,  and  by  every  means  passible  render  the  field  aseptic. 

The  wound  having  thrown  off  its  sloughs,  suppurated,  become 
clean,  and  formed  granulations,  the  poultices  are  to  be  taken  off,  and 
simple  dressings  substituted.  These  should  be  adapted  to  the  con- 
ditions of  the  sore,  according  to  the  directions  for  treating  ulcers. 

When  the  wound  is  so  severe  that  extensive  mortification  will  be 
sure  to  follow,  the  limb  must  be  immediately  taken  off,  to  save  the 
life  of  the  patient.  .     . 

Granulation  and  Scarification. 

Suppurating  wounds  heal  in  the  same  way  as  ulcers.  The 
chasm  is  filled  up  by  the  appearance  of  little  soft  elevations  of  new 
substance,  which  originate  at  all  points,  and  meet  at  the  centre,  draw- 
ing the  sides  nearer  together,  and  raising  the  bottom  towards  the  sui- 
face  This  is  called  granulation,  because  these  elevations  look  lilce 
grains;  and  the  result  is  a  new  tissue,  of  a  peculiar  character,  wbicli 
constitutes  the  cicatrix,  on  scar. 

Reproduction  of  Lost  Parts, 

Among  some  of  the  lower  animals,  whole  limbs  which  have  been 
destroyed  are  easily  reproduced.  It  is  not  so  with  man  ;  though  cer- 
tain parts,  when  only  partially  destroyed,  are  sometimes  regenerated. 
Thus,  portions  of  skin,  of  considerable  extent,  are  often  reproduceU; 


iT-i-iitiiiiri ' 


8UKGICAL   DISEASES. 


646 


sntations,  or  pnul- 
that  has  first  been 
I  the  pain  and  in- 
,  (25),  (27), and 


inds. 

,  or  Avhiitever  else 
BS,  leaving  jagged 
liout  suppuration, 
in.  They  suppur- 
;  even,  sometimes, 
)8  are  occasionally 
1,  lock-jaw  is  a  fre- 

)8ely  together,  and 
Sometimes  a  su- 
alof  inflamination 
tches,  and  apply  a 
fever,  restlessness, 
um  (118),  will  be 
gain  disinfect  the 
Id  aseptic, 
ippurated,  become 
0  be  taken  off,  and 
iapted  to  the  con- 
treating  ulcers, 
ortification  will  be 
sn  off,  to  save  the 


ion. 

r  as  ulcers.  The 
elevations  of  new 
it  the  centre,  draw- 
m  towards  the  sui- 
ilevations  look  like 
ar  character,  which 


ts. 

s  Avhich  have  been 
\\  man  ;  though  cer- 
etimes  regenerated. 
I  often  reproduced ; 


and  so  are  the  whole  of  some  long  bones,  when  destroyed  by  necrosis. 
Tlie  same  is  true,  to  some  extent,  of  ligaments.  But  portions  of 
brain,  and  spinal  marrow,  and  muscle,  and  mucous  membrane,  when 
once  removed,  are  never  regenerated. 

Gunshot  Wounds. 

At  a  time  when  fire-arras  are  so  mucli  carried  about  the  person, 
and  so  often  used  for  purposes  of  duelling  and  murder,  it  is  proper 
that  every  peraon  should  know  something  of  the  modes  of  treating 
gunshot  wounds. 

Treatment.  —  It  is  often  proper  to  make  a  gunshot  wound  larger 
at  the  orifice.  When  this  is  done,  it  is  generally  on  the  side  where 
the  bullet  has  passed  out,  if  it  has  gone  entirely  through.  A  bullet 
is  always  to  be  removed,  if  it  can  be  felt. 

The  dressings  are  at  first  to  be  superficial,  light,  unirritating  and 
aseptic.  The  common  antiseptic  dressing,  covered  with  a  piece  of  oiled 
silk,  is  one  of  the  best.  Where  suppuration  occurs,  because  of  the 
introduction  of  germs  into  the  wound,  poultices  may  be  called  for,  but 
the  douching  and  cleansing  of  the  wound  with  hot  oil  of  milk  solu- 
tion is  often  demanded  and  always  grateful. 

Poisoned  Wounds. 

To  the  bites  and  stings  of  various  creatures  man  is  exposed  in 
most  climates,  and  in  all  seasons  of  the  year.  These  may  be  divided 
into  three  classes. 

Bites  of  Mosquitoes  and  Spiders,  and  Stings  of  Bees  and  Wasps. 

—  For  these,  the  best  applications  are  a  solution  of  common  salt,  or 
water  of  ammonia,  or  sugar  of  lead  (239),  or  laudanum,  or  tincture 
of  iodine.  If  none  of  these  are  at  hand,  at  the  moment,  cover  the 
part  with  wet  earth.  Tincture  of  arnica  (240)  is  a  good  application. 
(See  article  on  Bites,  etc.) 

Bites  of  Venomous  Snakes.  —  Either  instantly  cut  out  a.  piece 
from  the  bitten  part,  or  apply  a  dry  cup,  to  prevent  the  absorption  of 
the  poison.  Suction  with  the  mouth  will  sometimes  answer  the  same 
I)urpose.  After  doing  one  of  these  things,  touch  the  part  with  caustic 
potash.  Internally,  give  Fowler's  solution,  twenty  drops,  in  a  little 
water,  every  two  hours.  Also  purgative  injections,  stopping  the  ar- 
senic when  purging  is  well  established ;  or  drink  freely  of  whiskey. 

For  the  bite  of  the  rattlesnake,  the  only  known  remedy  is  alcoholic 
drink,  taken  in  large  quantities,  and  immediately.  Gin  and  whiskey 
are  believed  to  be  the  liest.  Fill  the  system  full.  When  the  poison 
has  begun  to  take  effect,  enormous  quantities  will  be  borne,  before 
intoxication  can  be  induced.  Keep  the  whole  person  saturated  until 
the  symptoms  decline. 


546 


8UE0ICAL  DISEASES. 


Fractures. 

The  existence  of  a  fracture  is  to  be  known  by  the  symptoms. 
TWb  are  DakT  swelling,  deformity  from  the  limb  bending  to  one 
ride  8om  tiCXrteni^gof  the  limb,  or  loss  of  power  to  use  it,  and 
a  crS  oTiating  sound  or  sensation  from  the  rubbing  of  the  ends 
of  tKokenW  together.     There  are  several  kinds  of  fi^ctures. 

They  are 

The  Trav^etM  Fracture,  which  is  directly  across  the  bone. 

The  Oblique  Fracture,  which  runs  from  side  to  side,  in  an  oblique 
direction. 

!Z%e  Longitudinal  Fracture,  which  runs  lengthwise  of  the  bone. 

A  Simple  Fracture  is  one  in  which  the  bone  is  broken  simply,  with- 
out  any  wound  of  the  flesh  with  it. 

A  Compound  Fracture  consists  of  a  simple  fracture,  and  of  an  ex- 
ternal wZnd  in  addition,  caused  by  pushing  the  end  of  the  broken 
bone  through  the  flesh. 

A  Complicated  Fracture  is  one  in  which,  besides  tiie  breaking  of  the 
bone  tS  is  the  dislocation  of  a  joint,  the  wounding  of  an  artery 
tre'xtnslve  tearing  of  the  soft  parte,  or  the  wounding  of  the  bowels 
or  some  other  internal  organ. 

A  G<mminuted  Fracture  is  one  in  which  the  bone  is  broken  into 
several  pieces. 

Trentment  of  Fractures.  —  When  a  bone  is  broken,  the  first  thing 
toKrrste  get  t?e  injured  person  to  his  home,  or  to  the  nearest 
ho^e       T^do  this  in  a  riugh  or  careless  way  might  add  much  to 

*^inf  iSTarm  which  is  broken,  let  it  be  placed  in  a  broad  sUng. 
extending  from^he  elbow  to  the  fingers.     In  this  condition  the  pa- 
tient!l?\i  tolerable  health,  and  the  distance  - -ot  g^f ' -^^  ^"^ '' 
easier  to  walk  home,  than  to  bear  the  jolting  of  a  carnage. 
^S'^  lag  or  the  thigh  he  hroien,  then  a  hurdle  of  s^me^-^rt  ( 1 ,, 

soon  as  possible,  and,  being 
covered  with  straw,  or  blan- 
kets, or  garments,  the  pa- 
tient should  be  gently  lifted 
FI0.1B6.  upon    it    by    just    persons 

enough  to  raise  him  easily  from  the  ground.  This  shoidd  now  b 
canried  bv  four  persons,  two  at  each  end,  moving  with  great  gently 
ntr  and  keeping  exact  step  with  each  other  If  these  persoM 
Shold  of  tL  fnds  of  two  poles,  laid  under  the  hurdle^  they J^l 
find  they  can  carry  it  much  more  easily.     If  no  hurdle  be  at  hand, 


'V 


by  the  symptoms. 
,b  bending  to  one 
ower  to  use  it,  and 
ubbing  of  the  ends 
cinds  of  fractures. 

38  the  bone, 
side,  in  an  oblique 

rise  of  the  bone, 
roken  simply,  with- 

ture,  and  of  an  ex- 
end  of  the  broken 

i  the  breaking  of  the 
nding  of  an  artery, 
inding  of  the  bowels 

bone  is  broken  into 

roken,  the  first  thing 
me,  or  to  the  nearest 
might  add  much  to 

ed  in  a  broad  sling, 
lis  condition  the  pa- 
lot  great,  will  find  it 
a  carriage. 
Ueof  some  sort  (Fig. 
must  be  obtained  as 
i  possible,  and,  being 

with  straw,  or  blan- 
r  garments,  the  pa- 
lould  be  gently  lifted 
it    by    just    persons 

This  should  now  be 
ag  with  great  gentle- 
r.     If  these  persons 

the  hurdle,  they  will 
hurdle  be  at  hand, 


SURGICAL  DISEASES. 


let  four  poles,  two  long  ones,  and  two  short  ones,  be  laid  across  each 
other  at  right  angles,  and  fasten  together  with  nails  or  strings.  Then 
lay  u})on  these  an  old  door,  or  some  loose  boards ;  and  the  injured 
person  may  be  easily  carried  upon  this  temporary  structure.  A 
blanket  fastened  upon  four  poles,  in  the  manner  of  a  cot-bed,  will 
answer  a  good  purpose. 

Having  placed  the  patient  upon  the  hand-carriage,  bring  the  sound 
limb  and  the  broken  one  snug  together,  and  tie  them  to  each  other 
with  two  or  three  pocket  handkerchiefs ;  this  will  support  the  broken 
limb,  and  prevent  its  being  shaken  about  and  injured  by  motion.  In 
doing  this,  the  limb  should  be  laid  as  near  as  possible  in  the  natural 
position,  so  that  the  bones  may  not  get  out  of  place,  and  their  ends 
get  pushed  through  the  flesh. 

The  Reduction,  or  Setting  of  the  Fracture,  is  the  first  thing  to  be 
done.  By  this  is  meant  the  bringing  of  the  ends  of  the  broken  bone 
together,  and  adjusting  them  to  each  other  in  their  natural  position. 
This  is  done  by  what  surgeons  call  extension,  counter-extension  and 

coaptation. 

Extension  means  taking  hold  of  the  limb  below  the  fracture  and 
pulling  from  the  body. 

Counter-Extension  is  pulling  above  the  fracture  towards  the  body. 
These  opposite  puUings  are  done  at  the  same  time  to  overcome  the 
force  of  the  muscles,  which  contract,  and  draw  the  ends  of  the  bone 
by  each  other  and  shorten  the  limb. 

Sometimes  no  extension  or  counter-extension  is  necessary,  the  ends 
of  the  broken  bone  not  being  pulled  out  of  their  place.  When  the 
pulling  is  necessary,  it  should  be  gentle  and  steady. 

Modern  surgery  has  developed  two  simple  mechanical  means  of 
making  extension  and  counter-extension  for  the  purpose  of  overcom- 
ing muscular  spasm  which  rarely  fail.  One  is  by  the  use  of  elastic 
rubber  bands,  and  the  other  by  the  attachment  to  the  limb  of  a  cord 
running  over  a  pulley  at  the  foot  of  the  bed  and  sustaining  a  suitable 
weight.  The  method  of  employing  these  will  be  given  in  detail  in 
connection  with  special  fractures. 

Coaptation  means  adjusting  the  ends  of  the  bone  to  each  other. 

The  next  thing  is  to  provide  for  keeping  the  ends  of  the  broken 
bone  steadily  in  contact,  so  that  nature  may  have  a  fair  chance  to 
unite  them. 

To  secure  this  object,  mechanical  contrivances  are  used,  which  are 
simple,  and  may  always  be  had  without  difficulty. 

They  consist  of  linen  bandages,  about  the  breadth  of  four  fingers, 
and  from  four  to  ten  yards  long ;  and  pads,  made  of  old  woollen  cloth 
or  blankets  lightly  quilted  together,  or  pillow-cases  filled  with  tow,  or 
chaff,  or  cut  straw,  or  even  leaves ;  and  of  splints,  made  of  clapboards, 
or  thick  shingles,  four  fingers  wide,  and  in  length  corresponcUng  with 


pa  NT 


548 


SURGICAL   DISKASKS. 


that  of  the  broken  limb;  or  wheat  straw  laid  sidn  bysi(l(!,  and  (inilit-il 
into  a  piece  of  ch)th  to  prevent  them  niovinjif  alMiut.  A  very  useful 
splint  may  l)e  made  from  the  fresh  hark  of  tree.s. 

The  pads  are  to  Ikj  placed  under  the  splints,  to  prevent  injuries  to 
the  skin;  and  the  bandages  to  bo  bound  over  the  whole. 

A  great  point  is  to  have  the  splints  accunttely  adapted  in  each  case, 
and  the  ability  to  affect  this  is  an  important  element  of  success  in  tliis 
branch  of  surgery.  Wood  may  be  generally  cut  into  suitable  shape, 
but  it  is  perhaps  easier  to  use  moulded  splints  of  leather,  felt,  gutUi- 
percha,  or  shellac  cloth.  Tlie  starched  or  plaster  bandage  or  guinined 
paper  may  be  effectively  used ;  and  with  a  proper  pair  of  shears, 
sheets  of  tin  or  zinc  may  l)e  cut  into  splints,  which  will  answer  ad- 
mimbly.     Woven  iron  wire  splints  are  highly  recommended. 

For  some  hours  after  a  limb  is  broken,  the  parts  continue  to  swell, 
and  if  bound  up  immediately  with  the  pads,  splints,  etc.,  niiich 
needless  pain  will  be  occasioned.  It  is  best,  therefore,  not  to  put 
these  on  under  two  or  three  days,  but  merely  to  lay  the  limb  in  a 
natural  position,  and  perhaps  lightly  bind  one  splint  to  it.  Broken 
ribs  and  collar-bones  are  exceptions,  and  should  be  bound  up  imme- 
diately. 

A  broken  arm  lies  easiest  half  bent,  upon  a  pillow ;  the  thigh  or 
leg,  upon  the  outside,  with  the  knee  bent. 

When  the  apparatus  is  once  adjusted,  the  less  it  is  meddled  with 
the  better. 

In  fractures  of  the  shoulder  or  arm,  u  sling  is  a  contrivance  of  great 
importance.  This,  if  well  made  and  adjusted,  keeps  the  broken  bone 
in  its  place,  and  at  the  same  time  allows  the  patient  to  take  some 
exercise  by  walking  about. 

Besides  the  above  contrivances,  there  is  the  double  inclined  plane 


FIO.  167. 


(Fig.  157)  for  giving  the  leg  the  advantage  of  a  bent  position.  There 
are  2^so  fracture-boxes  (Fig.  \b^)^waA  fracture-cradles, —  the  latter  to 
keep  the  bed-clothes  lifted  away  from  the  painful  limb.  Fracture- 
beds  are  now  brought  to  great  perfection,  and  one  should,  if  possible, 
be  procured  when  the  patient  is  likely  to  be  confined  a  long  time 
wiUi  a  compound  fracture.     The  fracture-box  represented  by  Fig. 


SURGICAL   DISEASES. 


640 


Hi(l(!,  ami  (jiiilii'il 
A  very  usi'fiil 

event  injuries  to 
liole. 

)ted  in  each  case, 
of  success  in  this 
to  suitable  sha[iu, 
lather,  felt,  gutUi- 
idage  or  gunuued 
jr  pair  of  shcare, 
h  will  answer  ad- 
mtnended. 
continue  to  swell, 
dints,  etc.,    much 
refore,  not  to  put 
lay  the  limb  in  a 
it  to  it.     Broken 
)  bound  up  imme- 

ow;  the  thigh  or 

;  is  meddled  with 

)ntrivance  of  great 
)8  the  broken  bone 
ent  to  take  some 

uble  inclined  plane 


nt  position.  There 
dies,— the  latter  to 
il  limb.  Fracture- 
should,  if  possible, 
ifined  a  long  time 
epresented  by  Fig. 


LIS,  may  Iw  made  from  thin  ImmimIs,  l)y  any  r!arj)Pnter.  It  1ms  a 
Iiirif(i;  at  the  knt-r  to  enahlo  it  to  i'liilil  tlic  double  purpose  ot  a  dnublu- 
inolined  plane  and  a  fracture-lnix. 


ma.  16M. 

The  Way  in  which  Broken  Bones  Unite. 

The  union  of  broken  bones  is  much  slower  than  that  of  severed 
flesh.  The  ends  of  the  bone  l)eing  kept  steadily  together,  they  soon 
become  surrounded  by  a  swelling  of  the  soft  parts,  which  change  to 
a  sort  of  osseous  substance,  making  a  kind  of  bony  hoop,  to  act  as  a 
splint  or  support,  —  nature  not  being  willing  to  trust  the  surgeon  to 
keep  the  fragments  exactly  in  their  place.  This  is  called  a  provi- 
sional callus,  because  it  only  has  a  temporary  use. 

This  First  Stage  lasts  about  ten  days.  At  the  end  of  this  time,  a 
spongy  sul)stance  appeal's  between  the  ends  of  the  bone.  This  sub- 
stiince  is  not  bone,  but  in  the  swelling  around  the  fracture  specks  of 
bone  begin  to  be  deposited;  the  fibrin  here  poured  out  becoming 
first  cartilage,  and  then  receiving  into  itself  phosphate  of  lime,  it  be- 
comes bone.  A  similar  work  is  going  on  within,  in  the  part  called 
the  medullary  membrane. 

Tliis  Second  Statue  lasts  from  the  tenth  to  the  twenty-fifth  day. 

Tiien  begins  the  Third  Stage,  which  goes  to  the  end  of  the  sixth 
or  eighth  week.  During  this  period  the  external  swelling,  and  the 
internal  medullary  membrane,  become  completely  ossified  and  firm ; 
though  the  ends  of  the  bone  are  not  yet  grown  together. 

Tlie  Fourth  Stage  goes  to  the  end  of  the  fifth  or  sixth  month.  Dur- 
ing this  time,  the  external  swelling,  or  provisional  callus,  becomes  cov- 
ered with  a  periosteum,  and  the  ends  of  the  Itones  themselves  are  fas- 
tened together  by  a  bony  union. 

The  Fifth  Stage  extends  from  the  fifth  or  sixth  to  the  twelfth  month. 
During  this  time,  the  ends  of  the  bone  become  grown  together  so 
strongly  that  the  bony  ring,  or  provisional  callus,  is  no  longer  Avanted, 
and  it  becomes  absorbed,  and  disappeais ;  in  other  words,  having  no 
further  use  for  it,  Nature  takes  off  her  splint.  The  place  where  the 
fracture  was  is  now  as  strong  as  any  other  part. 


til 


dkMiM* 


:.50 


ftUROICAL   T)IHEA8R8. 


Union  in  Compound  Fractures. 

Thk  wnion  of  cuinpouiKl  friiclurcs  taki's  pliu'i;  in  ii  (lift'crent  way 
from  that  of  a  siinpli;  fracture,  jiistdem-riljed.  'IMit*  Ix  U(!h  rotnaiii  din- 
united  Heveral  weeks,  and  tliere  m  no  proviHioiial  cal'iUH  *^ornied;  but 
after  some  weeks  tlie  eiids  of  the  Inme  niiften  and  </ rami  I  ate,  and  tliCHe 
granulatiouH  are  gradually  changed  into  lK)ne. 

In  notliing  have  the  benefits  of  antise|Mis  been  shown  so  vividly  as 
in  the  treatment  of  compound  fractures.  Twenty  years  ago  a  larji^c 
percentage  of  all  compound  fractures  either  suppumted  or  caused  the 
death  of  the  patient ;  but  now  suppuration  and  high  mortality  are  not 
seen.  The  wound  is  treated  exactly  like  any  other  wound,  on  ascptii' 
principles,  the  Ixines  being  lield  in  phice  as  usiuil.  Union  thus  resiiltH 
without  suppuration,  and  a  cure  is  completed  in  one-half  the  time,  with 
over  fifty  per  cent  less  moi-tality  than  was  the  case  previous  to  the 
introduction  of  aseptic  and  antiseptic  surgery. 

The  first  thing  in  event  of  a  compound  fmcture  is  to  render  the 
parts  aseptic  as  soon  and  lus  completely  as  possible.  This  may  Ik;  done 
by  a  thorough  scrubbing  with  tincture  green  soap  and  water  for  live 
or  ten  minutes,  and  then,  after  washing  off  the  soap  with  alcohol,  to 
thoroughly  scrub  the  skin  adjoining  the  wound  with  sonie  one  of  the 
disinfectants  mentioned  under  the  heading  of  Sei^is  and  Asepsis ;  as, 
for  instance,  corrosive  sublimate,  one  part  to  two  thousand  parts  of 
water.  The  wound  is  to  be  dressed  precisely  as  any  wound,  and  is 
to  be  so  arranged  that  access  may  be  had  to  it  for  future  dressings. 
When  skin  and  flesh  are  much  torn  they  may  be  sewn  together  with 
a  needle  and  thread  or  silk  which  htvs  l)een  boiled  five  minutes.  The 
stitches  are  to  be  removed  from  the  fourth  to  seventh  day.  The  bones 
are  to  be  approximated  just  as  in  simple  fractures,  and  splintu 
applied. 

Formerly  the  mortality  of  compound  fractures  was  ve.  -  high,  owing 
to  the  invasion  of  the  tissues  by  germ-life,  but  since  the  introduction  of 
antiseptic  measures  in  surgery,  the  death  rate  has  fallen  so  markedly 
as  to  be  a  matter  of  great  pride  to  surgeons  and  tlie  world  at  large. 

In  cases  where  the  wound  does  not  allow  of  good  coaptation,  and 
much  mangling  of  the- tissues  has  occurre«l,  it  may  be  well  not  to  sutine 
the  parts,  but  to  dress  them  with  some  antiseptic  gauze  drainage,  and 
do  them  up  like  an  open  wound. 

Time  Required  for  Uniting  Different  Bones. 

rRACTTTRKS  of  the  arms  unite  sooner  than  those  of  the  legs. 

The  ribs  and  collar-bone  unite  with  tolerable  firmness  in  about  a 
month ;  those  of  the  arm  in  six  weeks  ;  of  the  thigh  and  leg  in  eiglit 
weeks.     I  only  mean  the  firmness  derived  from  the  provisional  callus. 

A  broken  bone  will  unite  much  sooner  in  a  healthy  person  than  in 
an  unhealthy  one ;  much  sooner  in  a  young  than  in  an  old  person. 


it^m^m 


liURniCAL   niSRAHR.S. 


661 


15. 

ii  (liffovent  way 
i«  lUiH  reimiin  tlis- 
liiH  'orineil ;  hut 
nulaie,  aiitl  tlit'HH 

iwn  so  vividly  as 
ears  ayo  a  larj^c 
ted  or  cauKt'(l  the 
mortality  are  not 
vound,  oil  aKcptii' 
nioii  thiiH  results 
alf  the  time,  with 
previous  to  tiie 

is  to  render  the 
This  may  Ik;  done 
,nd  water  for  five 
)  with  alcohol,  to 
li  some  one  of  the 
1  and  Asepsis ;  as, 
thousand  parts  of 
iiy  wound,  and  is 
future  dressings, 
wn  together  with 
ive  minutes.  The 
hday.    The  bones 
ures,  and   splints 


8  ve.y  high,  owing 
le  introduction  of 

alien  so  markedly 

e  world  at  large. 

)d  coaptation,  and 
well  not  to  suture 

auze  drainage,  and 


fit  Bones. 

I  of  the  legs, 
mness  in  about  a 
;h  and  leg  in  eight 
provisional  callus. 
thy  person  than  in 
n  an  old  person. 


As  II  goniT.il  rule.  I  he  apparatus  shou'l  1h'  kept  on  tliiriy  days  in 
the  I'iisf  of  I'liihlnii  :  forty  (hiys  in  that  of  adults;  and  much  hnigor 
in  that  of  aged  pei'sons. 

False  Joint. 

Thk  union  of  a  l)rokon  Ikiiio  is  sometimes  prevented  by  a  frequent 
n\i>ving  of  the  liinh.  The  ends  of  tht-  lK)ne,  having  faile(l  to  grow  to- 
gether, will  sometimes  t)econie  nmnded  and  smoothed,  uniting  only 
hy  a  kind  of  ligament,  and  aequire  the  habit  of  sliding  U[)on  each 
other,  and  thus  form  what  is  called  n  false  or  artijinal  joint, —  the 
limb  IxMug  permanently  cajmble  of  landing  to  some  extent,  at  the 
place  of  the  fracture. 

Fractures  of  the  Skull. 

TnF.SE  are  always  dangerous  in  tiieir  nature,  and  the  aid  to  be  de- 
rived from  surgery  is  much  less  than  in  other  fractures.  If  a  fracture 
of  the  skull  produce  deep  sleep  and  snoring,  and  the  patient  does 
not  show  any  symptoms  of  pain  when  pinched,  etc.,  we  are  to  infer 
that  a  piece  of  l)one  is  pressed  down  upon  or  into  the  brain. 

In  this  civse,  if  the  position  of  the  iilow  Im  known,  a  cut  is  to  be 
made  through  the  skin,  two  or  three  inches  long,  down  to  tlie  bone. 
If  arteries  bleed,  they  nuiirt  Ik?  taken  liold  of  with  a  pair  of  forceps, 
aiui  tied  with  a  silk  thread,  the  ends  of  which  are  to  be  cut  off.  The 
hone  being  well  exposed  by  one  or  two  incisions,  the  piece  which  is 
l)ressed  down  upon  the  brain  is  to  be  raised  with  a  clusel,  or  some 
similar  instrument,  to  a  level  with  the  other  bones.  The  surface 
nmst  then  be  cleansed  antiseptically,  the  hair  around  shaved  off,  the 
.skin  brought  together,  and  the  cut  edg«;s  reunited  by  sticking  plaster. 

When  the  inflammation  ajjpeara,  twenty-four  hours  after,  it  is  to  be 
kept  down  by  doses  of  from  five  to  ten  drops  of  tincture  of  vcratrum 
viride,  given  every  one  or  two  houra. 

Fractures  '>f  the  Bones  of  the  Nose. 

In.tukies  of  this  kind  may  generally  be  rectified  by  passing  a  strong 
prol)e  up  the  nostril,  and  pressing  out  the  bones  to  their  natural  place, 
at  the  same  time  using  the  fingei-s  on  the  outside  to  prevent  their 
being  pressed  out  too  far.  Inflammation  must  be  kept  down  by  cloths 
wet  in  cold  water  and  laid  on,  and  by  light  diet. 

Fracture  of  the  Lower  Jaw. 

Tht8  usually  takes  place  near  the  chin.  It  may  occur  also  near 
the  angles  of  the  jaw.  It  may  be  simple  or  compound,  and  is  known 
by  the  pain,  the  swelling,  the  inability  to  move  the  jaw,  the  indenta- 
tion felt  by  the  finger,  the  irregularity  of  the  teeth,  and  the  grating 
sensation  felt  while  moving  the  ja;  •  with  the  hand  placed  on  the  back 
fragment. 


r>52 


HUROICAL  I)t8KA8E8. 


Treatment.  —  T.^'ionc  orltotli  tInimliH  Ih>  int.ro<hico«l  into  the  moiiili, 
With  lliuric,  ku()p  thu  iKi)'l<  |)iii'(   ol'  llir  jiiw  Htatitniiiiy,  iiii<l   pull  Im- 

wiinl  tlu!  fnn;  purl  with  thi*  tlii^ciH  on  thii 
oiitHid*!.  In  thiH  way  the  fnirlnr,  cuii  smiii 
lit-  put  ri^ht.  'I'liis  dom-,  hIiuI  thu  nioiitli 
lirnily,  tuul  piaci*  a  thick  cnniprttHH  of  lint 
ovor  th(!  l>rok(Mi  part;  ovctr  tluH  put  a  piwe 
of  paHtt>l)<)ai-(l,  wetted  ho  aH  to  bend  casilv 
to  the  partH,  and  over  tluH  a  Htronj^  band- 
age of  muHlin,  two  and  a  half  in(;huH  wide, 
with  a  Hniall  ba^r  to  fit  and  hoUl  the  chin; 
all  which  is  reprcHented  in  Fi^.  169. 
For  fi  fortnij>ht  tlie  patient  niust  feed  on  gruel,  broth,  arrow-root 
and  milk,  that  the  jaw  may  not  be  diuplacud  by  chewing. 


Via.  iBO. 


Fracture  of  the  Collar-Bone,  or  Clavicle. 

This  accident  generally  occurs  about  the  middle  of  the  lK)ne,  and 
is  generally  caused  by  falls  on  the  arm  and  shoulder. 


FlO.  160. 


FIO.  161. 


Symptoms.  —  Ptain  and  tenderness  at  the  place  of  the  injury,  and 
inability  to  lift  the  arm  ;  a  small  bunch  or  prominence  at  the  point  of 
the  fracture ;  the  distance  from  the  pohit  of  the  shoulder  to  the 
breiiHtrlx)ne  shorter  than  on  the  other  side ;  and  the  dropping  down- 
wards, forwards,  and  inwards  of  the  shoulder.  To  make  the  case 
sure,  compare  the  two  bones,  and  see  whether  they  agree. 

Treatment. —  Place  the  knee  between  the  shoulder-blades,  and 
gi'asping  the  round  ends  of  the  shoulders  with  the  two  hands,  draw 
them  gently  back  till  the  ends  of  the  bone  come  t<i  their  proper  place; 
or  place  the  elbow  of  the  patient  close  to  the  body,  and  a  little  for- 
ward, and  then  push  it  upward. 


SUItOICAL  DIRRASRH. 


663 


1(1  into  lliA  mouili, 
a'y,  an<l  pnll  I'ln- 
,li(^  lin^tTH  on  till! 

fllirtliri   Clin  sniiii 

I,  hIiuI  thu  nioiitli 
citniprnHH  of  lint 

!!•  tlllH   put  !l  pilHL' 

iiH  to  bond  t'tiHily 
lis  II  Htronjj  hiimi- 
liiilf  indiuH  wide, 
lid  hold  the  chin; 
in  Ki^.  159. 
broth,  arrow-root 
iwiug. 

Clavicle. 

I  of  the  lione,  and 
jr. 


FlO.  161. 

of  the  injury,  and 
ence  at  the  point  of 
le  shoulder  to  the 
he  dropping  down- 
To  make  the  case 
\f  agree. 

loulder-blades,  and 

le  two  hands,  draw 

their  proper  place; 

dy,  and  a  little  for- 


To  retain  the  fihouldfiH  in  tliis  npwiird  and  l)iickwiird  position  for 
::onu!  wcekH,  piiHM  a  llaniicl  bundiigc.  four  inches  wide,  arnuiid  tint 
front  of  one  Hhouldcr,  under  the  iirni-jtit,  acroHs  the  back,  over  th« 
opposite  Hhonldcr,  under  the  other  arm-pit,  and  a^ain  acrosH  the  liaek, 
in  the  form  of  the  lif,'nre  oo.  'i'o  prevent  the  bandaj,'e  from  cutting 
the  Hkin,  put  pads  under  the  arms.     (Kigs.  160  and  Itil.) 

Fracture  of  the  Shoulder-Blade. 

When  this  accident  happeiiH,  the  body  of  the  l)one  is  generally 
broken  acrosH  by  some  great  direct  violence.  In  a  few  in^ttances,  the 
end  next  to  the  collar-bone  is  broken.  * 

Symptoms.  —  Great  i)ain  in  moving  the  shoulder,  "d  the  ffratiruj 
Hensiition  wiiicdi  may  Ihj  felt  by  placing  one  hand  on  upper  end 

of  the  l)one,  and  int  ving  the  lower  portion  with  the  otiier. 

Treatment.  —  A  bandage  must  be  passed  round  the  chest,  and  a 
few  turns  Iks  made  around  the  nj)per  arm,  so  as  to  fasten  it  to  the 
side,  and  prevent  all  motion.  Purging,  low  diet,  and  the  tincture  of 
veratrum  viride  will  be  required  to  keep  down  inflammation. 

Fracture  of  the  Acromion,  or  the  end  of  the  scapula  which  unites 
with  the  collar-lx)ne,  may  l)e  known  by  the  flattening  of  the  shouhler, 
—  the  l)roken  part  l)eing  drawn  down  by  the  action  of  the  deltoid 
muscle. 

Treatment.  —  It  must  be  supported  by  the  same  bandages  m  are 
used  for  a  fracturi  of  the  collar-lxme ;  and  the  elbow  must  Im  well 
raised,  so  that  the  head  of  the  upper-arm  bone  may  l)e  lifted  against 
the  upper  portion  of  thescapul",  and  act  as  a  prop  to  keep  it  in  place. 
No  pfld  should  be  put  in  the  arm-pit,  for  this  would  push  the  broken 
part  too  much  outward.  Gentle  motion  of  the  arm  may  be  begun 
about  the  sixth  week. 

Fracture  of  the  Upper-Arm  Bone. 

Thk  bone  of  the  upper-arm  is  most  frequently  broken  near  the 
centie,  though  it  may  be  fractured' near  the  ends.  It  may  be  known 
by  taking  hold  of  the  arm  above  and  below  the  suspected  fracture, 
and  attempting  to  move  the  ends  of  the  upper  and  lower  fragments 
upon  each  other.  If  there  be  a  fracture,  the  grating  of  the  broken 
ends  against  each  other  will  either  be  heard  or  felt.  The  arm  will 
also  be  bent  and  helpless ;  and  if  the  ends  of  the  bone  be  slipped  by 
each  other,  it  will  be  shortened. 

Treatment.  —  Let  a  powerful  man  take  hold  of  the  arm  and  pull 
gently  and  gradually,  but  with  considerable  force,  till  the  arm  is 
brought  to  its  natural  length,  another  man  taking  hold  of  the  body 
of  the  patient,  and  pulling  in  an  opposite  direction.  In  the  mean 
time,  the  surgeon  is  to  adjust  the  ends  of  the  bone  to  each  other,  and 


554 


SURGICAL   DISEASES. 


Fio.  162. 


apply  a  bandage,  but  not  very  tightly,  from  the  elbow  to  the  shoulder, 
and  over  this,  four  splints,  with  pads  under  them  ;  one  in  front,  roiuli- 
ing  from  the  shoulder  to  the  bend  of  the  elbow, 
with  a  few  turns  of  the  bandage  over  it ;  another 
behind,  reaching  from  the  shoulder  to  the  point 
of  the  elbow,  with  a  few  turns  of  the  bandage 
around  it  also ;  another  on  the  inside,  extending 
from  the  arm-pit  to  the  inner  projection  of  the 
bone  at  the  elbow,  also  secured  by  a  few  turns  of 
the  bandage ;  and  the  fourth  one  on  the  outside, 
reaching  from  thy  shoulder  to  the  outside  knob 
at  the  elbow.  The  whole  is  now  to  be  secured 
either  by  a  bandage  or  tape.  (Fig.  162.)  The  arm  is  to  be  confined 
to  the  side,  and  the  hand  and  fore-arm  placed  in  a  sling.  In  from 
seven  to  ten  days,  the  drest-ug  should  be  taken  off  to  see  if  all  is 
right. 

Fracture  of  the  Elbow. 

This  may  be  known  by  the  patient  being  able  to  bend  the  arm, 
but  not  straighten  it,  and  by  the  grating  which  may  be  heard  or  felt 
when  the  urm  is  moved  back  and  forth  by  the  operator,  and  also  by 
the  severe  pain  felt  in  the  fractured  part. 

Treatment.  —  First  apply  leeches  and  evaporating  lotions  to  re- 
duce the  inflammation.  When  this  is  effected,  straighten  the  limb, 
and  apply  a  bandage  snugly  from  the  fingers  to  the  elbow.  The 
broken  end  of  the  bone  must  now  be  brought  to  its  place,  and  the 
bandage  continued  over  it,  and  for  a  few  inches  above  it.  Secure  it 
here,  and  bring  it  back,  —  carrying  it  above  and  below  the  elbow  for 
several  times ;  and  then  extend  it  up  to  the  shoulder.  A  splint 
must  now  be  applied  to  the  inner  side  of  the  arm  to  prevent  its  being 
bent,  extending  from  the  hand  nearly  to  the  shoulder,  and  another, 
of  similar  shape,  to  the  outside.  The  joint  should  be  kept  quiet  for 
four  or  five  weeks,  during  which  time  the  splints  may  be  taken 
off  three  or  four  times,  to  see  if  there  is  any  chafing  of  the  skin,  or 
any  disturbance  of  the  bones.       * 


Fractures  between  the  Elbow  and  Wrist. 

The  part  of  the  arm  between  the  elbow  and  wrist,  called  the /ore- 
arm,  has  two  bones,  —  one  extending  from  the  elbow  on  the  inside 
to  the  wrist  at  the  root  of  the  little  finger,  called  the  ulna,  and  the 
other  on  the  side  next  the  thumb,  a  shorter  and  a  smaller  bone,  and 
called  the  radius. 

When  both  these  bones  are  broken  at  the  same  time,  the  fracture 
may  be  easily  discovered ;  when  only  one,  the  sound  bone  keeps  the 
other  iu  place,  and  the  injury  is  not  so  easily  made  out. 


SURGICAL  DISEASES. 


555 


y  to  the  shoulder, 
ine in  front,  niiuh- 
snd  of  the  elbow, 
1  over  it ;  another 
ilder  to  the  point 
I  of  the  bandage 
inside,  extending 
projection  of  the 
by  a  few  turns  of 
le  on  the  outside, 
the  outside  knob 
ow  to  be  secured 
1  is  to  be  confined 
a  sling.  In  from 
)fip  to  see  if  all  is 


to  bend  the  arm, 
ly  be  heard  or  felt 
jrator,  and  also  by 

ting  lotions  to  re- 
raighten  the  limb, 

the  elbow.  The 
its  place,  and  the 
)ove  it.  Secure  it 
ilow  the  elbow  for 
loulder.  A  splint 
)  prevent  its  being 
ilder,  and  another, 

be  kept  quiet  for 
its  may  be  taken 
ng  of  the  skin,  or 


tid  Wrist. 

ist,  called  the  /ore- 
bow  on  the  inside 
.  the  ulna,  and  the 
smaller  bone,  and 

!  time,  the  fracture 
nd  bone  keeps  the 
e  out. 


Treatment.  —  Relax  the  muscles  by  bending  the  elbow,  and  then, 
by  extension  and  counter-extension,  put  the  ends  of  the  bones  in 
proper  place ;  then  place  two  splints,  thickly  padded  in  the  centre, 
one  upon  the  front  of  the  hand  and  forearm,  and  the  other  upon  the 
back  of  the  hand  and  forearm,  —  ti;e  palm  of  the  hand  beir\g  turned, 
not  towards  the  chei  t,  but  downwards.  They  are  to  be  covered  with 
a  bandage  from  the  lingers  to  the  elbow.  The  whole  arm  and  hand 
should  be  placed  in  a  sling,  and  remain  in  this  position  four  or  five 
weeks. 

Fractures  of  the  Wrist,  Hands,  and  Fingers. 

The  setting  of  fractured  bones  in  these  parts  is  to  be  done  by  ex- 
tension and  counter-extension,  as  in  the  case  of  other  bones. 

If  the  wrist  be  broken,  a  splint  should  be  applied  in  front  and  one 
behind,  and  a  bandage  bound  tightly  from  the  hand  half  way  to  the 
elbow. 

In  fracture  of  the  bones  of  the  hand,  a  pad  or  compress  must  be 
put  upon  the  palm  of  the  hand,  and  a  splint  placed  over  this,  with  a 
bandage  extending  from  the  wrist  to  near  the  ends  of  the  fingers. 

If  one  finger  only  be  broken,  apply  narrow  pasteboard  splints  on 
four  sides,  and  cover  them  with  a  narrow  bandage ;  and  then  bandage 
the  whole  hand. 

In  all  these  fractures,  place  the  hand  in  a  sling.  About  three 
weeks  will  be  required  for  the  bones  to  unite  properly,  and  several 
weeks  more  for  the  parts  to  acquire  their  natural  usefulness. 

Fracture  of  the  Ribs. 

This  accident  occurs  either  by  blows,  or  by  being  crushed  between 
two  opposing  forces.  One,  two,  or  more  ribs  may  be  broken  at  a 
time,  according  to  circumstances. 

Symptoms.  —  A  fixed,  piercing  pain,  made  worse  by  breathing, 
coughing,  or  any  other  motion,  and  also  a  grating  sensation  during 
the  taking  of  a  long  breath,  the  hand  being  laid  upon  the  injured 
part  at  the  time. 

Treatment.  — The  ribs  are  to  be  held  steadily  in  their  place  by 
pressure.  To  effect  this,  request  the  patient  to  draw  in  a  long  bieath, 
and  hold  it.  While  the  ribs  are  swelled  out  in  this  way,  and  the 
broken  ends  are  thus  brought  to  their  proper  place,  pass  a  woollen 
bandage,  five  or  six  inches  wide,  several  times  tightly  around  the 
chest,  from  the  arm-j .'  '.^  to  the  pit  of  the  stomach.  This  will  confine 
the  muscles  of  the  chest,  and  the  breathing  will  have  to  be  done  with 
the  muscles  of  the  belly,  and  the  ribs  will  thus  be  kept  still,  and 
have  a  chance  to  grow  together. 

If  the  pleura  he  wounded,  and  inflammation  follow  from  this  or 
other  cause,  the  patient  must  be  confined  in  bed,  kept  on  a  low  diet, 


556 


SURGICAL  DISEASES. 


and  his  pulse  be  kept  down  by  tincture  of  veratrum  viride.  The 
bowels  should  be  emptied  by  recipes  18,  or  10,  or  27,  or  41,  both  to 
subdue  inflammation,  and  to  give  the  diaphragm  a  chance  to  drop 
down  freely. 

Fracture  of  the  Breast-Bone. 

Symptoms.  —  Thd  injured  part  is  frequently  either  sunk  down  or 
raised  up ;  there  is  difficult  breathing,  cough,  spitting  of  blood,  pain, 
inability  to  lie  on  the  back,  and  a  grating  noise  caused  by  breathing. 

Treatment.  —  The  same  as  that  for  broken  ribs.  Should  the  broken 
part  be  pressed  down  upon  the  lung,  so  as  to  cause  serious  difficulty 
of  breathing,  an  incision  may  be  made,  and  the  broken  piece  raised 
up  with  a  chisel,  or  stiff  case-knife,  or  some  similar  instrument. 


Fracture  of  the  Hatinch-Bones,  or  Pelvis. 

These  fractures  are  dangerous,  —  being  often  connected  with  some 
other  injury,  as  tearing  of  the  bladder,  lower  bowel,  or  great  veins  or 
arteries.  Fortunately,  however,  they  are  only  caused  by  some  great 
violence,  and  do  not  often  occur. 

Treatment.  —  Place  the  patient  in  the  easiest  possible  position,  and 
keep  him  entirely  at  rest.  Generally  a  catheter  should  be  kept  in  the 
bladder,  that  the  water  may  pass  off  easily ;  and  the  whole  hips 
should  be  bound  round  tightly  with  a  flannel  or  calico  bandage,  and 
made  as  firm  and  fixed  as  possible,  to  keep  the  broken  bones  together. 
The  most  perfect  rest  must  be  ordered  for  six  weeks  or  two  months. 

If  the  extreme  lower  end  of  the  sacrum,  the  os  eoccygU  (Figs.  8—  3) 
be  broken,  the  separated  portion  must  be  put  in  its  place  by  introduc- 
ing the  finger  into  the  rectum ;  and  the  bowels  must  be  kept  loose  by 
gentle  physic,  that  the  broken  bone  may  not  be  pushed  from  its  place 
by  tlie  pressure  against  it  of  hard  stools. 

Fracture  of  the  Thigh-Bone. 

The  points  where  this  bone  are  broken  are  at  its  upper  portion  or 
neck,  and  near  its  middle.  The  break  at  this  latter  place  may  be 
straight  across,  or  oblique,  —  partially  lengthwise.  When  oblique, 
the  point  of  the  bone  may  stick  into  one  of  the  large  muscles,  and  be 
made  fast  by  it. 

Symptoms.  —  The  fracture  in  the  middle  of  the  bone,  if  it  be  trans- 
verse, may  be  known  by  some  swelling  or  irregularity  discovered  by 
running  the  hand  along  the  thigh,  and  grasping  it  here  and  there  ; 
and  if  it  be  oblique,  the  ends  of  the  lx)ne  will  be  drawn  by  each  other, 
and  the  limb  will  be  shortened. 

Treatment.  —  Place  the  patient  on  his  back,  and  let  two  strong 
men  use  extension,  —  one  taking  hold  near  the  hip,  and  the  other 


SURGICAL  DISEASES. 


557 


rum  viride.  The 
27,  or  41,  both  to 
a  chance  to  drop 


le. 

her  sunk  down  or 
ng  of  biood,  pain, 
xsed  by  breathing. 

Should  the  broken 
!  serious  difficulty 
oken  piece  raised 
r  instrument. 

or  Pelvis. 

nnected  with  some 
I,  or  great  veins  or 
sed  by  some  great 

ssible  position,  and 
)uld  be  kept  in  the 
id  the  whole  hips 
alico  bandage,  and 
ten  bones  together, 
jks  or  two  months. 
occygia  (Figs.  8—  3) 
1  place  by  introduc- 
st  be  kept  loose  by 
shed  from  its  place 


ne. 

ts  upper  portion  or 
atter  place  may  be 
e.  When  oblique, 
rge  muscles,  and  be 

!  bone,  if  it  be  trans- 
iarity  discovered  by 
it  here  and  there ; 
rawn  by  each  other, 

and  let  two  strong 
hip,  and  the  other 


grasping  the  limb  at  the  knee  and  pulling  steadily  and  strongly  till 
the  limb  is  of  the  proper  length,  and  the  ends  of  the  bone  are  in  their 
place.  The  man  who  takes  hold  of  the  upper  end  of  the  limb  may 
hold  it  more  firmly  and  with  less  fatigue  by  passing  a  folded  sheet 
around  the  groin. 

The  extending  force  being  still  continued,  the  operator  is  now  to 
apply  the  splints,  which  are  to  be  four  in  number,  —  one  in  front, 
reaching  from  the  knee-pan  to  the  groin  ;  one  behind ;  one  on  the 
inside,  from  the  upper  part  of  the  thigh  to  the  inside  of  the  knee ; 
and  a  fourth  one,  about  four  inches  wide,  reaching  from  the  arm-pit 
to  a  distance  of  two  or  three  inches  beyond  the  sole  of  tlie  foot.  Cot- 
ton must  be  placed  under  these  splints  to  prevent  their  injuring  the 
skin,  and  they  must  be  of  a  width  to  nearly,  but  not  quite,  touch 
each  other.  These  being  properly  adjusted,  and  the  extension  still 
continued  if  the  fracture  is  oblique,  the  bandage  is  now  to  be  firmly 
applied  from  the  foot  to  the  upper  part  of  the  thigh,  and  then  passed 
a  few  times  around  the  body.  This  fracture  is  sometimes  treated 
without  splints,  as  represented  in  (Fig.  163). 


Fio.  184. 


Six  or  seven  weeks  will  be  required  for  the  bones  to  grow  together, 
during  which  time  the  patient  will  need  to  lie  upon  his  back.  But  the 
dressing  may  now  and  then  be  biken  off  and  put  on  again. 

Sometimes  only  a  single  long  splint  is  used;  sometimes  no  splint; 
ni  still  other  cases,  four  splints,  —  the  outside  one  being  short,  and 
the  limb  resting  on  a  double  inclined  plane. 


558 


SURGICAL  DISEASES. 


Fracture  at  the  Neck  of  the  Bone.  —  When  the  bone  is  broken  at 
the  neck,  close  to  the  hip-joint,  the  injury  is  known  by  the  knee  and 
foot  turning  outward,  and  by  the  limb  being  an  inch  or  two  shorter 
than  the  other  (Fig.  164).  This  is  an  accident  to  which  old  persons 
are  particularly  liable.  When  the  bone  is  broken  here,  it  seldom 
grows  together  again.  The  union  which  is  formed  is  generally  by  a 
ligament. 

Treatment. —  This  requires  a  very  Jong  splint,  reaching  from  the 
armpit  to  beyond  the  sole  of  the  foot,  and  bound  firmly  with  a  band- 
age, as  in  fracture  in  the  middle  of  the  thigh.  The  limb  should  be 
kept  extended,  and  the  injured  one  must  be  bound  to  the  other  by  a 
bandage,  keeping  both  legs  straight  and  immovable.  A  broad  leather 
strap,  bound  firmly  round  the  hips  and  thighs  will  be  serviceable. 

Two  or  three  months  will  be  required  for  the  injury  to  become  re- 
paired, so  that  the  limb  may  be  used.  The  patient  must  get  up  cau- 
tiously, and  be  careful  not  to  use  the  limb  much  so  long  as  pain  is 
produced. 

•    Fracture  of  the  Knee- Pan. 

The  knee-pan  (patella)  may  be  broken  up  and  down,  or  across ;  — 
the  latter  fracture  is  the  more  common.  It  is  a  troublesome  fracture, 
and  is  very  apt  to  leave  a  stiff  knee. 

Symptoms.  —  When  the  bone  is  broken  across,  the  patient  cannot 
stand  upon  the  limb ;  the  leg  may  be  flexed  or  crooked,  but  cannot 
be  straightened ,  the  upper  part  of  the  knee-pan  is  drawn  up  away 
from  the  lower  portion,  leaving  a  wide  gap,  into  which  the  fingers 
may  be  laid,  —  at  the  top  and  bottom  of  which  the  rough  edges  of 
the  movable  bones  may  be  felt. 

Treatment.  —  First,  reduce  the  inflammation  by  tincture  of  arnica, 
leeches,  etc.  Then  straighten  the  limb,  and  put  a  well-paddgd  splint 
beliind,  to  keep  the  knee  motionless ;  place  the  patient's  body  in  a 
half-sitting  posture,  and  raise  the  foot  considerably  above  a  level. 
Put  ^  bandage  over  the  splint,  beginning  half  way  up  the  thigh,  and 
extending  down  to  the  knee-p  -i,  and  being  made  very  tight  just 
above  the  broken  bone,  so  that  it  cannot  easily  slip  under  it.  The 
broken  bones  must  now  be  brought  together,  and  the  bandage  be 
passed  below  and  again  above  the  knee  several  times  in  the  form  of 
a  figure  8,  to  keep  the  bones  from  parting. 

The  bandage,  generally,  may  not  be  removed  for  a  fortnight.  After 
this  period,  if  everything  has  gone  on  well,  the  limb  may  be  carefully 
bent  a  little  every  day,  to  avoid  a  stiff  knee. 


Fracture  of  the  Bones  of  the  Leg. 

The  leg  is  that  part  of  the  limb  between  the  knee  and  ankle, 
has  two  bones ;  the  smaller  on  the  outside,  called  the  fibula ; 
larger  on  the  inner  and  front  side,  called  the  tibia,  or  shin-bone. 


It 

tlie 


bone  is  broken  at 
by  the  knee  and 
h  or  two  shorter 
ivhich  old  persons 
1  here,  it  seldom 
is  generally  by  a 

reaching  from  the 
rmly  with  a  hand- 
le limb  should  be 
to  the  other  by  a 
.  A  broad  leather 
be  serviceable, 
jury  to  become  re- 
i  must  get  up  cau- 

0  loug  as  pain  is 

1. 

own,  or  across ;  — 
ublesome  fracture, 

the  patient  cannot 
•ooked,  but  cannot 
is  drawn  up  away 
which  the  fingers 
16  rough  edges  of 

T  tincture  of  arnica, 
well-paddsd  splint 
patient's  body  in  a 
bly  above  a  level. 

1  up  the  thigh,  and 
,de  very  tight  just 
Lip  under  it.  The 
id  the  bandage  be 
nes  in  the  form  of 

a  fortnight.   After 
lb  may  be  carefully 


e  Leg. 

nee  and  ankle.  It 
led  the  fibula;  the 
(,  or  shin-bone. 


SURGICAL   DISEASES. 


659 


Fig.  186. 


One  or  both  of  these  may  be  bioken  at  the  same  time.  If  both 
are  broken,  it  is  impossible  to  walk  upon  the  limb ;  there  is  a  change 
in  its  shape ;  it  may  be  bent ;  and  the  grating  of  the  broken  ends  oi 
the  bones  may  be  felt  or  heard. 

Treatment.  —  First,  adjust  the  bones  by  means  of  extension  and 
counter-extension,  as  in  other  fractures. 
Then  apply  two  splints,  one  on  the  out- 
side from  the  knee  to  the  solo  of  the  foot; 
the  other  u])on  tlie  inside.  Over  these  a 
bandage  is  to  l)e  firmly  applied,  reaching 
from  the  toes  to  the  knee.  The  leg  may 
rest  upon  the  side  or  the  back,  as  the  com- 
fort of  the  patient  may  require.  Upon 
the  side  is  generally  the  easiest  position, 
with  tlie  knee  a  little  bent  (Fig,  165). 

The  dressing  may  be  removed  in  six  or  seven  days,  to  see  that  the 
bones  are  in  their  proper  place.  Five  or  six  weeks  will  be  required 
for  recovery ;  and  at  the  end  of  this  time,  the  dressing  may  be  laid 
aside.     But  the  patient  must  use  his  leg  very  gradually. 

In  the  treatment  of  fractures  of  the  shafts  of  the  bones  of  the 
lower  extremities,  three  indications  should  be  fulfilled :  Fii-st,  coap- 
tation and  fixation  of  the  fragments ;  second,  moderate  extension ; 
third,  gentle  compression  and  support.  Provided  these  requirements 
are  carried  out,  it  matters  little  what  apparatus  may  be  employed ; 
bnt  that  which  can  be  applied  with  the  least  disturbance  of  the 
fractured  bone,  and  is  most  comfortable  to  the  feeling  of  the  patient, 
should  be  preferred. 

The  best  mode  of  extension  and  counter-extension  now  in  use  is 
by  raising  the  foot  of  the  bedstead  about  eight  inches,  by  a  block  of 
wood  placed  under  each  fore-leg.  Tins  makes  an  inclined  plane,  and 
the  body  consequently  tends  to  incline  towards  the  head  of  the  bed ; 
this  is  the  counter-extension. 

Then  extension  is  made  as  follows :  A  strong  piece  of  adhesive 
plaster,  about  two  and  one  half  inches  wide  and  about  three  feet  long, 
is  applied  to  the  sides  of  the  leg,  extending  from  a  little  below  the 
knee,  leaving  a  loop  under  the  foot  four  or  five  inches  long.  This 
is  secured  firmly  in  place  by  a  bandage  to  the  whole  length  of  the 
leg.  A  piece  of  cord  is  fastened  to  the  loop  and  passed  over  a  pul- 
ley, which  is  fixed  to  the  foot-board  of  the  bed.  To  the  other  end  of 
this  cord  is  attached  a  weight.  This  need  not  exceed  ten  or  twelve 
pounds. 

In  this  way  we  get  our  counter-extension  and  extension :  the  body 
IS  drawir.g  one  way  and  the  weight  is  pulling  the  other  all  the  time. 

Tliis  is  a  simple  and  comfortable  way  of  treating  fractures  of  the 
shafts  of  tlie  bones  of  the  lower  extremities  wliich  require  extension. 
It  may  be  applied  to  the  different  fractures  of  the  neck  of  the  thigh 
bone,  to  fractures  of  the  shaft,  and  also  to  fractures  in  the  shafts  of 
the  bones  of  the  leg. 


:i:^.  r'.TFi  it'  -^^u.j.    •:;»jr:.rjt'-  tt-- 


560 


SURGICAL  DISEASES. 


w% 


It  is  the  best  and  most  effectual  way  of  preventing  undue  short- 
ening that  we  have  in  use,  and  what  is  of  as  great  importance  to  the 
patient,  a  most  comfortable  way  of  keeping  the  painful  limb  in  the 
proper  shape. 

Fractures  of  the  Bones  of  the  Foot. 

These  are  to  be  treated  in  the  same  manner  with  fractures  of  the 
hand.  They  are  often  attended  with  much  other  mischief,  as  lacei-a- 
tion  of  the  flesh,  ligaments,  etc.  Hence,  cutting  off  the  foot,  or  a 
part  of  it,  is  often  necessary.  Pasteboard  splints  are  frequently  used 
in  these  fractures.  If  matter  forms,  it  must  be  let  out  by  opening 
the  parts. 

Compound  Fractures. 

When,  in  connection  with  a  broken  bone,  there  is  a  wound  of  the 
flesh,  which  leads  to,  and  communicates  with  the  space  between  the 
broken  ends  of  the  bone,  the  whole  injury  is  called  a  compound  frac- 
ture. The  wound  in  the  flesh  may  be  caused  by  the  same  force 
which  breaks  the  bone,  as  a  bullet  from  a  gun,  or  a  cart-wheel,  or 
some  machinery  in  which  the  limb  is  entangled.  Quite  often  the 
flesh  wound  is  caused  by  one  of  the  ends  of  the  bone  being  forced 
through  the  flesh  and  skin. 

But,  however  caused,  a  compound  fracture  is  of  a  much  more 
serious  nature  than  a  simple  one ;  and  it  is  particularly  dangerous 
when  a  joint  is  involved.  It  is  more  serious  above  the  knee  and 
elbow  than  below,  and  more  to  be  dreaded  in  the  lower  limbs  than 
in  the  upper. 

Treatment.  —  An  attempt  should  always  be  made  to  preserve  the 
limb ;  it  should  not  be  cut  off,  unless  the  compound  fracture  is  of 
the  worst  kind.  But  if  there  be  no  hope  of  saving  the  limb,  the 
amputation  should  be  performed  at  once,  while  the  constitution  is 
tranquil,  and  before  it  has  been  shocked  and  injured  by  suppuration, 
abscesses,  and  sepsis,  which  sometimes  follow  such  grave  injuries. 

But,  suppose  it  be  determined  not  to  cut  the  limb  off,  —  as  it  gen- 
erally should  be,  —  the  first  thing  is,  after  the  bone  is  set,  to  close  the 
wound  against  all  entrance  of  air,  and  to  cause  it  to  heal  by  the  first 
intention,  that  is,  without  suppuration.  To  do  this,  one  method  is  to 
cover  the  wound  with  lint  dipped  in  blood ;  but  the  more  usual  mode 
is,  to  bring  the  sides  of  the  wound  together,  and  secure  them  very 
carefully  by  strips  of  adhesive  plaster,  in  the  same  way  as  in  common 
cuts.  The  bandage  should  be  kept  wet  with  cold  water,  by  squeez- 
ing a  sponge  over  it,  or  by  sprinkling  cold  water  upon  it  as  fast  as  it 
l)ecomes  dry. 

It  will  be  necessary,  in  this  case,  to  keep  the  l)ed-clothes  away  from 
the  limb  while  it  is  thus  wet,  which  may  be  done  by  cutting  a  barrel 
hoop  in  two,  and  nailing  it  to  two  pieces  of  lath.     There  should  be 


ntrr-rr  ■'"--'-■—^■°--' 


8UROI0AL  DISKASES. 


661 


y  undue  short- 
portance  to  the 
ul  limb  in  the 


Foot. 

fractures  of  the 
achief,  as  lacera- 
S.  the  foot,  or  a 
,  frequently  used 
out  by  opening 


g  a  wound  of  the 
)ace  between  the 
a  compound  frac- 
y  the  same  force 
r  a  cart-wheel,  or 
Quite  often  ihe 
)one  being  forced 

of  a  much  more 
icularly  dangerous 
ove  the  knee  and 

lower  limbs  than 

ide  to  preserve  the 
und  fracture  is  of 
ving  the  limb,  the 
the  constitution  is 
•ed  by  suppui-ation, 
h  grave  injuries, 
mb  off,— as  it  gen- 
B  is  set,  to  close  the 

to  heal  by  the  first 
lis,  one  method  is  to 
he  more  usual  mode 
I  secure  them  verj- 
e  way  as  in  common 
Id  water,  by  squeez- 

upon  it  as  fast  as  it 

Hl-clothes  away  from 

,,  by  cutting  a 
There  should  be 


air  circulating  under  the  sheet,  that  the  heat  of  the  inflammation  may 
not  keep  the  limb  in  a  steam  bath. 

Should  the  wound  heal  by  the  first  intention,  the  danger  will  soon 
be  over,  and  the  treatment  may  be  the  same  as  for  simple  fracture. 
But  this,  unfortunately,  does  not  always  occur. 

It  occasionally  happens,  that  after  three  or  four  days,  the  patient 
grows  restless,  has  very  short  and  disturbed  sleep,  is  hot  and  thirsty, 
has  headache  and  shivering  fits,  is  more  ill  towards  evening,  wanders 
in  his  mind,  or  becomes  delirious,  and  perhaps  dies  in  ten  days  or  a 
fortnight  from  the  sepsis  or  blood-poisoning  that  has  taken  place. 
If  the  symptoms  are  a  little  less  severe,  the  wound  will  at  first  dis- 
charge a  small  quantity  of  dirty,  bloody  matter,  which,  if  everything 
goes  well,  \v'ill,  by  degrees,  change  to  healthy  matter,  without  smell, 
of  a  straw-coi  ^r,  and  about  as  thick  as  cream. 

The  fever,  and  other  bad  symptoms,  will  now  subside ;  the  sleep 
and  appetite  come  back,  and  a  new  process  begins,  that  of  healing  by 
granulation,  or  the  formation  of  new  flesh  to  fill  up  the  gap  made  by 
the  wound. 

For  old  persons,  or  those  whose  health  has  been  broken,  this  stage 
is  full  of  danger,  and  is  apt  to  result  in  death,  if  the  lower  limb  be 
the  injured  part. 

li  the  constitution  proves  unable  to  bear  up  against  this  stage  of 
the  injury,  alternate  heat  and  sweating  set  in,  the  face  is  flushed  with 
a  pink  color,  the  pulse  becomes  weak  and  quick,  the  body  wastes,  the 
appetite  disappear,  the  tongue  becomes  diy  and  brown,  restlessness, 
wandering,  and  delirium  follow  in  quick  succession,  and  all  are 
speedily  terminated  by  death.  With  the  setting  in  of  these  symp- 
toms, the  wound  stops  discharging,  or  throws  out  only  a  thin,  wateiy 
and  stinking  matter.  Quite  often  the  skin  and  other  parts  mortify, 
and  if  there  be  strength  enough  to  throw  off  the  dead  parts,  the 
broken  ends  of  the  bone  stick  out,  looking  dead  and  white. 

When  the  constitutional  symptoms  begin,  open  and  thoroughly 
disinfect  the  wound  and  provide  for  free  drainage ;  a  poultice  may 
also  be  used  if  much  pain  be  present.  The  poultice  must  be 
contiimed  till  the  wound  is  filled  with  new  flesh  nearly  to  the 
surface. 

It  must  be  said  in  justice  to  modem  surgery,  that,  if  antiseptics 
are  used  at  the  first  dressing  of  the  wound,  we  expect  union  by  first 
intention,  and  the  avoidance  of  pus  formation  with  all  the  dangers 
this  entails.  The  wound  is  to  be  treated  just  like  other  fresh 
wounds,  aseptically ;  the  limb  may  then  be  done  up  like  a  simple 
fracture,  but  the  dressings  should  be  so  arranged  as  to  allow  of  sub- 
sequent inspection.     (See  article  on  Asepsis,  etc.,  p.  618.) 

Dislocations.  —  Luxations. 

The  surfaces  where  two  bones  meet  and  glide  upon  each  other  for 
the  purposes  of  a  joint,  are  called  articular  surfaces,  and  the  union  is 


662 


SURQIOAL   DISEASES. 


said  to  be  an  articulation.  These  surfaces  are  covered  hy  a  smooth 
cartilage,  to  render  their  play  upon  each  other  easy. 

The  joints  are  held  together  by  cartilaginous  straps  and  ligaments, 
which  serve  as  pullies  ;  by  the  aid  of  these,  the  joints  turn  back  and 
forth,  as  a  door  opens  and  shuts  upon  its  hinges. 

When  by  some  external  violence,  or  the  weakening  of  these  liga- 
ments, these  surfaces  are  suddenly  separated,  or  forced  apart,  there 
is  said  to  be  dinlocation  or  luxation. 

Joints  are  divided  into  two  kinds,  the  ball-and-socket  (orbicular), 
which  has  a  rotatory  motion,  as  the  shoulder,  hip,  thumb,  —  and  the 
angular,  or  pump-handle  (ginglymoid),  as  the  elbow  and  knee. 

The  ball-and-socket  joints  have  a  greater  diversity  of  motion,  and 
are  more  exposed  to  dislocation.  They  are  likewise  more  easily  put 
in  their  place. 

In  a  Primary  Dislocation,  the  bone  is  thrown  at  once  into  the 
place  where  the  surgeon  finds  it. 

The  Secondary  Dislocation  is  one  in  which  the  muscles  pull  the 
head  of  the  bone  still  further  from  its  natural  place  than  it  was 
thrown  by  the  first  shock  of  violence. 

A  Dislocation  is  Simple  when  there  is  no  wound  penetrating  the 
synovial  membrane. 

it  is  Compound  when  attended  by  such  a  wound. 

A  Dislocation  is  Complete'  when  the  articular  surfaces  are  entirely 
separated. 

It  is  Incomplete  when  the  separation  is  only  partial. 

Recent  Dislocations  are  rectified  with  comparative  ease. 

Old  Dislocations  are  hard  to  be  repaired,  and  sometimes  cannot  be 
reduced  at  all. 

The  Symptoms  of  Dislocation  are,  inability  to  use  the  joint ;  the 
head  of  the  bone  being  felt  in  an  unnatural  place  ;  the  limb  shortened, 
lengthened,  or  distorted ;  a  change  in  the  shape  of  the  joint,  etc. 

Simple  dislocations  are  generally  trivial.  Compound  dislocations 
often  render  amputation  necessary,  and  are  always  perilous. 

Aged  persons  are  less  liable  to  dislocations  than  the  young. 

When  a  dislocation  and  a  fracture  occur  at  the  same  time,  the 
dislocation  is  to  receive  attention  first. 

A  dislocation  is  to  be  reduced  by  a  gradual  and  continuous  extend- 
ing force.  The  reduction  is  known  by  the  limb  recovering  its  natural 
length,  shape  and  direction,  and  by  its  being  able  to  perform  certain 
motions  which  are  not  possible  while  in  a  dislocated  state.  The  pain 
is  immediately  reduced  upon  reduction  taking  place.  In  shoulder 
and  hip  dislocations,  the  head  of  the  bone  makes  a  loud  noise  when 
it  slips  into  its  place. 


.i»»'..,ii«»iw.TK*-mSr  •-,»,;*;.-  !a«aht(itaB«PWiiM«iw<i«gaMiiiiBa<a^^ 


BUROIOAL  DISBASBS. 


563 


rered  by  a  smooth 

Y- 

•aps  and  ligaments, 

ints  turn  back  and 

ling  of  these  liga- 
Porced  apart,  there 

socket  (orbicular), 
thumb,  —  and  the 
)w  and  knee, 
ity  of  motion,  and 
se  more  easily  put 

at  once  into  the 

I  muscles  pull  the 
place  than  it  was 

id  penetrating  the 


irfaces  are  entirely 

irtial. 
Ave  ease, 
tmetimes  cannot  be 

use  the  joint ;  the 
the  limb  shortened, 
'  the  joint,  etc. 
)ound  dislocations 

perilous. 

the  young. 
16  same  time,  the 

continuous  extend- 
overing  its  natural 
to  perform  certain 
i  state.  The  pain 
ace.  In  shoulder 
k  loud  noise  when 


Dislocation  of  the  Lower  Jaw. 

Gaping  very  wide  is  the  usual  cause  of  this.  It  hac  been  known 
to  result  from  a  mere  yawn.     One  or  both  sides  may  be  disjointed. 

Symptoms.  —  If  but  one  side  is  dislocated,  the  chin  is  twisted  to 
one  side,  and  immovable,  and  the  jaws  are  partially  open ;  if  both 
sides,  the  mouth  is  wide  open,  the  chin  projects,  there  is  a  hollow  in 
fiont  of  each  ear,  great  pain,  inability  to  speak,  and  dribbling  of 
spittle  from  the  mouth. 

Treatment.  —  To  effect  a  reduction,  cover  the  thumbs  with  a  towel 
or  a  piece  of  wash-leather  to  prevent  their  being  injured  by  a  sudden 
snapping  together  of  the  jaws,  and  then,  standing  in  front  of  the 
patient,  introduce  them  into  the  mouth,  press  them  upon  the  crown 
of  the  back  lower  teeth,  at  the  same  time  lifting  the  chin  with  the 
fingei-s. 

After  the  jaw  is  set,  it  should  be  kept  bandaged  for  a  few  days, — 
the  bandage  being  merely  passed  once  or  twice  over  the  top  of  the 
head,  and  under  the  chin.  No  solid  food  requiring  chewing  should 
be  taken  for  a  short  time. 

Dislocation  of  the  Collar-Bone. 

This  may  take  place  by  the  end  attached  to  the  breast-bone  slip- 
ping over  or  under  that  bone,  or  by  the  other  end  slipping  above  or  be- 
low the  bone  to  which  it  is  attached.  "When  the  firat  named  end  of 
the  bone  slips  over  the  breast-bone,  it  is  said  to  be  a  forward  disloca- 
tion ;  when  it  slips  under  the  breast-bone,  it  is  backward.  In  this 
latter  form  of  dislocation,  the  end  of  the  collar-bone  sometimes  presses 
upon  the  gullet,  and  prevents  swallowing. 

Symptoms.  —  In  the  forward  dislocation  of  the  inner  end  of  the 
bone,  a  bunch  may  be  felt  by  the  hand  at  the  top  of  the  breast-bone ; 
in  the  backward  dislocation,  a  depression  or  hollow.  The  upward  dis- 
location of  the  outer  end  of  the  collar-bone  may  be  known  by  the 
flattened  and  sunken  condition  of  the  shoulder. 

Treatment.  —  To  put  the  bone  in  its  place  in  the  first  of  these  ac- 
cidents, draw  the  shoulders  back,  by  which  means  the  collar-bone  (clav- 
icle) is  drawn  away  from  the  breast-bone  (sternum),  and  easily  slips 
into  its  place.  To  reduce  the  dislocation  at  the  other  end  of  the 
bone,  place  the  knee  between  the  patient's  shoulder-blades  (scapulae), 
and  draw  his  shouldere  backwards  and  upwards.  After  the  reduction, 
support  the  arm  in  a  sling. 

Dislocation  of  the  Shoulder- Joint. 

The  head  of  the  long  bone  of  the  arm  (humerus)  may  be  displaced 
in  three  different  directions,  —  dowmoard,  into  the  arm-pit  (axilla)  ; 


664 


BURGIOAL  DISEASES. 


fil 


11 


forward,  under  the  muscles  of  tho  breiist;  and  backward,  uimhi  ilu; 
back  of  tlie  Hhoulder-blivdc. 

It  is  rccogniznd  by  the  shoulder  losing  its  roundners,  iind  becoming 
flat;  by  the  lengthening  of  the  arm;  by  the  head  of  the  Ixme  bring 
felt  in  the  arm-pit ;  and  by  severe  pain. 

To  effect  the  reduction  in  the  fii-st  form  of  displacement,  put  tlie 
patient  on  a  bed,  or  upon  the  floor.  Put  one  heel  in  the  arm-pit, 
agfainst  the  head  of  the  l)one.  Then,  taking  hold  of  the  arm  alK»ve 
the  elbow,  or  at  the  wrist,  pull  steadily,  and  push  with  the  li(;t'l. 
(Fig.  166.)  The  extension  may  \re  more  steady  and  powerful  by  a 
double  towel  arouud  the  surgeon's  ueck. 


Fio.  tM. 

If  the  reduction  cannot  be  effected,  relax  the  muscles  by  a  warm 
bath  or  by  etherization. 

A  simpler  method  often  succeeds  and  is  the  only  one  require*',  in 
certain  forms  of  shoulder  dislocation.  Bend  the  elbow  at  right  an- 
gles and  place  it  at  the  side  of  the  body.  Next  rotate  the  fore-arm 
outward  as  far  as  possible ;  then  carry  the  elbow,  still  flexed,  inward 
and  upward  onto  the  chest,  and  then  allow  the  elbow  to  fall.  The 
head  of  the  humerus  often  slips  into  place  with  the  greatest  of  ease. 

After  the  reduction,  a  sling  will  be  required,  and  three  weeks'  or  a 
month's  rest. 

Dislocations  of  the  Elbow-Joint. 

Op  these  there  are  six  varieties.  In  the  first,  both  bones  of  the 
fore-arm  (radius  and  ulna)  are  thrown  backwards  ;  in  the  second,  both 
are  drawn  backwards  and  inwards;  in  the  third,  both  are  thrown 
backwards  and  outwards  ;  in  the  fourth,  the  vlna  alone  is  forced  back- 
wards ;  in  the  fifth,  the  radius  is  forced  forwards  ;  and  in  the  sixth, 
the  radius  is  thrown  backwards. 

In  general,  these  dislocations  are  all  easily  set.     In  the  first  four, 


;'/  :■ 


. 


BUROICAL   niHKABKB. 


Sfif) 


akteard,  iipoii  llie 

gi'«,  ivnd  lie(;()niiii^ 
•f  the  Ikiiu!  being 

laconieiit,  put  the 
1  in  thu  arm-pit, 
)f  the  arm  alM)ve 
(h  with  tlie  li(;t'l. 
id  powerful  by  a 


inscles  by  a  wa  nn 

y  one  require'',  in 
ilbow  at  rigiit  aii- 
)tate  the  fore-arm 
till  flexed,  inward 
bow  to  fall.  The 
3  greatest  of  ease, 
thiee  weeks'  or  a 


int. 

)oth  bones  of  the 
n  the  second,  both 

both  are  thrown 
lone  is 'forced  back- 

and  in  the  sixth, 

In  the  first  four, 


FtO.  167. 


the  knpo  la  to  }^o.  planed  at  the  l)ond  of  the  elbow,  and  the  foro-ami 
bout  upon  it,  i\ui  siirguon  ^niHpiii^  the  upper  arm  with  one  liaiid, 
and  tilt;  fore-arm  with  the  oUu^r.  In  tho  (iiHlocatiuuH  ol'  tlu;  rudiiiH, 
tliu  upper  arm  is  to  Ihj  put  in  a  foced  condition,  wiiiiu  the  Hur^i>oii 
takes  hold  of  the  hand  and  pulls,  at  tho  same  time  throwing  the  lM)iie 
forward.  If  the  luxation  Ih»  iNickwards,  there  must  l)o  tho  same  ex- 
tension and  couuter^jxtension,  whde  the  fore-arm  is  bent. 

Treatment.  —  The  fore-arm  must  Ix)  placed  in  n  half-l)ent  position, 
and  a  splint  should  be  bandaged  npon  the  front  of  tlu;  whole  lind), 
compresses  being  placed  upon  the  head  of  the  houvH  opposiU-  the  di- 
rection of  the  dislocation.  This  confinement  must  bo  continued  three 
weeks. 

Dislocations  of  tlie  Wrist. 

These  are  caused  by  falls  upon  the  hand.  Both  the  radius  and 
ulna  may  be  thrown  back- 
wards or  forwards  upon 
the  wrist,  causing  a  pro- 
jection either  in  front  or 
behind.  (Fig.  167.)  The 
bones  are  to  be  set  by 
pulling  in  opposite  direc- 
tions upon  the  hand  and  the  forearm,  and  pressing  laterally,  if  the 
displacement  be  at  the  side  of  the  wrist. 

Treatment.  —  Put  a  straight  splint  on  the  front,  and  another  on  the 
back  of  the  fore-arm  and  hand,  with  compresses  on  both  sides  of  the 
wrist,  and  a  Iwindage  over  the  whole.  Support  the  fore-arm  in  a  sling, 
and  keep  down  inflammation  by  cold  water,  cooling  lotions,  etc. 

Dislocatiokis  of  the  Bones  of  the  Hand. 

Some  one  of  the  carpal  bones  may  be  pushed  up  out  of  its  place, 
80  as  to  form  a  projection  on  the  back  of  the  hand.  To  put  it  in  its 
place,  press  upon  it  simply,  and  then  put  compresses  on  the  front  anil 
back.;  with  straight  splints  upon  these  and  a  bandage  over  all.  Put 
the  hand  in  a  sling. 

Dislocations  of  the  finger-joints  may  generally  lie  replaced  by  bend- 
ing the  displaced  phalanx  over  the  head  of  the  bone  from  which  it 
has  been  disjoined.  Sometimes  a  good  deal  of  extension  and  counter- 
extension  are  required,  for  which  purpose  a  piece  of  cord  may  be 
wound  around  the  finger,  —  the  skin  being  protected  by  covering  it 
with  a  piece  of  wetted  buck-skin. 

Dislocations  of  the  Hip-Joint. 

These  are  four  in  number,  —  upwards,  downwards,  bachvards  and 
upwards,  forwards  and  upwards. 


i^ 


560 


StJRQICAL   UISKASCfl. 


To  niduco  tlu'HO,  a  jjroatcr  amount  of  powoi-  Ih  needed  iliiui  in  the 
dislocations  of  any  other  lM)iie,  —  owin^  to  the  greater  |)ower  of  the 
niiiHclos  wliieh  are  to  \)f  overcome. 

DislocatioiiH  of  this  joint  are  often  (confounded  with  fracture  of  tliu 
head  and  neck  of  tlie  thigh  bone.  This  hitter  may  he  diHtinguishiil 
from  the  luxation  hy  the  grating  sound  t-)  Iw  he:ud,  by  the  possiljility 
of  pulling  the  limb  out  to  itH  natural  length,  and  by  its  Ixnng  slmrt- 
ened  u])  again  by  the  action  of  the  muscles  the  moment  the  pulling' 
is  given  up. 

The  Upward  DiAlocatlon  of  the  head  of  this  l)one  upon  the  lituk 
of  the  haunch-lM»ne  is  known  by  the  mliorteninif  of  the  limb,  and  liy 
the  knee  and  foot  turning  inward,  —  the  foot  lapping  over  the  oppo 
jjite  foot,  and  the  great  toe  resting  upon  the  other  instep.  (Fig.  ItiH.) 

The  Dislocation  Downward  is  known  by  the  lenc/theniru/  of  tliu 
limb,  the  projection  of  the  knee,  the  turniiui  of  the  foot  and  knee  out- 
ward, and  the  bending  of  the  body  forward.     (Fig.  1H9.) 


FlO.  108. 


FIO.  169. 


The  Dislocation  Backward  and  Upward  is  distinguished  by  the 
inclining  of  the  foot  and  knee  inward,  the  drawing  up  of  the  heel,  and 
the  resting  of  the  great  toe  against  the  ball  of  the  great  toe  of  the 
other  foot.     (Fig.  170.) 

The  Dislocation  Upward  and  Forward  is  known  by  the  shorten- 


J:  ^4. 


!C(l«ll   lllllll   ill   tlic 
iifT  poWtT  ol     tlu' 

th  fracture  (»f  tlic 
'  Ih!  ili8tinfj;uishcil 
by  tlio  ixmsilnlity 
y  itH  being  sluirl- 
ineiit  the  imHin^' 

)no  iijton  the  Uuik 

the  limb,  iiiul  by 

ijT  over  the  oppo- 

nBtep.   (Fig.  ItiH.) 

leru/thenin(/  of  llu' 
foot  and  knee  out- 

r:it>9.) 


FIO.  169. 


distinguished  by  the 
y  up  of  the  heel,  and 
he  great  toe  of  the 

own  by  the  shorten- 


BUIKilOAL   lilHEASEH. 


667 


iiig  of  tho  limb,  and  the  turninq  of  the  foot  and  knee  outward.     (Fig. 
171.) 

For  replatiing  tho  l)one,  put  tho  patient  upon  a  tJible,  on  hiH  Uvck. 
Driiw  a  sheet  l)et\veen  iiis  thiirlis,  and  extending  it  uj)  by  the  side  of 
his  lK)dy,  let  it  Int  fastent'd  fo  u  Htiplc.  I'ut  a  padded  l)elt.  with  rings 
uttuched,  around  the  injured  liml).  jiiHt  alxtvu  tht*  knee.     To  these 


FlO.  170. 


FlO.  171. 


rmgs,  fasten  one  block  of  a  pulley,  and  attach  the  other  to  a  post, 
giving  the  pulley-rope  to  an  assistant.  The  surgeon  now,  standing 
on  the  injured  side,  directs  gradual  extension  to  be  made,  while  he, 
by  his  hands,  or  by  a  l)and  passing  around  the  injured  thigh  and  over 
his  own  shoulders,  lifts  the  head  of  the  bone,  and  guides  it  iuto  its 
socket.     Etherization  is  not  infrequently  required. 

Treatment.  —  Keep  the  patient  in  bed  for  two  weeks  or  more,  with 
his  knees  tied  together  by  a  strip  of  muslin,  and  a  broad  belt  around 
his  hips. 

Dislocations  of  the  Knee- Pan  or  Patella. 

This  bone  may  be  thrown  outward,  causing  a  great  projection  on 
the  outside,  and  an  inability  to  bend  the  knee. 

It  may  be  thrown  inward,  causing  the  same  impossibility  to  bend 
the  knee,  and  a  projection  on  the  inside. 

To  restore  the  bone  to  its  place,  put  the  heel  of  the  patient  upon 


I 


:J 


■■■■ 


568 


SURGICAL  DISEASES. 


the  shouLler  of  an  assistant;  then  press  down  the  edge  of  the  knee- 
pan  which  is  farthest  from  the  centre  of  tiie  joint,  thus  tilting  U[)  the 
other  edge  of  the  bone,  when  the  muscles,  aided  by  a  lateral  pressure, 
will  draw  it  to  its  place. 

Treatment.  —  Put  a  straight  splint  upon  the  back  of  the  limb, 
and  make  moderate  pressure  upon  the  knee  by  a  bandage.  Cold 
water,  or  cooling  washes,  should  generally  be  applied.  Keep  the  pa- 
tient in  bed  two  weeks. 

Dislocations  of  the  Knee-Joint. 

There  are  four  of  these, — forward^  backward,  inward  and  out- 
ward. 

They  are  readily  corrected  by  extemion  and  counter-extension  from 
.he  ankle  and  thigh,  and  pressure  upon  the  head  of  the  displaced 
bone. 

Treatment  much  the  same  as  for  displacement  of  the  knee-pan. 


Dislocations  of  the  Ankle. 

These  may  occur  in  a  forward,  backward,  outward,  and  inward 
direction.     (Figs.  172  andl73.) 


PlO.  172. 


PlO.  173. 


To  rectify  it,  bend  the  limb,  so  as  to  relax  the  muscles  on  the  back 
of  the  leg;  then,  \7hile  extension  and  counter-extension  are  made 
upon  the  foot  and  thigh,  press  firmly  on  the  dislocated  bone,  and  thus 
force  it  to  its  place.      • 

Treatment.  —  Confine  the  foot  and  leg  in  splints  made  of  thick 


SURGICAL   DISEASED. 


669 


ge  of  the  knee- 
is  tilting  up  the 
lateral  pressure, 

ick  of  the  liml), 
bandage.  Cold 
I.     Keep  the  pa- 


nt. 

inward  and  out- 

ir-extension  from 
of  the  displaced 

the  kneu-pan. 


ard,  and  inward 


iscles  on  the  back 
tension  are  made 
ed  bone,  and  thus 

ts  made  of  thick 


pastelward,  soaked  in  hot  water  and  moulded  to  tlie  shape  of  the 
liinh,  with  a  foot-pioce  at  right  angles.  Keep  the  patient  in  bed  five 
or  six  we«^ks,  and  when  he  begins  to  walk,  support  tlie  ankle  with  a 
roller  bandage,  or  a  laced  gaiter. 

Contusions.  —  Bruises. 

When  any  blunt,  hard  substance  comes  in  violent  collision  with 
the  soft  parts  of  the  l  .y,  without  breaking  the  skin,  the  injury  re- 
ceived is  called  a  bruise.  One  of  these  accidents  generally  ruptures 
a  great  number  of  the  very  smallest  blood-vessels,  which  let  out 
blood  under  the  skin,  producing  '^ black  and  blue"  or  livid  spots 
(ecchymosis).     What  fist-fighters  call  a  Mack  eye  is  an  example. 

Treatment.  —  Cold  applications  at  first  to  prevent  the  blood  run- 
ning out  of  the  small  vessels  under  the  skin.  After  the  inflammation 
has  subsided,  stimulating  applications,  as  vinegar  and  water,  alcohol, 
camphorated  liniment,  ammonia  and  alnohol,  equal  parts,  and  some- 
times bandages. 

Sprains. 

A  SPRAIN  is  a  forcible  wrenching  and  twisting  of  a  joint  to  such  a 
degree  as  to  stretch  and  more  or  less  lacerate  the  ligaments  of  the 
part,  and  sometimes  to  break  a  tendon,  but  without  entirely  displac- 
ing a  bone.  Its  symptoms-  are,  violent  pain,  swelling,  and  discolora- 
tion of  the  parts  from  the  blood  running  into  the  cells  under  the  skin. 
In  elderly  persons,  the  effects  of  sprains  are  very  tedious,  disabling 
them  for  many  weeks,  or  even  months. 

Treatment.  —  Elevate  the  limb,  keep  the  joint  perfectly  quiet, 
and  apply  cold  lotions  or  fomentations.  When  the  inflammation  is 
all  past,  apply  stimulating  liniments,  and  bandages,  or  shower  the 
part  with  cold  water. 

When  first  done,  put  the  part,  if  possible,  into  as  hot  water  as  can 
be  borne  and  maintain  it  there  for  half  an  hour,  then  strap  the  part 
moderately  tight  with  plaster.  An  ice-bag  applied  over  a  joint  when 
the  hot  water  cannot  be  obtained,  or  is  inapplicable,  is  nearly  as  effica- 
cious. 

Ruptures  of  Tendons. 

These  accidents  are  known  by  a  sudden  snap,  followed  by  pain, 
loss  of  motion  in  the  part,  and  swelling  and  discoloration. 

Treatn.ent.  —  Ph.  3  the  part  in  such  a  position  as  to  relax  the 
broken  tendon,  the  ends  of  which  must  be  brought  together,  and  re- 
tained in  contact  till  they  grov  together.  They  are  to  be  sewn 
aseptically  and  the  wound  treateu  like  any  closed  wound. 


I 


570 


SURGICAL  DISEASES. 


Diseases  of  the  Bones. 

The  bones  are  supplied  with  blood-vessels  and  nerves ;  and  as  they 
live  and  grow  like  other  parts  of  the  body,  so  they  become  diseased 
and  die  in  like  manner. 

Ulceration  of  tlie  Bones.  —  Caries. 

Bones,  like  the  soft  parts,  when  attacked  by  violent  inflammation, 
may  ulcerate,  discharge  matter,  and  heal  by  granulation ;  or,  having 
lost  a  portion  of  their  substance,  may  sink  under  entire  disorganiza- 
tion and  death.  '  This  disease  passes,  in  some  parts  of  the  country, 
under  the  name  of  "fever  sore."  It  is  generally  the  result  of  poor 
blood,  scrofula  and  like  disease,  and.  hence  needs  tonic,  constitutional 
as  well  as  local  treatment,  cod-oil,  iron,  etc. 

Treatment.  —  Apply  splints,  and  keep  the  part  in  a  state  of  abso- 
lute rest.  Subdue  the  local  inflammation  by  the  usual  means.  If 
the  disease  arise  from  scrofula  or  syphilis,  use  the  remedies  for  those 
diseases. 

Death  of  the  Bones.  —  Necrosis. 

This  is  like  mortification  of  the  soft  parts.  It  occurs  from  injuries 
and  inflammation  of  the  periosteum. 

It  is  known  by  dull, deep-seated— sometimes  acute— pain;  and  is 
followed  by  increase  of  size,  from  the  formation  of  new  bone  around 
the  old,  — the  old  being  gradually  broken  into  pieces,  and  discharged 
through  external  openings. 

Treatment.  —  Poultices  and  quieting  fomentations.  Resort  will 
generally  be  made  to  surgery. 

Unnatural  Growth  of  Bones.  —  Exostosis. 

This  disease  consists  either  of  a  tumor  of  a  bony  nature,  growing 
upon  and  arising  from  a  bone,  or  an  enlargement  of  a  bone.  It 
springs  from  the  periosteum,  or  from  the  surface  of  a  bone,  or  from 
its  spongy  texture.  The  enlargement  or  the  tumor  may  be  white 
and  hard,  like  ivory,  or  dark-colored  and  spongy,  or  a  mixture  of  the 

two.  ,   ,     .  , 

At  first,  a  tumor  of  this  kind  is  not  attended  with  pain  or  incon- 
venience. It  comes  on  slowly,  and  sometimes  remains  nearly  sta- 
tionary for  several  years. 

Treatment.  —  If  the  tumor  be  large  and  inconvenient,  remove  it 
with  the  knife.  If  not,  use  local  pressure  with  pads  and  bandages; 
also  leech,  blister,  and  restrict  the  patient  to  a  spare  diet. 


■ftm^ 


SURGICAL   DISEASES. 


571 


rves ;  and  as  they 
become  diseased 


Diseases  of  the  Joints. 

Some  of  these  diseases  begin  in  the  cartilages,  some  in  the  synovial 
membrane,  and  others  in  the  heads  of  the  bones. 


anes. 

ent  inflammation, 
ation ;  or,  having 
ntire  disorganiza- 
3  of  the  country, 
he  result  of  poor 
[lie,  constitutional 


in  a  state  of  abso- 
usual  means.  If 
remedies  for  those 


osis. 

3curs  from  injuries 

ite — pain;  and  is 

new  bone  around 

es,  and  discharged 

ions.     Resort  will 


Exostosis. 

ly  nature,  growing 
mt  of  a  bone.  It 
>f  a  bone,  or  from 
mor  may  be  white 
>r  a  mixture  of  the 

ith  pain  or  incon- 
emains  nearly  sta- 


Lvenient,  remove  it 
ids  and  bandages; 
ire  diet. 


Disease  of  the  Hip-Joint.  —  Coxalgia. 

This  generally  consists  in  inflammation  of  the  synovisil  membrane 
and  capsular  ligament  of  the  hip-joint,  ending  frequently  in  ulceration 
and  destruction  of  the  head  and  neck  of  the  thigh  bone. 

The  symptoms  are  fullness  in  the  groin ;  pain,  which  is  increased 
by  motion ;  aggnivated  when  the  limb  hangs  without  touching  the 
ground  ;  is  more  felt  in  the  knee  than  in  the  hip  itself ;  and  shoots 
down  along  the  inside  of  the  leg,  as  far  as  the  instep.  The  thigh 
inclines  forward,  and  the  limb  has  the  appearance  of  being  longer 
than  the  other,  —  though  in  the  latter  stages,  it  is  really  shorter. 

Treatment.  —  Before  suppuration  takes  place,  apply  leeches  and 
blisters,  and  enjoin  perfect  rest.  After  suppuration,  keep  the  patient 
upon  his  back,  on  a  mattress,  and  mould  to  the  parts  thick  paste- 
board splints,  with  pads,  and  give  tonics.  Keep  the  bowels  open  with 
senna  and  bicarbonate  of  potash,  and  rub  the  parts  with  iodide  of 
potassium  ointment,  or  with  preparations  (282),  (283),  (195).  The 
disease  being  scrofulous,  the  iodide  of  potassium  (140)  may  be  taken 
with  advantage  internally.  The  disease  occurs  for  the  most  part  in 
children.  They  should  be  put  on  a  long  splint  from  the  very  first 
and  the  joint  kept  immobilized. 

White  Swelling.— Synovial  Degenerations. 

There  are  several  diseases  of  the  knee-joint,  characterized  by  swell- 
ing and  white  color  from  tension  of  the  skin,  which  have  passed 
under  the  common  name  of  white-swelling.  The  diseases  are  not 
strictly  the  same,  but  as  they  all  affect  the  knee,  and  have  symptoms 
to  some  extent  in  common,  it  is  well  enough  to  group  them  under 
the  same  title, — especially  as  one  treatment  is  adapted  to  all. 

One  is  a  pulpy  disease  of  the  synovial  membrane.  It  begins  with 
a  trifling  stiffness,  and  a  slight  swelling.  The  swelling  increases  by 
degrees,  and  on  touching  the  part  there  is  a  sensation  as  if  it  con- 
tained fluid.  By  and  by  the  caitilages  ulcerate.  The  disease  is  in- 
curable, as  the  synovial  membrane  is  finally  converted  into  a  pulpy 
substance,  and  the  limb  has  to  be  amputated. 

Another  of  these  is  inflammation  of  the  synovial  membrane,  be- 
ginning with  ulceration  of  the  cartilages.  It  Ixigins  with  pain  in  the 
joint,  which  is  severe  at  one  point,  and  attains  its  height  in  a  week. 
In  a  day  or  two,  the  joint  is  swollen  from  a  collection  of  water. 

Treatment.— Splints  and  entire  rest)  as  in  all  chronic  diseases  of 


572 


SUUGICAL   DISEASKS. 


the  joints.  Also  a  generous  diet,  and  whatever  is  calculated  to  huild 
up  the  health.  For  the  tubercular  variety  an  injection  of  iodoform 
dissolved  in  glycerine  is  most  commonly  used. 


Bunions. 

This  is  an  inflammation,  enlargement,  and  hardening  on  the  inside 
of  the  ball  of  the  great  toe.  It  is  frequently  connected  with  a  distor- 
tion of  the  toe,  which  seems  partially  out  of  joint.  The  projection 
of  the  joint  exposes  it  to  great  irritation  from  the  shoe,  and  to  re- 
peated attacks  of  inflammation.     It  occasions  great  suffering. 

Treatment. — Remove  the  pressure  from  the  part,  and  when  there 
is  inflammation,  keep  the  foot  quiet  and  elevated  upon  a  chair,  apply- 
ing leeches,  poultices,  etc.     Another  method  is  to  cover  the  bunion 

with  soap-plaster,  spread  on 
thick,  soft  leather,  or,  put  the 
toe  in  a  separate  compartment 
of  the  stocking,  like  the  finger 
of  a  glove.  Then  enclose  it 
in  a  separate  part  of  the  shoe, 
which  is  contrived  by  fixing 
a  piece  of  firm  sole-leather  in  the  bottom  of  the  shoe,  so  as  to  make 
a  separate  compartment  for  the  toe.  By  this  means  the  pressure 
against  the  side  is  removed.  Sticking  plaster  may  be  spread  on 
wash-leather,  and  a  piece  cut  out  the  size  of  the  bunion.  This  will 
take  off  a  portion  of  the  pressure  of  the  shoe,  and  will  hasten  the 
cure. 

Fig.  174  represents  a  ganglion  or  tumor  formed  upon  the  syno- 
vial sheath  of  the  tendon  which  bends  the  finger. 


FlO.  174 


Whitlow.  —  Felon.— Paronychia. 

This  is  an  abscess  of  the  fingers,  of  which  there  are  three  kinds,— 
the  first  situated  upon  the  surface  of  the  skin,  the  secdnd  under  the 
skin,  the  third  within  the  sheath  which  contains  the  tendons  of  the 
fingers,  and  sometimes  involving  the  covering  of  the  bone. 

The  latter  form  of  the  disease  is  the  most  terrible,  and  begins  with 
redness,  swelling,  and  a  deep-«eated  and  throbbing  pain,  which  grad- 
ually becomes  so  excruciating  as  to  banish  all  sleep,,  and  nearly  drive 
the  patient  to  distraction.  Finally  matter  form>'  and  burrows  in  the 
deeper  parts  of  the  finger,  and  at  lengtli  fina  an  opening,  which 
brings  relief. 

Treatment.  —  Carry  the  hand  in  a  sling ;  apply  a  leech  or  two, 
and  use  poultices.  A  poultice  made  of  equal  parts  of  powdered  slip- 
pery-elm bark,  poke-root,  ground  flax-seed  aad  lobelia^eeds,  mixed 
with  hot  ley,  and  changed  twice  a  day,  is  an  admirable  application. 


iii^iasE, 


:iit:;;". 


fs'^&£ism:mi 


fi   lift 


iloulatecl  to  build 
bion  of  iodoform 


SURGICAL   DISEASES. 


573 


When  these  methods  fail  to  stop  the  progress  of  the  abscess,  the 
finger  should  be  laid  open  with  the  scalpel,  cutting  down  to  the  bone. 
This  will  give  vent  to  the  matter,  and  the  wound  may  be  dressed 
with  poultices,  until  the  inflammation  is  subdued,  and  the  healing 
process  is  well  established*  when  some  simple  salve  may  be  applied. 


ling  on  the  inside 
ted  with  a  distor- 
The  projection 
shoe,  and  to  re- 
suffering. 

t,  and  when  there 
ion  a  chair,  apply- 
cover  the  bunion 
aster,  spread  on 
ather,  or,  put  the 
rate  compartment 
ng,  like  the  finger 
Then  enclose  it 
I  part  of  the  shoe, 
atrived  by  fixing 
oe,  so  as  to  make 
lans  the  pressure 
ay  be  spread  on 
anion.  This  will 
i  will  hasten  the 

i  upon  the  syno- 


via. 

ire  three  kinds, — 
secdnd  under  the 
le  tendons  of  the 
le  bone. 

e,  and  begins  with 
pain,  which  grad- 
»,.and  nearly  drive 
id  burrows  in  the 
n  opening,  which 

y  a  leech  or  two, 
of  powdered  slip- 
belia-seeds,  mixed 
able  application. 


Stiff  Joint.  —  Anchylosis. 

Tras  is  of  two  kinds,  complete  and  incomplete, — complete  when  the 
bones  of  the  joint  have  become  firmly  united  by  bony  matter,  and 
incomplete  when  the  motions  of  the  joint  are  very  much  interrupted, 
hut  not  entirely  destroyed.  The  first  is  the  result  of  ulcerations  of 
the  cartilages  of  the  joints,  and  of  the  heads  of  the  bones  ;  the  latter, 
of  fractures,  sprains,  bruises,  thickening  of  the  synovial  membrane, 
and  weakening  of  the  muscles. 

Treatment. — No  treatment  is  of  much  use  in  the  first-named  form 
of  the  disease.  By  sawing  through  the  bone,  piid  then  daily  moving 
the  limb  back  and  forth,  a  false  joint  may  be  made,  but  it  is  apt  to 
grow  together  again,  and  finally  defeat  the  purpose  of  the  surgeon. 
When,  however,  stiffness  arises  from  the  weakening  of  the  muscles, 
and  some  other  causes  involving  the  ligaments  and  tendons,  something 
may  be  done  by  daily  frictions  with  stimulating  liniments,  champooing, 
and  warm  fomentations ;  and  by  gently  bending  the  joint  back  and 
forth,  several  times  every. day,  as  much  as  can  be  done  without  pain. 

Tumors. 

A  TUMOR  is  a  swelling  which  consists  of  a  new  production,  not 
constituting  any  portion  of  the  original  structure  of  the  body.  There 
are  several  kinds  of  tumors ;  but  it  is  sufficient  for  my  purpose  to 
follow  Mr.  Ferguson,  and  divide  them  into  the  malignant  and  non- 
malignant. 

Cancer. 

This  belongs  to  tl  -  class  of  malignant  tumors.  It  has  two  stages. 
The  first  is  that  oi  induration  or  seirrhus,  during  which  it  has, 
under  the  finger,  the  feeling  of  stony  hardness.  The  second  stage  is 
that  of  ulceration  or  open  cancer. 

Cancer  most  often  attacks  the  female  breast,  tlie  skin,  the  mucous 
membranes,  the  tongue,  the  stomach,  the  neck  of  the  womb,  the  lips, 
etc.  It  rarely  occui-s  in  subjects  under  thirty  years  of  age,  and  not 
often  in  persons  under  forty-five. 

The  Symptoms  of  Cancer,  when  it  appeai-s  in  the  breast,  are,  a  " 
puckered  condition,  and  dull,  leaden  color  of  the  skin ;  a  hard,  knotty, 
and  uneven  feel ;  and  occasionally  sharp  pains.     When  it  attacks 
the  skin  and  mucous  membranes,  there  is  a  hard,  warty  lump,  which 


674 


SURGICAL   DISKASE8. 


ulcerates,  after  a  time,  producing  an  open  sore,  with  a  hard  base. 

(Fig.  175.) 

The  sore  of  a  cancer  discharges  an 
irritating,  excoriating  matter,  which  has 
a  peculiarly  fetid  odor,  so  offensive  and 
so  different  from  any  other  smell,  that  it 
is  seldom  forgotten.  The  bones  of  a 
cancerous  person  break  with  great  ea«i!. 
Unmarried  females  are  much  more  liable 
to  the  disease  than  the  married.  Tlie 
cancerous  growth  is  composed,  in  part, 
of  cells,  rounded  or  caudate,  containing, 
as  seen  under  the  microscope,  nuclei, 
(Fig.  176.) 


FlO.  175. 


younger  cells,  and  granules. 


FIO.  178. 


FIO.  177. 


Fia.  V9. 


The  difference  between  these  cells  and  those  of  common  pu8-glol>- 
ules  may  be  seen  by  comparing  Fig.  176  with  177,  —  the  latter  being 
pus-corpuscles  highly  magnified  by  a  powerful  microscope.  Fig.  178 
represents  pus-globules  not  so  much  magnified. 

Treatment.  —  There  are  but  two  methods  of  treatment  which 
promise  any  success.  The  first  is  to  extirpate  the  tumor  by  a  surgical 
operation  before  the  disease  has  so  far  invaded  the  constitution  as  to 
be  sure  of  returning.  The  other  is  that  adopt'  I  by  Dr.  J.  W.  Fell, 
an  American  physician,  who  was  permitted  tu  try  his  remedies  in 
one  of  the  English  hospitals,  and  who  drew  from  the  surgeons  in 
,  charge  of  it  a  favorable  report  of  the  results. 

Dr.  Fell's  remedies  are  mainly  blood-root  and  chloride  of  zinc  (336) 
made  into  a  paste.  The  skin  over  the  tumor  is  first  destroyed,  and 
this  paste,  spread  upon  strips  of  linen,  is  applied.  This  causes  an 
eschar,  into  which  incisions  are  made,  half  an  inch  apart,  taking  care 
to  avoid  the  living  tissue.  The  same  paste  spread  in  a  like  manner 
is  then  daily  inserted  into  the  furrows.  By  tbis  means,  which  is 
original  with  Dr.  Fell,  the  effect  of  the  cans  to  penetrates  through 
all  parts  of  the  tumor,  causing  the  whole  diseiised  mass  to  fall  off, 
and  leave  a  healthy,  granulating  surface. 

In  incipient  cancer,  where  the  disease  has  not  made  much  progress, 


SURGICAL   DISEASES. 


575 


dth  a  hard  base. 

er  discharges  an 
natter,  which  has 
so  offensive  and 
ther  smell,  that  it 
The  bones  of  a 
;  with  great  ease. 
much  more  liable 
le  married.  The 
omposed,  in  part, 
udate,  containing, 
icroscope,   nuclei, 


no.  ITS. 

common  pus-glol)- 
,  —  the  latter  being 
uoscope.     Fig.  178 

f  treatment  which 
tumor  by  a  surgical 
e  constitution  as  to 
by  Dr.  J.  W.  Fell, 
try  his  remedies  in 
>m  the  surgeons  in 

iloride  of  zinc  (336) 
first  destroyed,  and 
d.  This  causes  an 
sh  apart,  taking  care 
id  in  a  like  manner 
Ills  means,  which  is 
penetrates  through 
id  mass  to  fall  oS, 

nade  much  progress, 


Dr.  Fell  uses  the  above,  which  he  calls  a  brown  ointment  (886),  and 
in  connection  with  it  an  ointment  of  the  iodide  of  lead  (337),  using 
each  twelve  hours.  With  these,  he  claims  that  he  cures  incipient 
cancers  with  great  readiness.  He  also  employs,  internally,  half-grain 
doses  of  pulverized'blood-root  (143),  with  arsenic  and  cicuta. 

Dr.  Fell  claims  that  with  these  preparations,  he  has  often  cured 
lupus,  and  has  been  very  successful  with  them  in  treating  indolent 
ulcers.  Of  late  a  new  treatment  has  sprung  up — namely,  the  injec- 
tion of  anti-cancer  serum,  but  as  yet  a  definite  opinion  cannot  be 
given  as  to  its  results. 

Soft  Cancer.  —  Bleeding  Cancer. 

Medullary  Cancer. — Encephaloid  Tumor. — Fungus  Hematodes. 

This  varies  in  size  from  that  of  a  nutmeg  to  a  child's  head.  Its 
color  varies  from  white  to  deep  red.  At  times  it  is  soft  and  elastic  at 
first ;  at  other  times,  it  is  firm  and  tense.  The  patient  is  wan  and 
pale  from  the  beginning.  The  parts  do  not  ulcerate,  as  in  scirrhus ; 
but  after  the  skin  is  broken,  a  spongy,  bleeding  tumor  protrudes. 

Treatment.  —  Dr.  Fell's  method. 


)  f 


Black  Cancer. — Melanosis. 

This  is  an  organic  disease,  in  which  the  tissue  of  the  disordered 
part  is  converted  into  a  black,  hard  substance,  which  is  converted 
into  ulcerous  cavities.  This  often  appears  in  the  lungs,  and  is  met 
with  in  the  liver  and  other  parts. 

Its  symptoms  are,  a  sallow  complexion,  great  debility,  and  dropsi- 
cal swelling  of  the  limbs  before  the  termination. 

Treatment.  —  When  it  appears  externally,  Dr.  Fell's  treatment  is 
worth  a  trial.  When  in  the  lungs,  the  inhalation  of  tincture  of  blood- 
root  and  solution  of  chloride  of  soda  (241)  should  be  used.  Two 
teaspoonfuls  may  be  put  in  a  Vapor  Inhaler, — the  instrument  being 
filled  half  full  of  hot  water,  —  and  inhaled  ten  minutes,  three  times 
a  day;  the  blood-root  pills  (143)  being  taken  at  the  same  time. 

Fatty  Tumor.  —  Adipous  Sarcoma. 

This  is  the  most  common  of  all  the  forms  of  tumor.  These  bodies 
generally  have  a  soft  and  doughy  feel,  or  as  if  filled  with  wool. 
They  are  the  least  inclined  to  become  malignant,  and  consequently 
the  least  dangerous,  of  all  the  tumors.  Whatever  pain  there  is,  is 
caused  by  their  size,  weight,  and  pressure.  They  are  occasionally 
found  a  little  below  the  point  of  the  shoulder,  in  the  deltoid  muscle 
of  females,  and  are  caused  by  the  unreasonable  pressure  of  the  dress 
at  that  point.  -  ' 


576 


BTTROICAL  DISEASES. 


Trsatment.  —  They  should  be  removed  by  an  operation,  wliicli  is 
easily  performed,  as  they  separate  very  readily  from  surrouuding 
parts. 

Polypus. 

The  polypi  constitute  a  cl^s  of  tumors  growing  from  mucous 
membranes.  They  are  of  two  kinds,  —  the  toft,  jellyAike  polyjjus, 
and  Hiejlesht/  ox  fibrous  polypus. 

The  Soft  Polypus,  which  grows  from  the  nose,  has  not  mucli  feel- 
ing, and  is  not  particularly  disposed  to  bleed. 

The  Fleshy  Polypus  is  firmer  and  harder  than  the  preceding,  and 
most  generally  connects  itself  with  tlie  womb. 

Treatment.  —  Both  kinds  of  polypi  are  either  twisted  off  with  a 
pair  of  forceps,  or  strangled  by  puti'ng  a  string,  called  a  ligature, 
around  their  neck,  which  will  cause  them  to  fall  off  in  a  short  time. 


Piles,  —  Hemorrhoids, 

Thesb  venous  swellings  often  cause  so  much  pain  and  trouble,  are 
so  often  chronic  and  unyielding  to  medical  treatment,  that  surgical 
interference  becomes  now  and  then  a  necessity.  The  operation  for 
their  relief  and  cure  is  an  extremely  common  one,  and  nowadays  is 
limited  to  a  very  few  different  methods. 

The  carbolio  acid  treatment  which  has  found  favor  with  many 
consists  in  the  injection  into  the  pile  of  a  small  amount  of  carbolic 
acid  dissolved  in  glycerine  or  water.  The  process  is  simple  and 
almost  painless,  especially  if  done  after  numbing  the  parts  with  a  three 
per  cent  cocaine  solution.  The  carbolic  coagulates  the  blood  and  al- 
bumen of  the  tissues  and  causes  a  death  of  the  parts  with  a  subsequent 
sloughing  and  puckering.  The  advantage  of  this  procedure  lies  in 
the  ability  of  the  patient  to  be  up  and  about.  The  danger  lies  in 
the  risk  of  setting  free  a  clot  in  the  circulation,  causing  most  serious 
consequences  and  even  death.  It  should  be  used  only  in  selected 
cases  and  then  not  too  freely. 

A  second  method,  and  by  far  the  oldest,  is  to  encircle  the  pile  with 
a  ligature  and  allow  it  to  eat  through,  thus  destroying  the  pile  and 
causing  it  to  heal  behind  the  ligatures.  This  method  is  painful,  re- 
quires ether  and  necessitates  rest  in  bed.  A  third  way  is  to  burr. 
off  the  pile  by  means  of  a  cavtery  and  clamp.  It  is  far  preferable  to 
the  ligature,  requiring  but  a  few  days'  stay  in  bed,  and  is  less  painful. 
A  fourth,  and  the  most  scientific  method,  is  one  just  coming  into 
prominence,  and  consists  in  distecting  out  the  pile  area  and  sewing  the 
flaps  of  mucous  membrane  and  skin  together. 

Numerous  washes,  ointments,  and  lotions  have  been  used  to  tem- 
porize, but  the  only  sure  and  thorough  way  to  treat  obstinate  piles 
which  remain  after  continued  and  unsuccessful  attempts  to  remove 


SURGICAL   DISEASES. 


577 


operation,  wliicli  is 
from  BurrouucLug 


iwing  from  mucous 
1{,  jelly-like  polji)us, 

I,  has  not  much  feel- 

1  the  preceding,  and 

r  twisted  off  with  a 

g,  called  a  ligature, 

off  in  a  short  time. 


pain  and  trouble,  are 

itment,  that  surgical 

The  operation  for 

ne,  and  nowadays  is 

• 

id  favor  with  many 
I  amount  of  carbolic 
:ocess  is  simple  and 
the  parts  with  a  three 
ites  the  blood  and  al- 
i,rts  with  a  subsequent 
his  procedure  lies  in 
The  danger  lies  in 
causing  most  serious 
used  oiSy  in  selected 

encircle  the  pile  with 
jtroying  the  pile  and 
nethod  is  painful,  re- 
third  way  is  to  burr. 
It  is  far  preferable  to 
led,  and  is  less  painful, 
one  just  coming  into 
le  area  and  sewing  the 

ve  been  used  to  tern- 
)  treat  obstinate  piles 
il  attempts  to  remove 


i\w,  original  cause,  is  to  remove  them  once  for  all.  The  following 
salve  will  be  found  useful:  cocaine,  eight  grains;  gall  ointment, 
half  an  ounce  ;  mix.  Smear  well  over  the  jules  i.nd  then  push  them  up 
into  the  bowel.  Piles  should  always  l)e  returned  into  the  bowel 
when  po.s8ible  ;  this  of  itself,  when  practicable,  oftentinies  constitutes 
a  cure. 

Whenever  a  small,  round,  hard  pile  is  seen  on  the  outside  and  is 
very  painful,  it  shouhl  be  incised,  after  numbing  with  a  cocaine  so- 
lution, and  the  clot  turned  out.  This  simple  and  painless  procedure 
works  gieat  relief  and  often  a  cure. 

The  bowels  are  to  l)e  kept  open  daily  by  a  solution  of  tlie  citrate 
of  magnesia  (one-half  bottle^  which  keeps  the  bowels  loose  and 
causes  no  pain  in  defecation. 

Wens.  —  Encysted  Tumors. 

The  most  common  situation  of  these  is  under  the  skin  of  the  head. 
A  wen  is  simply  a  sac  full  of  various  mattei-s,  which,  when  examined 
with  a  microscope,  are  found  to  be  oil-globules,  epithelial  cells,  and 
crystals  of  stearine.  These  contents  are  secreted  by  the  internal 
surface  of  the  sac.  They  sometimes  look  like  curd  or  riQe,  sometimes 
like  suet,  and  sometimes  like  honey.  In  other  instances,  they  are 
mere  water,  and  they  have  been  known  to  consist  of  hair  or  horn. 
Those  tumors  are  round,  elastic,  and  movable,  and  are  without  pain. 
They  grow  slowly,  but  steadily. 

Treatment.  —  The  attempt  to  excite  inflammation  and  conse- 
quently absorption,  by  punctures,  setons,  or  injections,  are  danger- 
ous, and  ought  not  to  be  resorted  to.  If  the  tumor  is  small,  its 
opening,  indicated  by  a  small  black  spot,  may  be  found,  a  probe  be 
introduced  into  it,  and  the  contents  of  the  sac  be  squeezed  out ;  and 
this  may  be  repeated  as  often  as  necessary.  But  the  proper  and  only 
real  remedy  for  these  tumors  is  their  removal  by  a  surgical  operation, 
which,  under  aseptic  rules,  is  painless,  easy  and  sure. 


Fia.  179. 


Aneurisms. 

An  aneurism  is  a  tumor  formed  by  arterial  blood,  and  communi- 
cating with  an  artery.     A  true  aneurism  is  formed  by  the  coats  of  aa 


-■•jf" 


678 


SURGICAL  DI8RA8E8. 


artery  getting  weakened  by  some  cause,  and  swelling  out  so  a«  to 
form  a  pouch  or  sac.  (Fig.  179.)  There  are  o^her  kinds  of  aneu- 
risms, which  need  not  be  described. 

Symptoms.  —  An  aneurism  may  be  felt  as  a  tumor  somewlicre 
along  the  coui-He  of  an  artery,  and  it  beats  under  the  tiiiger  liku  tlie 
pulse.  The  beating  is  caused  by  a  fresh  quantity  of  blood  Ix-iiip 
{)Ushed  into  this  sac  with  every  stroke  of  the  heart.  If  it  Ihj  Hniull, 
I)res8ure  on  the  artery  alx)ve  it  will  so  far  shut  off  the  blood  from  it, 
that  it  will  feel  flaccid  or  soft.  The  patient  will  often  say  that  the 
tumor  began  to  appear  after  some  violent  strain,  when  something 
appeared  to  give  way.  In  the  chest,  aneurism  will  produce  an  un- 
natural pulsation  felt  by  the  patient.  In  the  belly,  it  may  generally 
be  felt  as  a  tumor  through  the  abdominal  walls. 

Distinction.  —  Tumors  which  lie  directly  over  arteries  are  lifted 
up  every  time  the  blood  is  driven  along  under  them,  and  hence  they 
pulsate  like  aneurisms ;  but  they  do  not  pulsate  when  small,  whereiiH 
aneurisms  do  from  the  begiiming  of  their  growth.  Aneurisms  are 
soft  at  first,  and  hard  afterwards;  whereas  tumors  are  generally  hard 
at  first,  and  finally  soft. 

Treatment.  —  In  some  few  fortunate  csvses,  aneurisms  get  well 
spontaneously.  If  the  flow  of  blood  through  them  can  be  stopped,  tlmt 
which  is  within  them  will  coagulate,  forming  a  hard  tumor,  wl;icli 
will  gradually  waste  away.  To  cure  them,  therefore,  we  must  stop 
the  circulation  through  them ;  and  this  may  be  done,  in  some  cases, 
by  compression.  The  pressure  upon  the  arteiy  must  of  course  he 
above  the  tumor,  and  should  not  be  so  great  as  to  stop  the  blood 
altogether,  but  only  very  materially  to  diminish  its  flow.  The  pres- 
sure is  applied  by  an  instrument  having  two  pads,  an  arc  of  steel,  a 
joint  in  the  middle,  and  a  screw  by  which  the  padded  extremities  are 
pressed  together.     (Fig.  180.) 

When  this  mode  of  treatment  is  not  practicable,  the  artery  must 
be  tied  between  the  aneurism  and  the  heart.  The  patient  should  be 
placed  in  bed,  with  the  limb  wrapped  up  to  preserve  its  temperature, 
and  placed  in  an  easy  position.    Nothing  cold  should  be  applied  to  it. 

The  force  of  the  circulation  should  be  reduced  by  the  tincture  of 
veratrum.     ,-  ,  ..      i. 

Bronchocele.  —  Derbyshire  Neck.  —  Goitre. 

Bronchocele  is  what  is  called  an  endemic  disease ;  which  means, 
a  disease  which  prevails  in  certain  localities.  This  complaint  is  preva- 
lent in  Nottingham  and  Derbyshire.  England,  among  the  Alps,  and 
especially  in  the  Tyrol  and  valley  of  the  Rhone.  It  is  thought  to  be 
produced  by  the  use  of  melted  snow,  and  water  impregnated  with 
lime  and  earthy  matter.  , 

•    Symptoms.  —  A  prominent,  soft,  elastic  tumor,  occupying  the  front 


SUKOICAL  DI8KA8K8. 


579 


ling  out  8o  as  to 
er  kindB  o£  uneu- 


tumor  somewliere 
he  finger  like  the 
ty  of  blood  k'ing 
t.  If  it  Ik)  Hniivll, 
the  blood  from  it, 
often  say  that  the 
1,  when  sometliing 
11  produce  an  un- 
>r,  it  may  generally 

arteries  are  lifted 

m,  and  hence  they 

hen  8malU  whereas 

ti.     Aneurisms  are 

are  generally  hard 

ineurisms  get  well 
can  be  stopped,  that 
hard  tumor,  which 
fore,  we  must  stop 
one,  in  some  cases, 
must  of  coui-se  be 
to  stop  the  blood 
its  flow.  The  pres- 
9,  an  arc  of  steel,  a 
Ided  extremities  are 

ble,  the  artery  nnist 
le  patient  should  be 
irve  its  temperature, 
uld  be  applied  to  it. 
i  by  the  tincture  of 

k.  —  Goitre. 

sease ;  which  means, 
3  complaint  is  preva- 
mong  the  Alps,  and 
It  is  thought  to  be 
jr  impregixated  with 

•,  occupying  the  front 


of  the  throAt,  in  the  situation  of  the  thyroi<l  gland,  and  like  it  in  shape. 
It  is  not  tender,  and  the  skin  is  not  discolored.  In  old  cases,  the 
tumor  Incomes  hard.  In  Fig.  181  the  tumor  is  so  large  as  to  have 
pushed  the  gullet  to  one  side. 


FIO.  IHO. 


Treatment. — The  usual  and  perhaps  the  best  remedy  for  this  dis- 
ease is  iodine.  It  may  be  given  m  iodide  of  potassium,  with  a  bitter 
or  some  other  article  (188),  (145),  (101).  An  iodine  ointment  may 
l)e  applied  to  the  tumor  (185). 

'Jlie  patient  should  move  away  from  the  infected  district,  and  re- 
side, if  possible,  upon  the  sea-coast. 

Water  in  the  Scrotum.  —  Hydrocele. 

As  the  name  shows,  this  is  a  collection  of  water  in  the  scrotum  or 
bag  which  holds  the  testicles. 

Symptoms.  —  It  presents  a  swelling,  shaped  like  a  pear,  smooth 
on  its  surface,  fluctuating  if  pressed,  without  pain,  but  causing  a  little 
uneasiness  by  its  weight.  On  placing  a  lighted  candle  on  one  side 
of  the  scrotum,  the  light  may  be  seen  through  it. 

Distinction.  —  This  complaint  may  be  distinguished  from  a  solid 
enlargement  of  the  testicle  by  its  not  being  so  heavy,  solid,  or  pain- 
ful, and  by  its  fluctuating  and  being  transparent ;  from  lupture,  by 
its  forming  slowly  instead  of  suddenly,  by  the  swelling  beginning  at 
the  lower  part  of  the  scrotum  instead  of  the  upper,  and  by  the  en- 
largement not  being  increased  by  coughing  as  it  is  in  rupture. 

Treatment. — In  children,  strong  scattering  washes  (353)  are  some- 
times successful.  But  most  commonly  a  number  of  punctures  are 
made  with  a  larffe  needle,  to  cause  :\e  fluid  to  escape  into  the  cull 
tissue  of  the  scrotum,  whence  it  is  removed  by  absorption. 

To  effect  a  radical  cure  in  grown  persons,  the  surgeon  is  to  grasp 


B80 


BUItnlCAL  DISEASRS. 


the  tumor  Iw-hiiid,  iiiid  introduoe  iv  trorur  iind  canula  into  tlio  hiio, — 
iMtiii^  riiritful  to  [toiiit  tlic  iiiHti'iiiiutiit  iiitWiudH,  so  uh  not  to  wniiiiil 
tin;  tt!Hti(do.  Tlu!  trowir  is  tlnMi  withdnuvii, —  lliu  (suiulii  hriii;,'  al 
tliu  Hiinit!  tiniu  ptiHlicHt  veil  into  tliu  auc,  ho  that  nonu  of  tlio  tlnid  may 
get  into  tlie  cell-tisHUo  outside  the  «ac.  Tlic  lluid  runs  oil'  linnii^li 
tlu!  (;auul<i.  When  this  Iihh  nil  cHuaped,  Home  Htiiiudiitiii^r  tluid,  -i^ 
conunou  liuie-water,  or,  still  l)elti;r,  tincture  of  iodine,  is  to  In*  injirUd 
through  tlie  'lanula  into  the  emptied  sac.  After  retaining  tliis  fidiii 
two  to  (ive  minutes,  it  is  permitted  to  flow  out.  In'Hiimmaliou  I'ol- 
lows,  wiiieh  breaks  up  the  secretion  of  water,  and  etTectM  a  cure  in 
two  or  three  weeks.  The  amount  of  fluid  thrown  in  should  he  aliout 
one  or  two  teaspoonfulsof  a  mixture  of  one  part  of  tini^ture  of  iodine 
and  two  j)artfl  of  water.  If  tim  lirst  operation  does  not  efTeet  a  com- 
pleto  cure,  it  may  be  repeated.  The  most  successful  of  all  troatinentH, 
however,  is  to  open  the  scrotum  and  disstict  out  the  greater  i)ait  of 
the  tiasue  which  coverti  the  teatidu  uud  which  seuruteu  the  fluid. 

Blood  In  the  Scrotum.  —  Ilaematorele. 

This  is  a  collection  of  blood  in  the  scrotum,  from  some  injury. 

Treatment.  —  If  the  quantity  of  blood  effused  be  small,  cold  \\\y 
plications  may  cause  it  to  be  ab8orl)ed.  If  it  be  large,  make  a  punc- 
ture, and  apply  a  poultice  for  the  blood  to  ooze  into. 


Acute  Inflammation  of  Veins.  —  Phlebitis. 

The  veins  are  subject  to  attacks  of  acute  inflammation,  which  con- 
stitutes a  very  dangerous,  and  often  fattvl,  disejise. 

Symptoms.  —  F'its  of  shivering,  or  perhaps  fainting,  a  rapid  pulse, 
anxiety  of  countenance,  lowness  of  spirits,  catching  (lains  about  tiie 
heart,  and  xivelUng,  redness,  tenderness  and  hardness  along  the  course  of 
the  affected  veins.  Sometimes  the  tongue  is  furred  brown  or  black, 
the  skin  is  sallow,  there  is  bilious  vomiting,  low  delirium,  and  death. 
In  ciises  less  rapid,  there  are  great  swelling  and  redness  over  the  dis- 
eivsed  veins,  and  abscesses  form,  which,  when  opened,  reveal  clots  of 
blood  mixed  with  pus.  Or,  the  patient,  while  remaining  low,  with  a 
sallow  countenance,  and  a  yellow  tongue,  will  complain  suddeulv  of 
intense  pain  in  some  joint,  as  the  knee  or  shoulder,  —  in  which  tliere 
will  be  a  rapid  formation  of  pus  ;  a  similar  suppumtion  will  follow 
in  other  joints,  as  well  as  in  the  lungs,  etc.,  unt"  the  patient  sinks, 
and  dies  of  exhaustion. 

Treatment.  —  Apply  leeches  freely  over  the  inflamed  veins,  —  also 
fomentations.  Every  abscess  should  be  opened  early.  Keep  the 
bowels  moderately  open  with  some  preparation  of  salts,  and  allay 
pain  and  restlessness  by  morphia.  Support  the  strength  by  beef-tea, 
etc. ;  and,  if  the  pulse  be  feeble,  give  wine  or  quinine. 


8UKU1UAL  OmKAHKS. 


581 


la  into  tlm  n;xt\  — 
as  not  to  Wdiiiiil 
I)  ciiiiulii  Ix^iii;,'  iit 
II!  of  tlio  lliiiil  may 
niiiH  olT  tliniii^li 
inuilatiii^r  tliiid,  iw 
le,  iH  to  lit!  injfi  ti'd 
b'taiiiint^  tliis  fnun 
liitlaiMinatioii  I'ol- 
effecUK  n  cuin  in 
in  should  he  ahout 
f  tinctun'  of  iodine 
!H  not  effect  a  coiii- 
il  of  all  troatnitMiK 
he  j^ieater  part  uf 
ruteu  the  fluid. 

latorele, 

)m  some  injury. 

1  he  small,  eold  a]> 
aige,  make  a  puuc- 
tto. 

-  Phlebitis. 
imation,  which  con- 

iting,  a  rapid  pidse, 
\g  pains  ahout  the 
«  along  the  course  of 
3d  brown  or  hlack, 
lelirium,  and  death. 
ednesa  over  the  dis- 
ned,  reveal  clots  of 
naining  low,  with  a 
raplain  suddeidv  of 
■r,  —  in  which  there 
>ui-ation  will  follow 
'  the  patient  sinks, 

flamed  veins,  —  also 
I  early.  Keep  the 
of  salts,  and  allay 
itrength  by  beef-tea, 
iuine. 


The  suppuration  may  ho  (dieoked,  in  thi«  as  in  other  complaints, 

liy  drinking  freely  of  chamomile  tea.     The  power  to  control  suppum- 

ion  haa  recently  txjfn  discovered  as  belonging  to  chamomile  flowers. 

Chronic  Phlebitis. 

This  is  a  far  less  serious  disease  than  the  preceding.  It  generally 
aft'ects  the  veins  of  the  legs. 

Symptoms.  —  Tenderness  and  hardness  of  the  affected  vein,  with 

swelling  around  it,  and  of  the  part*  IhjIow;  a  general  painfulness  of 

he  limb.     After  tlie  inflammation  has  sulwided,  the  vein  feels  hard, 

like  a  cord,  because  the  inflammation  causes  the  blood  within  to  co- 

acrulate,  and  harden,  so  that  notliing  can  pass  through  the  vessel. 

Treatment.  —  Leeches,  fomentations  or  cold  lotions,  as  the  patient 
may  choose,  purgatives  and  rest,  with  the  limb  elevated.  Subse- 
quently, when  the  inflammation  seems  completely  subdued,  friotiou 
with  camphorated  oil  and  bandages. 

Enlarged  or  Varicose  Veh^s. —  Varix. 

The  veins  which  lie  near  the  surface,  especially  those  of  the  legs, 
are  apt,  by  exhausting  labor  upon  the  feet,  and  by  strains,  to  get 
weakened,  so  that  their  valves  lose  their  tone,  and  the  r  sides  stretch 
and  give  way  in  certain  places,  letting  the  blood  bulge  out,  and  form 
purple  bunches.  These  bags  of  blood,  lying  along  upon  the  surface 
of  the  limb,  form  knotty  tumors,  looking  like  blood-boils.  They  oc- 
casion a  kind  of  distress,  but  no  sharp  pain. 

Persons  of  weak,  soft  and  relaxed  muscles  and  blood-vessels  are 
particularly  liable  to  this  complaint.  It  often  attacks  women  in  the 
family  way. 

Treatment.  —  Where  only  a  few  veins  are  affected,  it  may  be 
sufficient,  in  some  cases,  to  apply  firmly  over  them  a  few  strips  of 
leather,  spread  with  soap-plaster.  But  generally  it  is  better  to  sup- 
port the  whole  limb  with  a  good  woolen  bandage,  or  with  a  laced 
stocking,  which  should  be  applied  in  the  morning  before  the  patient 
is  up.  It  is  generally  well,  also,  to  use  friction,  with  some  liniment, 
or  iodine  ointment.  Lead-water,  or  alum-water,  or  an  infusion  of 
white-oak  bark,  may  be  used  with  advantage.  Burdock  and  plantain 
leaves,  bound  upon  the  skin,  and  removed  before  they  are  dry,  are 
useful.  Showering  with  cold  water  strengthens  the  veins.  An  elas- 
tic silk  stocking  made  for  the  limb  is  the  best  general  measure. 

Rupture.  —  Hernia. 

Hernia  signifies  a  protrusion  of  any  internal  organ  from  the  cavity 
where  it  belongs  ;  but  the  term  is  generally  restricted  so  as  to  mean 
no  more  than  a  protrusion  of  the  bowel  through  the  walla  of  the  belly. 


ji 


582 


SURGICAL   DISEASES. 


When  the  abdominal  walls  are  weak,  from  any  cause,  no  matter 
what,  —  lifting,  straining,  or  making  violent  muscular  exertion  of  any 
kind,  will  then  often  cause  the  bowel  to  force  itself  through  at  the 
most  debilitated  spot ;  and  pushing  the  lining  of  the  belly,  the  peri- 
toneum, along  before  it,  a  bag  or  sac  is  formed,  in  which  the  project- 
ing bowel  is  enclosed,  forming  an  external  tumor. 

Divisions  of  Hernia.  —  Rupture  may  occur  in  several  different 
places,  and  has  accordingly  received  different  names. 

Umbilicai  Hernia  is  a  protrusion  of  the  bowel  at  the  umbilicus  or 
navel.  This  is  most  common  in  children  soon  after  birth;  and 
women  who  are  often  pregnant  are  liable  to  it. 

Ventral  Hernia  is  that  which  occurs  at  any  part  of  the  belly  where 
other  forms  of  rupture  do  not  appear. 

Inguinal  Hernia  is  that  in  which  the  bowel  protrudes  at  the  groins, 
or  through  the  abdominal  rings. 

Scrotal  Hernia  is  that  in  which  the  bowel  descends  into  the  bag 
or  scrotum. 

Femoral  Hernia  is  the  dropping  down  of  the  bowel  behind  what 
is  called  Poupart's  ligament,  and  appearing  as  a  tumor  at  the  upper 
part  of  the  thigh. 

Reducible  Hernia.  —  Rupture  is  said  to  be  rediieible,  when  the 
bowel  may  be  put  back  into  the  cavity  from  which  it  came. 

Irreducible  Hernia.  —  Hernia  is  called  irreducibh  .vhen  the  pro- 
truding bowel  cannot  be  returned  into  the  belly. 

Strangulated  Hernia  is  that  form  of  the  complaint  in  which  the 
bowel  is  so  pressed  upon  at  the  point  where  it  passes  through  the 
walls  of  the  belly  that  it  is  strangled  or  constricted  so  that  its  contents 
cannot  pass  through.   ■    .  -  .  %     ., 

Symptoms  of  Hernia.  —  A  soft  tumor,  which  may  be  compressed, 
appears  somewhere  about  the  belly ;  and  is  increased  in  size  when 
the  patient  stands  up.  It  also  swells  when  he  coughs,  or  makes  any 
exertion;  and  grows  smaller,  or  entirely  disappears,  when  he  lies 
down. 

Treatment.  —  In  a  case  of  reducible  hernia,  the  first  thing  to  be 
done  is  to  put  the  bowel  back  in  its  place,  which  is  accorapUshed  by 
gently  pressing  and  kneading  the  tumor;  and  swaying  it  back  and 
forth,  —  b'^ing  careful  to  use  no  violence,  —  until  it  can  be  pushed 
within  the  abdominal  walls.  It  is  then  to  be  kept  in  its  place  by  the 
use  of  a  truss,  made  expressly  to  fit  the  case.  This  instrument  should 
be  constantly  worn  by  day,  and  by  night,  too,  if  not  too  irksome ;  but 
if  worn  by  day  only,  it  should  always  be  applied  before  rising  in  the 
morning. 


SURGICAL   DISEASES. 


583 


jT  cause,  no  matter 
liar  exertion  of  any 
slf  through  at  the 
the  belly,  the  peri- 
which  the  projectr 

n  several  different 
les. 

at  the  umbilicus  or 
1  after  birth;    and 

t  of  the  belly  where 

trudes  at  the  groins, 

jcends  into  the  bag 

bowel  behind  what 
tumor  at  the  upper 

redrmhle,  when  the 

ch  it  came. 

leihU  A^hen  the  pro- 

aplaint  in  which  the 

passes  through  the 

I  so  that  its  contents 

.  may  be  compressed, 
greased  in  size  when 
oughs,  or  makes  any 
►pears,  when  he  lies 

he  first  thing  to  be 
1  is  accomplished  by 
waying  it  back  and 
bil  it  can  be  pushed 
pt  in  its  place  by  the 
is  instrument  should 
not  too  irksome ;  but 
I  before  rising  in  the 


Irreducible  Hernia  may  be  palliated  by  wearing  a  truss  with  a  hol- 
low pad,  whicli  will  so  evenly  and  firmly  embrace  the  tumor  as  neither 
to  irritate  it,  nor  permit  any  further  protrusion  or  enlargement. 

Stranguiated  Hernia.  —  If  a  person  has  worn  a  truss  for  some 
time,  and  suddenly  leaving  it  off,  makes  some  violent  exertion,  either 
the  bowel  or  omentum  is  liable  to  be  suddenly  forced  through  a  nar- 
row aperture,  and  to  become  strangled.  In  such  case,  the  patient 
has  flatulence,  colicky  pains,  a  sense  of  tightness  across  the  belly,  and 
a  desire  to  go  to  stool,  but  no  ability  to  pass  anything.  Then  follows 
vomiting,  first  the  contents  of  the  stomach,  then  mucus  and  bile, 
and,  lastly,  the  fecal  matters  from  the  bowels,  which  are  not  per- 
mitted to  pass  on  to  their  natural  outlet.  The  neck  of  the  hernial 
sac  now  becomes  swelled,  tender  and  pain  ' ,  the  countenance  is  anx- 
ious, and  the  pulse  small,  hard  and  wiry ;  and,  after  a  time,  the  tu- 
mor begins  to  mortify,  the  patient  expresses  himself  free  from  all 
pain,  and  soon  after  dies. 

In  the  treatment,  the  bowel  is  to  be  returned  if  possible,  lo  do 
this,  the  bladder  should  fii-st  be  emptied  with  a  catheter,  and  the 
patient  should  lie  down  with  his  shouldei-s  raised,  and  both  his  thighs 
bent  towards  the  belly,  and  placed  close  to  each  other,  so  as  to  relax 
all  the  ligaments  and  muscles  of  the  '  jUy.  The  surgeon  may  now 
work  gently  for  half  an  hour,  if  necessary,  trying  to  put  the  bowel 
back,  but  must  be  very  careful  not  to  excite  inflammation  by  any 
violence. 

If  he  does  not  succeed,  efforts  are  next  to  be  made  still  further  to 
relax  the  muscles,  as  well  as  to  reduce  the  force  of  the  heart's  action, 
and  to  diminish  the  size  of  the  tumor.  With  the  tincture  or  fluid 
extract  of  veratrum  viride,  the  heart's  action  and  force  of  the  circula- 
tion may  be  reduced  to  any  desirable  extent. 

To  reduce  the  tumor,  apply  pounded  ice  in  a  bag,  or  a  freezing 
mixture  (354.)  If  the  pain  be  acute  give  large  doses  of  opium  or 
morphia.     Ether  is  generally  required  to  reduce  a  hernia. 

If  all  these  remedies  fail,  there  is  then  no  hope  but  in  relieving  the 
stricture  by  a  surgical  operation,  which  must  not  be  deferred  too  long. 

General  DirectionA. —  Rupture  is  an  exceedingly  common  affec- 
tion. Perhaps  every  third  or  fourth  person  suffei-s  from  it  more  or 
less.  Females,  from  motives  of  delicacy,  are  apt  to  conceal  the  mis- 
fortune, and  not  seek  advice.  This  exposes  them  to  danger.  Queen 
Caroline,  wife  of  George  II,  lost  her  life  by  such  concealment. 

A  swelling  coming  on  suddenly  in  the  groin  cr  at  the  navel,  after 
considerable  exertion,  may  be  taken  to  be  a  rupture  without  nmch 
fear  of  mistake. 

The  complaint  being  discovered,  the  bowel  should  be  put  back  in 
its  place,  and  a  truss  be  put  on  at  once.  In  the  case  of  young  per- 
sons, a  truss  may  frequently  effect  a  cure ;  but,  that  it  may  do  this,  it 
should  not  be  taken  off,  night  or  day,  except  to  cleanse  it,  and  then 
only  when  the  — arer  is  in  bed. 


, 


584 


SURGICAL   DISEASES. 


Those  who  can  afford  it  should  have  two  trusses  of  the  same  size 
iuid  strength,  so  that  if  one  get  out  of  order,  the  other  may  take  its 
place  while  it  is  being  repaired ;  for  an  hour's  absence  of  the  truss 
might  occasion  a  mischief  which  it  would  require  months  to  repaii. 

Persons  having  a  rupture  must  be  very  careful  to  keep  costiveness 
at  a  distance ;  for  straining  at  stool  is  highly  injurious. 

Varicocele.  —  Cirsocele. 

This  is  an  enlargement  or  varicose  state  of  the  spermatic  veins 
and  may  be  mistaken  for  hernia,  inasmuch  as  standing  and  coughing 
increase  it.  But  it  feels  like  a  bag  of  worms  ;  and  by  this  peculiar- 
ity may  be  distinguished  from  rupture. 

Treatment.  — Wear  a  suspensory  bandage.  Have  an  operation 
done  if  this  fails  to  relieve.  i 

Deformities  and  Irritations  of  tlie  Spine. 

Lateral  Curvature.  —  There  are  several  varieties  of  curvature  of 
the  spine.  Some  of  them  are  caused  by  the  destruction  of  some  por- 
tion of  the  spinal  column  by  disease.  It  will  not  be  necessary  for  me 
to  treat  of  these  forms  of  curvature,  as  they  can  only  be  investigated 
and  treated  by  the  most  skilful  surgeons.  Those  who  will  use  this 
book  chiefly,  would  hardly  think  of  meddling  with  them. 

The  curvature  which  arises  from  debility  of  the  bones,  ligaments,, 
and  muscles,  and  which  is  very  common  among  females,  has  the  tol- 
lowing 

cymotoms.  —  At  first  there  is  a  projection  of  one  collar-bone,  or 
'    *^  one  side  of  the  chest,  or  one  shoulder  is 

considerably  el«^^ated,  and  is  popularly 
thought  to  be  y,omng  out"  On  exami- 
nation, the  right  shoulder  and  the  right 
side  of  the  chest  will  be  found,  generally, 
to  be  rounded  and  lifted  up,  while  the 
other  is  sank  down  p.nd  concave.  At  the 
same  tim-:,  the  left  'lip  sticks  out,  and  the 
loins  on  the  right  side  have  an  inward 
curve.  The  spinal  column  will  have  a 
curve,  as  in  Fig.  182. 

Causes.  —  This  affection  is  caused  by 
occupations  which  keep  the  body  in  a 
laterally  distorted  position,  and  tax  one 
bide  of  the  body  more  than  the  other. 
It  is  produced  in  children  who  study 
their  lessons  at  school  with  one  elbow 
resting  on  a  high  desk.  The  muscles, 
no.  182.  too,  get  so  weakened  in  many  females  of 


iw 


SURGICAL   DISEASES. 


685 


of  the  same  size 
;her  may  take  its 
ance  of  the  truss 
aonths  to  repair. 
)  keep  costiveiiess 

LOUS. 


,e  spermatic  veins 
ling  and  coughing 
I  by  this  pecuUar- 

lave  an  operation 


he  Spine. 

es  of  curvature  of 
iction  of  some  por- 
e  necessary  for  me 
ily  be  investigated 
J  who  will  use  this 
I  them. 

!  bones,  ligaments, 
males,  has  the  fol- 

one  collar-bone,  or 
)r  one  shoulder  is 
and  is  popularly 
out."  On  exami- 
der  and  the  right 
e  found,  generally, 
'ted  up,  while  the 
I  concave.  At  the 
sticks  out,  and  the 
e  have  an  inward 
)lumn  will  have  a 

ction  is  caused  by 
jp  the  body  in  a 
ition,  and  tax  one 
re  than  the  other, 
lildren  who  study 
)1  with  one  elbow 
isk.  The  muscles, 
n  many  females  of 


luxurious,  .sedentary  and  indolent  habits,  that  they  cannot  hold  tlie 
hoiiy  frame  of  the  body  in  an  upright  position,  and  (ho  jointed 
(•(liiiiiin  of  bones,  called  the  spine,  sags  down  to  one  .side,  iiiul"  draws 
tlic  whole  skeleton  of  the  trunk  out  of  shape. 

Treatment.  —  The  first  thing  to  be  done  is  to  learn  what  particu- 
lar attitude  of  the  body  has  occasioned  the  distortion.  This  discov- 
ered, every  possible  effort  is  to  be  niade  to  break  up  the  habit,  what- 
ever it  may  be.  If  it  be  standing  on  one  foot,  or  sleeping  on  one 
side,  or  reading  or  writing  with  the  elbow  high,  keep  a  constant 
watch  and  strict  rule  over  the  patient. 

Exercise  in  the  open  air  should  be  free,  and  taken  daily.  The  use 
of  the  dumb-bells  is  excellent  for  both  sexes  }■  but  girls  should,  in 
addition,  have  all  the  variety  of  elegant  exercise  furnished  by  calis- 
thenics. Wealthy  parents,  whose  daughtera  are  tenderly  bred,  should 
never  let  them  grow  up  without  the  invigoration  which  these  exer- 
cises impart. 

When  the  curvature  is  marked,  and  the  debility  considerable,  these 
vigoroiis  exercises  should  be  taken  for  a  time  with  moderation,  and 
the  patient  should  lie  down  and  rest  immediately  after  taking  them. 

In  many  cases  considerable  benefit  is  derived  from  the  mechanical 
sujjport  afforded  by  supporters  of  various  kinds.  These  are  now  con- 
structed and  adapted  to  the  body,  with  considerable  skill,  by  those 
who  make  their  construction  a  study  and  a  business. 

Spinal  Irritation.  —  The  spinal  column  is  liable,  at  certain  points, 
to  become  congested,  and  consequently  sore  and  irritable. 

Sympto»n£.  -  The  symptoms  of  this  state  of  things  are  very  varia- 
ble  and  numerous,  as  all  sorts  of  sensations  of  the  skin,  from  utter 
numbness  and  insensibility  up  to  the  most  acute  sensitiveness,  de- 
scribed as  creeping,  shooting,  coldness,  tingling  and  the  crawling  of 
^  ants.  There  may  be  neuralgic  pains,  spasm,  cramp,  trembling  or 
palsy  of  the  voluntary  muscles ;  or  a  fixed  pain  and  tenderness  in 
some  joint  or  other  part ;  or  palpitation  of  the  heart,  ^jjtziness  and 
wind  and  pain  in  the  stomach. 

When  any  of  these  symptoms  appear,  and  cannot  be  traced  to  any 
other  cause,  we  are  to  suspect  some  irritability  of  the  spinal  column, 
and  to  search,  accordingly,  in  that  direction.  The  proper  method  of 
search  is,  to  make  firm  pressure  on  each  of  the  projections  of  the 
spine,  and  to  pass  over  the  projections  a  sponge  wrung  out  of  hot 
water.  If  there  be  trouble  here,  the  patient  will  now  be  likely  to 
complain  of  severe  pain  at  some  one  point.  Or,  the  tender  place 
will  generally  be  found  sooner,  by  tapping  with  the  ends  of  the  fin- 
gem,  with  quick  and  sharp  strokes  along  upon  the  projecting  bones 
of  the  spine.  The  patient  will  be  pretty  sure  to  wince  when  the  ten- 
der point  is  reached. 

Treatment. — Apply  leeches,  and  follow  them  with  a  blister,  or 
stimulating  liniment,  or  some  strong,  slightly  irritating  plaster,  and 
the  tenderness  will  be  very  likely  to  disappear,  as  if  by  magic. 


086 


SURGICAL   DISEASES. 


Wry  Neck.  —  Caput  Obstipum. 

In  this  complaint,  the  head  is  drawn  over  towards  one  of  the  shoul- 
ders, with  the  face  generally  turned  towards  the  opposite  side.  This 
is  caused  by  the  rigid  contraction  of  a  particular  muscle.  In  some  in- 
stances, however,  other  muscles  are  affected,  and  the  head  may  be 
drawn  in  other  directions,  or  be  twitched  about  in  various  ways. 

I  had  a  singular  case  from  New  Hampshire,  which,  though  not 
exactly  wry  neck,  was  a  kindred  disease,  and  is  worthy  of  being  men- 
tioned. The  subject  of  it  was  a  young  lady  of  good  physical  develop- 
ment, but  inclined  to  nervous  complaints.  Her  head  was  chiefly. 
drawn  over  backwards,  sometimes  so  as  to  lie  for  a  short  time  flat 
upon  the  back,  with  no  power  to  raise  it.  She  was  obliged,  ordinar- 
ily, to  let  her  head  lean  a  little  to  one  side,  and  rest  upon  the  hand, 
in  order  to  keep  it  steady.  When  walkin  j,  with  the  head  erect,  with- 
out this  support,  it  was  every  few  moments  jerked  over  backward 
and  a  little  to  one  side,  the  chin  being  thrown  up  in  a  most  unseemly 
way.     The  case  partook  of  the  nature  of  chorea. 

Treatment.  —  For  the  genuine  wry  neck,  where  the  muscle  wliich 
draws  the  head  to  one  side  is  rigid  and  inflamed,  the  treatment  should 
consist  of  leeches,  poultices,  purgatives,  blisters  and  alteratives.  When 
the  muscles  causing  the  distortion  are  not  rigid,  electro-magnetism,  or 
the  shower-bath  may  have  a  good  effect.  In  some  cases,  strychnine 
will  do  well. 

The  peculiar  case  mentioned  above  completely  recovered,  under 
the  use  of  the  extract  of  St.  Ignatius'  bean  (95),  one  pill  three 
times  a  day,  and  gradually  increased  to  nine  pills  a  day.  She  also 
took  iron,  and  was  put  upon  a  most  energetic  system  of  out-door  ex- 
ercise. Considering  the  stubborn  and  severe  nature  of  the  complaint, 
her  complete  recovery  was  as  unexpected  to  her  friends  as  it  was 
gratifying.  As  the  majority  of  wry  neck  cases  are  due  to  muscular 
contrdction%f  a  rheumatic  type,  the  remedies  employed  for  that  dis- 
ease should  be  used  here.  In  all  cases  the  hot  applications  should 
not  be  lost  sight  of. 

Foreign  Bodies  in  the  Eye. 

When  a  person  complains  of  some  substance  in  the  eye,  the  inside 
of  the  lower  eyelid  and  lower  portion  of  the  ball  should  first  be  ex- 
amined, the  person  being  directed  at  the  same  time  to  look  up.  H 
nothing  be  discovered  there,  the  patient  is  then  to  be  directed  to  look 
downward.  This  will  expose  to  view  the  upper  part  of  the  globe. 
At  the  same  time,  the  eyelashes  should  be  taken  between  the  thumb 
and  finger,  and  the  lid  turned  upward  over  some  round  smooth  thing, 
as  a  pencil,  which  will  turn  the  lid  wrong  side  out,  and  bring  to  view 
whatever  is  on  the  inner  surface.     Any  foreign  body  discovered  may 


SURGICAL   DISEASES. 


587 


m. 

B  one  of  the  shoul- 
)po8ite  side.  This 
luscle.  Ill  some  iii- 
the  head  may  be 
various  ways, 
which,  though  not 
»rthy  of  being  nien- 
1  physical  develop- 

•  head  was  chiefly 

•  a  short  time  flat 
IS  obliged,  ordinar- 
jst  upon  the  hand, 
he  head  erect,  witli- 
:ed  over  backward 
in  a  most  unseemly 

e  the  muscle  wliich 
le  treatment  should 
1  alteratives.  When 
ectro-magnetism,  or 
le  cases,  strychnine 

ly  recovered,  under 
95),  one  pill  three 
is  a  day.  She  also 
}tem  of  out-door  ex- 
re  of  the  complaint, 
sr  friends  as  it  was 
re  due  to  muscular 
iployed  for  that  dis- 
applications  should 


n  the  eye,  the  inside 
1  should  first  be  ex- 
me  to  look  up.  H 
)  be  directed  to  look 
r  part  of  the  globe. 
between  the  thumb 
round  smooth  thing, 
It,  and  bring  to  view 
body  discovered  may 


be  removed  by  wiping  it  off  with  the  head  of  a  pin,  having  a  silk 
hai  archief  turned  over  it.  If  this  fails  to  detach  it,  it  may  be 
carefully  picked  up  by  running  under  it  the  point  of  a  wet  tooth-pick. 

Stye.  —  Hordeolum. 

A  STYE  is  nothing  more  nor  less  than  a  small,  painful  boil  at  the 
edge  of  the  eyelid. 

Treatment.  —  In  severe  cases,  apply  a  poultice ;  and  open  it  as 
soon  as  it  begins  to  point.  After  it  has  discharged  all  it  is  likely  to, 
apply,  on  going  to  bed,  for  two  or  three  nights,  a  little  diluted  nitrate 
of  mercury  ointment.  Tonics  and  alteratives  are  frequently  required 
to  break  up  the  formation  of  styes. 

Inflammation  of  the  Edge  of  the  Eyelids. 

Ophthalmia  Tarsi. 

This  inflammation  often  involves  the  Meibomian  glands,  which 
then  secrete  a  sticky  mucus,  which,  not  being  wiped  away  during 
sleep,  glues  the  lids  together,  so  that,  on  waking  in  the  morning,  the 
patient  cannot  get  his  eyes  open.  The  complaint  is  generally  chronic 
and  obstinate,  lasting  a  long  time.  Weakly  persons,  with  disordered 
digestion,  are  most  subject  to  it.  In  some  cases  the  lids  ulcerate,  and 
the  lashes  fall  out.  Generally  the  lids  are  considerably  inflamed  for 
a  few  days,  and  then,  the  inflammation  subsiding,  branny  sca^  s, 
which  may  be  brushed  off,  form  along  the  borders  of  the  lids,  at  the 
roots  of  the  lashes. 

Treatment.  —  The  health  being  generally  disordered,  needs  first  to 
be  improved  by  all  possible  means,  as  by  alteratives,  tonics,  bathing, 
exercise  in  the  open  air,  travelling  if  practicable,  and  a  generous  diet. 

While  the  lids  are  inflamed,  they  should  be  bathed  by  a  wash  com- 
posed of  sulphate  of  zinc,  twelve  grains  ;  laudanum,  two  drams ;  and 
soft  water,  twelve  ounces.  The  redness  and  heat  having  subsided, 
and  the  bowels  being  opened  by  a  gentle  dose  of  physic,  an  astrin- 
gent wash  should  be  applied  once  or  twice  during  the  day  (208), 
(209),  and  a  small  piece  of  the  diluted  nitrate  of  mercury  ointment 
be  rubbed  along  the  borders  of  the  lid,  with  a  pencil-brush  at  night. 
This  will  generally  effect  an  immediate  improvement,  and  in  time 
will  bring  about  a  cure.         . 

Disorder  of  the  Lashes. 

Trichiasis. —  This  signifies  a  growing  inward  of  the  eyelashes. 

Dystrichiasis.  —  This  is  a  double  row  of  eyelashes,  one  of  which 
grows  inward. 

Treatment.  —  Pull  out  the  misplaced  hairs,  and  continue  to  do  so 
as  fast  as  they  appear. 


6 


v*S! 


u 


588 


SUKGICAL   DISEASES. 


IHosis. 

This  is  a  falling  down  of  the  upper  eyelid,  from  palsy  of  the  tliiid 
nerve.  It  is  sometimes  attended  with  headache  and  dizziness,  and 
may  be  the  forerunner  of  apoplexy. 

Treatment.  —  Begin  the  treatment  with  purgatives,  and  then  us(> 
every  means  to  improve  the  health,  especially  exercise  out  of  doors. 

Chronic  Inflammation  of  the  Lachrymal  Sac. 

When  the  mucous  lining  of  the  nasal  duct  gets  thickened  and 
obstructed,  the  patient  complains  of  great  weakness  of  the  eye,  Avhich 
is  constantly  weeping,— the  nostril  on  the  same  side  having  a  cones- 
ponding  drynesi.  The  tears  not  passing  down  through  the  obstructed 
duct,  collect  in  the  lachrymal  sac,  and  form  a  small  tumor  by  the  side 
of  the  nose.  By  pressing  the  finger  upon  this,  the  tears  may  l)e 
squeezed  out  through  the  upward  passage,  and  glairy  mucus  along 
with  them.  There  is  generally  tenderness  of  the  sac,  and  sometimes 
redness  of  the  skin.  There  is  commonly  inflammation  of  the  mucous 
membrane  lining  the  eyelids,  etc. 

Treatment.  —  The  acute  inflammation  of  the  sac  must  be  treated 
by  leeches,  purgatives,  and  cold  washes. 

Chronic  inflammation  of  the  sac  requires  a  special  attention  to  the 
general  health.  The  diet  should  be  carefully  regulated,  and  the  alka- 
line sponge-bath  used  every  day,  with  brisk  rubbing  after  it.  When 
the  sac  gets  very  full,  the  patient  should  try  gently  to  force  the  con- 
tents down  into  the  nose  by  pressing  upon  the  upper  side  of  the 
tumor  ;  and  he  may  promote  the  same  object  by  strongly  drawing  m 
his  breath  often  with  his  mouth  and  nostrils  both  tightly  shut.  Hie 
so-called  citrine  ointment,  fuU  strength,  may  be  applied  to  the  eye- 
lids at  bed-time,  and  a  little  of  prescription  r211)  may  be  dropped 
once  during  the  day  into  the  inner  corner  of  the  eye. 

Purulent  Ophthalmia.  —Egyptian  Ophthalmia. 

Owing  to  the  glaring  sunshine,  and  the  particles  of  sand  witli 
which  the  air  is  loaded,  this  disease  is  endemic  in  Egypt.  Hence  its 
name  Egyptian  ophthalmia. 

Symptoms.  —  It  begins  with  stiffness,  itching,  and  watering  d 
the  eyes,  and  a  feeling  as  if  there  were  dast  in  them.  The  lids  are  a 
little  swelled,  and  become  glued  together  during  sleep.  The  mucous 
mambrane  which  lines  the  Hds  and  covers  the  ball  is  intensely  red 
and  swollen,  and  discharges  a  copious  quantity  of  pus.  There  is  a 
severe  burning  pain  extending  to  the  cheek  and  temple,  with  hea.l- 
ache  and  fever.  The  eyes  cannot  be  opened.  It  is  both  contagious 
^d  infectious. 


t 


SURGIOAL  DISEASES. 


589 


1  palsy  of  the  tliiid 
and  dizziness,  and 

tives,  and  then  use 
rcise  out  of  doors. 

tirytnal  Sac. 

jets  thickened  and 
58  of  the  eye,  which 
ide  having  a  corius- 
3Ugh  the  obstructed 
1  tumor  by  the  side 
I  the  tears  may  be 
glairy  mucus  along 
sac,  and  sometimes 
ation  of  the  mucous 

sac  must  be  treated 

cial  attention  to  the 
iilated,  and  the  alka- 
ing  after  it.  When 
tly  to  force  the  con- 
)  upper  side  of  the 
strongly  drawing  in 
I  tightly  shut.  The 
applied  to  the  eye- 
1)  maybe  dropped 
eye. 

I  Ophthalmia. 

rticles  of  sand  witli 
1  Egypt.     Hence  its 

ig,  and  watering  (if 
lem.  The  lids  are  a 
sleep.  The  mucous 
ball  is  intensely  red 
of  pus.  There  is  a 
1  temple,  with  head- 
It  is  both  contagious 


Treatment.  —  At  the  very  beginning,  apply  a  nitrate  of  silver  wash 
(211)  twice  a  day.  With  this  application,  a  low  diet,  and  five  to 
ten-drop  doses  of  fluid  extract  or  tincture  of  veratrum  viride,  every 
hour,  tliis  terrible  complaint  may  often  be  broken  up. 

If  the  disease  have  reached  its  height,  and  there  is  great  fever  and 
lieadache,  the  patient  may  be  freely  purged  (81),  and  the  pain  bo 
allayed  by  cocaine  applied  with  a  camel's  hair  brush. 

The  patient  must  he  kept  in  bed,  in  a  dark  room,  with  the  head 
elevated. 

The  eyes  should  be  frequently  washed  out  gently  with  warm  water, 
or  a  decoction  of  poppies,  containing  one  grain  of  alum  to  an  ounce. 
This  must  be  done  with  a  piece  of  fine  sponge,  or  with  a  small 
syringe.  Once  or  twice  a  day,  a  few  drops  of  solution  of  nitrate  of 
silver,  two  grains  to  the  ounce  of  soft  water,  may  be  dropped  in 
the  eyes  from  a  camel's-hair  pencil.  As  soon  us  the  disease  begins 
to  give  way,  the  alum  in  the  poppy  decoction  may  be  increased  a 
little. 

Purulent  Ophthalmia  of  Children. 

This  always  begins  within  a  short  time  after  birth,  —  generally 
on  the  third  day. 

Symptoms. — The  edges  of  the  lids  at  first  become  red,  and  glued 
together,  and  the  membrane  lining  them  is  red  and  rough.  The  eye 
remains  closed.  The  conjunctiva  or  membrane  wliich  covers  the 
globe,  next  becomes  intensely  scarlet,  and  so  much  swelled,  at  times, 
that  the  lids  turn  out ;  and  it  discharges  a  thick  purulent  matter. 
The  child  is  feverish  and  restless. 

Causes.  —  Exposure  to  cold  and  damp,  bad  nursiug,  omitting  to 
wash  away  from  the  eyes  the  cheesy  secretions  of  the  skin,  and  the 
contact  of  gonorrl:oeal  and  leucorrhoeal  secretions  of  the  vagina  at 
birth. 

Treatment.  —  Wash  out  the  eye  frequently,  and  gently,  with  a 
weak  astringent  wash  (207),  (203),  or  put  between  the  lids  once  a 
day,  a  large  drop,  with  a  camel's-hair  pencil,  of  prescription  (208). 
When  the  disease  is  declining,  apply  to  the  lids,  with  a  camel's-hair 
pencil,  the  ordinary  citrine  ointment  of  the  druggist. 

Catarrhal  Ophthalmia. 

Symptoms.  —  In  this  complaint,  the  white  of  the  eye  becomes  in- 
flamed and  very  red,  the  redness  being  superficial,  so  that  the  vessel 
can  be  moved  by  pulling  the  eyelids  ;  generally  there  is  a  thin  mu- 
cous discharge,  which,  in  sevei-e  cases,  becomes  thick  and  purulent. 
It  is  caused  by  cold  and  damp. 

Treatment*  —  If  there  be  considerable  pain  and  headache,  give 
purgatives  (31),  (19),  and  continue  them,  once  a  day,  till  the  symp- 


ifimiiM 


'itimatoSRni 


■iniUM** 


m 


690 


BUKUIUAL   DIHKASKS. 


toms  of  active  inflainniatiou  subside.  Ai)ply  to  the  eyes  a  poultice 
of  slippery  elm,  and  bathe  them  frequently  with  a  decoction  of  pitppy 
leaves,  lukewarm  or  cold,  according  to  the  choice  of  the  patiuiit. 
Smear  the  edges  of  the  lids  at  night  with  fresh  lard ;  and  when  the 
inflammation  begins  to  decline,  use  diluted  nitrate  of  mercury  oint- 
ment instead.  Keep  tlie  eyes  well  protected  from  the  light  with  a 
shade.  A  large  drop  of  a  solution  of  jiitrate  of  silver,  two  to  four 
grains  to  the  ounce  of  water,  may  be  \)\it  into  the  eye  two  or  tiirco 
times  a  day.  Sometimes  sulphate  of  zinc,  four  grains  to  the  ounce 
of  water,  will  do  well,  or  cocaine  solution,  4  per  cent. 

When  the  disease  reaches  the  chronic  stage,  —  the  pain  and  head- 
ache having  passed  off,  —  some  astringent  applications  will  1h^  re- 
quired, as  a  very  weak  solution  of  nitrate  of  silver  (208),  or  a  drum 
each  of  powdered  witchhazel  hmves  and  golden  seal,  steeped  for  ten 
minutes  in  a  gill  of  boiling  water,  and  strained  when  cold. 

Scrofulous  Ophthalmia. 

This  disease  is  chiefly  confined  to  childi-en  under  eight  yeai-s  of 
age- 
Symptoms*  —  Entire  inability  to  bear  light ;  the  lids  are  spasmoiU- 
cally  closed,  and  the  head  constantly  turnel  away  from  the  light. 
The  blood-vessels  of  the  conjunctiva  are  not  particularly  injected, 
with  the  exception  of  one  or  two  large  ones  which  run  towards  the 
cornea,  and  terminate  in  one  or  more  small  opaque  pimples.  The 
cornea  frequently  ulcerates,  and  the  complaint  is  very  obstinate,  — 
being  liable  often  to  recur. 

Treatment.  —  As  in  all  scrofulous  complaints,  it  is  important  in 
this  to  look  after  the  general  health.  No  more  physic  is  required 
than  to  keep  the  bowels  open ;  and  even  this,  if  costiveness  exist, 
had  better  be  done  by  bread  made  from  unbolted  wheat  flour,  by 
injections  of  cool  or  tepid  -water,  and  by  exercise.  The  health  must 
be  supported  by  iron,  sarsaparilla,  stillingia,  and  quinine. 

The  eye  is  to  be  strengthened  by  cold  water  applied  to  the  lids, 
the  forehead,  and  the  temples.  The  eyes  may  be  bathed  likewise  with 
a  warm  decoction  of  poppies,  or  of  chamomile  flowers  or  cocaine. 

But  one  of  the  best  applications. is  a  solution  of  nitrate  of  silver, 
one  or  two  grains  to  the  ounce  of  water,  a  few  drops  being  put  into 
the  eye  once  or  twice  a  day.  Occasionally  a  solution  of  sulphate  of 
copper,  of  the  same  strength,  may  be  used  with  decided  advantage. 

Both  eyes  should  be  protected  by  a  shade. 

Inflammation  of  the  Cornea.  —  Comeitis. 

Symptoms.  —  The  cornea  is  rough,  red,  opaque,  and  generally 
prominent.  There  is  some  pain  and  inability  to  bear  light,  but  not 
great.     The  pulse  is  frequent,  and  the  skin  dry. 


SURGICAL  DISEASES. 


691 


B  eyes  a  poult  i(;e 
ecoction  of  poppy 
e  of  the  piiliiMit. 
(1 ;  and  when  the 
I  of  mercury  oint- 
the  light  with  a 
ilvcr,  two  to  four 
eye  two  or  tlueo 
ains  to  the  ounce 
int. 

he  pain  and  head- 
iations  will  l)e  re- 
•  (208),  or  a  dram 
al,  steeped  for  ten 
len  cold. 


der  eight  years  of 

e  lids  are  spasmodi- 
a,y  from  the  light, 
rticularly  injected, 
h  run  towards  the 
(jue  pimples.  The 
very  obstinate,  — 

it  is  important  in 
!  physic  is  required 
f  costiveness  exist, 
jed  wheat  flour,  by 
The  health  must 
quinine. 

ipplied  to  the  lids, 
jathed  likewise  with 
wers  or  cocaine, 
jf  nitrate  of  silver, 
rops  being  put  into 
ition  of  sulphate  of 
lecided  advantage. 


-  Corneitis. 

ique,  and  generally 
)  bear  light,  but  not 


Treatment. — If  the  inflammation  be  acute,  use  leeches,  purgatives, 
tincture  of  veratrum.  Apply  fomentations,  and  smear  belladonna 
ointmert  on  the  eyebrows. 

For  ti.j  chronic  form,  give  quinine  and  other  bitters,  and  put  blis- 
tei-s  upon  the  nape  of  the  neck,  and  behind  the  eara.  The  wine  of 
opium,  and  the  diluted  nitrate  of  mercury  ointment,  must  be  applied 
to  the  lids,  or  cocaine. 

Inflammation  of  the  Iris.  —  Iritis. 

Thk  iris  is  covered  with  a  serous  membrane,  and  is  very  liable  to 
adhesive  inflammation. 

Symptoms.  — In  the  first  stage,  the  iris  changes  its  color,  and  the 
pup  1  is  contracted.  In  the  next  stage,  lymph  is  poured  out  upon  the 
surface  in  a  thin  layer,  sometimes,  which  looks  rusty,  and  sometimes 
in  larger  quantities,  filling  the  whole  cavity  of  the  aqueous  humor. 

Causes.  —  Injuries,  or  overworking  the  eye,  but  more  frequently 
a  taint  of  the  system  from  gout  or  syphilis. 

Treatment. — If  there  be  considerable  inflammation,  apply  leeches 
to  the  temples,  and  keep  down  the  circulation  by  tincture  of  vera- 
trum. To  relieve  pain,  if  any,  paiiit  with  cocaine  or  morphia. 
The  strength  is  generally  to  be  suppcvted  by  quinine ;  and  in  many 
instances,  iodide  of  potassium  is  to  be  given  as  an  alterative.  A  little 
solution  of  atropia,  one  grain  to  the  ounce  of  water,  is  to  be  dropped 
into  the  eye  once  or  twice  a  day,  and  a  warm  infusion  of  slippery- 
elm  bark,  or  of  marshmallow,  to  be  used  as  a  wash.  The  bowels  to 
be  kept  open  by  gentle  physic. 

Weakness  of  Sight.  —  Muscw  VoUtantes. 

This  is  an  affection  to  which  persons  of  weakly  constitution  are 
liable,  and  those  who  write  much,  or  examine  very  small  objects. 

Symptoms.  — Dimness  of  sight;  uneasiness  on  exposure  to  a  strong 
light ;  and  specks  floating  before  the  eyes,  —  often  looking  like  flies. 

Treatment.  —  The  complaint  depends  on  debility,  natural  or  ac- 
quired; and  tonics,  as  quinine  and  iron,  and  the  shower  or  sponge 
bath,  and  out-door  exercise,  are  the  proper  remedies. 

Imperfect  Vision. — Amaurosis. 

The  complaint  here  referred  to  is  dependent  on  some  change  in 
the  optic  nerve  or  the  brain,  —  most  commonly  the  former. 

Symptoms. — In  some  cases  the  sight  becomes  suddenly  dim,  and 
is  perhaps  soon  lost  altogether;  but  more  often  it  is  impaired  by  slow 
degrees,  —  being  only  defective  at  intervals,  as  when  the  stomach  is 


)^'mafmmmmtf9^im'imaMtimmm0iimt 


T 


692 


BUROIOAL   DIBEABKS. 


out  of  order,  or  the  eyes  have  been  fatigued.  At  one  timo,  it  will 
begin  with  objects  appearing  dim;  at  another,  with  their  hcinp 
double;  at  still  another,  with  the  ability  to  see  only  one  Imlf  of 
objects.  In  some  instances,  the  complaint  begins  with  a  crooked 
or  disfigured  or  discolored  appearance  of  things  looked  at.  AEraiii 
it  will  begin  as  near-sightedness,  or  far-sightedness ;  or  the  patient 
cannot  measure  distances,  and  will  miss  his  aim  in  pouring  water 
into  a  glass,  or  in  putting  a  match  to  the  wick  of  a  lamp.  The  llamo 
of  a  lamp  will  appear  split.  At  times  the  eye  does  not  l)ear  lijjlit; 
at  other  times  it  longs  for  it,  and  objects  do  not  appear  illuminated 
enough. 

Distinction.  —  Amaurosis  may  be  distinguished  from  cataract  hy 
there  being  no  opaque  body  to  be  seen  behind  the  pupil ;  and  by  the 
light  of  a  candle  appearing  discolored,  split,  or  lengthened,  or  irides- 
cent ;  whereas  in  cataract  vision  m  only  clouded,  and  a  lighted  candle 
looks  as  if  surrounded  with  a  mist. 

Chances  of  Cure.  —  These  are  generally  not  very  favorable,  unless 
the  remedies  employed  very  soon  produce  good  effects. 

Treatment. — Electro  galvanism  is  one  of  the  most  promising  reme- 
dies. Bayberry  root,  dried  and  reduced  to  an  impalpable  powder,  and 
taken  as  a  snuff,  is  occasionally  useful.  Cayenne,  steeped  in  water, 
one  grain  to  one  ounce  of  water,  and  a  little  of  it  dropped  into  the 
eye,  may  stimulate  the  palsied  nerve,  and  in  some  cases  restore  siglit. 

Blisters  may  be  applied  behind  the  ears,  or  a  seton  may  be  tried 
upon  the  back  of  the  neck,  with  some  promise  of  success. 

But  probably  nothing  will  do  better  than  cold  bathing, —  a  shower 
bath  if  it  can  be  borne,  —  outnioor  exercise  vigorously  pursued,  and 
an  adherence  for  a  long  time — perhaps  a  year — to  a  strictly  vege- 
table diet,  at  the  same  time  using  nervine  tonics,  etc.  (316). 

Short  and  Long  5ight. 

Short  5ight,  called  myopia,  depends  on  too  great  a  convexity  of  the 
cornea,  or  crystaline  lens,  or  vitreous  humor, — one  or  all, — and  tiie 
consequent  formation  of  the  image  of  the  object  inspected  a  little  in 
front  of  the  optic  nerve,  or  retina, — as  at  a  (Fig.  183),  instead  of  ati, 


Fig.  183. 


where  it  should  be  formed.     The  rays  of  light  are  brought  to  n  focus 
before  they  reach  the  retina. 


S.-.^J!L-. 


SUWilCAL   DISKASKH. 


5D3 


it  one  timo,  it  will 
witli  their  being 
5  only  one  liiilf  of 
18  with  a  crooked 
looked  at.  Ap;ain 
38.S ;  or  the  patient 
I  in  pouring  water 
I  lamp.  The  tlame 
068  not  bear  liglit; 
appear  illuminated 

hI  from  cataract  by 
9  pupil ;  and  by  the 
iigthened,  or  irides- 
kud  a  lighted  candle 

ary  favorable,  unless 
ffects. 

nost  promising  rcnie- 
ialpable  powder,  and 
le,  steeped  in  water, 
it  dropped  into  the 
3  oases  restore  sight. 
seton  may  be  tried 
[  success. 

bathing, —  a  shower 
)rou3ly  pursued,  and 
—  to  a  strictly  vege- 
1,  etc.  (316). 

t. 

eat  a  convexity  of  the 

one  or  all, — and  the 

t  inspected  a  little  in 

183),  instead  of  at  6, 


riiildrcn  aro  either  l)orn  with  this  defect,  or  it  is  brought  on  by  too 
clo.so  study,  or  by  long  apidioation  of  the  eyes  to  minute  objects. 

It  may  lie  remedied  frequently  by  exercising  the  eyes  in  looking  at 
distant  objcc^ta.  Children  alllictcd  in  this  way  sliould  liave  their 
studies  abridged,  and  their  exercise  in  the  open  air  increased.  Wiiilo 
studying  they  should  have  some  apparatus  applied  to  them  which 
shall  kv!ep  the  chin  elevated,  so  that  the  head  cannot  be  dropped  too 
low,  and  the  eyes  brought  too  near  the  book.  And  the  book  slould 
each  day  be  jilaced  a  very  little  further  from  the  eyes. 

Glasses  worn  by  peraons  having  this  defect  of  vision  should  Ims 
concave,  as  at  c. 

Long  Sight,  or  presbyopia,  depends  on  the  humora  of  the  eye  not 

heiiiji  convex  enough.     In  this  case,  the  image  of  the  inspected  object 
,  is  formed  beyond  the  optic  nerve,  as  at  d  (Fig.  184).     This  is  one  of 
tho  earliest  signs  of  advancing  age. 


ire  brought  to  a  focus 


Ho.  184. 

This  defect  is  to  be  remedied  by  glasses  which  are  convex,  e.  Per- 
sons  iu  the  early  autumn  of  life  must  not  resort  to  glasses  too  hastily, 
or,  indeed,  until  they  are  Compelled  to,  nor  should  they  change  those 
fii-st  used  too  soon.  Ghisses  should  make  objects  look  distinct  and 
bright,  but  not  larger  than  natural. 

Squinting.  —  Strabismus. 

Ix  strabismus,  the  eyes  arie  not  parallel  in  their  i)osition  and  mo- 
tion. 

It  is  supposed  that  one  eye  may  become  weaker  tiian  the  other,  or 
that  the  visual  axis  of  the  two  may  not  be  adjusted  alike,  so  that  one 
eye  —  perhaps  the  more  defective  one  —  turns  aside  to  escape  the 
distorted  vision,  or  possibly  the  injury  to  itself  which  would  follow 
the  attempt  to  make  eyes  of  unequal  power  work  evenly  together. 
The  opposing  muscles  lose  their  counterbalancing  force,  and  the  in- 
ternal rectus,  gaining  the  preponderance,  draws  the  eye  inward,  —  for 
the  squint  is  more  often  convergent  than  divergent;  that  is,  the  eye 
turns  in  more  often  than  out.     Both  eyes  sometimes  squint. 

Treatment.  —  In  recent  cases  there  is  some  chance  of  curing  this 
coniplrtint  without  a  surgical  operation.  The  patient  should  not  be 
lu  the  society  of  other  squinting  pei-sons,  so  as  to  learn  it  by  imitation. 

Iu  the  first  place  care  should  be  taken  that  the  bowels  are  kept  in 


I 


-, 


,i.-,a..:'ai.,^ 


•AiiinMiatalMi^aiimHn-- 


I'JWWMu"  tiJuiwigwrmi ' 


504 


HUltiilCAL   DI8RA8F.H. 


good  condition,  iind  that  the  frunonil  health  is  well  fortified  hy  IhiUi- 
iiig,  tonics,  and  excrciMo.  The  patient  Hhould  be  made  to  Htand 
before  a  gliiHH,  and  while  he  cIohcs  the  Hound  eye,  look  steadily  at 
Home  ol)ject  with  the  H(|uiiiting  eye.  Lot  him  do  this  till  the  eyn  is  a 
little  tired;  then  let  him  open  Uie  sound  eye,  when  theHiiuintingone 
will  turn  anide.  But  by  compelling  it,  in  this  way,  Hcvenil  tim-M  u 
day,  to  wo'k  in  a  Htraight  line,  it  may,  perhaps,  be  taught  to  remain 
parallel  with  the  other. 

Nervine  tonics,  as  strychnine  (86),  (94),  (05),  (816),  will  noimc- 
times  do  good  service ;  and  electro-gidvanism  has  l)een  found  iiscful 
in  many  cases. 

But  in  old  and  ol)stinate  ciises,  the  only  cure  is  found  in  diviiHiiir 
the  muscle  which  j)ulls  the  eye  to  one  side,  —  the  internal  rectus,  if 
the  eye  is  drawn  in,  —  the  external  rectus,  i£  it  is  drawn  out. 

I 

Affet:tlons  of  the  Ear. 

Thehk  are  so  common,  that,  in  almost  every  family,  they  re(piiio 
attention,  at  one  time  or  another.  And  deafness,  which  so  often 
results  from  these  disorders,  is  so  serious  a  misfortune  that  every 
affection  of  the  ear  should  receive  early  attention. 

Examination  of  tlie  Meatus.  —  For  examining  the  meatus,  or  ex- 
ternal passage  of  the  ear,  there  is  perhaps  no  better  instrument  than 

a  simple  silver  or  glass  tube,  of  the  size 
and  shape  represented  in  Fig.  186. 

To  make  the  examination  properly, 
place  the  patient  either  in  a  sitting, 
kneeling,  or  standing  posture,  as  may  \k 
Fio.  186.  ^  "  most  convenient,  with  the  ear  directly 
under  a  good  stream  of  gas-  or  lamp-  or 
sun-light.  Then  take  hold  of  the  ear  with  the  thumb  and  finger,  and 
gently  draw  it  outward  and  backward,  and  with  the  other  hand  in- 
troduce the  small  end  of  the  tube  or  speculum,  and  cany  it  forward 
as  far  as  it  will  go  without  producing  pain.  Then  by  gently  swaying 
the  largo  end  of  the  tube  back  and  forth,  a  stream  of  light  may  k' 
made  to  illuminate  all  sides  of  the  passage.  If  the  lining  of  this 
passage  is  smooth,  dry,  pearly-white,  and  shining,  and  is  without  wax, 
it  may  be  regarded  as  healthy.  At  the  close  of  the  passage,  tiie 
tympanum  may  be  seen,  and  should  be  semi-transparent,  dry,  and 
grayish-white.  "Within  this  may  be  seen  the  handle  of  the  malleus. 
coLiing  from  above  downward  and  forward.  This  bone  runs  about  half 
way  across  the  tympanum,  and  divides  it  into  an  upper  front,  and 
a  lower  back  part.  This  lower  back  portion,  when  viewed  through 
the  speculum,  is  more  glistening  than  the  upper  and  front  part,  ami 
a  bright  spot  of  light  is  seen  on  its  most  rounded  portion,  which  is 
just  below  and  Ixjhind  the  i)()int  of  the  malleus.  Inflammation  causes 
this  innermost  part  of  th(     leatus  to  become  thickened,  vascular,  or 


%- 


8URUICAL   IIIBRA8E8. 


r)9r> 


I  fortified  by  biitli- 
JO  inudo  to  sUiiul 
e,  look  Bteadily  at 
lluH  till  thi)  eyo  Ih  a 
I  the  stiuiiitinjj  one 
ly,  Heveml  tiinvs  a 
)  tiuight  to  remain 

,  (816),  will  Hoiiie- 
l)een  found  u«oful 

found  ill  dividing 
I  internal  rectus,  if 
I  drawn  out. 


'amily,  they  require 
388,  which  so  often 
jfortune  that  t'veiy 

g  the  meatus,  or  ex- 
,ter  instrument  than 
438  tube,  of  the  size 
in  Fig.  185. 
imination  properly, 
ither    in    a    sitting, 

posture,  as  may  l)e 

,h   the    ear    directly 

of  gas-  or  lamp-  or 

lumb  and  finger,  and 

the  other  hand  in- 
and  carry  it  forward 
;n  by  gently  swaying 
sam  of  light  may  be 
[f  the  lining  of  tliis 
,  and  is  without  wax, 

of  the  passage,  the 
transparent,  dry,  and 
indie  of  the  malleus. 
8  bone  runs  about  half 

an  upper  front,  and 
vhen  Ariewed  through 
r  and  front  part,  and 
ded  portion,  whioh  is 

Inflammation  causes 
hickened,  vascular,  or 


granular,  —  like  the  conjunctiva  of  the  cy«^  when  it  is  inflamed:  it 
uIho  cauHeM  it  to  Hocrutu  and  diHchargc  matter. 

Inflammation  of  the  Meatus.  —  Olorrhn'a. 

This  is  quite  a  common  complaint  among  delicate  children  ;  and 
may  occur  a8  the  result  of  Hcarlet  fever,  or  be  excited  by  curreutti  of 
cold  air,  by  rotten  teeth,  or  by  deranged  stomach  and  lH)welH. 

Symptoms.  —  Fever,  headache,  intense  pain  in  the  ear,  and  swell- 
ing of  the  glands  of  the  neck.  After  a  time,  a  reddish,  watery  dis- 
charge comes  on,  which  soon  grows  thicker  and  mattery.  The  fever 
disappears  with  the  appearance  of  the  thick  matter.  An  examination 
with  the  speculum  shows  the  whole  meatus  to  he  swollen,  vascular, 
and  covered  with  a  slimy  matter. 

Unless  great  attention  be  given  to  cleanliness,  the  discharge  be- 
comes very  abundant  and  fetid,  and  lasts  for  a  long  time ;  and  if 
neglected,  will  be  likely  to  lead  to  very  serious  consecpiences,  even 
the  decay  of  some  of  the  bones  of  the  head. 

Treatment. — While  the  inflammation  is  acute,  and  there  is  fever 
and  pain,  the  diet  should  be  confined  to  mere  liquids,  —  as  rice-watei-, 
gruel,  etc.,  and  the  bowels  should  be  opened  with  some  preparation  of 
salts,  the  ear  being  gently  syringed,  occasionally,  with  warm  water 
or  decoction  of  poppies,  and  being  covered  with  a  warm  poultice  of 
flax-seed  or  bread  and  milk.  In  place  of  a  poultice,  a  soft  linen  bag, 
lilled  with  bran,  and  dipped  in  hot  water,  may  be  kept  on  the  ear. 
If  tliere  be  great  pain  and  headache,  put  leeches  behind  the  ear. 

The  pain  and  fever  being  gone,  and  the  mattery  discharge  having 
come  on,  the  case  is  to  be  treated  like  other  chronic  diseases  of  mu- 
cous membranes  in  scrofulous  constitutions,  by  tonics,  alteratives, 
warm  baths,  and  out-door  exercise. 

The  ear  may  now  be  gently  syringed  out  with  castile  soap  and 
water,  and  immediately  after  with  a  weak  solution  of  alum,  or  sul- 
phate of  zinc,  one  grain  to  a  dram.  This  may  be  done  twice  a  day. 
Or,  a  little  of  a  mixture  of  two  drams  of  solution  of  sugar  of  lead 
and  half  a  pint  of  water  may  be  dropped  into  the  meatus,  and,  after 
remaining  two  or  three  minuies,  be  allowed  to  run  out.  If  the  dis- 
charge be  very  fetid,  two  drams  of  solution  of  chloride  of  lime,  with 
half  a  pint  of  wat«r,  will  make  a  suitable  wr^h  with  which  to  syringe 
it,  applying,  once  a  day,  a  solution  of  nitrate  of  silver,  five  grains 
to  the  ounce  of  water. 

Should  the  discharge  stop  at  any  time,  and  pain  and  fever  come 
on,  lay  aside  these  astringent  applications,  and  go  back  at  once  to  the 
leeches,  purgatives,  poultices  and  fomentations. 


ti^:- 


j3T 


596 


SUBOIOAL  DISEASES. 


Wax  In  the  Ear. 

The  oar  sometime.s  becomes  completely  filled  with  wiix,  mixed 
with  hairs  and  flakes  of  scarf-skin,  impeding  greatly  the  sense  of 
hearincr. 

Treatment.  — Let  the  ear  be  gently  syringed  each  morning  witli 
warjn  soapsuds,  so  as  to  thoroughly  clear  out  the  whole  mass  of 
matter,  after  having  dropped  into  the  ear  the  night  before  four  oi'  iive 
drops  of  oil.  The  water  may  be  quite  warm,  and  a  little  cotton  sliould 
be  loosely  inserted  after  the  syringing. 

Earache.  —  Otalgia. 

Symptoms. — This  is  simply  neuralgia  of  the  ear,  and  comes  on  in 
fiita  of  excruciating  pain,  which  shoots  over  the  head  and  face.  It 
may  be  distinguished  from  inflammation  of  the  ear  by  the  sudden- 
ness and  intensity  of  the  pain ;  by  its  not  throbbing,  not  increasing 
in  intensity,  not  being  attended  by  fever,  and  not  coming  and  going 
without  apparent  cause. 

Treatment.  —  Fill  or  remove  all  rotten  teeth,  which  may  be  sus- 
pected as  the  cause  of  the  suffering.  Give  iron,  particularly  the 
citrate  combined  with  strychnine  (316).  The  core  of  an  onion  after 
being  baked,  applied  to  the  ear  as  hot  as  it  ca:i  be  borne,  will  often 
give  relief.  The  onion  is  to  be  baked  whole.  The  core  then  is  taken 
out  while  hot  and  inserted  in  the  ear. 

Inflammation  of  the  Tympanum.  — Deafness. 

„   .,.,;^    :,,.  ,    t,„...v.         Otitis.   .^.  ^^■  •:"•."''.: '■?-.■  •';''-,. 

Symptums.  —  In  the  acute  form  of  the  disease,  there  is  violent 
pain,  ringing  noises  in  the  ear,  and  delirium.  When  the  suppuration 
takes  place,  there  is  a  chill,  and  a  heavy,  tensive  pain. 

'  In  the  chronic  form  of  the  complaint,  the  lining  membrane  of  the 
tympanic  cavity  has  its  vessels  a  little  enlarged,  with  blood  sorae- 
tim6s  effused  into  its  substance,  or  lymph  upon  its  surface,  or  the 
membrane  is  thickened,  and  sometimes  covered  with  tuberculous 
Qoncretions,  or  there  are  fibrous  bands  occupying  nearly  the  whole 
of  the  cavity. 

Symptoms.  -  These  are  slight, — the  first  perceptible  change  being 
generally  deafness  in  one  or  both  eaic.  There  may  be  a  woolly  sen- 
sation, with  noises  or  ringing,  and  slight  aching  pains. 

Treatmenr  — As  the  deafness  in  these  cases  generally  depends  on  a 
chrc  lie  inflammation  of  the  tympanic  membrane,  the  best  remedies  are 
those  which  improve  the  condition  of  the  digestive  organs  and  gen- 
eral health,  as  regular  diet,  bathing,  pure  air,  and  exercise,  with  tonics 


>"„■-. 


J 


SURQICAL  DISEASES. 


507 


with  wax,  mixed 
atly  the  sense  of 

ach  morning  witli 

le  whole  msiss   of 

hefore  four  or  live 

little  cotton  sliould 


r,  and  comes  on  in 
ead  and  face.  It 
ar  by  the  sudden- 
ng,  not  increasing 
coming  and  going 

jvhich  may  be  sus- 
1,  particularly  the 
B  of  an  onion  after 
e  borne,  will  often 
i  core  then  is  taken 


-  Deafness. 


e,  there  is  violent 

en  the  suppuration 

)ain. 

f  membrane  of  the 

with  blood  some- 
its  surface,  or  the 

with  tuberculous 
r  .nearly  the  whole 

ptible  change  being 
ly  be  a  woolly  sen- 
ains. 

lerally  depends  on  a 
le  best  remedies  are 
i^e  organs  and  gen- 
ixercise,  with  tonics 


and  alteratives.  Occasionally,  a  leech  or  two,  or  a  blister  behind  the 
ear  will  be  serviceable.  But  generally  dry  cupping  behind  and  in 
front  of  the  ear  will  answer  the  purpose  for  calling  the  blood  away 
from  the  thickened  membrane. 

If  the  inflammation  be  acute,  it  must  be  combatted  with  purging 
blisters,  poultices  and  fomentations. 

When  deafness  is  caused  by  inflammation  in  the  Eustachian  tubes, 
or  from  enlargement  of  the  tonsils,  etc.,  the  tonsils  mu3t  be  cut  off, 
and  a  solution  of  nitrate  of  silver,  twenty  grains  to  the  ounce,  must 
Le  thrown  upon  the  mouths  of  the  tubes  with  a  shower  syringe. 

Bleeding  from  the  Nose. — Epidaxis. 

Treatment.  —  In  full-blooded  persons,  with  redness  of  face,  and 
subject  to  headache  and  dizziness,  bleeding  from  the  nose  may  be 
salutary,  and  necessary  to  ward  off  apoplexy,  and  should  not  be  too 
suddenly  stopped. 

When  the  bleeding  is  such  as  to  require  to  have  it  arrested,  plug 
the  nostrils  with  the  scraping  from  a  fur  hat,  or  with  lint,  dipped  in 
a  strong  solution  of  alum  or  tannin  or  Monsel's  persalt  of  iron,  one 
part  to  ten  parts  of  water.  To  give  immediate  relief,  press  up  undor 
the  upper  lips  or  apply  something  cold  to  the  back  of  the  neck. 

Ingrowing  Toe-Nail. 

To  most  persons,  the  above  words  will  suggest  some  unpleasant 
associations,  for  there  are  few  bat  have  had  some  painful  experience 
with  this  affection.  It  is  usually^  like  corns  and  some  other  trouble- 
some things,  the  penalty  inflicted  for  wearing  tight  shoes.  It  gener- 
ally appears  upon  the  great  toe.  The  constant 
pressure  of  a  narrow  boot  or  shoe  against  the  side 
of  the  toe,  causes  the  edge  of  the  nail  to  sink  into 
the  flesh,  producing  inflammation  and  pain,  and 
finally  ulceration.  Nature,  attempting  to  repair 
the  mischief,  sends  out  granulations,  which,  being 
perpetually  irritated,  shoot  up  into  unhealthy 
growths,  called  proud  Jlesh.  Thenceforward,  the 
sufferings  of  the  patient  become  incessant ;  and  he 
cannot  now  even  compromise,  as  he  would  be  glad  | 
to  do,  ^^  putting  on  shoes  of  ample  dimensions,  but' 
is  obliged  to  negotiate  a  peace  by  putting  away  the 
shoe  altogp+bcr,  or  by  cutting  a  hole  through  it  to 
take  off  tn^  pressure.  At  the  risk  of  giving  the  reader  a  few  d:  ' 
twinges  every  time  he  looks  upon  this  page,  we  place  here,  in 
186,  a  good  representation  of  this  tormenting  disorder,  as  a  sale- 
able warning  against  the  folly  of  giving  the  toes  narrow  quarters. 

Treatment.  —  Make  a  lye  by  putting  half  a  pint  of  hard-wood 


Fia.  186. 


BMtti 


598 


SURGICAL   DISEASES. 


I^f^ 


ashes  into  a  quart  of  hot  water ;  bathe  the  toe  in  this,  while  warm, 
twenty  minutes,  every  day.  Immediately  after  each  bathing  apply  u 
poultice  made  of  ground  slippery  elm  and  weak  lye,  changing  tlie 
[)Oultice  twice  a  day.  As  fast  as  the  inflammation  is  subdued  by 
♦this,  press  a  little  fine  lint  gently  under  the  edge  of  the  nail.  At  each 
subsequent  dressing,  cut  off  as  much  of  the  nail  as  is  raised  out  of  the 
tender  flesh,  with  the  keen  poiit  of  a  penknife.  Continue  to  do  this 
till  the  whole  offending  portion  is  cut  away. 

If  the  above  treatment  does  not  reduce  the  inflammation  and  great 
tenderness,  spread  some  extract  of  belladonna  upon  lint,  —  lay  this 
upon  the  diseased  part,  and  put  a  poultice  over  it. 

When  the  disorder  begins  to  make  its  appearance,  it  is  a  good  plan 
to  scrape  the  nail  very  thin  on  top ;  this  will  cause  it  to  grow  upon 
the  upper  surface,  and  to  give  way  at  the  tender  part,  so  as  to  obvi- 
ate, sometimes,  the  necessity  of  any  other  treatment. 

The  following  is  the  best  treatment.  Wash  the  toe  in  warm  water, 
and  m^ke  the  parts  dry  with  cotton  wool.  Then  gently  press  cotton 
wool  in  between  the  toe-nail  and  the  tender  projecting  flesh,  and  ex- 
tend it  along  the  groove  back  between  the  skin  and  nail.  Next,  wet 
the  end  of  a  piece  of  nitrate  of  silver,  and  rub  it  thoroughly  upon  the 
nail,  close  to  the  cotton,  not  allowing  it  to  touch  the  tender  flesh; 
then  put  on  a  thin  layer  of  cotton  wool,  and,  in  two  or  three  hours, 
a  poultice  around  the  toe. 

In  two  dajrs,  the  nail  will  be  perfectly  black,  and,  aa  far  as  the  ni- 
trate was  we:l  applied,  will  be  separated  from  the  parts  underneath, 
and  may  be  taken  off  without  pain. 

If  the  nail  is  very  thick.,  scrap  off  the  black  and  deadened  pai-t  in 
two  days,  and  apply  the  nitrate  again.  This  treatment  is  a  vast  im- 
provement on  the  old  and  cruel  practice  of  tearing  off  the  live  nail. 

Chafing  and  Excoriation. 

When  the  neck,  arm-pits,  thighs,  etc.,  of  children,  get  chafed  or 
excoriated,  a  remedy  may  be  found  by  keeping  the  parts  clean,  and 
by  dusting  them  with  powdered  slippery  elm,  starch  or  talcum  pow- 
der. If  this  does  not  effect  a  cure,  api'^y  Turner's  cerate,  or  wash 
the  parts  with  a  solution  of  sulphate  of  zinc,  or  nitrate  of  silver,  five 
grains  to  the  ounce  of  soft  water. 

Grown  persons  may  treat  these  troubles  very  much  in  the  same 
way,  ox  by  wearing  cotton  between  the  parts  wliich  rub  together. 


Foreign  Substances  in  the  Nose. 

When  any  foreign  substance  gets  lodged  in  the  nose,  close  the 
mouth  and  Uie  opposite  nostril,  and  then  blow  forcibly  through  the 
obstructed  side.  If  this  is  not  successful,  press  the  thumb  against  the 
nose  above  the  obstructing  body,  and  then  make  a  hook  of  a  piece  of 


SURGICAL   DISEASES. 


599 


this,  wliile  ■warm, 
ch  bathing  apply  a 

lye,  changing  tlie 
ion  is  subdued  by 
:  the  nail.  At  each 
is  raised  out  of  the 
Ilontinue  to  do  this 

mmation  and  great 
)on  lint,  —  lay  this 

Be,  it  is  a  good  plan 
56  it  to  grow  upon 
part,  80  as  to  obvi- 
snt. 

toe  in  warm  water, 
gently  press  cotton 
icting  flesh,  and  ex- 
nd  nail.  Next,  wet 
horoughly  upon  the 
h  the  tender  flesh; 
wo  or  three  hours, 

nd,  as  far  as  the  ni- 
B  parts  underneath, 

id  deadened  part  in 
),tinent  is  a  vast  im- 
ig  off  the  live  nail. 

dren,  get  chafed  or 
the  parts  clean,  and 
irch  or  talcum  pow- 
aer's  cerate,  or  wash 
aitrate  of  silver,  five 

T  much  in  the  same 
ich  rub  together. 

Nose. 

the  nose,  close  the 
forcibly  through  the 
le  thumb  against  the 
a  hook  of  a  piece  of 


wire  or  knitting  needle,  and  pressing  it  up  over  the  offending  sub- 
stance, pull  it  down. 

Foreign  Substances  in  the  Ear. 

If  flies  and  other  insects  get  into  the  ear,  fill  the  ear  with  sweet 
oil,  and  then  syringe  it  out  with  warm  water.  Sometimes  it  will  be 
sufficient  to  hold  the  head  down  on  one  side,  and  have  the  ear  filled 
with  water,  —  remaining  quiet  in  this  position  for  a  short  time,  when 
the  insect  will  rise  to  the  surface.  If  any  hard  substance  be  got  into 
the  ear,  lie  down  quietly  upon  the  affected  side,  and  send  for  a  phy- 
sician. 

Foreign  Substances  in  the  Outlet. 

If  the  substance  have  not  gone  beyond  the  reach  of  the  thumb  and 
finger,  thiust  them  down  as  far  as  possible,  and  try  to  pull  it  out;  or, 
a  small  curved  pair  of  forceps  will  reach  still  lower  than  the  fingers. 
Or,  tliis  failing,  let  some  one  place  one  hand  firmly  on  the  chest  of 
the  choking  person,  and  give  him  a  smart  blow  or  two  between  the 
shoulders  with  the  other  hand.  If  the  substance  be  down  some  way 
in  the  gullet,  it  may  be  pushed  along  into  the  stomach  by  some 
smooth,  blunt  instrument. 

Foreign  Bodies  in  the  Windpipe. 

Sometimes  foreign  bodies  will  remain  a  long  time  in  the  windpipe, 
and  will  only  create  some  inflammation  and  cough,  but  not  any  im- 
mediately dangerous  symptoms.  When  the  body  has  gone  entirely 
below  the  epiglottis,  l)ut  little  can  be  done,  except  to  give  a  pinch  of 
snuff  to  cause  sneezing,  and  to  direct  the  patient  to  expel  the  air  ex- 
plosively from  the  lungs  by  a  few  energetic  and  sudden  coughs.  This 
may  drive  the  offending  body  out. 

Bleeding  from  Wounds. 

If  bleeding  occur  from  any  part  where  a  bone  lies  near  the  surface, 
as  the  head  or'  face,  it  may  generally  be  stopped  by  pressing  firmly 
against  the  bone  with  a  finger,  or  a  piece  of  cork,  or  by  binding  on 
tightly  a  hard  pad.  If  this  does  not  succeed,  lift  up  each  edge  of  the 
wound,  and  examine  carefully  to  see  if  any  small  stream  of  blood  is 
spouting  out  in  jets.  If  so,  an  artery  is  wounded,  and  the  point  of 
small  forceps  or  tweezers  must  be  dipped  in  where  the  jets  come 
from;  the  spouting  mouth  taken  hold  of  and  drawn  out;  and  a 
strong  silk  thread  passed  aro'ind  it,  and  tied  below  the  forceps.  The 
white  and  gaping  mouth  of  the  vessel  may  then  be  seen. 

If  the  bleeding  be  profuse  from  an  arm,  the  whole  current  of  blood 
to  that  limb  must  be  cut  off,  which  may  be  done  by  some  person 
pressing  a  thumb  firmly  into  the  neck  behind  the  middle  of  the  col- 


:^jtd.*^\£^: .  '.■.-^.^^'^^^..-Si^.^  .  ■^..^^.^■^.^■^t.^-.-r.-.  -^.^i.^..:  j^:.t'^.  •  .:•::.. :..^f^-:..J:^.- 


600 


SURGICAL   DISEASES. 


lar-bone.  This  will  clam  ap  the  blood  in  the  great  artery  of  the  arm, 
as  it  conies  out  of  the  chest.  The  handle  of  a  door-key,  wrapped  in 
several  folds  of  linen,  may  be  pressed  upon  this  place  for  a  long  time 
until  medical  assistance  can  be  had. 

Dangerous  bleeding  from  the  thigh  or  leg  may  often  be  stopped  by 
pressing  the  great  artery  just  below  tlie  crease  of  the  groin. 

If  the  bleeding  be  below  the  middle  of  the  upper  arm,  or  middle 
of  the  thigh,  pass  a  handkerchief  once  or  twice  around  the  limb,  as 
far  above  the  wound  as  possible,  and  tie  it  tightly.  Slip  a  stiff  stick 
under  thi^,  and  turn  it  round,  like  the  handle  of  an  auger,  until  tlie 
handkerchief  becomes  so  tight  as  to  stop  the  bleeding.  This  arrange- 
ment is  called  a  stick-tourniquet,  and  is  intended  to  answer  the  same 
purpose  as  the  instrument  represented  by  Fig.  155. 

One  of  the  best  methods  now  in  use,  of  arresting  hemorrhage  in 
cases  of  accidental  injuries  ol  the  large  arteries  of  the  extremities,  is 
by  surrounding  the  limb  above  with  two  turns  of  a  piece  of  rubber 
tubing  about  three-fourths  of  an  inch  ia  diameter,  and  tying  it  tiglit. 
This  safely  and  effectually  controls  all  bleeding. 

Advantage  is  taken  of  this  elastic  property  of  rubber  in  controlling 
hemorrhage,  in  performing  what  is  called  bloodless  operations  of  sur- 
gery. It  is  called  Esmarch's  method,  from  the  name  of  the  origitiii- 
tor.  It  may  be  resorted  to  in  all  operations  on  the  extremities,  whether 
of  amputations,  che  removal  of  tumors,  or  in  the  minor  operations  of 
removing  needles,  and  whenever  the  bleeding  interferes  with  the  per- 
formance of  the  operation. 

It  is  applied  as  follows :  The  limb  should  first  be  tightly  bandaged 
with  an  elastic  rubber  bandage  about  three  inches  wide,  from  below 
upwards,  and  then  surrounded  at  the  highest  'point  with  a  band  or 
tube  of  rubber  in  the  place  of  a  tourniquet.  The  bandage  is  then  to 
be  removed,  when  the  operation  may  be  performed  in  temporarily 
bloodless  tissues. 

An  amputation  of  the  thigh  may  be  thus  performed  without  loss  of 
any  blood  of  consequence. 


Anaesthetics. 

In  these  days  when  so  much  wonderful  surgery  is  done  and  when 
everybody  desires  to  have  the  advantage  of  all  modern  methods  being 
employed  in  the  treatment  of  their  case,  a  little  knowledge  of  anses- 
thesia  will  be  of  service  to  the  reader.  Before  the  discovery  of  ether 
an  operation  meant  torture  to  the  patient.  If  you  should  visit  some 
of  the  old  operating-rooms  you  would  find  rings  in  the  floor  to  which 
ropes  tised  to  be  attached  in  order  to  hold  down  the  patient.  Ether 
is  the  most  commonly  employed  anaesthetic,  and  is  safe  to  inhale,  sure 
in  its  action  and  gives  the  least  mortality.  Something  like  one  per- 
son in  50,000  dies  from  the  inhalation  of  ether  against  one  in  15,000 
to  30,000  when  inhaling  other  anaesthetics.     It  is  not  over  pleasaut 


SURGICAL   DISEASES. 


601 


artery  of  the  arm, 
)r-kt:y,  wrapped  in 
,ce  for  a  long  time 

[ten  be  stopped  by 
,he  groin, 
er  arm,  or  middle 
round  the  limh,  as 
Slip  a  stiff  stick 
in  auger,  until  the 
ing.  This  arrange- 
io  answer  the  same 
t. 

ing  hemorrhage  in 
the  extremities,  is 
a  piece  of  rubber 
and  tying  it  tight. 

bber  in  controlling 
s  operations  of  sur- 
ime  of  the  origina- 
xtremities,  whether 
minor  operations  of 
rferes  with  the  per- 

be  tightly  bandaged 
!8  wide,  from  below 
»int  with  a  band  or 
1  bandage  is  then  to 
ned  in  temporarily 

•med  without  loss  of 


y  is  done  and  when 
>dern  methods  being 
knowledge  of  anses- 
le  discovery  of  ether 
)U  should  visit  some 
in  the  floor  to  which 
the  patient.  Ether 
9  safe  to  inhale,  sure 
lething  like  one  per- 
gainst  one  in  15,000 
is  uot  over  pleasant 


to  inhale,  as  it  is  somewhat  pungent  and  choky  to  breathe  when  first 
inhaled.  Tliis  sensation  soon  passes  off.  A  longer  time  is  required 
to  produce  anaesthesia  with  ether  than  with  chloroform,  but  its  greater 
sjifoty  overbalances  this  slight  disadvantage.  Vomiting  more  fre- 
quently occurs  after  ether  than  after  chloroform. 

Chloroform  is  the  next  most  commonly  employed  anaesthetic.  It 
is  agreeable,  quick  in  its  action,  and  very  little  is  required.  It  is 
the  common  angesthetic  in  European  practice,  yet  its  greater  mortality, 
the  sudden  change  in  heart  and  lung  action,  render  its  usefulness 
much  more  limited  in  this  country  than  that  of  ether.  It  is  employed 
especially  in  cases  complicated  by  lung  and  kidney  disease  in  the 
young  and  very  old. 

The  A.  C.  E,  mixture,  so-called,  is  still  a  third  anaesthetic,  and  is 
composed  of  a  mixture  of  alcohol,  chloroform  and  ether,  and  is  fre- 
^acntly  given  to  start  a  case  with,  as  its  inhalation  is  pleasant  and 
its  anaesthetic  properties  quick.  Its  mortality  rate  lies  between  that 
of  ether  and  chloroform.  Some  people  take  these  anaesthetics  with 
perfect  comfort;  others,  being  timid,  require  a  larger  amount  and 
give  in  to  its  soporific  effects  very  slowly. 

Of  late  Cocaine  has  been  introduced  into  medical  practice  as  a 
means  of  rendering  the  flesh  numb  and  painless  when  injected  under 
the  skin  about  the  site  of  the  part  to  be  operated  on.  It  has  the  great 
advantage  of  maintaining  the  senses  other  than  that  of  sensation  and 
pain  perfectly  intact.  By  its  use  large  operations  may  be  done,  and, 
in  the  case  of  minor  operations,  time  and  money  are  saved  and  bad 
after-effects  are  avoided.  Sometimes  a  temporary  faintness  occurs 
from  the  use  of  a  too  strong  solution,  but  this  can  always  be  avoided 
by  weaker  solutions  and  overcome  at  the  time  by  a  little  stimulant. 

There  is  a  popular  feeling  that  ether  and  chloroform  leave  their 
traces  in  the  system  for  a  long  time  afterward ;  such  is  not  the  case, 
however,  and  fear  need  never  be  entertained  that  the  system  will  be 
left  the  weaker  for  it. 

In  the  use  of  anaesthetics  proper,  certain  rules  are  to  be  observed. 
Nothing  solid  is  to  be  eaten  for  a  number  of  houi-s  previous  to  the  in- 
halation. All  artificial  teeth  must  be  removed  and  all  waist-bands 
and  tight  clothing  should  be  loosened  if  not  removed. 

A  little  strong  coffee  or  a  little  brandy  and  hot  water  may  be  given 
by  mouth  to  prevent  the  subsequent  vomiting  and  nausea. 

Care  of  the  Teeth. 

Decay  and  loss  of  the  teeth  is  common  even  among  the  young. 
Few  persons  at  the  age  of  twenty  have  sound  teeth,  and  the  ten- 
dency to  decay  is  no  doubt  to  some  extent  inherited;  but  with  care- 
ful attention  they  may  be  preserved  in  good  condition  till  late  in  life. 
Parents  should  inculcate  in  their  children  the  habit  of  cleanliness  of 
the  teeth. 


Sf...; 


»iri,*h-*Uf.nti 


i^i 


602 


SURGICAL   PT£)EASE8. 


Rotting  of  the  Teeth.— Cams. 

This  is  not  confined  to  any  age,  temperament,  or  condition  of 

^°  The 'teeth  become  diseased,  die,  and  drop  away,  while  all  the  other 
orcans  are  sound  and  active. 

The  Creator  doubtless  intended  that  all  the  members  of  the  same 
body  should  be  equally  durable ;  but  certain  laws  of  nature,  violated 
by  us  habitually,  turn  upon  us,  as  it  were,  in  anger,  and  smite  us  full 
in  the  face,  breaking. our  teeth,  and  robbing  us  of  the  means  of  pre- 
serving  the  health  which  we  do  not  appear  to  prize. 

When  rotting  begins  in  the  teeth,  its  progress  is  more  or  less  rapid 
and  their  destruction  is  certain,  unless  it  is  arrested  by  artificial 

™  Tlfe"  enamel  is  nature's  fortification  to  protect  the  teeth  against  ex- 
ternal injuries.     When  this  is  broke.,  or  worn  away,  the  bone  of  the 
tooth  becomes  exposed,  and  rotting  begins  immediately.     Whateve 
has  a  tendency  to  crack,  break  up,  or  destroy  the  enamel,  therefore,  is 
to  be  carefully  avoided.  '  ^ 

Hot  Drinks,  or  hot  food,  coming  suddenly  in  contact  with  the  en- 
amel, are  liable  to  crack  it,  and  expose  the  bony  substance  of  the 
tooth.  The  enamel  is  exceedingly  brittle,  much  like  glass  in  its 
structure,  and  is  easily  cracked  when  exposed  to  sudden  transitions 
from  heat  to  cold,  and  from  cold  to  heat. 

Luxurious  Living  often  deranges  the  general  health,  and  causes 
acid  and  unhealthy  secretions  in  the  mouth,  which  act  injuriously 
upon  the  enamel. 

Acids  are  injurious  to  the  enamel;  and  when  taken  sb  medicine, 
should  be  well  diluted,  and  in  some  cases,  drunk  through  a  tube,  so 
as  not  to  come  in  contact  with  the  teeth.  Sugar  is  not  directly  inju- 
rious to  the  teeth,  as  many  suppose ;  but  i.f  allowed  to  ^e^  about 
and  between  them,  it  may  generate  an  acid  which  is  destructive  to 
the  enamel. 

A  Crowded  Condition  of  the  teeth  in  the  mouth  causes  the  enamel 
to  wear  away,  and  leads  to  rotting;  in  which  case,  early  attention 
and  advice  from  a  dentist  is  quite  important. 

Food  Lodged  Between  the  Teeth,  and  in  their  depressions,  is  a 
cause  of  extensive  decay.  Animal  and  vegetable  ."patter, j^hen  ex- 
nosed  to  warmth  and  moisture,  soon  generate  an  acid  which  corrooes 
the  enamel.  The  teeth,  consequently,  often  begin  to  decay  in  parte 
where  one  presses  upon  another,  and  in  depressions,  where  food  lodge^ 
and  remains.  This  shows  the  necessity  of  cleausiug  the  mouth  and 
teeth  often,  — particularly  after  meals. 


/. 


SURGICAL   DISEASES. 


603 


nes. 

t,  or  condition  of 

while  all  the  other 

mbers  of  the  same 
of  nature,  violated 

r,  and  smite  us  full 
the  means  of  pie- 

;e. 

}  more  or  less  rapid, 

rested  by  artificial 

he  teeth  against  ex- 
i^ay,  the  bone  of  the 
iiately.  Whatever 
3namel,  therefore,  is 

jontact  with  the  en- 

ly  substance  of  the 

;h  like  glass  in  its 

sudden  transitions 

L  health,  and  causes 
lich  act  injuriously 

taken  as  medicine, 
:  through  a  tube,  so 
•  is  not  directly  inju- 
ved  to  remain  about 
ah  is  destructive  to 

th  causes  the  enamel 
case,  early  attention 

Bir  depressions,  is  a 
jle  matter,  when  ex- 
acid  which  corrodes 
rin  to  decay  in  parts 
ris,  where  food  lodges 
isiug  the  mouth  and 


Mercury,  when  taken  to  the  extent  of  salivation,  —  whether  it  be 
calomel,  corrosive  sublimate,  blue  pill,  or  any  other  form  of  it,  — 
causes  inflammation  of  the  membranes  about  the  teeth,  and  indirectly 
produces  ctries. 

Acidity  of  the  stomach,  the  contact  of  decaying  teeth  and  dead 
stumps  with  sound  ones,  diseased  and  ulcerated  gums,  and,  above 
all,  a  filthy,  unclean  and  unwholesome  condition  of  the  mouth,  are 
active  causes  of  diseased  teeth. 

improper  Tooth-Powders,  us  those  containing  gritty  particles,  are 
to  be  avoided. 

Tobacco,  by  deranging  the  general  health,  may  be  indirectly  inju- 
rious to  the  teeth.  Smoking  blackens  the  teeth ;  and  though  chewing 
may  be  useful  in  deadening  the  sensibility  of  the  nerve  of  a  decaying 
tooth,  this  alone  is  not  a  sufficient  reason  for  so  uncleanly  and  disa- 
greeable a  habit,  while  so  many  agents  may  be  found  to  produce  the 
same  effect. 

Tartar.  —  This  is  derived  from  the  saliva,  and  is  found,  when  ex- 
amined by  the  microscope,  to  be  composed  of  myriads  of  living 
animals.  When  first  deposited  around  the  teeth,  it  is  in  a  soft  state ; 
but,  when  not  brushed  away,  it  soon  hardens,  and  changes  from  a 
yellow  to  a  brown,  and  sometimes  to  a  black  color ;  and  often  in 
children  it  becomes  a  dark  green.  It  destroys  the  beauty  of  the 
teeth,  giving  them  a  filthy  and  revolting  look ;  the  setting  of  the 
teeth  in  their  sockets  is  weakened ;  their  appearance  is  elongated ; 
the  periosteum  or  covering  of  the  fang  becomes  inflamed  and  tender ; 
and,  if  the  proper  remedy  be  not  applied,  the  teeth  will  become  loos- 
ened, and  finally  fall  from  their  sockets.  It  causes  the  gums  to  be- 
come inflamed,  swollen,  tender,  and  ulcerated,  and  loads  the  breath 
with  a  disagreeable  fetor.  Its  direct  influence  on  the  teeth  is  not 
great ;  but  it  vitiates  all  the  secretions  of  the  mouth,  and  is  thus  a 
very  efficient,  though  an  indirect  cause  of  decaying  teeth.  In  all 
cases,  it  should  be  immediately  and  carefully  removed,  and  some 
astringent  wash,  made  from  Peruvian  or  oak  bark,  be  applied  to 
reduce  the  inflammation  and  swelling  of  the  gums. 


Tooth-Ache. 

This  is  generally  caused  by  an  exposure  of  the  nerve  which  fills 
the  internal  cavity  of  the  tooth.  This  exposure  is  caused  by  a  frac- 
ture, or,  more  commonly,  by  the  rotting  away  of  a  part  of  the  tooth. 
This  nerve  is  extremely  sensitive ;  and,  by  coming  in  contact  with 
the  air  and  acrid  substances,  inflammation  is  excited,  and  tooth- 
ache is  the  consequence. 

Teeth  sometimes  ache  when  they  are,  to  all  appearance,  perfr^ctl)- 
sound.     This  may  be  caused  by  bony  enlargements  of  the  ends  of 


.    I 


■:vi' 


604 


8'JBaiOAL   PI8KA8E8 


y-A 


the  fangs,  inflammation  of  the  periosteum,  a  peculiar  irritability  and 
ague  of  the  face,  which  excite  neuralgia,  etc. 

Pain  of  a  sound  tooth  is  sometimes  caused  by  sympathy  with  a 
decajdng  one,  by  a  disordered  stomach,  or  by  scurvy,  pregnancy,  tar- 
tar, or  whatever  excites  painful  sympathetic  action  in  the  nerves  of 
the  face. 

Treatment Tooth-ache  may  bo  quieted  by  placing  a  drop  of  oil 

of  cloves,  or  cajeput,  or  a  drop  of  creosote  upon  a  piece  of  cotton, 
and  inserting  it  into  the  cavity  of  the  tooth,  and.  bringing  it  into  con- 
tact with  the  exposed  nerve.  A  few  drops  of  a  five  per  cent  solution 
of  cocaine  placed  in  the  tooth  by  means  of  absorbent  cotton,  or  even 
wiped  around  the  gum,  acts  very  beneficially  and  usually  quiets  the 
worst  tooth-ache.     Chloroform  likewise  is  often  good. 

Pains  of  the  face  and  jaw,  when  not  the  consequence  of  rotten 
teeth,  may  be  relievul  by  holding  brandy,  or  whiskey,  or  rum,  or 
diluted  tincture  of  cayenne,  or  hot  water,  in  the  mouth,  and  by  ex- 
ternal applications  of  laudanum,  Oliver's  plaster,  a  mustard  plaster, 
or  ho[)s  steeped  in  alcohol,  or  a  blister  behind  the  ear.  But  for  teeth 
too  much  decayed  to  bo  saved  by  filling,  there  is  no  remedy  so  proper 
as  extraction. 

Filling  Teeth. 

There  is  no  operation  of  the  dentist  of  more  real  and  lasting 
benefit  to  the  patient  than  that  of  filling  rotten  teeth. 

A  tooth  that  is  well  filled  before  its  nef vp  is  exposed,  is  as  service- 
able as  a  sound  one,  and  nearly  as  durable.  Its  preservation  for 
many  years  is  perfect  and  complete. 

It  is  necessary,  in  the  performance  of  this  operation,  to  remove 
very  carefully  all  rotten  and  foreign  matter  lodged  in  the  cavity ;  to 
make  the  cavity  of  a  dovetail  shape,  so  as  to  retain  the  filling ;  to  wipe 
it  perfectly  dry;  and  to  press  the  gold  in  so  as  to  make  the  cavity 
perfectly  water  and  air  tight.  A  tooth  filled  in  this  way  may  be 
preserved  many  years,  and  in  many  cases  during  life. 

When  decay  has  gone  so  far  as  to  expose  the  nerve  and  render  a 
tooth'  painful,  the  nerve,  in  all  cases,  should  be  destroyed  before  the 
cavity  is  filled ;  otherwise  there  may  be  soreness,  and  sometimes  ex- 
treme pain  making  the  extraction  of  the  tooth  absolutely  necessary. 

A  tooth  filled  after  the  nerve  is  destroyed  is  not  as  good  as  if  filled 
before  the  nerve  was  exposed ;  the  walls  of  the  cavity  are  thinner  and 
weaker,  and  consequently  are  more  liable  to  break  and  crumble  away 
when  brought  into  contact  with  hard  substances ;  and  the  filling  will 
be  more  likely  to  be  loosened.  There  is  likewise  some  danger  of  ulcer- 
ation and  absorption  at  the  root  of  a  tooth,  when  filled  in  this  condition, 
which  makes  it  very  important  that  teeth  should  be  filled  early. 

Gold  foil  is  preferable  to  all  other  substances  for  filling  teeth.  H 
it  is  properly  dressed  and  polished,  it  will  remain  in  the  mouth  for 
many  years  without  any  sensible  loss  of  its  substance. 


SUUOIOAIi   DIHKASKS 


605 


,ar  irritability  and 

'  sympathy  with  a 
y,  pregnancy,  tar- 
in  the  nerves  of 

icing  a  drop  of  oil 
a  piece  of  cotton, 
inging  it  iiitocou- 
)  per  cent  solution 
nt  cotton,  or  even 
usually  quiets  the 
lod. 

leqnence  of  rotten 
liskey,  or  rum,  or 
mouth,  and  by  ex- 
1  mustard  plaster, 
jar.  But  for  teeth 
)  remedy  so  proper 


B  real  and  lasting 

5th. 

josed,  is  as  service- 

3  preservation  for 

eration,  to  remove 
i  in  the  cavity ;  to 
the  filling;  to  wipe 
a  make  the  cavity 

this  way  may  be 
ife. 

lerve  and  render  a 
stroyed  before  the 
and  sometimes  ex- 
isolutely  necessary, 
as  good  as  if  filled 
ity  are  thinner  and 
and  crumble  away 
and  the  filling  will 
ntie  danger  of  ulcer- 
ed in  this  condition, 
m  filled  early. 
)r  filling  teeth.    If 

in  the  mouth  for 
buce. 


The  First  Teeth. 

It  is  an  imperative  duty  of  parents  to  see  that  their  children's  teeth 
have  early  and  careful  attention. 

The  health  and  durability  of  the  permanent  teeth  depend  materi- 
ally on  the  healthy  condition,  regularity  and  durability  of  the  tempo- 
rary ones.  It  may  seem  strange  that  diseases  of  the  first  set  of  teeth 
should  influence  the  set  which  is  to  follow ;  but  wlien  we  consider 
that  the  rudiments  of  the  second  set  already  exist  when  the  first  are 
cut,  it  is  not  unreasonable  to  suppose  they  may  inherit  disease  from 
their  predecessors. 

Cleaning  the  Teeth. 

The  most  important  rule  to  be  observed  in  the  preservation  of  the 
teeth  is  to  keep  them  perfectly  clean,  and  never  to  allow  any  foreign 
substance  to  remain  on  or  about  them.  A  decaying  tooth  should 
never  be  allowed  to  remain  in  the  mouth  ;  it  causes  others  to  decay. 

If  tartar  has  been  allowed  to  collect,  have  it  removed  immediately. 
The  teeth  should  be  carefully  and  thoroughly  brushed  daily  with 
warm  water,  and  the  occasional  use  of  a  dentifrice  that  is  impalpably 
fine,  and  that  contains  no  acid. 

A  Brush  has  no  bad  effect  upon  the  teeth,  as  some  suppose,  for 
the  parts  of  the  teeth  most  exposed  to  the  friction  of  a  brush  are 
never  the  first  to  begin  to  decay.  This  beginning  of  decay  takes 
place  in  their  depressed  surfaces,  and  where  they  touch  each  other. 
A  soft  brush  is  better  for  the  teeth  than  a  stiff  one,  because  the  lat- 
ter is  apt  to  fret  the  gums,  and  cause  them  to  recede,  which  gives 
the  teeth  a  lengthened  appearance. 

Teeth  in  a  crowded  condition  should  never  be  filed,  unless  they 
begin  to  decay. 

Tooth-Picks,  made  of  quill,  or  wood,  or  ivory,  should  be  used  after 
meals,  and  all  particles  of  food  lodged  between  the  teeth  should  be 
removed. 

In  Sickness.,  the  rules  for  cleanliness  of  the  teeth  should  be  more 
rigidly  enforced  than  at  any  other  time,  as  then  they  are  more  ex- 
posed to  destructive  agents,  and  are  liable  to  participate  in  the  gen- 
eral debility  and  disease  of  the  system. 

Influence  of  Diseased  Teeth  upon  the  Health. 

The  bad  effects  of  a  diseased  and  unclean  mouth  upon  the  general 
health  are  of  more  serious  consequence  than  most  people  are  aware, 
in  twenty-four  houi-s,  we  breathe  twenty  thousand  times ;  and  what 
must  be  the  effect  upon  the  delicate  structure  of  the  lungs,  when, 
for  days,  months  and  years,  the  air  we  breathe  is  drawn  through  a 


iVfTSftfjuram^— 


njAiiiim 


606 


SUKOIOAI,    D'SEASES. 


1 

s 


depository  of  filth,  and  is  poisoned  by  being  mixed  with  effluvia 
arising  from  decayed  and  diseased  matter  in  the  mouth. 

The  intermittent  fevers  of  the  West  are  caused  by  the  eflla.iii 
arising  from  the  decaying  matter  of  low  grounds  and  marslies,  which 
can  hardly  be  more  pernicious  than  the  effluvia  from  the  impuiity 
and  corruption  generated  in  an  unclean  mouth,  filled  with  decayiii),' 
teeth.  Dr.  Hays  says  "  no  species  of  animal  matter  is  sc  offensive  to 
the  health  and  vitality  of  the  adjoining  substance,  whether  nerve,  or 
membrane,  or  any  part  or  portion  of  the  living  body,  as  decaying 
bone." 

Dr,  Ira  Warren's  Paracentesic  Instrument. 

PtTNOTDRiNO  the  chest  for  drawing  off  water  in  extensive  pleuritic 
effusion,  as  practised  of  late,  has  proved  one  of  the  most  valuable 
operations  in  modern  surgery.  Like  most  new  operations,  however, 
it  has  been  embarrassed  by  imperfect  instruments. 

The  annexed  cut  represents  an  improved  instrument  which  I  have 
just  invented,  by  which  this  operation  is  made  extremely  simple  and 
easy.     At  the  right  hand  is  the  puncturing  instrument,  including  the 


V 


i 


FIO.  187. 


external  canula,  and  the  trochar  inserted  -in  it.  At  the  letter  i  is  a 
sliding  guard  which  moves  back  and  forth,  and  may  be  set  at  the 
point  of  desired  depth  to  which  it  is  desirable  to  puncture,  and  made 
fast  by  a  screw.  By  this  arrangement  it  may  be  driven  home  to  the 
desired  depth,  without  any  fear  of  going  too  far,  or  of  falling  short 
of  the  mark.  The  guard  also  serves  in  a  measure  to  keep  the  instru- 
ment steady  during  the  operation,  and  to  prevent  inflicting  pain  by 
having  it  oscillate  about.     At  6  is  a  tubular  attachment  opening  into 


•Wf 


8lTR(iICAL   IiIBEABES. 


607 


ixed  with  effluvia 
louth. 

ed  by  the  efllu.irt 
Did  marshes,  wliich 
from  the  impurity 
lied  with  decaying 
31-  is  so  offensive  to 
,  whether  nerve,  or 
body,  afl  decaying 

strutnent. 

extensive  pleuritic 

the  most  valuable 

perations,  however, 

iment  which  I  have 
tremely  simple  and 
ment,  including  the 


the  canula ;  to  this  an  india-rubber  hose  is  attached,  which  connects, 
lit  the  other  end,  with  tlie  cock  a,  upon  the  exhausted  receiver  o. 
To  a  cock,  c,  on  the  other  side  of  the  receiver,  another  rubber  hose  is 
fastened,  which  connects  at  the  other  end  with  an  air-pump. 

The  mode  of  operating  is  exceedingly  simple.  First,  exhaust  tlie 
receiver;  then  quickly,  yet  gently,  plunge  iu  the  instrument,  and, 
leaving  the  canula,  withdraw  the  trocar  till  the  point  passes  the  con- 
necting tul)e  at  b,  when  the  water  will  '  mediately  flow,  in  a  full 
stream,  into  the  exhausted  receiver  o.  lue  working  of  the  appara- 
tus is  extremely  beautiful.  Five  pints  of  water  may  be  taken  away 
with  it  in  five  minutes,  —  an  amount  which  cannot  be  got  with  the 
old  instrument  in  much  less  than  half  an  hour.  If  the  patient  can- 
not bear  to  have  it  drawn  so  rapidly,  the  stream  may  be  wholly  or 
partially  arrested,  at  any  moment,  by  entirely  or  partly  closing  the 
cock  a. 

The  reader  will  see  that  the  apparatus  is  so  arranged  that  the  ad- 
mission of  air  into  the  chest  is  entirely  impossible. 

The  artist,  in  making  the  drawing  for  me,  has  inserted  the  instru- 
ment much  farther  forward  than  the  point  usually  selected. 

My  apparatus  has  a  second  puncturing  instrument,  a  little  larger 
in  size,  for  the  purpose  of  operating  in  ascites,  or  dropsy  of  the  belly. 

This,  or  similar  instruments,  can  be  bought  of  any  good  dealer  in 
surgical  instruments. 


.  At  the  letter  i  is  a 
i  may  be  set  at  the 
I  puncture,  and  made 
B  driven  home  to  the 
r,  or  of  falling  short 
re  to  keep  the  instrii- 
nt  inflicting  pain  by 
ichment  opening  into 


A  BRIEF  TREATISE  ON  THE 

HOM(EOPATHIC  TREATMENT  OF 

DISEASES. 


BY  A.  E.  SMALL,  M.D., 
Pbmidint  or  tkb  Hahnkm ann  Mbdioal  Collmb,  OmoAoo. 


I> 


'in 


In  the  following  pages  will  be  found  a  reliable  guide  in  the  ad- 
ministration of  homeopathic  remedies  for  the  various  ills  known  to 
occur  in  almost  every-day  life.  Nearly  every  disease  incident  to  the 
human  family  is  briefly  considered,  and  the  corresponding  treatment 
explicitly  stated.  It  must  be  borne  in  mind  that  homceopatliic 
remedies  are  addressed  to  vital  forces,  whose  derangement  may  be 
seen  in  the  manifold  forms  of  disease.  But,  in  order  to  obtain  the 
desired  effect  from  the  administration  of  any  remedy  for  a  given  case, 
a  certain  principle  must  be  observed  in  its  selection.  This  princi- 
ple is  believed  to  be  a  competent  guide  in  affiliating  remedies  to  dis- 
eased conditions.  The  discovery  of  a  universal  law  of  cure,  which 
points  out  the  direct  relationship  between  all  diseases  and  their 
remedies,  is  ascribed  to  Hahnemann,  the  founder  of  the  homoeopathic 
system  of  medicine.  By  numerous  experiments  with  drugs  upon 
healthy  individuals,  he  ascertained  that  diseases  are  curable  by  such 
medicines  as  are  capable  of  producing  similai-  characteristics :  as,  for 
instance,  chamomile  will  produce  a  colic,  and  will  cure  a  similar  one 
from  some  morbific  cause;  hence,  the  formula,  "«SV7ni7ia  gimilibvs  cu- 
rantur,"  is  the  principle  that  guides  in  the  administration  of  remedies. 
Every  medicine  has  a  specific  range  of  action  in  the  body :  one  will 
act  on  one  set  of  organs,  and  another  on  another  set ;  some  will  direct 
their  energies  so  as  to  affect  one  locality,  and  others  to  another. 
The  only  way,  therefore,  of  ascertaining  how  a  remedy  will  direct 
its  action  to  any  local  or  general  disease  is  by  trying  it  first  upon 
healthy  persons  in  order  to  ascertain  its  range  of  action.  As  disease 
manifests  its  action  by  symptoms,  so  remedies  show  their  action  by 
symptoms,  in  a  similar  manner ;  and,  when  a  disease  presents  itself 
for  treatment,  a  remedy  must  be  selected  whose  pathogenetic  effects 
upon  those  in  health  resemble  the  phenomena  of  the  disease.  The 
homoeopathic  materia  medica  is  made  up  of  a  collection  oi  remedies 
that  have  been  thus  tried.  Those  employed  in  this  treatise  are  of 
this  character,  and  are  comprised  in  the  following 

608 


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23  WEST  MAIN  STREET 

WEBSTER,  N.Y.  14580 

(716)  872-4503 


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Microfiche 

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HOMffiOPATHIC   TREATMENT  OF   DISEASES. 


600 


.  Acouite.  3. 
,  Aloea.  6. 
,  Alumina.  6. 

Ammonium  carb.  6. 
,  Antimonium  crud.  6. 
.  Apis  mellifica.  6. 
,  Arnica  montana.  3. 

Arseiiicum  album.  6. 

Aurum  metallicum.  6. 

Anacardium.  3. 

Baptisia.  1. 

Belladonna.  3. 
.  Bismutli  subnit.  3. 

B;  yonla  alba.  3. 

Calcarea  carb.  6. 

Calendula.  1. 

Camphora.  3. 

Capsicum.  3. 

Cantharis.  3. 

Cannabis  sat.  3. 

(Jarbo  animalis.  6. 

Carbo  veg.  6. 

Causticum.  6. 

Chamomilla.  3. 

China,  o. 

Ciitilidonium  maj.  3. 

Ciraicifu^a  racem.  1. 

Cicuta  virosa.  3. 

Cina.  3. 

Cocculus  indicus.  3. 

Coffea  cruda.  6. 

Colchicum.  3. 

Colocynthis.  3. 

Conium  mac.  3. 

Crocus  sativa.  3. 

Cuprum  acet.  6. 


♦  LIST  OF  EEMEDIES. 


37.  Digitalis.  3. 
t38.  Dioscorea  villosa.  2. 

oO.  Drosera  rotundifolia.  3. 

40.  Dulcamara.  3. 
t41.  Elaterium.  3. 

42.  Euphorbium.  3. 

43.  Euphrasia.  3. 
144.  Ferrum  redact.  3. 

45.  Gambogia.  3. 

46.  Gelsemium.  1. 
t47.  Graphites.  6. 

48.  Olonoinum.  6. 

49.  Holleborus  nig.  6. 
ISO.  Ilepar  sulpli.  6. 

61.  Hyoscyamus  nig.  3. 

62.  Hamamelis.  1. 

63.  Ignatia  amara.  3. 

64.  lodium.  6. 

66.  Ipecacuanha.  3. 

66.  Iris  versicolor.  3. 
t67.  Kali  carb.  6. 
t68.  Kali  bichromicum.  3. 

69.  Lachesis  trig.  6. 

60.  Ledum  palustre.  3. 

61.  Laurocerasus.  3. 
t62.  Leptandria.  3. 

t63.  Lycopodium  clav.  6. 

64.  Lobelia  inilata.  3. 

66.  Mercurius  corrosivus.  6. 
t66.  Mercurius  vivus.  6. 
t67.  Mercurius  iod.  3. 
t68.  Mercurius  biniod.  3. 

69.  Mercurius  sol.  6. 

70.  Mezerium.  3. 

71.  Moschus.  6. 

72.  Natrum  muriat.  6. 


73.  Nitrum.  6. 

74.  Nitric  acid.  6. 
76.  Nux  vomica.  6. 

76.  Nux  moschata.  6. 

77.  Opium.  3. 

78.  Oleander.  3. 

79.  Petroleum.  6. 

80.  Phosphorus.  6. 

81.  Phosphoric  acid.  6. 
t82.  Platina.  6. 

83.  Phytolacca  decandra.  1. 

84.  Pulsatilla.  6. 

85.  Podophyllum  pelt.  3. 

86.  Rhus  tox.  3. 

87.  Ruta  graveolons.  3. 

88.  Sabina.  3. 

89.  Sambucus  nig.  3. 

90.  Sanguinaria.  3. 

91.  Secale  cornutum.  3. 

92.  Senega.  3. 

93.  Sepia  succus.  6. 
194.  Sillcea.  6. 

96.  Spigelia.  3. 

96.  Spongia.  3. 

t97.  Stannum.  6. 

98.  Staphysagria.  3. 

99.  Stramonium.  3. 
tlOO.  Sulphur.  6. 

101.  Sulphuric  acid.  6. 

102.  Tartar  emet.  6. 

103.  Uva  ursi.  1. 

104.  Urtica  urens.  3. 
106.  Veratrum  album.  3. 
106.  Veratrum  viride.  1. 

tl07.  Zincum  met.  6. 


TINOTUEES  FOR  EXTERNAL  USE. 


1.  Aconite. 

2.  Arnica. 

3.  Baptisia. 

4.  Calendula. 


6.  Cantharis. 

6.  Conium. 

7.  Causticum. 

8.  Hypericum. 


9.  Ruta gra-eolens, 

10.  Staphysagria. 

11.  Urtaoa  urens. 


mn 


M& 


I..  V 


RULES   FOR   THE   ADMINISTRATION   OF   REMEDIES. 

As  specific  dirsctions  will  be  found  in  the  treatment  of  each  dis- 
ease treated  of  in  this  work,  only  a  few  general  rules  are  necessary. 

1.  In  acute  cases,  the  chosen  remedy  may  be  repeated  every  hour 
or  two  hours,  until  a  change  occurs  ;  then  it  is  prudent  to  wait  awhile 
for  the  result. 

2.  Tf  there  is  no  favorable  reaction  within  a  few  liours,  or  in  very 
acute  pain,  within  half  an  hour,  select  another  remedy  according  to 
the  indications ;  and,  should  no  favorable  reactign  follow  the  adminis- 
tration of  this,  select  another,  and  so  on. 

3.  When  convalescence  follows  the  administration  of  a  remedy,  it 
need  not  be  repeated  unless  the  recuperation  reaches  a  certain  point 
and  then  ceases ;  in  which  event,  select  a  remedy  according  to  indi- 
cations. 

•The  remedies  marked  t  should  bo  bought  as  triturations.  Ask  the  pharmacist  to  pre- 
pare them  all  on  the  decimal  scale,  and  so,  also,  the  dilutions.  The  triturations  may  be 
liiven  dry  on  the  tongue,  a  small  powder  the  size  of  a  pea ;  or  the  same  amount  or  more 
dissolved  in  half  a  tumblerful  of  water,  a  teaspoouful  at  one  dose,  when  it  is  desirable  to 
repeat  the  medicine  at  short  intervals. 


1 

■M 


610 


HOMfEOPATHIC   TRKATMENT  OF   DISEASES. 


4.  The  same  remedy  may  be  repeated  in  case  of  continued  con- 
valescence becoming  interrupted,  provided  there  is  no  change  other 
than  amelioration  of  symptoms. 

5.  A  change  of  remedies  is  admissible  in  obstinate  cases,  when  one 
has  been  employed  for  some  time  without  the  desired  effect.  In 
chronic  cases,  it  is  well  to  try  the  remedy  at  least  a  week  before 

changing. 

6.  In  chronic  diseases,  the  remedies  need  not  be  repeated  oitener 
than  once  or  twice  in  twenty-four  hours,  and  even  at  longer  intervals. 

FORMS   OF  MEDICINES   FOR   ADMIKISTRATION. 

There  are  four  forms  in  which  homoeopatliic  medicines  are  pre- 
pared for  rse :  1.  Mother  tinctures  prepared  from  fresh  plants;  2. 
Triturations  prepared  from  metals,  salts,  earths,  and  herbs  ;  3.  Dilu- 
tions prepared  from  the  tinctures;*  and,  4.  Globules  medicated  with 
the  solutions.  The  last  two  are  generally  employed,  and  the  first 
two  occasionally,  in  household  practice.  When  water  is  employed 
as  a  medium  for  the  administration  of  either  form,  five  drops  of  the 
tincture  or  dilution,  or  ten  globules  (use  size  No.  30),  or  three  or 
four  grains  of  the  trituration,  may  be  thoroughly  mixed  in  half  a 
tumbler  of  water,  and  a  dessertspoonful  of  this  mixture  will  suffice 
for  a  dose.  The  tumbler  containing  the  medicine  should  be  care- 
fully covered,  and  kept  away  from  the  light  and  from  any  cor- 
rupting odor;  and  all  other  medicines,  teas,  tonics,  and  stimulants 
are  strictly  prohibited  during  its  administration ;  and  all  medicated 
poultices,  lotions,  and  the  like,  must  be  avoided,  because  of  their 
interference  with  the  medicinal  action  of  the  remedy. 


KULES    FOR    PRESERVING   THE   PURITY   OF   MEDICINES. 

1.  The  medicines  should  be  kept  in  a  small  box  or  chest,  exclu- 
sively for  this  use,  carefully  closed,  and  in  a  cool  place.  Examine 
the  corks  often  to  see  that  they  are  perfectly  tight. 

2.  Be  careful  to  keep  the  vials  corked  always  with  the  same  cork, 
or  one  that  has  never  been  used  for  any  other  purpose  ;  and  be  par- 
ticularly careful  not  to  misplace  the  corks,  or  fail  to  replace  the 
identical  one  each  time  when  a  vial  is  uncorked  for  use. 

3.  Never  put  medicine  into  a  vial  that  has  been  alieady  used  for 
one  of  a  different  kind,  unless  it  be  thoroughly  washed  and  baked. 

4.  Every  vial  should  be  labelled,  to  prevent  mistakes ;  and  every 
glass,  spoon,  or  cup  should  be  carefully  cleansed  before  using  it  in 
the  preparation  of  a  remedy. 

6.  Never  use  the  same  spoon  in  giving  medicines  of  a  different 
kind  to  different  persons  sick  in  the  same  house. 

•  Dilations  »re  recommended  to  be  prepared  on  the  decimal  «cafe. 


Ilfl! 


'  1 


DISEASES. 

I  case  of  continued  con- 
there  is  no  change  other 

obstinate  cases,  when  one 

,  the  desired  effect.     In 

at  least  a  week  before 

not  be  repeated  oftenor 
even  at  longer  intervals. 

IINI8TRATI0N. 

latliic  medicines  are  pre- 
jd  from  fresh  plants;  2. 
rths,  and  herbs ;  3.  Dilu- 

Globules  medicated  with 
J  employed,  and  the  first 
When  water  is  employed 
jr  form,  five  d'-ops  of  the 
size  No.  30),  or  three  or 
roughly  mixed  in  half  a 

this  mixture  will  suffice 
medicine  should  be  care- 
light  and  from  any  cor- 
as,  tonics,  and  stimulants 
ation;  and  all  medicated 
avoided,  because  of  their 
le  remedy. 

TY   OP   MEDICINES. 

mall  box  or  chest,  exclu- 
ti  a  cool  place.  Examine 
ly  tight. 

Lways  with  the  same  cork, 
her  purpose  ;  and  be  par- 
es, or  fail  to  replace  the 
jrked  for  use. 
has  been  already  used  for 
whly  washed  and  baked, 
vent  mistakes ;  and  every 
sansed  before  using  it  in 

r  medicines  of  a  different 
house. 

t  on  the  itdmal  fcale. 


HOMCEOPATHIC    TKEATMENT   OF   DISEASES.  611 


ANTIDOTES  TO  MEDICINES. 

In  some  exceeding  impressible  conditions,  the  remedy  chosen  may 
produce  intense  aggravation  of  suffering,  which  may  be  relieved  by 
the  administration  of  a  drop  of  Spirits  of  camphor.  If  Belladonna 
should  provoke  an  aggravation.  Aconite  will  antidote  its  effect,  and  so 
will  Camphor  ;  and  this  latter  is  regarded  as  the  general  antidote  of 
homoeopathic  remedies,  two  of  which  should  seldom  be  given  in  alter- 
nation, because  of  the  liability  of  their  neutralizing  the  effects  of 
each  other.  For  the  same  reason  it  will  not  do  to  change  from  one 
remedy  to  another  suddenly.  A  period  of  from  four  to  six  hours 
should  intervene  in  acute  cases,  except  in  emergencies  of  great  pain, 
and  from  one  to  two  days  in  chronic  affections. 

EXTERNAL  APPLICATIONS. 

Compresses  wet  with  cold  water,  covered  with  a  dry  bandage,  are 
always  a  convenient  and  successful  resort  for  bruises,  sprains,  and 
injuries  in  general.  Tepid  applications,  or  cold  when  agreeable,  in 
the  same  way,  may  be  applied  to  local  inflammatory  affections.  Warm 
poultices,  to  hot  and  inflamed  surfaces,  will  often  exert  a  salutary 
influence.  The  tinctures  named  for  external  use  may  at  times  be 
employed  in  full  strength ;  but  lotions  made  of  a  teaspoonful  of  any 
one  of  them,  to  a  cupful  of  cold  water,  is  the  usual  form  of  applying 
them.  Mustard  poultices  may  be  employed,  either  in  full  strength, 
or  tempered  by  adding  to  the  ground  mustard  a  due  proportion  of 
meal.  Sintple  cerate,  cold  cream,  and  healing  salves  may  be  em- 
ployed when  needed ;  but  any  strongly  medicated  poultice,  plaster, 
salve,  or  ointment  must  not  be  used  when  taking  homoeopathic  reme- 
dies. 

BATHING. 

Persons  of  debilitated  constitutions  should  not  bathe  too  frequently; 
for  those  of  robust  constitutions,  this  luxury  may  be  indulged  in  to 
almost  any  extent.  Bathing  in  very  cold  water  is  not  recommended. 
Tepid  baths  are  the  most  beneficial,  and  should  be  taken  regularly 
throughout  the  year.  Kot  baths  are  weakening  and  relaxing.  They 
may  be  employed  for  children  in  convulsions,  and  to  overcome  rigid- 
ity of  the  skin,  or  for  a  cold.  Sulphur  baths  are  sometimes  recom- 
mended for  rheumatism;  but  they  should  be  taken  with  caution ;  and 
this  remark  is  applicable  to  all  vapor-baths.  Sea-bathing  is  good  for 
dyspepsia,  and  those  inclined  to  biliary  derangements.  Consump- 
tives derive  but  little  benefit  from  any  kind  of  bathing  aside  from 
necessary  ablutions.  Tlie  addition  of  salt  to  the  water  is  recom- 
mended in  cases  of  debility. 


B 


I- If 


m 


612 


HOMOEOPATHIC   TKEATMENT   OK   DISEASES. 


DIET  AND  REGIMEN. 

But  little  need  be  said  about  diet  here,  as  that  which  is  appropriate 
is  pointed  out  in  the  following  pages,  as  a  part  of  the  treatment  for 
each  individual  case.  It  may  be  remarked  simply  that  no  medicinal 
condiment  or  food,  no  stimulant  or  other  medicinal  beverage,  can  be 
employed  when  taking  homceopathic  remedies ;  and,  further,  all  pa- 
tients must  be  placed  in  the  best  possible  condition  for  recovery. 
They  must  have  clean  and  well-ventilated  apartments,  and  plenty  of 
fresh  air.  They  must  have  clean  and  well-aired  bedding.  They 
must  have  proper  clothes  and  food  to  correspond  with  the  appetite 
and  wants  of  the  system.  An  experienced  nurse  is  of  great  impor- 
tance, especially  in  fevers. 

For  description  of  diseases,  see  first  part  of  this  book.  It  is  unneces- 
sary to  duplicate  the  descriptions  and  symptoms,  as  they  are  the  same 
for  any  school  of  medicine,  the  remedies  and  manner  of  treatment 
only  differing. 


IM 


DISEASES. 


;hat  which  is  appropriate 
art  of  the  treatment  for 
imply  that  no  medicinal 
dicinal  beverage,  can  be 
es ;  and,  further,  all  pa- 
condition  for  recovery, 
partments,  and  plenty  of 
ll-aired  bedding.  They 
spond  with  the  appetite 
nurse  is  of  great  impor- 

this  book.  It  is  unneces- 
)m8,  as  they  are  the  same 
id  manner  of  treatment 


DISEASES  OP  THE  HEAD. 


Headache.  —  Cephalalgia. 

This  affection  is  usually  attendant  on  other  difficulties,  and  must 
Iw  treated  with  reference  to  the  cause.  If  from  cold,  affecting  the 
entire  system,  and  accompanied  by  pains  in  the  back,  give  Niix 
vomica.  If  from  heat,  or  determination  of  blood  to  the  head,  Bella- 
donna. If  from  chilliness,  Arsenicum.  For  rheumatic  headache  in 
cold,  damp  weather,  Bryonia.  For  that  produced  by  constipation, 
Nux  vomica.  Bilious,  Merc.  viv.  Sick-headache,  Iris  versicolor,  Sepia, 
Pulsatilla,  or  Sulphur:  Nervous  headache,  Coffea.  For  headache 
caused  by  suppressed  eruption,  Calcarea  or  Sulphur.  From  sup- 
pression of  the  menses,  Pulsatilla.  From  a  fall,  or  fatigue.  Arnica. 
From  simple  cold  in  the  head.  Aconite.  A  dose  of  four  globules,  of 
any  remedy  selected,  may  be  repeated  every  four  hours  until  relieved. 

Vertigo,  Swimming  of  the  Head. 

This  uncomfortable  feeling  consists  in  a  sensation  of  the  head 
whirling  around,  causing  one  to  stagger,  and  sometimes  to  fall.  If 
from  a  deranged  stomach,  Nux  vomica.  If  from  a  cold,  G-elsemium 
or  Arsenicum.  From  derangement  of  the  biliary  system,  Aconite, 
Pulsatilla,  or  Bryonia.  Vertigo  produced  by  rush  of  blood  to  the 
head.  Aconite  or  Belladonna.  The  remedy  indicated  may  be  repeated 
in  the  usual  dose  every  two  hours.  For  vertigo  from  riding  in  a 
carriage,  Oocculus.  From  a  shock  or  fall,  Arnica.  Dose  and  ad- 
ministration as  above. 


1   "r 

If 


•tr  ii 


Ringworm  of  the  Scalp. 

This  IS  a  pustular  eruption,  that  begins  at  one  or  more  points  upon 
the  hairy  scalp,  and  spreads  sometimes  so  as  to  involve  much  of  the 
surface.  When  there  are  a  number,  they  spread  until  they  coalesce 
and  form  a  continuous  eruption,  from  which  exudes  a  greenish  or 
sanious  matter,  that  mats  the  hair,  and  renders  the  whole  appearance 
of  the  head  disgusting.  Great  care  is  required  to  keep  the  surface 
clean ;  and,  for  this  purpose,  no  soap  should  be  used.    Water,  softened 

613 


f  j  t 


014 


mSKASES   OF   THE   HEAD. 


by  tlie  white  of  a  raw  egg,  is  a  better  wasli.  Calcarea  may  be  ad- 
miiiistered  in  the  usual  dose  every  morning  and  evening.  If  this 
remedy  does  not  prove  ellicient,  give  Sulphur  in  the  same  way,  and 
also  ffepar  mlph.,  or  Lycopodium.  The  head  may  be,  at  the  same 
time,  washed  once  or  twice  a  day  with  a  lotion  made  of  twenty  drops 
of  the  tincture  of  Sulphur  in  a  half-tumbler  of  water. 

Scald-head.  —  Tinea  Capitis. 

This  is  also  an  eruption  upon  the  scalp,  that  may  be  dry  or  humid. 
•For  the  dry  scald-head,  Natrum  muriaticum  or  Sulphur  may  be  ad- 
ministered twice  or  three  times  a  day.  For  the  humid  scald-head, 
Lycopodium,  Arsenicum,  Conium,  or  Graphites  may  be  given  twice  a 
day.  The  same  restriction  as  to  the  use  of  soap  must  be  observed, 
and  the  same  measures  for  cleansing  may  be  recommended,  as  in  the 
case  of  pustular  ringworm  of  the  scalp. 

•  Ulcers  of  the  Scalp. 

In  scrofulous  children,  these  ulcers  sometimes  occur  in  the  form 
of  small  furunculi,  or  boils,  exceedingly  sore  and  painful.  The  best 
remedies  are  Arsenicum,  ffepar  sulph..  Nitric  acid,  and  Silicea.  They 
may  be  given  as  required  in  daily  doses  of  four  globules.  The  ulcers 
may  be  wet  with  Hamamelis  Virginica,  after  having  been  pricked  with 
the  lancet. 

Baldness. 

When  the  hair  falls  from  the  head  by  reason  of  debility,  the  reme- 
dies to  be  given  are  China  and  Ferrum ;  when  in  consequence  of 
perepiration,  Mercurius ;  from  the  use  of  quinine,  Belladonna,  or 
Pulsatilla;  if  from  the  abuse  of  mercury,  Carbo.  vegeta. ;  if  from 
grief  or  trouble,  Phos.  acid.  If  baldness  occurs  after  protracted 
inflainmatory  diseases,  and  nervous  and  typhoid  fevers,  give  Calcarea 
in  daily  doses,  or  ffepar  sulph.  and  Silicea.  For  dandruff,  give  Ly- 
copodium. 


D. 


Ii.  Calcarea  may  he  ad- 
y  and  evening.  If  this 
ur  in  the  same  way,  and 
sad  may  be,  at  the  same 
in  made  of  twenty  drops 
of  water. 


Capitis. 

at  may  be  dry  or  humid, 
or  Sulphur  may  be  aJ- 
f  the  humid  scald-head, 
?«  may  be  given  twice  a 
soap  must  be  observed, 
recommended,  as  in  the 


Ip. 

imes  occur  in  the  form 
I  and  painful.  The  best 
acid,  and  Silicea.  They 
ir  globules.  The  ulceis 
aving  been  pricked  with 


on  of  debility,  the  reme- 
i^hen  in  consequence  of 
quinine.  Belladonna,  or 
Oarbo.  vegeta. ;  if  from 
occurs  after  protracted 
oid  fevers,  give  Calcarea 
For  dandruff,  give  Ly- 


DISEASES  OP  THE  BRAIN  AND  NEBVE8. 


Brain  Fever. 

This  disease  comes  on  with  more  or  less  pain  in  the  head,  attended 
with  heat  and  delirium ;  the  eyes  also  exhibit  a  red  or  fiery  appear- 
ance :  and  this  pain,  heat  and  delirium  are  sometimes  followed  by  drow- 
siness and  inclination  to  vomit.  The  pulse  is  usually  rapid  and  feeble. 
In  brain  fever,  there  is  loss  of  appetite,  great  restlessness,  short,  com- 
atose naps,  and  frequent  inclination  to  cry  out  with  pain.  Aconite  is 
useful  to  commence  with,  and  this  may  be  followed  with  Belladonna. 
If  respiration  is  hurried  and  labored,  give  Arsenicum.  If  brain  fever 
is  brought  on  by  a  fall,  or  a  blow  upon  the  head,  give  Arnica  ;  and  if 
no  relief  follows  in .  twenty-four  hours,  Glonoin.  If  from  trouble  or 
grief,  Ignatia.  If  from  intoxicating  drinks,  Kux  vom.  If  at  the  men- 
strual period,  Pulsatilla.  If  from  intense  study,  or  close  application 
to  business,  Sulphur  and  Nux  vomica. 

Rush  of  Blood  to  the  Head. 

The  signs  of  this  occurrence  are  intense  headache  or  vertigo  at 
first,  which  is  followed  by  fainting,  and  of'^en  with  loss  of  conscious- 
ness ;  at  times  there  will  be  twitching  and  spasms.  The  difficulty 
may  occur  from  various  causes,  and  is  common  with  females  and 
those  of  nervous  temperament.  Aconite,  in  solution,  may  be  put  iu 
the  mouth  of  the  patient,  and  also  the  head  may  be  wet  with  cold 
water.  The  head  should  be  laid  a  little  lower  than  the  body ;  the 
lower  extremities  should  be  rubbed,  and  friction  should  be  applied  to 
the  arms  and  hands.  Belladonna  may  be  given  after  Aco  lite,  or,  in 
grave  cases,  Glonoin.  If  the  rush  of  blood  has  been  caused  by  run- 
ning and  getting  heated,  give  Arnica,  and  bathe  the  temples  with  a 
solution  of  twenty  or  thirty  drops  in  half  a  tumbler  of  water.  If  at 
the  menstrual  period,  give  Pulsatilla.  In  plethoric  persons,  exposed 
to  the  heat  of  the  sun,  give  Nux  vomica,  and  apply  friction  to  the  ex- 
tremities. If  in  consequence  of  having  drunk  stimulating  beverages, 
Arsenicum  and  Nux  vomica.  If  from  indigestion,  Pulsatilla.  If  from 
fright,  Aconite.     If  from  exposure  to  winter  cold,  Camphora.    The 

616 


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616 


PI8KA8E8   OF   THE   BRAIN   AND   NKHVES. 


dose  of  any  of  the  remedies  selected  may  bo  repeated  every  fifteen 
minutes  until  the  patient  is  better. 

Sunstroke.  —  Coup  de  Soleil. 

Protracted  exposure  to  the  heat  of  the  sun  will  sometimes  pro- 
duce a  sudden  prostration  of  the  nerves,  and  an  intense  headache, 
causing  blindness,  vertigo,  and  extreme  sensitiveness  to  the  glare  of 
light,  and  sometimes  a  sudden  chilliness  and  shuddering,  extremely 
alarming.  This  is  termed  sunstroke,  and  frequently  is  so  intense  as 
to  prove  fatal  in  a  few  hours.  The  remedies  that  have  been  found 
the  most  useful  are  Glonoin^  Belladonna,  Phosphorus.  These  may  be 
given  singly,  and  repeated,  until  relief  is  obtained,  every  thirty  min- 
utes. As  soon  as  the  patient  recovers  consciousness,  give  China,  in 
thf  usual  dose,  several  times  a  day ;  or,  if  there  be  disturbance  of  di- 
gestion and  feeble  voice,  or  entire  loss  of  voice,  Antimonium  cnulum. 
The  patient,  when  convalescent,  should  be  kept  out  of  the  sun,  and 
away  from  strong  light.  After  one  has  suffered  from  sunstroke,  it 
may  be  several  weeks  before  he  really  recovera.  When  it  occurs  in 
summer,  his  system  will  be  exceedingly  impressible  to  the  sun's  rays 
until  cold  weather,  or  until  his  nerves  regain  their  normal  vigor. 
Great  care  should  be  exercised  in  reference  to  the  diet.  For  after 
treatment,  Laohesis  or  Nitrio  add  often  indicated. 

Apoplexy.  —  Apoplexia. 

This  alarming  disorder  is  the  result  of  a  sudden  determination  of 
the  blood  to  the  head,  which  produces  a  rupture  of  some  one  or  more 
of  the  blood-vessels  of  the  brain,  and  a  hemorrhage  in  the  nervous 
centre.  When  only  the  left  side  of  the  brain  sustains  this  injuiy, 
the  right,  upper,  and  lower  extremities  are  liable  to  paralysis.  When 
the  right  is  similarly  effected,  the  left  side  usually  becomes  paralyzed. 
When  both  hemispheres  of  the  brain  become  implicated  in  the  hem- 
orrhage, there  usually  occurs  general  paralysis,  and  the  patient  falls 
entirely  senseless.  There  are  premonitory  symptoms  of  this  disorder, 
which,  if  carefully  heeded,  may  suggest  a  treatment  that  will  ward 
off  the  difficulty.  These  symptoms  are  vertigo,  fullness,  and  dull 
headache,  and  sometimes  nose-bleed.  When  one  feels  an  uncomfort- 
able fullness  of  the  head,  under  which  he  walks  with  an  unsteady 
gait,  he  may  find  relief  by  one  or  two  doses  of  Aconite  ;  or  if  he  finds 
this  uncomfortable  fullness  takes  the  form  of  a  dull,  stupefying  head- 
ache. Belladonna  may  be  preferable,  and  is  the  leading  remedy.  If 
there  is  vertigo  and  fullness,  with  prostration,  Nux  vomica  is  indicated. 
In  case  of  nose-bleed,  give  Aconite,  Bryonia  or  Pulsatilla.  These  pre- 
liminary symptoms  may  be  made  to  disappear  with  these  remedies, 
when  otherwise  they  might  augment  until  an  apoplectic  attack  set 
in.     Then  is  the  period  of  danger.    But  few  cases  of  sanguinary 


v„_ 


NKKVE8. 
)o  repeated  every  fifteen 

!  Soleil. 

sun  will  sometimes  pro- 
nd  an  intense  headache, 
jitiveness  to  the  glare  of 
d  shuddering,  extremely 
equently  is  so  intense  as 
38  that  have  been  found 
osphorus.  These  may  be 
tjiined,  every  thirty  miii- 
ciousness,  give  China,  in 
lere  be  disturbance  of  di- 
ice,  Antimonium  cnidum. 
:ept  out  of  the  sun,  and 
fered  from  sunstroke,  it 
ers.  When  it  occurs  in 
ressible  to  the  sun's  rays 
^in  their  normal  vigor. 

to  the  diet.  For  after 
cated. 

oda. 

sudden  determination  of 
ture  of  some  one  or  more 
lorrhage  in  the  nervous 
ain  sustains  this  injuiy, 
ible  to  paralysis.  When 
ually  becomes  paralyzed. 
i  implicated  in  the  hem- 
lis,  and  the  patient  falls 
mptoms  of  this  disorder, 
reatment  that  will  ward 
irtigo,  fullness,  and  dull 

one  feels  an  uncomfort- 
Bvalks  with  an  unfeteady 
)f  Aconite  ;  or  if  he  finds 

a  dull,  stupefying  head- 
;he  leading  remedy.    If 

Nux  vomica  is  indicated, 
tr  PuUatilla.  These  pre- 
ar  with  these  remedies, 
.n  apoplectic  attack  set 
:ew  cases  of  sanguinary 


DLSKASKti   OK  THE   BKAIN   AND   NEKVES. 


617 


iipoplcxy  arc  cured  ;  and  yet  some  do  recover.  When  the  clot  pres- 
sing upon  the  brain  is  of  snuill  si/,e,  and  ihe  hemorrhage  comparatively 
light,  an  alworption  of  (he  dot  may  take  place,  and  the  patient  re- 
cover; but,  when  the  clot  is  loo  largis  to  be  disposed  of  by  the  pro- 
cess of  absorption,  it  becomes  an  obstacle  in  the  way  of  recovery: 
and  yet  active  measures  should  in  all  cases  be  called  into  requisition. 
Aconite  Bho\x\il  be  placed  in  the  mouth,  and  the  face  should  be  bathed 
with  it.  The  bowels  should  be  moved  l)y  an  enema,  and  cold  appli- 
cations, or  rather  applications  of  tejiid  water,  should  bo  made  to  the 
liead.  Friction  should  be  applied  to  the  surface  of  the  entire  body 
and  the  extremities.  Belladonna  is  also  a  remedy  that  may  be  ad- 
ministered, if  possible,  and  repeated  every  half-hour  or  hour.  Ignatia, 
m  persons  of  lymphatic  temperament,  may  be  given  in  the  same  way. 
Arnica  may  be  administered  internally  and  externally.  The  skin 
may  be  rublxnl  with  it ;  the  usual  doses  may  be  given  every  hour,  by 
placing  the  globules  in  the  month.  If  the  attack  follows  the  nose- 
bleed, anil  there  is  heavy  or  labored  bieathijig,  Arsenicum  or  Puhatilla 
may  be  used.  It  is  important  to  get  an  action  on  the  bowels  as  soon 
as  possible. 

Epilepsy,  Fits. 

This  disease  is  termed  the  falling  sickness,  as,  without  warning, 
the  patient  loses  consciousness,  and  falls  insensible  to  the  ground  or 
floor,  with  convulsive  motion  of  the  limbs,  distortion  of  the  muscles 
of  the  face,  frothing  at  the  moutli ;  and  sometimes  the  mouth,  lips 
and  jaws  are  spasmodically  closed,  the  hands  clinched,  and  a  general 
rigidity  of  the  muscles  of  the  entire  body.  After  a  time,  the  rigidity 
passes  off,  and  all  the  muscles  become  relaxed ;  the  patient  then  aj> 
pears  to  be  in  a  deep  slumber,  and  remains  so  for  a  longer  or  shorter 
period,  and  then  awakes  to  consciousness,  feeling  wearied,  but  totally 
unaware  of  anything  unusual  having  occurred.  Confirmed  epilepsy 
is  rarely,  if  ever,  cured.  When  the  disease  is  not  congenital,  the  in- 
cipient stage  may  be  overcome.  Sulphur,  or  Calcarea  carb.,  may  be 
given  when  the  first  signs  of  the  difficulty  occur ;  and  this  may  be 
followed  with  Belladonna,  Hyoscyanms  or  Ignatia.  When  epilepsy  is 
brought  on  by  intemperance,  its  first  signs  may  be  attacked  with  Nux 
vomica,  and  the  sooner  the  patient  can  be  brought  into  a  state  of  total 
abstinence  the  better.  Cuprum  met.  may  be  given  to  this  class  of 
patients  when  there  is  pain  in  the  head,  and  nausea,  attending  the 
incipient  stage.  Opium,  when  there  is  inclination  to  sopor,  may  be 
given  every  two  hours.  Stramonium,  also,  when  there  ij  deep  sleep 
and  loss  of  consciousness.  When  there  is  loss  of  memory  following 
one  of  these  falling  or  unconscious  fits,  give  Sulphur,  China,  Ferrum 
and  Nux  vomica,  —  all  are  required  to  effect  a  cure ;  the  only  hope 
for  which  is  in  preserving  the  patient  in  a  condition  for  the  curative 
action  of  the  remedies.  In  all  cases,  between  the  attacks,  no  fat 
food  should  be  eaten  ;  but  a  simple,  nutritious,  and  spare  diet  should 
be  adhered  to. 


Vi.'f, 


m 


■  q(^» .«■■■'■■-'  -■•^'■■'■■^-''.■i'<'-r.'^i''*\<'^j-f>'~. 


618 


niHEASKH    OK   TlIK    BltAIN    ANIi    NKIIVKS. 


Acute  Inflammation  of  the  Spinal  Cord.—  Myeletis. 

This  is  denoted  by  pain  in  th(!  IkvcU,  along  the  couim(!  of  the  Hpinc. 
which  also  effects  the  Mpinai  nerves,  and  results  in  general  sutt'eriiiir 
of  the  trunk.  When  the  cervical  or  neck  portion  of  the  cord  is  im- 
plicated, there  is  pain  and  stiffness  of  the  neck,  and  pain  in  the  hack 
pai't  of  the  head  ;  and  sometimes  the  accessory  nerves  become  so  af- 
fected as  to  produce  derangement  of  the  organs  of  speech  and  deglu- 
tition. Aconite  is  one  of  the  remedies  that  must  be  employed  to  re- 
move the  inflammation  when  in  this  location.  Hypericum  is  another; 
and  this  may  be  used  internally  and  externally  three  times  a  day. 
Verat.  viride  is  considered  by  some  a  speciflc  remedy.  When  the 
dorsal  portion  of  the  spinal  cord  is  beset  with  inilammation,  th'^-e  is 
shortness  of  breath,  dyspncua,  or  fainting,  and  a  sense  of  suffocation. 

There  is,  at  the  sime  time,  i)ain  in  the  back  and  chest,  and  rapid  ac- 
tion of  the  heart.  The  spinal  accessory  nerves,  that  supply  the  in- 
tercostal muscles,  partaking  of  the  difficulty,  renders  the  function  of 
lungs,  diaphragm  and  heart,  severtilly,  impaired.  Aconite,  for  the  in- 
flammation in  this  locality,  may  be  given  at  first,  and  repeated  every 
hour;  and  a  lotion  of  twenty  drops  of  the  tincture  in  half  a  tumbler 
of  water  may  be  applied  to  the  spine.  Belladonna  may  Ik;  given 
when  there  is  intense  pain  between  the  shoulder-blades.  Bryonia  is 
quite  essential  when  every  motion  of  the  patient  aggravates  the  suf- 
fering ;  Oonium,  when  the  pain  is  not  so  marked,  but  the  respiration 
is  difficult ;  Cocculus,  also,  when  the  pain  in  the  biick  affects  the  stom- 
ach, producing  nausea  and  prostration  ;  Pulsatilla,  when  this  occurs 
in  young  women  and  children,  or  in  those  of  lymphatic  temperament. 
The  patient  should  take  but  little  exercise,  if  any.  If  only  the  lower 
portion  of  the  spinal  column  is  affected,  there  will  be  pain  in  the 
small  of  the  back.  The  secretion  of  the  kidneys  may  be  diminished 
or  increased  ;  the  bladder,  also,  may  be  implicated.  The  womb  may 
be  subject  to  neuralgic  pains ;  the  nerves  accessory  may  implicate  the 
abdomen,  and  cause  severe  pains.  Nux  vomica,  when  the  pain  is  the 
most  prominent  in  the  small  of  the  back,  and  when  there  is  pain  in 
the  bowels,  and  constipation.  When  the  bladder  is  implicated,  or 
spasmodically  closed,  Hyoscyamus  is  the  remedy.  When  there  is  too 
great  secretion  of  the  urine,  Nur  vom.  and  Sulphvr  will  obviate  tlie 
difficulty.  When  this  portion  of  the  spinal  co  d  is  affected,  the 
womb  may  become  subject  to  neuralgic  pains.  Belladonna,  Cicuta, 
Ignatia  and  Nux  vom.  are  all  valuable  remedies.  Conium,  to  remove 
the  inflammation  of  the  cord,  may  be  given  every  three  hours,  unti) 
the  pain  ceases.  If  spasms  attend  the  difficulty,  j^ive  Hyoscyamns 
every  two  hours,  as  long  a3  they  last,  or  else  Ignatia  or  Belladonna. 
If  the  inflammation  is  brought  on  by  a  fall,  or  shock  upon  the  nerves, 
give  Hypericum  every  two  hours,  and  bathe  the  back  with  a  lotion  of 
the  tincture,  —  forty  drops  in  hulf  a  tumbler  of  water.     Bryonia  is 


^OMMTOPWrall- 


'HF 


NKUVKH. 


lal  Cord. —  Myeletis. 

r  tilt'  courso  of  the  spine, 
lilts  ill  gmioml  suffuriiij,' 
)rtion  of  the  cord  is  im- 
ck,  and  pain  in  the  hack 
loiy  iiervea  become  ho  ut- 
aiiH  of  speech  and  deghi- 
niust  l)e  enn)loyed  to  re- 
llypericum  ia  aiiotht'r; 
nally  three  times  a  day. 
ific  remedy.     Wlien  the 
ih  inlhimmation,  th'u-o  is 
id  a  Sense  of  HufTocation. 
k  and  cliest,  and  rapid  ac- 
ives,  that  supply  the  iii- 
r,  renders  the  function  of 
ired.    Aconite,  for  the  in- 
first,  and  repeated  every 
incture  in  half  a  tumbler 
iflladonna  may  l)e  given 
ulder-blades.     Bryonia  is 
atient  aggravates  the  suf- 
uked,  but  the  respiration 
the  biick  affects  the  stoni- 
Isatilla,  when  this  occurs 
f  lymphatic  temperament, 
if  any.    If  only  the  lower 
;here  will  be  pain  in  the 
idneys  may  be  diminisheil 
)licated.     The  womb  may 
cessory  may  implicate  the 
nica,  when  the  pain  is  the 
nd  when  there  is  pain  in 
bladder  is  implicated,  or 
fiedy.     When  there  is  too 
Sulphvr  will  obviate  tlie 
inal  CO  d  is  affected,  the 
linfi,     IfelladomM,  Cicuta, 
idles.    Conium,  to  remove 
L  every  three  hours,  unti) 
ficulty,  rrive  Hyoacyamxii 
le  Ignatia  or  Belladonna. 
jr  shock  upon  the  nerves, 
the  back  with  a  lotion  of 
ler  of  water.     Bryonia  is 


niSEAHKU   OK   TIIK    IIKAm    AND   NKRVEH. 


fil9 


idso  goo<l  for  inflammation  of  the  cord  in  the  Inmlwir  region,  and  es- 
pocially  when  motion  augments  the  suffering.  The  diet  for  all  per- 
sons having  the  nervous  centr«'8  implicated  must  bo  simple  and  nu- 
tritious. 

Paralysis,  Palsy. 

Wrkn  the  whole  muscular  system  becomes  so  feeble  and  trembling 
Its  to  1)6  no  longer  controlled  by  the  will,  it  is  a  ciwe  of  palsy;  and 
tliia  is  brought  on  by  some  trouble  in  the  nervous  centres.  It  attends 
apoplexy,  epilepsy  and  other  affections  incident  to  the  nervous  cen- 
tres. Inflammation  of  the  spinal  cord  will  often  produce  the  affec- 
tion. The  palsy  may  affect  only  one  hand  or  one  cheek ;  or  it  may 
l)e  more  general,  and  all  the  muscles  may  Ixj  smitten  with  paralytic 
weakness.  Belladonna  is  often  indicated  for  rightrsided  paralysis, 
and  is,  perhaps,  the  l^est  remedy,  in  the  majority  of  cases.  Pulsatilla 
is  one  of  the  best  remedies  for  this  disorder :  give  a  dose  of  it  three 
times  a  d\y.  If  this  does  not  cure,  give  Ooc<ntliis,  in  the  same  way,  or 
Niix  vomica,  China  or  Ignatia.  For  palsy  of  the  tongue,  give  Calcarea ; 
for  palsy  of  the  ittce,  Pulsatilla  ;  for  palsy  of  the  arms  and  legs,  give 
Mercurius  viv.,  Nux  vomica,  Pulsatilla  and  Bryonia.  If  the  palsy  is  the 
result  of  a  shock  or  fall,  give  Arnica.  If  great  weakness  and  slow 
fever,  give  Rhus  iox.  Strong  tea  and  coffee  are  not  advisable  Ixjver- 
ages  for  those  threatened  with  palsy.  Water,  milk  and  black  tea  of 
moderate  strength  may  be  allowed. 

Lockjaw,  Trismus. 

One  of  the  most  painful  affections  that  can  assail  human  nature  is 
the  shock  upon  the  nervous  system  ^  oduced  by  a  wound.  Loclgaw 
is  a  rigid  stiffness  of  the  muscles  of  the  jaws,  by  some  irritation  from 
a  wound  Injing  first  sent  to  the  brain,  and  thence,  by  some  nervous 
channel,  to  the  muscles  that  control  the  jaws ;  causing  them  to  as- 
sume a  painfully  rigid  '  ardness,  closing  them  beyond  the  possibility 
of  opening  them.  Pain  oftentimes  is  felt  in  other  muscles,  at  the 
same  time  causing  them  to  be  rigid.  One  of  the  common  resorts  to 
control  traumatic  fever,  or  the  fever  produced  by  a  wound,  is  brandy 
or  whiskey.  It  is  said  that  large  drafts  of  either  will  have  no  intoxi- 
cating effect  when  this  fever  is  present.  Tincture  of  Opium,  Black  Drop 
and  Opium  itself,  have  been  given  to  antidote  it,  and  sometimes  with 
success.  One  of  the  best  remedies  for  traumatic  fever,  or  that  pro- 
duced by  a  wound,  is  Arnica.  It  may  be  given  every  hour  or  two 
hours,  internally ;  or  applied,  in  the  full  strength  of  the  tincture,  to 
the  wound.  TYr^e  can  "^^  no  other  remedy  more  likely  to  produce 
pleasant  results,  unless,  .n  actual  injuiy  of  some  nerve,  Hypericum 
is  rnade  to  take  the  plhiie  of  Arnica.  If  the  patient  is  nourished 
tlirough  a  quill,  and  the  circulation  is  made  vigorous  by  stimulants, 
and  the  intensity  of  the  pain  is  kept  under  by  anodynes,  the  remedial 


I 

1 


"^aWnDWfStfc*-. 


620 


IJISEASKS   OF   THE   BKAIN   AND    NERVES. 


Lachesis  has  benefited 


effects  of  Arnica  and  Hypericum  may  cure, 
some  cases. 

Tetanus. 

This  is  the  general  disease  of  which  the  foregoing  is  a  part.  A 
wound  either  in  the  ball  of  the  foot  or  palm  of  the  hand  may  so  for- 
cibly transfer  its  irrit  .bility  to  the  brain,  that  the  brain  distributes 
the  effect  to  the  whole  system,  producing  that  most  painful  of  all  mor- 
tal sufferings,  —  the  lockjaw  or  general  tetanus.  Belladonna,  Nm 
von.Ln,  Ignatia,  Mercurius  viv.  and  Sulphur  may  be  employed  in  the 
general  form  of  the  disease,  in  addition  to  the  treatment  for  lockjaw. 

Delirium  Tremens. 

This  disease  is  the  sequel  of  persistent  inebriation.  When  a  man 
forgets  the  extremity  to  which  his  appetite  may  lead,  and  keeps  his 
nervous  system  excited  even  to  intoxication,  after  a  while  liis  stomacli 
will  lose  its  tone,  and  become  extremely  irritablo ;  his  system  conse- 
quently gains  but  little  support  from  food:  and,  what  is  still  worse, 
his  strength  leaves  him ;  his  mind,  operated  upon  by  his  weakened 
nerves,  is  filled  with  fancies,  and  he  is  unable  to  sleep.  Even  before 
he  becomes  delirious  he  has  what  in  conmion  parlance  is  termed  "  the 
horrors,"  which  seem  to  be  a  wretched,  nervous  agitation  and  fearful 
foreboding  of  trouble.  Finally,  the  mind  becomes  so  unsettled  as  to 
be  totally  deranged.  Illusory  pictures  present  themselves  continu- 
ally ;  such  as  serpents  and  other  reptiles,  with  other  hideous  sights 
too  numerous  to  particularize.  Unless  some  remedial  measures  are 
made  available  in  procuring  sleep,  his  life  in  this  world  will  soon  ter- 
minate. Bryonia  once  cured  a  case  of  delirium  tremens  in  an  army 
officer,  who,  in  delirium,  had  passed  eight  successive  nights  without 
sleep.  Nnx  vomica  will  often  quiet  the  nerves,  and  bring  about  a  cure. 
Opium  is  a  valuable  remedy,  and,  in  large  doses,  has  been  employed 
for  many  years.  Arsenicum  is  a  valuable  remedy  to  allay  the  irrita- 
bility of  the  stomach ;  Ignatia,  also,  when  there  is  much  inclination 
to  weep.  The  dose  of  any  of  the  remedies  may  be  four  globules,  or 
from  one  to  five  drops  of  the  dilution  in  a  spoonful  of  water ;  re- 
peated at  intervals  of  one  or  two  hours.  As  soon  as  the  patient  can 
eat,  give  him  the  lightest  kind  of  food,  gradually  increasing  its 
strength  until  he  is  able  to  take  full  meals. 

Neuralgia. 

This  disease  is  a  simple  pain  in  the  nerves,  and  manifests  itself  in 
various  parts  of  the  body,  —  most  frequently  in  the  face ;  and  may 
be  caused  by  decayed  teeth,  or  any  weakening  influence,  such  as  loss 
of  blood,  diarrhffia  or  dysentery.  A  torpid  liver  or  feeble  digestion 
may  be  the  source  of  the  pain.     It  is  usually  a  stubborn  disease,  and 


was«HMn***« 


NERVES. 

Lachesis  has  benefited 


foregoing  is  .a  part.  A 
of  the  hand  may  so  for- 
at  the  brain  distributes 
most  painful  of  all  mor- 
anus.  Belladonna,  Nnx 
nay  be  employed  in  the 
e  treatment  for  lockjaw. 


DISEASES   OF   THE   BKAIN    ANI»   NERVES. 


621 


s. 

ibriation.  When  a  man 
nay  lead,  and  keeps  his 
iter  a  while  his  stomacli 
;able ;  his  system  conse- 
and,  what  is  still  worse, 

upon  by  his  weakened 
3  to  sleep.  Even  before 
parlance  is  termed  "the 
>us  agitation  and  fearful 
jomes  so  unsettled  as  to 
snt  themselves  continu- 
;h  other  hideous  sights 

remedial  measures  are 
this  world  will  soon  ter- 
um  tremens  in  an  army 
ccessive  nights  without 
and  bring  about  a  cure, 
ses,  has  been  employed 
ledy  to  allay  the  irrita- 
ire  is  much  inclination 
nay  be  four  globules,  or 
spoonful  of  water ;  re- 
soon  as  the  patient  can 
radually  increasing  its 


,  and  manifests  itself  in 
in  the  face ;  and  may 
y  influence,  such  as  loss 
ver  or  feeble  digestion 
a  stubborn  disease,  and 


proves  in  some  cases  an  agony  of  suffering  for  years.  It  accompanies 
.spinal  irritation.  It  often  follows  miscarriages  in  females,  and  is  too 
frequently  an  accompaniment  of  other  female  diseases.  When  diseased 
teeth  are  evidently  the  cause,  Arsenicum  or  Belladonna  may  afford  re- 
lief;  or  else  let  the  tooth  or  teeth  be  extnacted.  If  from  extreme  de- 
bility, Ohina  and  Arsenicum.  Chamomilla,  when  there  is  a  flushed 
face  and  much  restlessness  and  extreme  inquietude.  Coniiim,  when 
it  accompanies  spinal  irritation.  Sepif  and  Oalcarea,  when  depen- 
dent upon  uterine  derangement.  For  neuralgia  of  the  stomach  and 
bowels,  give  Cocculus,  Ignatia  or  Pulsatilla.  •  That  which  occui-s  after 
miscarriage,  dysentery  or  diarrhoea,  requires  China,  Ferrum,  Nitric 
add  or  Sulphur.  Avoid  rich  foods.  Live  on  a  plain,  nourishing  diet 
and  keep  out  of  doors  as  much  as  possible. 

St.  Vitus's  Dance,  Chorea. 

A  DEBILITATED  condition  of  the  nervous  system  may  show  itself 
in  involuntary  twitchings  of  the  muscles  of  the  face,  extreme  rest- 
lessness of  the  limbs,  involuntary  movements  of  the  hands,  arms,  and 
the  entire  body.  Nux  vomica,  Ignatia  and  Cocculus  are  remedies  that 
will  cure  a  majority  of  cases.  China  is  best  for  debilitated  pei-sons  ; 
Belladonna,  for  those  of  nervous  temperament ;  Sulphur,  when  there 
has  been  suppressed  eruption.  One  remedy  should  be  selected  pnd 
tried  firat,  and  repeated  every  three  hours  until  the  patient  is  better ; 
or,  in  caae  of  no  change,  select  another,  and  so  on.  Children  afflicted 
with  chorea  should  not  be  confined  in  school  or  be  tasked  with 
studies. 

Stammering. 

This  is  but  another  form  of  chorea,  affecting  the  organs  of  speech. 
Belladonna,  Sulphur,  Hyoscyamus  and  Causticum  have  been  employed 
against  this  difficulty  and  with  success.  The  training  of  young  boys 
or  girls  addicted  to  stammering,  to  be  deliberate  in  their  efforts  to 
express  themselves,  will  often  accomplish  more  than  remedies.  It  is 
remarked  that  stammerers  can  sing  or  utter  any  sentence  in  song. 
This  would  indicate  the  propriety  of  enjoining  upon  all  thus  affected 
to  practise  slow  and  delibei-ate  speech.  Cuprum  met.  is  a  remedy  that 
has  cured  many  cases ;  and  so  has  Ferrum,  Ignatia  and  Belladonna. 
Employ  each  remedy  singly  and  repeat  eve*;y  three  hours. 

Loss  of  Memory. 

FoRGETPULNESS  may  be  the  result  of  nervous  disease,  as  well  as 
of  heedlessness.  Great  and  debilitating  losses  often  impair  the  mem- 
ory; so  does  a  resort  to  Opium  to  destroy  pain.  Excesses  of  any 
kind  may  result  in  this  difficulty.  The  remedies  that  have  Ikhmi  em- 
ployed are  Phosphoric  acid,  Sulphur,  Nux  vomica  and  Ignatia.  Of 
the  remedy  selected,  prepare  twenty  drops  in  half  a  tumbler  of  w  aoer 
and  give  a  tablespoonful  twice  a  day. 


M 


■%! 


DISEASES  OP  THE  EYE  AND  LIDS. 


stye. 

This  is  a  small  tumor  on  the  lid,  about  the  size  of  a  pea,  which  is 
quite  painfuL  Aconite  will  often  cure  in  a  day ;  Pulsatilla,  also,  af- 
fords speedy  relief ;  Belladonna,  when  the  inflammation  of  the  stye 
causes  redness  of  the  eyeballs;  Staph,  prevents  their  recurrence, 
taken  once  daily  for  a  while. 

Inflammation  of  the  Eyelids. 

When  the  entire  lids  become  involved  in  acute  inflammation, 
Aconite,  in  the  usual  dose,  may  be  given  every  two  hours  until  re- 
lieved ;  Puis.,  the  same  way,  when  there  is  burning,  with  flow  of 
tears.  If  the  lids  become  congested,  red  and  swollen,  give  Bella- 
donna. If  the  inflammation  is  -chronic,  give  Calcarea  once  a  day, 
or  else  Sulphur  or  Hepar  sulph.  If  dependent  upon  gastric  or 
bilious  derangement,  give  Nux  vomica  or  Mercurius  every  two  hours 
until  relieved,  the  latter  especially  when  there  are  cutting  pains, 
worse  nights. 

Iritis,  Inflammation  of  the  Iris. 

The  little  circle  in  the  front  of  the  eyeball,  which  we  call  the  iris, 
is  subject  to  inflammation.  It  may  result  from  a  cold,  or  from  in- 
jury, or  from  some  impurity  of  the  blood.  When  from  a  cold,  Aco- 
nite speedily  affords  relief.  If  very  painful.  Belladonna.  If  from 
injury.  Arnica  or  Aconite.  The  patient  must  be  kept  in  a  dark  room 
until  the  inflammation  passes  off.  To  relieve  acute  pain,  resort  has 
been  had  to  Morphine,  in  one-eighth  of  grain  doses,  repeated  every 
four  hours  if  necessary.  It  is  doubtful  if  any  external  applications 
in  iritis  ever  prove  beneficial.  If  any  are  used,  none  are  better  than 
water  in  which  six  grains  of  Opium  to  a  gill  has  been  boiled. 

Scrofulous  Sore  Eyes. 

In  persons  of  a  strumous  constitution,  a  cold,  or  any  undue  ex- 
posure of  the  eyes,  may  cause  them  to  be  the  seat  of  scrofulous  in- 


1_ 


h 


E  AND  LIDS. 


DISEASES   OF  THE   EYE   AND   LIDS. 


623 


flammation;  in  which  event,  there  will  be  a  redness  of  the  eyeballs, 
and  swelling  and  ulceration  of  the  lids,  and  a  greater  or  less  accumu- 
lation of  matter  beneath  the  lids.  This  disease  is  often  very  painful, 
and  destructive  to  the  coats  of  the  eye ;  and,  what  is  worse,  it  be- 
comes the  fruitful  source  of  cataract  and  blindness.  When  the  eyes 
fii-st  become  inflamed  and  burning,  Arsenicum  may  be  given ;  when 
tlie  lids  are  implicated,  give  Calcarea  ;  when  the  inflammation  passes 
off,  leaving  white  spots  on  the  cornea,  give  Sulphur^  Hepar  sulph. 
or  Conium.     Daily  doses  of  the  remedy  selected  will  be  suflBcient. 


the  size  of  a  pea,  which  is 
I  day ;  Pulsatilla,  also,  af- 
inflammation  of  the  stye 
>revent8  their   recurrence, 


Eyelids. 

I  in   acute   inflammation, 
every  two  hours  until  re- 
is  burning,  with  flow  of 
and  swollen,  give  Bella- 
ive   Calcarea  once  a  day, 
jpendent  upon   gastric  or 
fercurius  every  two  hours 
there  are  cutting  pains, 


f  the  Iris. 

lall,  which  we  call  the  iris, 

from  a  cold,  or  from  in- 

When  from  a  cold,  Aco- 

ful.  Belladonna.     If  from 

ist  be  kept  in  a  dark  room 

eve  acute  pain,  resort  has 

rain  doses,  repeated  every 

any  external  applications 

used,  none  are  better  than 

II  has  been  boiled. 

Eyes. 

a  cold,  or  any  undue  ex- 
the  seat  of  scrofulous  iu- 


Syphilitic  Sore  Eyes. 

SoMETiMKS  syphilis  will  affect  the  eyes  and  threaten  the  destruc- 
tion of  sight.  The  lids  will  inflame  ;  the  cornea  will  be  congested, 
and  of  a  bluish  red  ;  the  conjunctiva  will  become  the  seat  of  inflam- 
mation, and  sometimes  of  ulceration.  Mercurius  iod.  may  be  given 
first,  while  the  patient  is  kept  in  a  quiet  and  dimly  illuminated  room, 
two  doses  daily.  If  the  patient  has  already  been  treated  with  Mer- 
curius, give  Nitric  acid  or  Repar  sulph.  If  considei-able  matter  ex- 
udes from  under  the  lids,  give  Aurum  once  a  day ;  and  if  the  eyes 
itch  continually,  give  Sulphur. 

Cataract. 

This  film  that  obstructs  the  sight  of  the  eye  is  undoubtedly  the 
sequel  of  scrofulous  inflammation  or  injury  of  the  crystalline  lens. 
It  is  simply  an  abnormal  growth  of  a  film  over  the  pupil  of  the  eye, 
partially  if  not  wholly  obstructing  the  sight.  Oonium  mac,  given 
twice  a  day.  Mere.  iod.  is  also  a  good  remedy ;  Phosphorus,  Causti- 
oum  or  Sulphur  may  be  indicated.  Either  may  be  repeated  twice  a 
day  when  selected. 

Rlieumatic  Sore  Eyes. 

Rheumatism  of  an  inflammatory  character  may  fall  with  great 
force  upon  the  eyes,  and  produce  severe  pain  and  temporary  blind- 
ness. Nux  vom..  Belladonna,  Bryonia  and  Aconite  are  remedies  that 
may  be  consulted.  Bryonia  may  be  given  three  times  a  day,  when 
every  effort  to  open  the  eyes  is  attended  with  pain;  Belladonna, 
when  the  pain  is  such  as  to  give  the  sensation  of  the  eyeball  being 
too  large  for  the  socket;  and  also  when  there  is  a  feeling  as  if  the 
eyeball  would  buret.  Sulphur,  for  dull  pain  in  the  eyeballs,  and  the 
sight  impaired.  Ilhus  when  the  eyes  are  pink  and  lame  on  moving 
them. 

Qonorrhceal  Sore  Eyes. 

When  the  eyes  become  inoculated  with  gonorrhoeal  matter,  there 
will  he  smarting,  and  then  inflammation  and  swelling  of  the  lids,  and 


n 


624 


DISEASES  OF  TUB   EYE   AND   L1D8. 


such  serious  infiltration  as  to  close  the  eyes;  and,  in  a  very  brief 
period,  a  perfect  disorganization  of  the  texture  of  the  eye  w?ii  take 
place.  As  soon  as  the  character  of  the  inflammation  becomes  known, 
It  is  well  to  make  some  compresses  of  linen  a  half-inch  thick,  and 
bind  them  tightly  over  the  eyes,  and  then  give  Cannabi%  every  three 
hours  for  two  or  three  days;  afterwards,  give  CanfAan's  in  the  same 
way ;  and,  after  the  smarting  pain  begins  to  cease,  carefully  remove 
the  compress,  keep  the  patient  in  a  dark  room,  and  Sulphur,  in  daily 
doses,  may  complete  the  cure. 

Specks  on  the  Cornea. 

Little  opaque  spots  on  the  cornea  may  be  U;ft  after  scrofuloi^  in- 
flammation has  passed  away.  These  may  be  removed  by  daily  doses 
of  Sulphur  or  Euphrasia. 

Watery  Eyes. 

When  the  eyes  are  watery,  or  prone  to  become  so,  from  slight  ex- 
posure to  wind  or  cold,  the  difficulty  may  be  obviated  with  daUy 
doses  of  Pulsatilla,  Mercurius  vivus  or  Lachesis.  Blood-shot  eyes 
will  be  relieved  by  daily  doses  of  Euphrasia. 

Squinting,  Strabismus. 

What  is  tern  -d  cross-eyed  in  persons  is  usually  the  sequel  of  some 
cerebral  disturbai  'S  that  have  deranged  the  normal  action  of  the 
little  muscles  thai  gulate  the  position  of  the  eyeballs,  and  give 
them  an  abnormal  or  squinting  appearance.  Sometimes  daily  doses 
of  Hyoscyamus  or  Belladonna  will  entirely  remedy  the  difficulty. 
Short-sightedness  may  be  remedied  by  daily  doses  of  Sulphur, 
Lyoqpodium  or  Pulsatilla, 


^'^■'liliiMIWi 


0  " 


Hliailll4M»i<*W.«li^ii..*».W<..^-'<W»WIIII..I*WiWfcl. 


'i>miitiii 


I  ii'«'nim<in«>«8inai>*» 


.-uiJafc- 


)  LIDS. 

res;  and,  in  a  very  brief 
,ure  of  the  eye  will  take 
iimation  becomes  known, 
3n  a  half-inch  thick,  and 
ive  Cannabis  every  three 
ve  Cantharis  in  the  same 
0  cease,  carefully  remove 
jm,  and  Sulphur,  in  daily 


DISEASES  OP  THE  EAE. 


rnea. 

36  U;ft  after  scrofulous  in- 
)e  removed  by  daily  doses 


become  so,  from  slight  ex- 
y  be  obviated  with  daily 
achesia.  Blood-shot  eyes 
a. 

smus. 

usually  the  sequel  of  some 
the  normal  action  of  the 
of  the  eyeballs,  and  give 
).  Sometimes  daily  doses 
sly  remedy  the  difficulty. 
r  daily  doses  of  Sulphur, 


Inflammation  of  the  Ear. 

When  there  is  inflammation  and  swelling  of  the  external  ear,  and 
it  has  a  red  and  fiery  appearance,  Pulsatilla  may  be  administered 
twice  a  day.  If  the  swelling  and  inflammation  extend  within,  so  as 
to  close  the  external  orifice,  give  Belladonna  twice  a  day  until  the 
difficulty  passes  away.     If  suppuration  threaten,  Hepar  sulph. 

Earache. 

This  may  result  from  cold,  or  from  gatherings  within  the  ear ;  or 
it  may  possibly  be  neuralgia,  or  proceed  from  decayed  teeth ;  or,  in 
children,  from  teething.  When  from  cold,  give  Chamomilla  or  Dul- 
camara three  times  a  day ;  if  from  injury,  Hypericum  or  Arnica;  if 
from  gatherings,  Hepar  sulph.  or  Calcarea  ;  if  from  decayed  teeth, 
Mercurius  viv. ;  if  in  teething  children,  Pulsatilla,  two  doses  a  day; 
if  the  pain  is  neuralgic,  give  Niix  vomica  or  Belladonna.  The  core  of 
an  onion  baked,  applied  to  the  ear  as  hot  as  it  can  be  borne,  will  often 
give  relief. 

Running  of  the  Ears.  —  Otorrhoea. 

Otorbhcea  may  be  occasioned  by  a  cold,  when  there  are  no  sores. 
For  this,  give  Pulsatilla;  when  from  sores  in  the  ears,  Calcarea.  If 
this  should  fail  to  cure,  try,  in  succession.  Sulphur,  Mercurius  viv. 
and  Silieea. 

Deafness,  Hardness  of  Hearing. 

To  remedy  this  difficulty  when  produced  by  a  cold,  give  iVkr  vom- 
ica eveiy  night  until  relieved.  For  that  which  occurs  after  scarlet 
fever,  Calcarea,  and  for  that  after  measles,  give  Pulsatilla  ;  from 
hardened  wax.  Sulphur ;  if  from  rush  of  blood  to  the  head,  or  con- 
gestion. Aconite  or  Belladonna  ;  Causticum,  if  these  fail.  The  reme- 
dies may  be  repeated  every  four  hours  until  relieved. 

626 


{*T? 


nMrrHMIHllilaiaaaWiilBil, 


626 


DISEASES   OF  THE   EAR. 


Nervous  Deafness. 

When  the  nerves  of  the  ear  lose  their  vitality,  and  deafness  re- 
sults as  the  consequence,  Photphorio  add  may  be  given,  in  drop 
doses,  twice  a  day ;  or  SiUphur  maj^  be  given  every  night,  or  Nux 
vomica  or  Caiieticum,  in  like  manner.  When  deafness  occurs  from 
Rheumatism,  Pulsatilla  may  be  given  three  timed  a  day.  Arsenicum^ 
Nitrie  acid,  Calcarea  and  Mercuriua  viv.  may  likewise  be  consulted. 
If  deafness  occurs  from  suppressed  eruption,  the  remedies  are  Sul 
phur,  Calcarea,  Graphites  or  Causticum  in  daily  doses.  If  deafness 
is  the  sequel  of  malarious  fevers,  Phosphorus  or  Phosphoric  acid,  in 
daily  doses ;  if  from  sudden  check  of  nose-bleed,  or  discharges  from 
the  nose  or  ears,  Hepar  sulphur  or  Lachesis  ;  if  from  enlargement  of 
the  tonsils,  Nitric  acid,  Mercurius  or  Aurum, 


^(~-»« 


{.. 


v9Kt*vf*r'^nmi'^mm\.  \  i,xsui."m'mjfiumnam 


MtlMMI— UWI  llWilnniliB 


5. 

itality,  and  deafness  re- 
may  be  given,  in  drop 
en  every  night,  or  Nux 
n  deafness  occurs  from 
inies  a  day.  Arsenieum,, 
'  Hkewise  be  consulted. 
,  the  remedies  are  Sul- 
aily  doses.  If  deafness 
t«  or  Phosphoric  acid,  m 
ieed,  or  discharges  from 
if  from  enlargement  of 


DISORDERS  OP  THE  NOSE. 


Nose-bleed. — Epastaxis, 

This  trouble  arises  from  various  causes  and  must  be  treated  ac- 
cordingly. When  it  arises  from  arterial  excitement,  Aconite;  from 
an  injury,  Arnica  ;  from  rush  of  blood  to  the  head.  Belladonna  ;  if 
from  inflammation  of  the  lungs,  Bryonia ;  in  typhoid  fever,  Rhu» 
tax. ;  if  caused  by  worms,  Qina  or  Spigelia;  if  from  weakness  or  de- 
biUty,  China  or  Carbo  veg. ;  if  from  cold  or  coryza,  Nux  vomica.  Dose, 
three  times  a  day.  To  give  immediate  relief  press  up  under  the  up- 
per lip  or  apply  something  cold  to  back  of  ueck. 

Obstruction  of  the  Nose. — Ozcma. 

OzfENA  is  an  entire  obstruction  of  the  nasal  ducts,  from  thickening 
of  the  mucous  membrane  or  other  causes.  If  from  accumulation  of 
the  mucus,  Pulsatilla  ;  if  from  suppressed  eruption.  Sulphur,  Lyco- 
podium  and  Oalcarea ;  if  from  scorbutic  tendency,  Bryonia ;  if  with 
diy  crusts,  Aurum.    The  usual  dose,  three  times  a  day. 


Polypus  of  the  Nose. 

Not  infrequently  a  morbid  growth  attached  to  the  mucous  mem- 
brane of  the  nose  will  fill  the  entire  nostril.  This  is  termed  a  poly- 
pus and  is  perfectly  curable.  Oalcarea,  when  the  disease  appears  in 
scrofulous  subjects ;  Sanguinaria,  when  a  cold  has  been  the  exciting 
cause ;  Sepia,  when  there  is  a  pain  in  the  head  and  nausea  ;  and  Star 
physagria,  when  it  is  the  sequel  of  other  disorders.  The  medicines 
may  be  given  in  the  usual  dose  and  repeated  every  four  horn's. 


627 


DISEASES  OF  THE  RESPIRATORY 

ORGANS. 


The  organs  of  respiration  embrace  the  nose,  larynx,  trachea,  bron- 
chia, lungs,  pleura,  heart  and  their  appendages.  We  will,  therefore, 
consider  the  diseases  that  affect  them  in  their  order. 

Coryza,  Cold  in  the  Head. 

When,  from  exposure  to  cold,  the  nose  becomes  stopped,  and  there 
is  an  inclination  to  sneeze,  and  the  eyes  become  more  or  less  affected, 
the  following  remedies,  as  indicated,  will  prove  useful :  Nux  vomica  at 
night,  should  the  coryza  be  more  apparent  in  the  afternoon  or  even- 
ing, and  particularly  if  it  is  attended  with  cold  affecting  the  entire 
system.  Stibium^  or  Tart,  em.,  is  a  good  remedy  to  lubricate  the 
stoppage  of  the  nasal  passages ;  Hepar  sulph.  also,  when  this  stop- 
page is  painfully  disagreeable ;  Arsenicum  or  Euphrasia,  when  there 
is  a  thin,  acrid  discharge  from  the  nose.  Pulsatilla  is  best  for  chil- 
dren and  ladies  when  suffering  from  nasal  catarrh.  Coryza  is  syn- 
onymous with  acute  catarrh,  as  both  affect  the  mucous  membrane 
that  lines  the  cavities  of  the  nose. 

Chronic  Catarrh  is  much  like  the  acute,  only  all  the  symptoms 
have  become  persistent.  Acute  catarrh  is  often  cured  in  a  few  days 
by  Mercurials,  Nux  vomica.  Belladonna,  Pulsatilla,  Tart,  em.,  Hepar 
sulphuris  and  Sulphur;  Mercurius,  for  stupefying  headache  with  ca- 
tarrh; iVki;  vomica,  when  tlie  catarrh  occasions  nausea;  Belladonna, 
when  there  accompanies  the  difficulty  pain  over  and  in  the  eyes; 
Pulsatilla,  when  there  is  depression  of  spirits ;  Tart,  em.,  Hepar 
sulph.  and  Sulphur,  to  remove  obstructions  in  the  nasal  ducts,  and 
to  subdue  irritation  and  soreness  of  the  external  orifices  of  the  ducts. 
Doses  as  usual,  repeated  three  times  a  day. 

In  the  treatment  of  chronic  catarrh,  other  remedies  are  called  into 
requisition.  Aurum  metallicum,  if  there  is  a  heavy  yellow  discharge 
from  the  nose,  or  crusts  form- at  night;  Mercurius  iodatus,  in  scrofu- 
lous persons ;  Aurum  muriaticum,  if  there  is  any  affection  of  the 
vomer  or  partition  of  the  nose ;  Sulphvr  and  Hepar  sulph.  are  both 
valuable  remedies,  as  are  Arsenicum  and  Lachesis,  when  the  peculiar 
symptoms  are  such  as  to  indicate  their  affiliation.     The  remedies  for 

628 


^m^m 


in 


riREABES   OF   THE   BESPIKATOKY   OROANS. 


629 


8PIRAT0RY 


(se,  larynx,  trachea,  bron- 
zes. We  will,  therefore, 
ir  order. 

Head. 

comes  stopped,  and  there 
me  more  or  less  affected, 
ve  useful :  Nux  vomica  at 
[1  the  afternoon  or  even- 
old  affecting  the  entire 
remedy  to  lubricate  the 
ph.  also,  when  this  stop- 
r  Euphrasia^  when  there 
uhatilla  is  best  for  cliil- 
catarrh.  Coryza  is  syn- 
b  the  mucous  membrane 


5,  only  all  the  symptoms 
ften  cured  in  a  few  days 
Isatilla,  Tart,  em.,  Mepar 
jfying  headache  with  ca- 
sus nausea ;  Belladonna, 
1  over  and  in  the  eyes; 
lirits  ;  Tart,  em.,  Mepar 
in  the  nasal  ducts,  and 
rnal  orifices  of  the  ducts. 

'  remedies  are  called  into 
I  heavy  yellow  discharge 
'ourius  iodatus,  in  scrofu- 
is  any  affection  of  the 
d  Hepar  sulph.  are  both 
cheats,  when  the  peculiar 
ition.     The  remedies  for 


the  chronic  form  need  not  bt>  repeated  so  often ;  once  in  twenty-four 
lioura,  in  the  usual  dose,  is  sufficient. 

Inflammation  of  the  Larynx. 

The  upper  part  of  the  windpipe  or  trachea  is  termeu  :he  "laryn^t" ; 
and,  when  inflamed,  it  is  said  to  be  affected  with  lar}'iigitis :  and  this 
may  be  acute  or  chronic. 

Acute  Laryngitis,  or  Infiammation  of  the  Larynx. —  This  trouble 
is  denoted  by  cough,  hoaraeness  and  sore  throat,  affecting  the  voice, 
and  rendering  respiration  somewhat  difficult  and  conversation  fa- 
tiguing or  painful.  It  comes  on  from  a  cold  and  may  be  the  continua- 
tion of  a  nasal  catarrh.  With  the  cough  there  is  usually  some  expec- 
toration, or  else  a  dry,  uncomfortable  sensation  and  inclination  to  be 
clearing  the  throat.  If  the  pulse  is  febril  or  full,  give  Aconite  in  the 
first  stage ;  and,  if  there  is  painful  soreness  of  the  larynx,  give  £eP- 
donna.  Aconite  will  remove  the  fever,  and  Belladonna  the  congestion 
of  the  capillary  vessels  of  the  mucous  membrane,  which  causes  tlie 
soreness.  Mercurius  viv.  often  follows  Belladonna  well.  If,  after  the 
employment  of  these  remedies,  expectoration  of  mucus  occurs  from 
coughing,  give  Phosphorus  or  Sanguinaria.  If  the  cough  is  tight,  as 
if  the  laiynx  was  closing  up,  give  Sambucus.  The  remedies,  in  the 
usual  doses,  may  be  repeated  every  two  hours.  The  diet  should  be 
simple,  but  nutritious. 

Chronic  Laryngitis,  or  Inflammation   of  the   Larynx.  —  The 

symptoms  of  this  form  of  the  disease  are  similar  to  those  of  the  acute 
variety,  only  the  cough  and  irritation  are  constant  and  the  expecto- 
ration sometimes  great.  The  disease  becomes  chronic  from  the 
weakening  of  the  organ  after  one  or  more  acute  attacks  of  the  dis- 
ease. It  sometimes  mitigates  in  warm  weather,  and  returns  again 
in  winter.  Argentum  metallieum  is  a  good  remedy  for  the  chronic 
form  when  characterized  by  soreness  of  the  throat.  Belladonna  is  al- 
ways useful  when  the  difficulty  is  aggravated  by  a  cold ;  Phosphorus, 
when  there  is  considerable  collection  of  mucus,  and  Hepar  sulph. 
when  there  are  excessive  drjrness  and  hoarseness.  Causticum  is  par- 
ticularly useful  when  the  inflammation  is  persistent,  and  the  cough 
constantly  excited,  and  when  it  resembles  a  croupy  cough,  and  comes 
on  spasmodically  or  in  paroxysms.  When  chronic  laryngitis  is  not 
kept  in  check  or  cured,  it  soon  runs  into  that  formidable  disease 
known  as  laryngeal  consumption  or  becomes  attended  vnth  hectic 
fever.  In  such  a  case,  give  Stannum  or  perhaps  Sulphur  ;  but  in  no 
case  more  than  one  dose  a  day.  The  patient  should  be  warmly  clothed 
and  should  always  provide  for  tempering  cold  air  before  it  is  inhaled 
into  the  lungs.  The  diet  must  be  nutritious,  aad  strictly  non-medi- 
oinul. 


K  if 


! 

4 

1 


c:)0 


Dlf  RABEH   OF   TJIK   ItKsMHATORY   ORGANS. 


Croup. 

Crofp  is  of  two  kinds,  spasmodic  and  membranous.  The  spiis- 
medic  is  the  result  of  a  cold ;  and  it  comes  on  with  a  hoarse,  rouph 
cough  which  is  often  Hpasmodic  and  suffocating.  The  catarrhal  or 
membmnous  comes  on  like  a  cold,  and  then  supervenes  a  crowing 
cough  and  copious  collection  of  mucus ;  and  sometimes  an  exudation 
of  a  membranous  character  fills  the  larynx  and  upper  portion  of  the 
trachea.  For  spiwmodic  croup,  Tartar  emetic  is  undoubtedly  the  best 
remedy;  Aconite, -when  there  is  fever;  Belladonna,  xi  the  throat  is 
sore ;  Ipecac,  if  the  breathing  is  asthmatic.  In  membranous  croup, 
a  resort  must  bo  had  to  Aconite  at  first,  to  induce  perspiration;  if 
this  fails,  give  Bryonia,  and  then  Spongia,  Iodine,  Bromine  and  Hepar 
mlph.,  in  the  order  mentioned.  The  usual  doses  may  be  given  every 
fifteen  or  twenty  minutes  when  the  symptoms  are  alarming.  Croup 
goes  under  the  technical  name  of  Cynanche  Trachealis,  because  it  im- 
plicates both  the  larynx  and  windpipe. 

Inflammation  of  the  Windpipe.  —Tracheitis. 

There  is  some  resemblance  of  this  disease  to  croup ;  and  yet  it 
may  occur  and  not  manifest  that  peculiar  character.  It  is  denoted 
by  cough,  sometimes  exceedingly  tight,  at  others  looser,  greater  or  less 
obstruction  of  the  breathing,  and  some  pain  and  soreness  of  the  throat 
above  and  a  tickling,  raw  feeling  below,  towards  the  bronchial  tubes. 
Aconite  is  essential  in  the  treatment  of  this  difficulty,  and  also  Bella- 
donna, Bryonia,  Phosphorus,  Causticum,  Hepar,  Sanguinaria  and  Span- 
gia.  It  is  to  be  observed,  however,  that  only  one  of  these  remedies 
must  be  given  at  a  time ;  five  drops  in  half  a  tumbler  of  water  and  a 
teaspoonful  every  thirty  minutes.    Diet  simple  and  non-medicinal. 

Acute  Bronchial  Inflammation. — Bronchitis. 

As  the  name  implies,  the  bronchial  tubes  become  highly  inflamed 
in  this  disease,  or  rather,  the  mucous  membrane  that  lines  them. 
There  is  much  cough  and  expectoration.  This  disease  is  called  ca- 
tarrhal fever  in  its  acute  form ;  and,  when  the  substance  of  the  lungs 
becomes  affected,  it  amounts  to  pneumonia.  Acute  bronchitis  re- 
quires, for  the  reduction  of  fever.  Aconite  or  Bryonia ;  Belladonna 
may  follow ;  and  when  copious  expectoration  commences,  give  Phoir- 
phorua ;  and,  some  time  after,  give  Hyoacyamua,  especially  for  the 
cough  at  night,  and  also  Calcarea  carb.  for  the  soreness  and  cough 
that  may  be  created.  Repeat  the  medicines,  in  the  usual  doses,  three 
times  a  day.  Diet  as  in  all  febrile  diseases.  Barley  or  flaxseed  tea 
for  drink  and  a  light  diet  of  toast  is  best. 


u 


'W»TMMWwaBMP«tt'gatiiii*»jaBWi 


avm^Ktv^itrnvsn.  jSf.)gg»* 


i   ORGANS. 


DlilEAHEH  OF  THK   KKHPIKATORY   UUUANH. 


631 


Tieinbranotis.  The  flpiw- 
on  with  a  hoarse,  rough 
,tiiig.  The  catarrhal  or 
n  supervenes  a  crowing 
sometimes  an  exudation 
ml  upper  portion  of  tlie 
r  is  undoubtedly  the  best 
\adonna,  if  the  throat  is 
In  membranous  croup, 
induce  perspiration;  if 
line.  Bromine  and  Hepar 
loses  may  be  given  every 
IB  are  alurming.  Croup 
rrachealis,  because  it  im- 


Chronic  Inflammation  of  the  Bronchia. 

LiKR  the  acute  form  of  the  disease  it  has  ito  seat  in  the  mucous 
membrane  that  lines  the  bronchial  tubes,  and  it  is  believed  t^)  l)e  the 
sequel  of  acute  bronchitis.  It  is  always  accompanied  by  a  cough,  and 
more  or  less  expectoration  ;  now  and  then  a  paroxysm  of  fever.  It 
is  a  tedious  and  troublesome  disease  ;  and,  when  not  cured,  is  always 
better  in  warm  weather,  and  much  aggravated  in  cold  ;  and  this 
would  point  to  a  perpetual  warm  climate  as  its  cure.  When  there 
are  paroxysms  of  fever,  give  Aconite;  if  there  is  pain  in  the  chest, 
Belladonna  ;  profuse  expectoration.  Phosphorus  or  Lycopod.;  hectic 
fever,  Stannum  ;  when  the  throat  is  sore,  give  Cnuatitmm.  Great  care 
must  be  taken  in  the  treatment  of  this  malady,  if  a  cure  is  expected, 
or  otherwise  it  will  terminate  in  a  lingering  consumption.  The  most 
generous  living  the  patient's  appetite  will  admit  of  must  be  supplied, 
but  free  from  medicinal  condiments. 


Ipe.  — Tracheitis. 

se  to  croup;  and  yet  it 
haracter.  It  is  denoted 
icrs  looser,  greater  or  less 
nd  soreness  of  the  throat 
ards  the  bronchial  tubes, 
iifficulty,  and  also  Bella- 
!r,  Sangainaria  and  Spon- 
y  one  of  these  remedies 
I  tumbler  of  water  and  a 
pie  and  non-medicinal. 


on.  — Bronchitis. 

become  highly  inflamed 
nbrane  that  lines  them, 
'his  disease  is  called  ca- 
le  substance  of  the  lungs 
Acute  bronchitis  re- 
or  Bryonia;  Belladonna 
n  commences,  give  Phos- 
amu8,  especially  for  the 
the  soreness  and  cough 
in  the  usual  doses,  three 
Barley  or  flaxseed  tea 


Lung  Fever.  —  Pneumonia. 

Lung  fever  is  indicated  by  pain  in  the  chest  cough,  flushed  face, 
quick  pulse,  rusty  expectoration,  headache,  lo.s8  of  appetite  and  op- 
pressed breathing.  Aconite  or  Bryonia  may  be  given,  in  the  usual 
dose,  every  hour  until  the  skin  becomes  moist ;  Belladonna,  if  the 
pain  continues  in  the  chest,  every  hour  until  relief  or  a  change  is 
necessary ;  Bryonia  may  follow  Belladonna,  if  heat  in  the  chest  is  a 
prominent  symptom ;  and  Phosphorus  may  follow  Bryonia,  provided 
the  expectoration  has  changed  and  a  more  plentiful  secretion  of  mucus 
is  thrown  off.  Each  medicine  may  be  given  in  hourly  doses  when 
called  for. 

This  disease  becomes  typhoid  pneumonia  when  the  fever  accom- 
panying the  inflammation  is  typhoid ;  in  which  event  Bryonia  may 
be  given  in  the  first  stage  and  Belladonna  if  there  is  a  manifest  in- 
clination to  sleep.  When  the  patient  begins  to  cough  up  mucus 
tinged  with  blood,  give  Phosphorus  ;  and,  if  very  much  prostrated, 
give  Mhus  tox.  As  to  diet  in  pneumonia,  give  the  patient  any  light, 
nourishing  and  soothing  drinks,  as  jelly-water,  barley-water,  rice-water, 
etc.    Application  of  warm  compresses  to  the  chest  is  recommended. 

Whooping  Cough. —  Tussis  Spasmodica. 

This  disease  often  comes  on  like  an  ordinary  cold  and  the  victims 
are  observed  to  have  frequent  coughing  fits ;  and  when  there  is  no 
fever  or  loss  of  appetite  and  the  fits  of  coughing  continue  to  be  re- 
peated, it  may  fairly  be  inferred  that  wliooping  cough  is  progressing. 
Soon  the  child  or  patient  will  begin  to  whoop  and  to  experience  fre- 
quent paroxysms,  and  draw  in  a  long  breath  or  whoop,  which  is  fol- 
lowed by  numerous  short  expirations.      Drosera  will  mitigate  the 


k;::W: 


W^W^^'^ 


632 


niSKAHKH   OK   TIIK    KKHPIUATORY   OROANH. 


HC'Vority  of  tlio  i)iiroxyHniH,  jind  ho  will  Hj/oitni^amux,  CoralUa  ruhra, 
Sanguinaria  mid  t'aiiHticum  ;  Chelidoniiiin,  if  thero  are  Hytn[)toiiiH  of 
pulmonary  (;oii}((!Htion;  but  there  it*  no  remedy  known  that  will  hn-ak 
it  up  at  once.  Give  a  dose  of  the  selected  remedy  immediately  after 
each  paroxyBm. 

Pleuritls.  —  Pleurisy. 

Inflammation  of  the  pleura  Ih  denoted  hy  sharj),  shooting  pains 
in  the  sideH  of  the  chest  that  interfere  with  respiration ;  quick  pulse, 
ilushed  face,  great  heat  over  the  chest,  etc.  Aconite,  in  the  usual 
dose,  may  l)o  given  every  twenty  minutes,  and  a  cloth  compress  of 
warm  water  may  be  applied  to  the  region  of  the  pain.  Avonite  miiy 
be  followed  with  Phosphonm,  given  eveiy  hour  until  relieved.  Bryo- 
nia is  good. 

Asthma. 

DiFPiouLT  and  laborious  breathing  may  be  hereditary  or  be  brought 
on  by  a  cold,  overexertion  or  exposure  of  some  kind.  It  comed  on 
in  paroxysms  tliat  sometimes  interfere  with  the  respiration  to  so  great 
a  degree  us  to  oblige  the  patient  to  sit  or  stand  in  order  to  get  breath. 
Many  cases  are  entirely  curable  with  Ipecac,  Arsenicum,  Apis  melli- 
fica,  Apocynum,  Lobelia  and  Tart,  emetic.  When  one  remedy  fails,  try 
the  next  until  a  fair  waifare  with  the  disease  has  been  encountered. 

Bleeding  from  the  Lungs. 

This  trouble  is  occasioned  by  the  rupture  of  some  of  the  blood- 
vessels in  the  bronchial  tube,  caused  either  by  mechanical  injury  or 
tubercles.  If  from  the  former,  Arnica  is  the  remedy ;  if  from  the 
latter,  ffamamelis.  In  case  of  pain  and  inflammation,  give  Phospho- 
rus ;  and  if  motion  aggravates,  give  Bryonia.  Let  the  patient  sit  up, 
if  able,  in  an  easy-chair  until  the  bleeding  ceases.  If  fever  and  ex- 
citement of  the  circulation  exist,  give  Aconite  often.  Once  in  a  half 
hour  at  first.     To  give  temporary  relief  give  strong  salt  and  water. 


Consumption. 

This  formidable  disease  may  be  hereditary  or  result  from  acci- 
dental causes.  When  hereditary,  it  may  not  develop  itself  until  adult 
age ;  and  one  of  the  first  signs  is  extreme  sensitiveness  to  cold,  a 
slight  cough,  defective  nutrition  and  extreme  emaciation ;  night- 
sweats  come  on  subsequently,  with  hectic  fever;  and,  at  a  later  stage, 
there  may  be  diarrhoea,  which  resists  remedial  measures  and  exhausts 
the  life  of  the  patient.  That  kind  brought  on  as  the  sequel  of  pri- 
mary affections  usually  supervenes  upon  bronchitis  or  some  other 
exhaustive  disease  that  proves  destructive  to  nutrition.  In  the  first 
stage,  or  wheu  chilliness,  debility  and  loss  of  flesh  become  apparent, 


OKOANH. 


DISKASKS   OK   THE    KKHI'IUATOUY   OIUtANS. 


033 


^cifamxH,  Cornllia  ruhnt, 
■  thertj  me  Hymptoiim  ot 
y  known  Unit  will  brciik 
smedy  immediately  after 


by  shari),  shooting  pains 
•cHpiration ;  quick  pulse, 
.  Aconite.,  in  the  usual 
,n(l  a  cloth  compress  of 
the  pain.  Aconite  may 
lur  until  relieved.   Bryo- 


I  hereditary  or  be  brought 
ome  kind.  It  comea  on 
lie  respiration  to  so  great 
id  in  order  to  get  breath. 
;.,  Arsenicum.^  Apis  melli- 
hen  one  remedy  fails,  try 
le  has  beep,  encountered. 


much  l)enofit  can  Imi  obtained  from  the  use  of  good  old  Hnurbon  or 
rye  V/'hiskey:  from  iialf  to  a  whole  winuglassful  may  Iks  taken  twit:e 
11  day.  The  introduction  of  carlH)n  into  tiie  syNtem  in  this  way  has 
often  pntved  of  great  sorvit^e.  When  there  is  deei>-Heat(!(l  pain  in  the 
lungH,  cHpecially  in  the  upper  i)urtion,  Lycupodium  ;  tiio  usual  dose 
may  Ui  given  every  day  and  continued  as  long  as  any  benetit  is  per- 
ceived. Lyeopoilium  may  bo  followed  by  tStannum  or  iSulphur,  pro- 
vided there  is  any  hectic  fever;  by  t'arho  animalitt  when  there  are 
night-sweats.  If  the  cough  becomes  troublesome  and  the  expectora- 
tion nmco-purulent,  J'hoH/ihonis  in  the  usual  <lo.s(?  may  be  given 
twice  a  day.  If  occasional  hemorrhage,  BeUaihmna  may  be  given,  if 
tli-re  is  pain;  Ipecac,  if  there  is  asthmatic  breathing;  and  Hamame- 
lis  ir.,  if  there  is  bleeding  from  the  lungs  without  nnuih  pain.  For 
thi-  !.  4t  stage  of  l)ronchial  consumption,  see  the  treatment  directed 
for  bronchitis.  After  tubercles  Income  manifest,  the  same  remedies 
may  be  indicated  as  for  the  hereditary  disease.  The  diet  for  (!on- 
sum^^t'ves  should  be  fish,  game,  beef,  mutton  and  vegetables  such  as 
potatoes,  beans  and  egg-plant ;  butter  and  (!ream,  witli  toast,  are  also 
allowable.  Let  the  diet  be  as  generous  us  the  patient  cau  take.  And, 
if  possible,  live  iu  the  open  air. 


Lungs. 

re  of  some  of  the  blood- 
by  mechanical  injury  or 
the  remedy;  if  from  the 
lammation,  give  Fhospho- 
!.  Let  the  patient  sit  up, 
leases.  If  fever  and  ex- 
lite  of  ton.  Once  in  a  half 
re  strong  salt  and  water. 


itary  or  result  from  acci- 
t  develop  itself  until  adult 
le  sensitiveness  to  cold,  a 
ireme  emaciation ;  night- 
ever;  and,  at  a  later  stage, 
lial  measures  and  exhausts 
t  on  as  the  sequel  of  pri- 
bronchitis  or  some  other 
to  nutrition.  In  the  first 
of  flesh  become  apparent, 


.  ?3i 


i 


DISEASES  OP  THE  URINARY  ORGANS. 


The  urinary  apparatus  includes  the  bladder  and  kidneys,  and  their 
appendages,  all  of  which  are  subject  to  inflammation. 

Inflammation  of  the  Bladder,  — Cystitis. 

-  /hen  urination  becomes  painful  and  difficult,  and  the  orifice  of 
the  bladder  seems  to  be  insufficient  for  voiding  the  urine,  we  have 
Stations  of  inflammation  of  the  bladder;  and  also  when  there  is 
frequent  inclination  to  urinate,  with  ability  to  pass  but  little  at  a 
tSie.     Aconite  maybe  given  at  first  if  fever  attend  the  difficulty; 
Belladonna  might  follow  Aconite  if  there  should  be  any  congestion; 
CaXris,  howUr,  is  one  of  the  best  remedies,  if  there  is  tenesmus 
or  straining.     Cannabis  sativa,  also,  is  a  good  remedy,  and  with  old 
people,  Arfenieum  is  often  beneficial.     It  is  well  to  drink  mucilagi- 
nous drinks,  and  subsist  mostly  on  gruel,  until  the  severe  symptoms 
ZZde.     All  this  trouble  may  pass  from  the  acute  to  the  chronic 
?ot;  of  the  disease,  and  be  an'entailed  cUfficulty.     The  best  way  to 
prevent  it  is  to  have  the  first  acute  stage  well  attended  to.     Ihe  tre- 
^uent  desire  to  urinate,  which  we  sometimes  And  -  aged  pejus 
may  be  due  to  chronic  inflammation  of  the  neck  of   the  bladder 
Sulphur,  given  every  night,  may  mitigate  the  disease  materiaUy;  and 
so  ato  aTcided  benefit  ma/be  gained  from  the  use  of   Comum 
ZaTatum.     The  same  diet  found  beneficial  for  the  acute  form  of 
this  disease  will  be  found  beneficial  for  the  chronic. 

Strangury. 

This  affection  consists  in  being  unable  to  void  the  urine,  and  is 
believed  to  be  the  result  of  inflammation  of  the  ne«\ of  the  bkdd^^^^ 
or  some  mechanical  pressuro  upon  the  urethra  It  often  F^ves Jo 
be  quite  painful,  and  attended  with  fever.  ^<^omte  m^y  he  guen 
eve?y  hou?  when  the  skin  is  hot,  dry,  and  feverish,  ovSpints  of  Cam- 
phor  in  drop  doses  every  twenty  minutes  until  relieved.  ^W«!^«  ^ 
if  the  stoppage  appears  to  be  ""Attended  with  i^ever;/7«»«A«nMt 
there  is  an  ineffectual  urging  to  urinate ;  and  Cannabis,  also,  when 

-.  634 


38ti<^9iWiirr.- 


DISEASES   OF  THE   URINARY   ORGANS. 


635 


ARY  ORGANS. 


ler  and  kidneys,  and  their 
immation. 

Jer.  —  Cystitis. 

fficult,  and  the  orifice  of 
iding  the  urine,  we  have 
;  and  also  when  there  is 
ty  to  pass  but  little  at  a 
irer  attend  the  diificulty; 
hould  be  any  congestion; 
jdies,  if  there  is  tenesmus 
)od  remedy,  and  with  old 
IS  well  to  drink  mucilagi- 
antil  the  severe  symptonis 

the  acute  to  the  chronic 
ficulty.  The  best  way  to 
roll  attended  to.  The  fre- 
nes  find  in  aged  persons, 
the  neck  of  the  bladder, 
he  disease  materially;  and 

from  the  use  of  Conium 
cial  for  the  acute  form  of 
3  chronic. 


e  to  void  the  urine,  and  is 
of  the  neck  of  the  bladder, 
rethra.  It  often  proves  to 
3r.  Aconite  may  be  given 
feverish,  or  Spirits  of  Cam- 
atil  relieved.  Hyoscyarmis. 
d  with  fever ;  Cantharis,  if 
;  and  Cannabis,  also,  when 


there  is  inability  to  evacuate  the  bladder.     Dose  and  administration, 
four  globules  every  hour. 

Stone. 

When  one  is  voiding  urine,  and  some  obstacle  to  its  passage  sud- 
denly interferes,  and  the  stream  is  cut  short,  we  may  infer  that  a 
stone  has  interposed  at  the  orifice  of  the  bladder.  The  symptoms 
lire  like  those  of  strangury.  Oftentimes  there  is  pain  in  passing 
mine,  inclination  to  pass  it  often,  and  straining  to  keep  the  stream 
flowing.  Against  the  ill  effects  of  stone  in  the  bladder,  Cantharis  or 
Cannabis  are  among  the  prominent  remedies.  Li/copodium,  Calcarea^ 
nd  Phosphorus  are  also  good  remed*'  The  two  remedies  first 
iiamed  may  be  given  in  drop  doses  every  hour,  and  the  three  last 
only  three  times  a  day.  The  patient  should  drink  soft  water,  Poland 
water  in  large  quantities,  if  possible,  and  live  upon  a  moderate  non- 
medicinal  diet,  avoiding  malt  and  distilled  liquors  as  a  beverage. 

Qravel. 

This  is  indicated  by  violent,  cutting,  intermittent  pains  in  the  re- 
gion of  one  or  the  other  hip  and  kidney  and  extending  down  the 
ureter  to  the  groin  or  down  the  thigh,  frequent  but  sea  ity  urine, 
fever,  and  nausea.  The  most  useful  remedies,  in  the  order  of  their 
importance,  are  Uva  ursi.  Belladonna^  Chamomilla.  and  Nitrum,  re- 
peated often. 

Retention  of  Urine. 

This  difficulty  results  from  fever  or  some  local  irritation,  and  con- 
sists simply  in  disinclination  to  evacuate  the  bladder,  not  from  ina- 
bility on  account  of  inflammation,  or  some  obstruction,  but  because 
there  is  an  irresistible  proneness  to  retain  tlie  urinary  secretion, 
either  from  nervous  weakness  or  spasm  of  the  neck  of  the  bladder. 
The  remedies  found  n  3t  useful  are  Cina,  Spigelia,  Hyoscyamus,  Bel- 
ladonna, and  Rhus  tax.  ^ither  of  these  may  be  given  and  repeated 
until  the  patient  is  relieved.  Hyoscyamus  and  Gina  are  preferable. 
With  old  people,  Arsenieum  or  Secale. 

Suppression  of  Urine. 

In  some  fevers  the  kidneys  do  not  perform  their  office,  and  the  uri- 
nary secretion  is  suppressed  and  thrown  back  upon  the  system  ;  and, 
as  a  consequence,  the  blood  fails  of  being  defecated,  and  the  result,  in 
a  short  time,  must  prove  quite  disastrous.  A  dose  of  Sulphur  may 
sometimes  overcome  this  difficulty,  and  set  the  organs  of  secretion  at 
work.  Baptisia,  Nitrum,  Pulsatilla,  Bryonia,  Rhus,  Cantharis,  and 
nny  of  the  remedies  that  act  specifically  upon  the  renal  region,  will 
be  likely  to  afford  relief.     The  remedies  may  be  repeated  every  two 


'ti 


^saw" 


£■ 


636 


DISEASES  OF  THE   URINARY   ORGANS. 


hours,  and  the  diet  should  be  mucilaginous  drinks.     Poland  water 
taken  in  large  quantities  is  good  in  all  cases  of  urinary  diseases. 

Incontinence  of  Urine. 

Some  persons  cannot  help  urinating  at  once  as  soon  as  the  bladder 
fills.  Their  incontinence  Ijecomes  manifest  when  no  opportunity 
offers  for  immediate  resort  to  the  water-closet,  and  in  many  instances 
becomes  painfully  mortifying,  and  renders  the  victim  an  object  of 
sympathy.  Mercurius  vivus  may  be  given  in  the  usual  dose,  three 
times  a  day.  If,  after  a  trial  of  a  few  days,  the  patient  is  not  im- 
proved, give  either  Opium,  China,  Oalcarea,  Caustimm,  or  Sulphur 
in  the  same  way. 

Wetting  the  bed.  —  Nocturnal  Enuresis. 

Children  addicted  to  this  habit  from  some  diseased  condition  may 
be  cured  by  daily  doses  of  Sulphur  or  Carlo  animalis,  or  perhaps 
Silicea,  or  Caustioum.  But  some  children  get  the  habit  and  become 
confirmed  in  it  from  no  physical  cause  whatever  ;  and,  if  no  measures 
are  taken  to  reform  them,  they  will  grow  up  under  the  impression 
that  they  cannot  help  it.  The  best  way  to  treat  such  is  to  impress 
upon  them  that  they  can  and  must  banish  the  habit.  Let  them  be 
impressed  even  to  shame  and  a  threat  of  chastisement  if  they  keep 
up  the  practice  •  and  in  most  cases,  this  is  all  that  is  necessary. 

Diabetes. — Immoderate  Flow  of  Sweet  Urine. 

There  is  no  disease  that  resists  more  stubbornly  the  action  of 
remedies  than  diabetes.  It  consists  in  a  copious  secretion  of  sweet 
urine,  that  contains  many  grains  of  solid  material  passing  away  from 
the  tissues  every  twenty-four  hours.  This  disease  will  emaciate  a 
fleshy  subject  in  six  week  i,  and  give  him  a  pale  and  sickly  look.  The 
disease  has  been  palliated,  but  never  cured  permanently  that  we  find 
any  record  of  ;  and  yet  Phosphoric  acid,  given  three  times  a  day,  has 
diminished  the  amount  of  the  secretion  from  twelve  to  two  quarts  in 
twenty-four  hours  ;  and  apparently  this  remedy,  with  Nitrate  of  ura- 
nium, has  effected  temporary  cures.  Muriatic  acid,  Sulphur,  and  Kali 
carb.  have  also  been  esteemed  as  valuable  remedies,  all  of  which  may 
be  given  in  the  usual  doses,  three  times  a  day.  I  would  also  recom- 
mend Poland  water  in  large  quantities. 

Bloody  Urine. 

As  gravel  is  believed  to  be  one  of  the  causes  of  this  difficulty,  and 
inflammation  of  the  bladder  is  believed  to  be  another,  the  same  reme- 
dies applicable  to  the  one  will  serve  for  the  other.  Arsenicum  may, 
however,  be  added  to  the  remedies,  particularly  if  there  is  any  burn- 
ing at  the  neck  of  the  bladder  and  tenesmus. 


::ismi«e!msmmm^-'' 


DEUANS. 


DISEASES  OF  THE   URINAllY  ORGANS.  637 


}  drinks.     Poland  water 
of  urinary  diseases. 

*ine. 

36  as  soon  as  the  bladder 
t  when  no  opportunity 
it,  and  in  many  instances 
the  victim  an  object  of 
in  the  usual  dose,  three 
I,  the  patient  is  not  ira- 
i,  Causticum,  or  Sulphur 

rnal  Enuresis. 

5  diseased  condition  may 
rbo  animalis,  or  perhaps 
et  the  habit  and  become 
iver  ;  and,  if  no  measures 
up  under  the  impression 
treat  such  is  to  impress 
the  habit.  Let  them  he 
lastisement  if  they  keep 
11  that  is  necessary. 

)/  Sweet  Urine. 

itubbornly  the  action  of 
jpious  secretion  of  sweet 
iterial  passing  away  from 
disease  will  emaciate  a 
3ale  and  sickly  look.  The 
permanently  that  we  find 
3n  three  times  a  day,  has 
1  twelve  to  two  quarts  in 
ledy,  with  Nitrate  of  ura- 
te acid,  Sulphur,  and  Kali 
smedies,  all  of  which  ma}- 
ay.     I  would  also  recom- 


Inflammation  of  the  Kidneys. 

When  there  is  pain  in  the  back,  and  increased  flow  of  urine,  and  a 
desire  to  urinate  frequently,  and  sometimes  severe  pain  in  the  hip  and 
side,  nausea,  vomiting,  and  fever,  there  is  undoubtedly  inflammation 
of  the  kidneys.  In  the  treatment  of  this  painful  difficulty,  we  find 
Arnica  the  best  remedy  if  the  inflammation  has  been  produced  by  a 
mechanical  injury.  If  from  a  cold,  Rhu^  tax.  or  Nux  vomica.  If 
there  is  much  fever.  Aconite ;  chilliness  down  the  spine,  Belladonna. 
When  there  is  obstinate  vomiting.  Bismuth.  The  patient  should  lie 
in  bed,  and  not  try  ercise  much  till  the  inflammation  passes  off. 

The  medicine  shoul  given  every  hour  or  two  houre,  according  to 
the  severity  of  the  innammation.  Use  Poland  water  in  large  quan- 
tities. 


ises  of  this  difficulty,  and 
e  another,  the  same  reme- 
!  other.  Arsenicum  may, 
arly  if  there  is  any  buni- 


-TiEW» 


^■W 


DISEASES  OP  THE  ORGANS  OP 
GENERATION. 


The  organs  of  generation  in  the  male  are  the  penis,  testes,  and 
their  appendages.  Those  of  the  female  are  the  vulva,  vagina,  womb, 
ovaries,  and  their  appendages. 

Inflammation  of  the  Urethra. 

The  urethra  is  the  common  passage  through  which  the  urine  passes 
from  the  bladder,  and  the  semen  from  the  testes.  When  it  becomes 
inflamed  from  cold,  or  as  the  sequel  of  some  acute  disease,  PuUatilla, 
Cannabis,  Mereuriua  viv.,  or  Sulphur  may  cure  the  difficulty  by  being 
given  every  two  or  three  hours.  One  remedy  only  must  be  given ; 
if  this  fails,  try  another;  but  if  the  disease  is  the  result  of  impure 
connection,  and  is  the  gonorrhoea  (or  clap),  give  Cantharia,  and  after- 
wards Cannabis.  If  there  is  painful  smarting,  give  these  remedies 
every  hour  in  alternation  until  the  discharge  ceases.  Give  Pulsatilla, 
also,  every  hour,  if  the  other  remedies  fail,  and  use  a  solution  of 
Hamamelii  in  water  as  an  injection. 

Syphilis. 

Nearly  allied  to  gonorrhoea  is  syphilis ;  only  the  latter  is  a  more 
formidable  result  of  impure  connection,  which  inoculates  the  blood. 
It  becomes  manifest  iu  discharge  from  the  urethra,  chancres,  buboes, 
etc.  When  there  is  a  purulent  discharge  from  the  urethra,  Mercu- 
riu8  viv.  may  be  given  persistently  for  eeveral  days,  and  this  may 
arrest  the  further  progress  of  the  disease;  but  should  it  not,  and 
chancres  make  their  appearance  on  the  prepuce  or  foreskin,  or  on  the 
glans,  burn  them  with  Nitric  acid,  full  strength  of  the  stores,  and 
then  give  Mercurius  corrosivua  every  six  hours  for  several  days; 
dressing  the  sores  with  lint  wet  with  cold  water  and  Calendula.  If 
the  chancres  heal,  it  is  well  and  good,  if  they  do  not,  give  Mercurius 
iodatus  three  times  a  day.  Let  the  patient  avoid  drinking  any  in- 
toxicating beverage  whatever,  and  abstain  from  all  medicinal  articles 
of  diet. 

638 


DISEASES  OF  THE   ORGANS   OF  GENEUATION. 


639 


IGMS  OP 


e  the  penis,  testes,  and 
tie  vulva,  vagina,  womb, 


rrethra. 

1  which  the  urine  passes 
stes.  When  it  becomes 
icute  disease,  Pulsatilla, 
e  the  difficulty  by  being 
dy  only  must  be  given ; 
is  the  result  of  impure 
ive  Cantharia,  and  after- 
ng,  give  these  remedies 
(eases.  Give  Pulsatilla, 
,  and  use  a  solution  of 


nly  the  latter  is  a  more 
!h  inoculates  the  blood, 
rethra,  chancres,  buboes, 
•om  the  urethra,  Mercu- 
jral  days,  and  this  may 
but  should  it  not,  and 
loe  or  foreskin,  or  on  the 
ngth  of  the  stores,  and 
lours  for  several  days ; 
ater  and  Calendula.  If 
y  do  not,  give  Mercurivs 
avoid  drinking  any  in- 
om  all  medicinal  articles 


Inflammation  of  the  Testicles. 

Sometimes  a  suppression  of  gonorrhoea  will  cause  inflammation  and 
swelling  of  tlie  testicles.  Both  may  be  implicated,  and  become  ex- 
ceedingly painful  and  enormously  swollen.  For  the  first  stage  be- 
fore the  swelling,  Aconite  may  be  given  every  two  hours  to  reduce 
the  general  febrile  condition  of  the  system.  Afterwards  Arnica  may 
he  given  to  lemove  the  soreness,  and  Pulsatilla  to  remove  the  swell- 
ing. Either  of  these  remedies  may  be  given  every  day,  three  times, 
until  the  object  for  which  they  are  given  is  accomplished.  Let  the 
patient  lie  in  bed,  and  apply  warm  compresses  to  the  part.  Let  him 
subsist  upon  a  spare  diet,  and  drink  no  exciting  drinks.  Let  him 
wait  with  patience  for  a  subsidence  of  the  swelling  and  inflamma- 
tion. 

Dropsy  of  the  Scrotum.  —  Hydrocele. 

Sometimes  inflammation  of  the  testes  will  result  in  hydrocele,  and 
the  scrotum  will  become  filled  with  water.  Helleborus  nig..  Apis  mel., 
and  Arsenicum  are  remedies  that  have  been  employed  to  cure  the 
difficulty ;  but  sometimes  remedies  prove  unavailing,  and  the  water 
has  to  be  drawn  off  by  a  trochar,  in  which  event  consult  an  experi- 
enced surgeon.  But  try  the  remediis  first,  and  give  each  named  in 
succession  (provided  the  first  or  second  does  not  prove  effectual), 
every  three  hours  during  the  day. 

Inflammation  of  the  Vulva. 

This  hiay  occur  from  acrid  leucorrhoea,  or  cold,  or  from  gonorrhoea; 
and,  from  whatever  cause,  it  requires  the  application  of  warm  water 
and  compresses,  and  a  dose  of  Aconite  or  Belladonna  every  hour  until 
relieved. 

Inflammation  of  the  Vagina. 

The  vagina  is  lined  by  a  mucous  membrane,  which  sometimes 
becomes  inflamed ;  and  when  from  a  cold,  producing  an  ordinary 
catarrh,  give  Nux  vomica  or  Sulphur,  night  and  morning,  until  better. 
If  from  chronic  irritation  of  the  membrane  there  is  a  leucorrhoeal 
discharge  from  the  vagina,  give  Sepia  night  and  morning.  If  this 
fails,  give  Calcarea  carh.;  and  if  this  fails,  give  Sulphur  in  the  same 
way.  Leucorrhoea  may  be  occasioned  by  falling  of  the  womb,  which 
irritates  the  mucous  membrane  of  the  vagina,  in  which  event  Sepia  or 
Nux  may  be  given  every  night,  with  full  prospect  of  a  cure. 

Inflammation  of  the  Womb. 

This  painful  malady  is  often  the  result  of  protracted  labor,  and  is 
known  by  great  thirst,  pain  over  the  region  of  the  womb,  and  great 


s-tsr 


,sS«* 


S-aiUP! 


— TSP- 


wam^ 


640 


DISEASES   OF   THK   ORGANS   OK   GENERATION. 


tenderness  of  the  touch.  Arsenicum,  given  every  three  hours  at  first, 
and  followed  by  Belladonna,  generally  proves  successful ;  but  Brij- 
onia  and  Rhus  tox.  or  Verat.  viride  may  be  resorted  to,  and  repeated 
every  three  hours,  if  found  necessary.  Inflammation  of  the  womb  is 
a  painful  difficulty  and  a  dangerous  one,  and  should  be  treated  with 
great  care.  Warm  bran  poultices,  if  the  patient  can  bear  them,  may 
be  applied  while  giving  the  remedies.  Injections  of  hot  water,  110 
degrees,  taken  at  night,  will  often  give  great  relief.  Would  recom- 
mend patient  to  consult  a  physician. 

Falling  of  the  Womb. 

The  womb  is  said  to  fall,  when  from  debility,  or  a  relaxed  condi- 
tion of  its  ligaments,  it  sinks  down  into  the  vagina;  and  this  is  indi- 
cated by  pain  in  the  back,  and  a  dragging  sensation  over  the  hips, 
and  bearing-down  pains.  These  are  often  attended  with  headaches 
and  other  derangements,  which  must  be  considered.  Nux  vomica, 
every  night,  is  one  of  the  most  valuable  remedies  for  prolapsus  uteri. 
Sulphur  sometimes  does  well.  Sepia  every  morning  has  often  cured 
and  relieved  the  headache,  nausea,  and  other  concomitant  symptoms. 
Calcarea  has  relieved  when  the  pain  is  most  prominent  about  the  hii)8; 
Ignatia,  when  the  difficulty  has  been  brought  on  by  grief.  Patients 
of  this  description  should  not  drink  coffee  or  strong  green  tea.  Black 
tea,  cocoa,  and  milk  may  be  allowed,  with  a  moderately  generous  diet. 

Inflammation  of  the  Ovaries. 

This  difficulty  is  denoted  by  sharp  pains,  either  in  the  right  or  left 
side,  or  both,  just  front  of  the  upper  edge  of  the  hip-bone.  It  some- 
times is  very  painful,  and  requires  rest  and  the  best  treatment  and 
nursing  to  subdue  it.  Conium,  in  daily  doses,  has  relieved  some  ;  so 
has  Pulsatilla,  Belladonna,  and  Ignatia.  Some  remedies  relieve  for 
a  time,  such  as  Bryonia  and  Rhv^s  tox.  Belladonna  will  cure  when 
the  inflammation  is  attended  with  headache  and  considerable  neu- 
ralgic pain  in  the  region  of  the  glands ;  if  much  fever  attends  the 
affection,  give  Aconite  three  or  four  times  a  day.  Now,  as  all  these 
affections  disturb  the  nervous  system,  and  give  rise  to  various  forms 
of  nervous  complaints,  such  remedies  as  Pulsatilla,  Ignatia,  Hyoncy- 
amus,  Nux  vomica,  Moschus,  and  Oaulophyllin  will  be  constantly 
needed,  and  stimulants  need  to  be  taken  with  great  caution.  Cold 
compresses  in  acute  attacks.  A  piece  of  flannel  soaked  in  hot 
laudanum  laid  over  the  ovary,  covered  with  a  dry  flannel,  will  give 
relief  and  enable  the  patient  to  sleep. 

Ulceration  of  the  Womb. 

Anything  that  irritates  the  mouth  of  the  womb  may  occasion,  first, 
inflammation  of  the  os  tincae,  and  then  ulceration.     Frequent  mis- 


lliiM^»l.<  .> 


'   GENERATION. 

1  every  three  hours  at  first, 
•oves  successful;  but  Bry- 
B  resorted  to,  and  repeated 
iflammation  of  the  womb  is 
md  should  be  treated  with 
patient  can  bear  them,  may 
njections  of  hot  water,  110 
■reat  relief.     Would  recom- 


Vomb. 

lebility,  or  a  relaxed  condi- 
he  vagina;  and  this  is  indi- 
ig  sensation  over  the  hips, 
n  attended  with  headaches 
»  considered.  Nux  vomica, 
emedies  for  prolapsus  uteri. 
ry  morning  has  often  cured 
:her  concomitant  symptoms. 
3t  prominent  about  the  hii»s: 
aght  on  by  grief.  Patients 
I  or  strong  green  tea.  Black 
a  moderately  generous  diet. 

e  Ovaries. 

18,  either  in  the  right  or  left 
e  of  the  hip-bone.  It  some- 
and  the  best  treatment  and 
doses,  has  relieved  some  ;  so 
Some  remedies  relieve  for 
Belladonna  will  cure  when 
ache  and  considerable  neu- 
;  if  much  fever  attends  the 
}8  a  day.  Now,  as  all  these 
id  give  rise  to  various  forms 
»  Pulsatilla,  Ignatia,  ffyoscy- 
>phyllin  will  be  constantly 
n  with  great  caution.  Cold 
5  of  flannel  soaked  in  hot 
with  a  dry  flannel,  will  give 


DISEASES   OK   THE   OKOAN8  OF  OENEKATION. 


641 


carriages  will  so  weaken  the  organ,  and  especially  its  ligaments,  as 
to  admit  of  its  being  easily  misplaced,  or  turned  backwards  or  for- 
wards. These  misplacements  are  often  the  cause  of  ulcerations,  and 
almost  always  the  source  of  weakening  leucorrhoea.  The  medical 
treatment  of  this  difficulty  is  of  the  first  importance.  Sulphur  every 
night  may  commence  the  treatment.  If,  after  using  the  Sulphur  for 
a  week,  the  purulent  discharge  becomes  less,  and  there  is  less  pain 
and  soreness  in  the  region,  and  still  considerable  pain  remaining  in 
the  back,  give  Nux  vomica  every  night  for  a  week.  If  these  two 
remedies  fail  of  bringing  about  a  cure,  then  drop  twenty  drops  of  the 
tincture  of  Calendula  (Marigold  flowers)  in  half  a  tumbler  of  water 
and  inject  it  into  the  vagina  every  day,  and  at  the  same  time  take  a 
dose  of  Sepia  every  morning.  Continue  this  treatment  as  long  as 
useful.  Culcarea,  taken  every  night,  sometimes  has  a  good  effect. 
Local  applications  to  the  ulcers  are  sometimes  made,  but  this  is  the 
business  of  the  surgeon. 

Leucorrhoea.  —  Whites. 

When  the  mucous  membrane  lining  the  womb  and  vagina  becomes 
irritated  or  inflamed,  it  undergoes  solution,  and  there  is  a  white  dis- 
charge. This  is  of  frequent  occurrence,  and  in  some  instances  is  such 
a  drain  upon  the  system  as  to  weaken  the  function  and  tone  of  the 
nutritive  organs.  Any  treatment  that  will  strengthen  the  whole 
system  will  generally  cure  the  derangement.  China,  Ferrum,  and 
Aurum  are  remedies  that  may  be  employed,  either  of  which,  in  daily 
doses,  will  prove  sufficient.  In  the  mean  time,  let  the  patient  refrain 
from  over-exertion.  A  more  aggravated  form  of  leucorrhoea  attends 
falling  of  the  womb,  and  this  perhaps  is  the  cause  of  the  difficulty. 
The  remedies  which  will  best  meet  this  difficulty  are  Sepia  and  Cal- 
earea  earh. ;  the  former  may  be  given  every  morning,  and  the  latter 
every  evening ;  or  perhaps  Nux  vomica  may  be  given  in  the  evening, 
and  Oalcarea  in  the  morning.  If  there  is  sick  headache  attending 
this  form  of  leucorrhoea,  Sepia  is  still  the  remedy.  If  other  biliary 
derangements  Nux  vomica  is  equally  applicable.  Ladies  afflicted 
with  any  of  these  uterine  difficulties  must  not  drink  strong  tea  or 
coffee;  but  mild  black  tea,  cocoa,  and  milk  should  be  the  chief 
beverages,  and.  if  the  appetite  permit,  a  moderately  generous,  but 
non-medicinal  diet  may  be  added. 


J  Womb. 

the  womb  may  occasion,  first, 
ulceration.     Frequent  mis- 


DISEASES  OP  THE  SKIN. 


Boils.  —  Furunculi. 


These  are  small,  circumscribed,  and  painful  tumore,. which  hepin 
in  the  form  of  a  pimple,  and  then  grow  until  they  acquire  the  wize 
of  acorns.  They  are  several  days  in  coming  to  maturity;  and  some- 
times their  painfulness  excites  fever  and  chilliness,  loss  of  appetite, 
and  other  derangements.  When  suppurating,  the  pain  in  them  is 
intense  and  pulsating  just  before  the  crisis.  As  soon  as  they  break, 
the  pain  diminishes,  and  very  soon  the  injury  is  repaired.  Aconite 
may  be  given  two  or  three  times  a  day  to  subdue  any  fever  that  may 
be  present.  Belladonna  also  will  remove  the  pain  of  congestion ;  and 
this  may  be  given  several  times  during  the  day.  Arnica  tincture  may 
be  applied  externally  to  remove  the  soreness,  and  with  great  advan- 
tage it  may  be  taken  internally ;  and  in  the  same  way  Hamameli%  Vir- 
ginica  may  be  employed.  Wet  a  compress,  and  apply  directly  over 
the  boils,  and  renew  several  times  a  day,  and  the  pain  will  be  very 
greatly  diminished.  Poultices,  in  case  of  very  large  boils,  may  prove 
of  pervice,  —  bread  and  milk  or  flaxseed ;  and,  when  employed,  give 
at  the  same  time  Hepar  sulpk,  four  globules,  and  repeat  twice  a  day. 
Amenicum  often  prevents  their  recurrence.  When  the  uoil  first  ap- 
pears drink  quantities  of  Indian-meal  water.  It  will  usually  blast  the 
boil  and  prevent  others  coming. 


Carbuncle.  —  Anthrax. 

The  difference  between  a  boil  and  a  carbuncle  is  this :  a  boil  is 
circumscribed,  but  a  carbuncle  travels,  or  moves  along  the  subcu- 
taneous tissue ;  and,  when  it  breaks,  it  seems  to  have  several  open- 
ings instead  of  one  as  in  the  case  of  the  boil.  Anthrax  is  a  trouble- 
some disorder;  sometimes  it  is  attended  with  active  inflammatory 
fever  and  sometimes  with  low  fever.  It  is  far  more  common  among 
old  than  young  people  and  sometimes  very  diflficult  of  cure.  A  car- 
buncle upon  the  back  of  the  neck,  accompanied  by  fever,  requires 
Aconite  during  the  time  of  its  development  and  afterwards  Hepar 
mlphuris.  The  effect  of  this  latter  remedy  is  to  hasten  suppuration. 
Phosphorus  is  also  employed  to  promote  the  same  end.  Bread  and  milk 

64a 


mtna  'riifr'i 


DISEASES   OK   THE   SKIN. 


643 


S  SKIN. 


li. 

riful  tumors,. which  hepiii 
itil  they  acquire  the  size 
g  to  maturity;  and  sonie- 
liilliness,  loss  of  appetite, 
ting,  the  pain  in  them  is 
.  As  soon  as  they  break, 
jury  is  repaired.  Aconite 
abdue  any  fever  that  may 
le  pain  of  congestion ;  and 
lay.  Arnica  tincture  may 
js,  and  with  great  advan- 
same  way  Haviamelis  Vir- 
i,  and  apply  directly  over 
nd  the  pain  will  be  very 
ery  large  boils,  may  prove 
ind,  when  employed,  give 
IS,  and  repeat  twice  a  day. 
When  the  ooil  first  ap- 
,    It  will  usually  blast  the 


hrax. 

irbuncle  is  this  t  a  boil  is 
■  moves  along  the  subou- 
ms  to  have  several  open- 
»il.  Anthrax  is  a  trouble- 
with  active  inflammatory 
far  more  common  among 
difficult  of  cure.  A  car- 
ipanied  by  fever,  requires 
mt  and  afterwards  Mepar 
(T  is  to  hasten  suppuration, 
same  end.  Bread  and  milk 


poultices  may  be  employed;  and  a  dressing  of  adhesive  plaster,  witli 
ii[)erture8  for  the  pus  to  discharge,  may  Ixj  applied  after  tlio  poultice. 
The  sore  should  bo  dressed  every  day ;  and,  if  very  painful,  compresses 
wet  with  llamameliH  may  be  lesorttnl  to.  To  remove  great  soreness, 
Arnica  may  be  used  in  the  same  way.  Sometimes  in  aged  people  a 
carbuncle  becomes  gangrenous ;  and  then  Armenicum  should  be  em- 
ployed, a  dose  every  three  houra.  When  the  disease,  or  carbuncle, 
comes  on  the  back,  either  to  the  right  or  left  of  the  spine,  it  is  liable 
to  make  its  way  downwards;  and,  in  order  to  prevent  its  doing* so  to 
any  extent,  compresses  bound  tightly  beneath  may  keep  them  where 
tliey  begin.  In  all  cases  where  there  is  active  fever  accompanying 
carbuncle.  Aconite  may  be  necessary ;  for  so  long  as  there  is  great 
art«rial  excitement,  it  will  tend  towards  the  carbuncle  and  greatly 
augment  its  severity.  Slow  fever,  or  a  lassitude  and  stupor,  attends 
the  discrasia,  give  Bryonia  and  repeat  every  three  hours  ;  or  perhaps 
Rhus  tax.;  Arsenicum,  if  the  pus  is  of  an  offensive  smell.  Carbuncles 
are  supposed  to  originate  from  low  conditions  of  the  circulation,  and 
therefore  a  generous  diet  is  suggested.  Avoid  medicinal  food  and 
condiments,  except  salt.    Animal  food  is  most  commended  for  a  diet. 

Abscesses. 

Abscesses  generally  form  in  the  subcutaneous  tissue,  but  manifest 
themselves  through  the  skin.  Generally  there  is  some  protuberance 
or  swelling  upon  the  surface  ;  sometimes  there  is  none.  Frequently 
there  will  be  some  redness  to  indicate  that  an  inflammatory  process 
is  going  on ;  and,  at  other  times,  there  will  be  no  indication  of  the 
kind.  An  abscess,  then,  is  simply  a  circumscribed  collection  of  pus, 
formed  from  broken-down  tissues  or  blood  corpuscles.  They  are  sub- 
ject to  medical  treatment.  Calcarea,  for  abscesses  in  scrofulous  per- 
sons, may  be  given  every  day,  and  especially  in  cases  of  scrofulous 
children.  Accesses  upon  the  arms  or  hands  may  be  cured  by  the 
use  of  Pulsatilla  or  Nux.  Abscesses  on  the  face  require  Bryonia  and 
Oalcarea  ;  abscesses  from  the  bone  require  Silicea.  Abscesses  should 
be  relieved  of  their  pus  by  the  lancet  as  soon  as  sufficiently  ripe. 
They  may  bfe  washed  with  Calendula  tincture.  Persons  prone  to 
suffer  from  abscesses  should  sulwist  upon  a  spare  diet,  and  should 
avoid  rich  gravies  or  great  quantities  of  buuter.  Bread,  potatoes, 
beans  and  peas,  beef  and  mutton  may  constitate  about  the  range  of 
diet ;  and  coffee,  ale,  cider  and  distilled  spirits  must  not  be  touched. 

Corns. 

The  feet  appear  to  be  the  only  locality  affected  by  corns ;  and  they 
occur  frequently  upon  the  toes.  A  com  is  simply  hardened  cuticle  or 
skin,  rendered  so  by  some  pressure  or  irritation  upon  the  surface,  such 
as  a  tight  boot  or  shoe.     Those  who  subject  the  feet  to  such  treat- 


~SM9M^^^^^^' 


044 


D18RASRB  OF  TIIR  SKIN. 


ment  in U8t  suffer  tin-  conHoquetices.  Tlio  lx?8t  treatment  for  ii  hi>ri' 
onrii  18  to  shave  off  tlie  liimi  Hkin  and  apply  tlie  tinctun*  of  Aniira 
or  perhaps  the  tincture  of  CaiiMaum.  It  is  naid,  however,  that  (h-K- 
jthitt'K^  Silicea^  Sulphur  and  Aiitimonium  cruii.  are  remodiert  that  may 
Im)  taken  internally  to  cue  corns.  Either  of  the  remed'es  may  Iw 
taken  in  daily  doseH.  A  .-orn-Malve  is  soinetimeH  applied,  made  of 
pine-pitch  or  diachylon.  Any  plastt'r  that  will  protect  the  teudt-r 
and  irritated  spot  from  the  pressure  of  the  hoot  will  \>e  found  useful. 

Ulcers. 

Ulcers  are  included  among  skin-affections  hecatwe  they  break  the 
continuity  of  the  skin  and  manifest  themselves  upon  the  surface.  An 
ulcer  is  formed  generally  hy  the  disorganizing  influence  of  inflainniii- 
tion  which  affects  the  membranes  and  skin.  Ulceration  of  the  sol't 
parts  and  ulceration  of  the  stomach  and  intestines  are  of  frequent  oc- 
currence: and  an  ulcer  is  slow  to  heal  and  constantly  discharges  pus. 
Ulcers  of  the  legs,  toes,  feet,  hands  and  arms  are  met  with  exlcii- 
sively.  Ulcers  of  the  lower  extremities  or  legs  and  feet  can  be  cured 
by  a  daily  dose  of  Silicea  or  of  Sulphur.  Ulcers  of  tlie  upper  extrem- 
ities, or  the  arras  and  hands,  can  be  cured  by  daily  doses  of  Calearea 
and  Oraphites.  Ulcers  of  the  soft  parts  require  Phosphorus  or  China. 
Ulceration  of  the  stomach  requires  Coniurn  or  Phosphorus.  Ulceration 
of  the  bowels  requires  Arsenicum.  Each  of  these  remedies  may  Ih; 
given  in  daily  doses,  and  continued  as  long  Jis  observation  teacht's 
their  utility.  Ulcerations  are  supposed  to  result  from  low  states  of  the 
blood;  and,  therefore,  stimulants  must  be  employed  to  tone  up  the 
system.  A  generous  diet  is  generally  to  be  commended.  There  is  no 
use  in  trying  to  heal  over  the  surface  of  an  ulcer ;  for,  in  so  doing,  it 
may  work  out  deeper  mischief  in  the  economy.  The  only  safe  way  Ih 
to  build  up  the  most  healthy  stsite  of  the  system,  and  let  tue  ulcer  dis- 
charge itself  and  heal  from  the  bottom.  Persons  subject  to  ulcei-s  are 
evidently  scrofulous  or  the  victims  of  some  i/ther  tiiint.  If  scrofu- 
lous, Arsenicum,  Silicea  or  Calearea  may  benefit  the  condition.  Ulcers 
arise  also  from  hereditary  syphilitic  taint.  Mercurius  viv.,  Mercurim 
iodatua  and  Mereunus  corr.  are  competent  to  eradicate  this  taint 
from  the  constitution;  so  Ls  Hepar  sulph.  or  Nitric  acid.  If  the  ul- 
cers arise  from  this  taint,  alcoholic  stimulants  must  be  avoided  and 
the  most  generous  moat  diet  must  take  their  place.  Whatever  l»e 
the  predisposing  cause  of  ulceration  known  in  a  family,  it  should'  be 
carefully  watched.    Avoid  eating  pork  and  lard  in  any  form. 

Chilblains. 

Frosted  feet,  as  this  complaint  is  termed,  occurs  mostly  in  cold 
weather,  and  most  frequently  in  persons  susceptible  from  some  con- 
stitutional taint.    It  has  been  observed  that  chilblains  will  assume  the 


Till 


Me 


N. 


»OHt  treatment  for  ii  hcrt- 
y  tilt)  tincture  of  ^\rtiii\i 
said*  howevrr,  tlmt  <fra- 
if.  are  remodicH  tlmt  may 
of  the  reined 't'«  may  Iw 
letimcH  applied,  made  of 
will  protect  the  tender 
K)ot  will  Im3  found  useful. 


18  hecaUHe  they  break  the 
es  upon  the  surface.  A» 
ii{r  influence  of  intlanniui- 
Ulceration  of  the  soil 
stines  are  of  frequent  oc- 
onstantly  discharges  [ms. 
rnus  are  met  with  exten- 
gs  and  feet  can  be  cuied 
cers  of  tlie  upper  extrcm- 
»y  daily  doses  of  Calcarea 
lire  PhoHj>hoTru»  or  China. 
\r  PhonphoruH.  I'lceration 
if  these  remedies  may  he 
g  as  observation  teaches 
iult  from  low  states  of  the 
employed  to  tone  up  the 
commended.  There  is  no 
ulcer ;  for,  in  so  doing,  it 
uy.  The  only  safe  way  is 
item,  and  let  tne  ulcer  dls- 
srsons  subject  to  ulcere  are 
3  crtber  tJiint.  If  scrofu- 
efit  the  condition.  Ulcers 
Mereurius  viv.,  Mercvrim 
t  to  eradicate  this  taint 
r  Nitric  acid.  If  the  ul- 
its  must  be  avoided  and 
leir  place.  Whatever  Iw 
I  in  a  family,  it  should  be 
lard  in  any  form. 


3d,  occurs  mostly  in  cold 
sceptible  from  some  con- 
chilblains  will  assume  the 


DISEASES  Of  THK  SKUf. 


645 


(;)iaracter  of  painful  sores  in  those  known  to  be  of  a  scrofulous  habit. 
The  feet  l)eing  very  suHceptible  to  cold,  l)ecomu  ohilled,  and  after- 
wards the  heels,  and  sonietinies  the  toes,  become  painfully  tender. 
Croton  tig.  or  Araenicum,  in  the  usual  dose,  may  be  administered 
twice  a  day  when  there  is  burning  heat  and  swelling ;  Nux  vomica^ 
ill  the  same  way,  wh^in  attended  with  rheumatic  pains.  Pulmtilla  is 
a  better  remedy  for  females  of  delicate  constitution  and  subject  to 
colds.  Wher  the  chilblains  iWHunie  a  bluish  appearance,  PhuHphoruii 
and  Sulphur  may  be  given ;  either  of  which,  in  the  usual  dose,  may 
lie  given  twice  a  day.  Externally  the  tincture  of  Arnica  may  be  aj)- 
l)lied  to  remove  soreness.  Tincture  of  Cantharig,  if  there  is  an  incli- 
nation to  blititer;  Jihus  tox..,  if  they  are  red  and  inflamed.  A  solution 
ot  glue,  in  warm  water,  has  been  found  a  good  palliative  us  a  foot- 
bath. 

Whitlow. 

This  is  an  inflammation  and  suppuration  around  the  nails  of  the 
fingers ;  sometimes  slight  and  at  other  times  exceedingly  jMiinful. 
Hepar  aulph.  taken  internally  will  hasten  to  a  crisis ;  Graphites  or 
MercuriuH  is  sometimes  used  for  the  same  purpose;  Silieea  will  has- 
ten suppuration  and  a  cure.  Rhu»  or  Lachesin,  if  the  sjrstem  is  in  a 
low  condition.  Either  remedy  may  be  administered  twice  in  twenty- 
four  hours. 

Itch.  —  Scabies. 

This  cutaneous  eruption  consists  of  small  pimples,  or  piistules, 
which  make  their  appearance  in  clusters  upon  the  skin  and  itch  and 
burn  continually.  They  are  believed  to  result  from  the  acarus  or 
itch-mite  imbedded  in  the  cuticle.  These  pimples  usually  break  out 
between  the  fingers,  on  the  hands  and  wrists,  and  over  the  body.  StU- 
phur  has  ever  been  found  *  salutary  remedy,  taken  internally,  and  ap- 
pHed  as  an  ointment  dp'.iy.  In  many  cases,  Calcarea,  Hepar  sulph., 
Mercuritig  and  Rhus  have  been  found  useful.  For  what  is  termed  the 
j)rairie  itch,  which  is  very  stubborn,  Mercurius  viv.,  taken  internally, 
and  an  ointment  of  the  red  oxide  of  mercury,  used  with  care,  exter- 
nally, has  proved  effectual.  Sulphur  ointment  has  been  in  general 
use,  and  is  of  great  service  if  used  sparingly  and  with  caution. 

Itching  of  the  Skin.— fV-Mn^ro. 

Sometimes  there  will  be  intense  itching  of  the  skin,  without  any 
apparent  eruption.  Scratching  or  rubbing  does  not  relieve  ;  every 
attempt  to  relieve  in  this  way  aggravates  the  difficulty.  There  is  no 
disease  of  the  skin  apparently  more  superficial,  nor  yet  more  annoy- 
ing. As  there  is  no  prominent  syi^^  torn  but  itching,  we  would  nat- 
umlly  suppose  that  some  simple  remedy  would  antidote  it.  But  not 
tio.    In  bilious  temperaments,  Mercurius  is  the  best  remedy.    In  sau- 


"S^^'^^f^fr   T  '^"Jl^^!'^:-' 


'i46 


DI8KA8KS   OK  TIIK   8KIN. 


guiue  teinperamentii,  Nux  vontUa,  or  |)erhfti«  Sulphur.  In  tin-  ner- 
vous, PulmtiUiu  J'/natia,  Sepia,  i'alrnrea  and  Conium.  TIk  ronicdy 
selected  to  meet  tlio  case  may  Us  fr'ivvn  twice  a  day  until  relievtMJ, 
unless  there  in  found  a  necessity  for  change. 

RlnSfWOrtn.  —  Herpes  Circinnatus. 

This  troublesome  disorder  usually  manifests  itself  upon  the  face, 
and  is,  at  first,  a  small  circular  eruption  that  enlarges  in  the  form  of 
a  ring.  The  cause  is  believed  to  be  a  minute  itcli-mite  which  lives 
in  the  skin  and  commits  its  circuitous  mischief.  Sometimes  (tiily 
one  ring  appears ;  at  other  times  there  are  several,  each  enlarging  its 
area  until  the  face  l)e<iome8  nearly  covered.  A  frequent  cause  of 
their  appearing  is  by  being  shaved  with  a  razor  that  communicates 
the  infection.  A  strong  tincture  of  Uyo»cyamui»  applied  to  the  sur- 
face, will  generally  extinguish  them  ;  but  there  must  be  some  consti- 
tutional predisposition  that  favoi-s  them;  and  therefore  internal  reme- 
dies must  be  employed.  In  case  of  syphilitic  taint,  daily  doses  of 
Mereurim  viv.  will  be  required.  In  those  of  strumous  constitutions, 
Calcarea,  Arsenieum  an  \  Sepia.  In  those  constitutionally  inclined  to 
erysipelas,  Rhus  tax..,  Duleamara,  Hepar  mlph.  and  Bryonia  will  be 
found  of  use.  Two  or  three  doses  of  the  remedy  selected  may  l)e 
administered  every  day;  and,  at  the  same  time,  the  Hyoscyamu* 
tincture  may  be  applied  externally.  This  treatment  has  been  found 
efficacious  in  most  cases.  A  dilute  tincture  of  Oantharis,  applied 
locally,  is  a  specific. 

Hives. 

Small  red  blotches  upon  the  skin,  that  bum,  itch  and  sting,  are 
usually  called  hives.  They  are  believed  to  result  from  some  de- 
rangement of  nutrition,  caused  by  certain  articles  of  diet.  But  lit- 
tle danger  attends  the  difficulty,  unless,  by  exposure  to  cold,  the 
eruption  is  made  to  recede,  and  it  falls  upon  the  bowels :  this,  some- 
times, in  children,  results  in  diarrhoea.  Pulsatilla  may  be  given  in 
the  usual  dose,  three  or  four  times  a  day.  In  young  children,  who 
may  be  teething,  Chamomilla  will  be  found  useful.  If  there  is  any 
nausea,  give  Bryonia  or  Ipecac^  and  the  derangement  will  be  cor- 
rected very  soon,     Vroton  tig.  is  a  fine  general  specific. 

Varicose  Veins. 

The  external  veins  upon  the  lower  limbs  sometimes  become  con- 
gested and  enlarged,  and  are  termed  "varicose."  Inflammation 
sometimes  attends  this  difficulty,  and  terminates  in  varicose  ulcers. 
The  best  remedy  known  for  simple  varicose  veins  is  Hamamelis  Virg. 
Pulsatilla  is  believed  to  be  useful,  and  also  Lachesis.  Either  of  these 
remedies  may  be  administered  three  times  a  day.     The  Hamamelis 


IN. 

|)H  Sulphur.  In  tliH  ner- 
11(1  Coniuni.  TIk  n'tncdy 
w\ce  11  (lay  until  I'uliuvtMl, 
}. 

'Jircinnatus. 

feats  itself  upon  the  face, 
ut  enlarges  in  the  form  of 
nute  itch-mite  which  lives 
liHchief.  Sometimes  only 
Hevenil,  each  enlarging  iU 
id.  A  frequent  cause  of 
razor  that  communicatcH 
yamuD  applied  to  the  sur- 
ihere  must  be  some  con.sti- 
id  therefore  internal  reiiie- 
ilitic  taint,  daily  doses  of 
of  strumous  constitutionH, 
[Jonstitutionally  inclined  to 
Iph.  and  Bryonia  will  be 
3  remedy  selected  may  Ixj 
me  time,  the  Hyoscyamm 
treatment  has  been  found 
bure  of  Cantharis,  applied 


burn,  itch  and  sting,  are 
[  to  result  from  some  de- 
articles  of  diet.     But  lit- 
by  exposure  to  cold,  the 
on  the  bowels  :  this,  some- 
*ul8atilla  may  be  given  in 
In  young  children,  who 
d  useful.     If  there  is  any 
derangement  will  be  cor- 
leral  specifict 

IS. 

bs  sometimes  become  con- 
•  varicose."  Inflammation 
minates  in  varicose  ulcers. 
le  veins  is  Hamamelis  Virg. 
)  Lachesis.  Either  of  these 
38  a  day.     The  Hamamelis 


niHKAHKS   OK   TIIK   .SKIN. 


647 


may  1)0  ftp[)lied  oxteriially  wImmi  adniinistorcd  inUrniilly  For  vari- 
cose ul(;ei-s,  Arnlcii  may  Im*  given  in  {\\v.  inlliunniatoiy  stiigc,  and 
/lipitr  tiulph.idU'r:  wlnsn  ulctMiilion  lakes  |»liice, /Irc.'^/iv/w  and  (Mr- 
III!  lU'ifetabUin  may  Ihj  calhtd  inti>  \im\  A  dose  every  day  will  hasten 
a  cure. 

Felons. 

Fklonr  commence  at  the  l)one,  lieneath  the  periosteum  or  mem- 
brune  that  surrounds  it.  They  are  very  painful,  and  most  commonly 
make  their  appearance  on  the  lingers  or  thumbs ;  at  first  a  prickling 
sensation  is  experienced,  as  from  a  splinter,  and  then  a  sensation  of 
heat  attended  with  intense  pain,  depriving  the  suff  'er  of  rest  or 
sleep.  The  skin  becomes  changed  in  color  at  the  sur  ts  and  there 
is  painful  tinobbing  and  swelling.  The  most  speedy  cure  for  a  felon 
is  to  thrust  in  the  1  inoet  to  the  bone,  and  give  vent  to  the  matter 
jjeneath  tiie  membrane  ;  and,  afterwa'ds,  an  application  of  warm  flax- 
seed poultices  will  keep  the  sore  discharging.  Previous  to  lancing, 
resort  has  sometimes  Injen  had  to  soaking  the  part  in  hot  water  to 
which  Ammonia  has  been  added,  to  ripen  and  prepare  the  way  for 
the  matter  to  come  to  the  surface.  Hepar  nulph.,  ttiken  internally, 
exerts  a  benelieial  influence  in  hastening  suppuration.  After  a  resoit 
to  the  lancet  is  had,  Silicea  is  a  valuable  remedy  to  hasten  a  cure. 
For  the  constitutional  disturbance  which  felons  excite,  Aconite  may 
be  given  to  reduce  arterial  excitement ;  Arnica,  to  remove  soreness ; 
Niix  vomica,  to  al  '.ay  an  irritable  condition  of  the  stomach  ;  and  Sul- 
phur, to  fortify  the  system  against  the  recurrence  of  the  difficulty. 
It  is  always  well  to  keep  the  l^-^iid  at  rest  until  the  pain  and  inllam- 
maticu  has  subsided. 

Tetter.    Salt  Rheum.— Herpes. 

Tetter  is  an  inflammatory  disease  of  the  skin,  which,  for  the  most 
part,  appears  upon  exposed  surfaces,  —  the  hands  and  the  face, — 
though  sometimes  it  comes  on  the  arms  and  legs.  It  is  a  red,  scaly 
or  burning  eruption,  very  stubborn  in  its  character,  and  painful.  It 
sometimes  becomes  complicated  with  constitutional  erysipelas  and 
causes  swelling  and  infiltration  of  the  cellular  tissues  around  the 
eyes ;  affects  the  ears  and  nose  ;  breaks  out  on  the  backs  of  the 
hands  and  arms,  and  in  the  bend  of  the  elbow-joint,  causing  the  skin 
to  crack  and  become  exceedingly  soro.  Sometimes  the  tetter  is  dry, 
sometimes  humid ;  and  at  others  scaly.  For  dry,  burning  tetter,  Ar- 
mnicum  is  a  valuable  remedy.  If  there  is  feverish  heat  in  the  skin 
generally,  Aconite  and  a  lotion  of  tincture  of  Aconite  may  be  a^)- 
plied  externally.  When  the  skin  cracks  and  is  dry,  it  may  be 
anointed  with  the  glycerole  of  Aloe».  The  burning  may  be  some- 
what allayed  by  applying,  with  a  down-brush,  a  little  rye-flour.  Sepia, 
Qalearea  and  Dulcamara  are  also  valuable  remedies  for  diy  tetter. 


ismssmM.^^^^^w^^^'^^mf^f^ 


648 


DISEASES   OF   THE   SKIN. 


The  remedies,  when  selected,  must  be  used  persistently,  two  or  three 
doses  a  day.  For  humid  tetter,  Bhux  tor.,  Conimn  and  Sulphur  may 
be  employed.  The  Rhus  tox.  may  be  given  at  first  and  repeated 
every  six  hours.  A  lotion  of  twenty  drops  of  the  tincture  in  half  a 
tumbler  of  water  may  be  applied  externally  ;  and  a  similar  prepara- 
tion of  Conium  may  be  used  externally  when  this  remedy  is  adminis- 
tered internally.  When  humid  tetter  smarts,  and  the  skin  is  broken, 
cold  cream  may  also  be  applied.  For  the  scaly  tetter,  Calcarea  carb. 
may  be  given  persistently  three  times  a  day  ;  if  this  fails.  Sepia,  es- 
pecially if  the  face  is  implicated.  When  the  eyes  or  ears  are  affected 
and  swollen  Mhus  tox.  and  Belladonna  may  be  given  alternately  every 
three  hours  until  better.  In  all  caaes  of  tetter  of  the  furfuraceous 
type,  Natrum  muriaticum  may  be  found  of  service  when  other  reme- 
dies fail.  Cantharis  is  account(  ^  a  general  specific.  All  persons  af- 
flicted with  the  disease  should  refrain  from  the  use  of  salt  provisions, 
pork,  rich  gravies  and  the  like ;  for  these  articles  of  diet  heat  the 
blood  and  augment  the  suffering. 


Scrofula. 

This  disease  shows  itself  in  swelling  of  the  glands  and  sores  upon 
the  face,  neck  and  extremities.  To  rid  the  blood  of  this  discrasia, 
Arsenieum  may  be  given  when  there  are  sores  or  ulcers  affecting  the 
soft  parts.  Sores  around  the  mouth  and  upon  the  faces  of  scrofulous 
children  may  be  cured  with  Pulsatilla  or  Bryonia.  For  swelling  of 
the  glands,  give  Mercurius  three  times  a  day ;  and,  if  there  is  a  ten- 
dency to  suppuration,  give  Hepar  mlph.  In  some  children  of  scrofu- 
lous taint,  vaccination  will  bring  out  sores  on  the  face,  hands  and 
arms.  This  has  been  ascribed  to  impure  vaccine  matter  ;  but  this  is 
not  usually  the  case,  as  the  best  virus  ever  used  will  often  be  fol- 
lowed with  this  result ;  and,  when  it  is,  Calcarea  carb.  or  Silicm  may 
l)e  given  in  daily  doses  till  the  humor  disappears.  Ointments  that 
simply  drive  these  humors  from  the  surface  are  pernicious  and  often 
result  in  producing  worse  forms  of  the  dist  ase.  Great  care  in  refer- 
ence to  diet  is  necessary  when  these  sores  break  out  upon  children. 
They  should  be  fed  mostly  upon  farinaceous  food.  Avoid  pork  in 
all  its  forms. 

Eczema.  * 

This  is  a  disease  of  the  skin,  that  may  be  brought  on  by  working 
in  smelting-furnaces,  where  the  victims  are  all  the  time  exposed  to 
much  heat,  and  are  obliged  to  work  among  cinders  and  steam.  The 
appearance  of  this  skin-disease  is  that  of  red  and  inflamed  spots  cover- 
ing the  entire  body.  The  biliary  system  seems  to  be  much  deranged, 
and  nutritive  system  impaired.  Persons  thus  affected  become  very 
much  prostrated,  and  suffer  intensely  from  the  burning  and  smarting 
of  the  eruption.     Almost  any  severe  exercise  that  heats  the  blood  of 


IV 


DISEASES   OF  THE  SKIN. 


649 


rsistently,  two  or  three 
7iiutn  and  Sulphur  may 
1  at  first  and  repeated 
f  the  tincture  in  half  a 
and  a  similar  prepara- 
this  remedy  is  adminis- 
and  the  skin  is  broken, 
y  tetter,  Calcarea  carb. 
if  this  fails,  Sepia,  es- 
lyes  or  ears  are  affected 
given  alternately  every 
er  of  the  furfuraceous 
rvice  when  other  reme- 
[)ecific.  All  persons  af- 
e  use  of  salt  provisions, 
-tides  of  diet  heat  the 


I  glands  and  sores  upon 
blood  of  this  discrasia, 
1  or  ulcers  affecting  the 

the  faces  of  scrofulous 
onia.  Fof  swelling  of 
;  and,  if  there  is  a  ten- 
lome  children  of  scrofu- 
)n  the  face,  hands  and 
iine  matter  ;  but  this  is 
used  will  often  be  fol- 
rea  carb.  or  Silicm  may 
pears.  Ointments  that 
re  pemiciious  and  often 
e.  Great  care  in  refer- 
eak  out  upon  children. 

food.     Avoid  pork  in 


brought  on  by  working 
11  the  time  exposed  to 
inders  and  steam.  The 
id  inflamed  spots  cover- 
is  to  be  much  deranged, 
.8  affected  become  very 
e  burning  and  smarting 
that  heats  the  blood  of 


those  usually  forced  to  live  upon  an  indifferent  diet  of  unwholesome 
food  will  become  subject  to  eczema.  To  treat  this  difficulty  success- 
fully is,  first  to  regulate  the  biliary  system  by  three  or  four  doses  of 
Nux  vomica  or  Mereurius  viv.,  for  several  days ;  and  then  follow  with 
Arsenicum,  Tartar  emetic,  Petroleum  or  Antimonium  crudum,  three  or 
four  doses  every  day  ;  and,  as  soon  as  the  appetite  and  stomach  will 
permit,  furnish  the  patient  with  a  generous  diet,  and  let  him  change 
liis  employment  for  one  of  less  exposure. 

Liver  Spots. — Maculce,  Moss. 

This  affection  consists  of  discolored  spota  upon  the  skin  of  the 
face,  sometimes  covering  the  surface  of  the  forehead  with  dark  dis- 
colorations  of  the  skin.  Derangements  of  the  liver  are  believed  to  be 
the  cause ;  and,  although  these  discolorations  are  not  painful  (except 
to  the  mind),  they  often  mar  the  countenance  and  annoy  those  smit- 
ten with  these  marks.  They  can  be  removed  with  appropriate  reme- 
dies. Sepia  is  one  of  the  most  prominent.  Chelidonium,  given  the 
same,  is  useful.  A  dose  should  be  given  morning  and  evening  per- 
sistently, until  the  color  fades  and  the  spots  disappear.  To  facilitate 
this,  let  the  patient  a^^oid  coffee,  milk,  eggs  and  all  oily  food.  An 
animal  diet,  of  the  lean  of  well-fed  beef  and  mutton,  is  preferable, 
with  bread.  Potatoes,  and  esculents  of  every  kind,  may  be  allowed ; 
but  gravy  and  mutjh  butter  are  pernicious  ;  as  are  stimulants,  such 
as  malt  liquors  and  highly  seasoned  soups. 

Scurvy. 

Persons  so  situated  as  to  be  obliged  to  subsist  upon  salt  provi- 
sions are  liable  to  become  affected  by  a  disease  termed  "  scurvy."  It 
manifests  itself  in  scorbutic  eruptions  upon  the  skin,  and  by  an  in- 
flamed and  sore  condition  of  the  gums,  which  sometimes  become  so 
much  affected  as  to  cause  the  teeth  to  become  loose.  The  want  of 
fresh  vegetables  or  lemons,  oranges  and  other  fruits,  is  believed  to  be 
sufficient  to  cause  the  difficulty.  To  cure  the  disorder,  a  wholesome 
diet  must  be  provided,  with  plenty  of  fruit,  fresh  provisions  and  vege- 
tables. The  only  remedy  necessary  to  carry  off  the  difficulty,  after 
providing  the  proper  diet  is  Natrum  muriatieum,  three  doses  a  day, 
— morning,  noon  and  night.  Mercuriu9  viv..  Nitric  acid  and  Muri- 
atic add  are  also  remedies  that  have  been  employed. 

B&rber's  Itch.  —  Sycosis  Mentagra. 

This  is  exclusively  a  disease  of  the  male  sex  and  occurs  about  the 
time  the  beard  begins  to  grow  thick  and  hard.  The  disease  is  sup- 
posed to  be  contracted  by  using  bad  soap  upon  the  face,  when  shav- 
ing or  washing  the  beard.     A  dull  razor,  that  pulls  and  irritates  the 


; 


650 


DISEASES  OF  THE   SKIN. 


skin,  may  form  the  nucleus  of  the  difficulty.  In  laboring  people,  ex- 
posed to  dust,  especially  of  tobacco,  and  where  there  is  not  particulai 
pains  in  washing  out  the  dust  frequently,  the  disease  is  likely  to  be 
generated.  The  disease  resembles,  in  some  degree,  the  herpes  of  the 
lips,  makes  its  fii-st  appearance  on  the  chin  in  small  clusters  of  red 
pimples,  or  tubercles,  each  of  which  is  perforated  with  a  hair.  These 
pimples  increase  in  size  and  disgusting  appearance,  though  not  pain- 
ful, until  arrested  by  some  remedial  means.  Graphites,  in  daily 
doses,  has  often  cured.  Mtrie  acid,  also,  twice  a  day,  has  proved  ef- 
ficient. Aurum  muriaticum,  alone,  will  cure  cases  in  those  having 
psoric  or  syphilitic  taint.  Silicea,  Carbo  animalia,  Hyoseyamus  tinc- 
ture (externally),  are  also  good  remedies.  Nitric  acid  may  be  ap- 
plied in  a  diluted  form,  externally,  and  also  Sulphur  ointment.  A 
solution  of  Iodide  of  Potass.,  two  grains  to  an  ounce  of  water,  applied 
several  times  daily,  cures  stubborn  cases. 


i 


I  ' 


In  laboring  people,  ex- 
B  there  is  not  particular 
!  disease  is  likely  to  be 
legree,  the  herpes  of  lh( 
n  small  clusters  of  red 
ited  with  a  hair.  These 
irance,  though  not  pain- 
Graphites,  in  daily 
ce  a  day,  has  proved  ef- 
i  cases  in  those  having 
maliB,  Hyoscyamua  tine- 
Nitric  acid  may  be  ap- 

Sulphur  ointment.     A 
ounce  of  water,  applied 


DISEASES  OP  THE  ORGANS  OF 
CIKCDLATION. 


The  heart,  its  appendages  and  valves ;  the  pericardium  or  mem- 
brane that  covers  the  heart ;  the  nerves  that  are  distributed  to  the  or- 
gan, as  well  as  the  arteries  and  veins,  —  are  embraced  in  the  organs 
of  circulation. 

Inflammation  of  the  Heart.  —  Endocarditis. 

When  a  sharp  pain  is  sometimes  felt  in  the  region  of  the  fifth  rib, 
with  quick  pulse,  flushed  face,  and  hurried  respiration,  there  are  in- 
dications of  endocarditis.  Aconite  in  the  usual  dose  may  be  given 
every  hour  until  the  frequency  of  the  pulse  is  diminished ;  Verat. 
viride,  if  Aconite  fails  to  reduce  the  pulse  in  twenty-four  houre.  If 
the  disease  has  been  brought  on  by  a  shock  or  injury,  Arnica  ;  if  from 
excessive  grief,  Ignatia  ;  if  from  cold,  Arsenicum  ;  if  it  is  the  sequel 
of  inflammatory  rheumatism,  Pulsatilla  ;  if  the  disease  terminates  in 
dropsy  of  the  pericardium  or  chest.  Apis  mellifica.  Let  the  diet  be 
simple  and  easy  of  digestion. 

Inflammation  of  the  Pericardium.  —  Pericarditis. 

AoiTTB  inflammation  of  the  pericardium  is  denoted  by  symptoms 
much  the  same  as  those  attendant  on  endocarditis,  and  may  be 
brought  on  by  a  cold,  a  sudden  check  of  perspiration,  or  simultanb- 
ously  with  a  sudden  attack  of  inflammatory  rheumatism.  Aconite  re- 
peated every  hour.  Pulsatilla  or  Bryonia  may  follow  in  the  usual 
dose,  and  be  repeated  every  hour  until  a  change  occurs.  The  peri- 
cardium, being  a  serous  membrane,  is  liable  to  a  profuse  collection  of 
serum  about  the  heart.  Apis  mellifica  in  the  usual  dose  every  two 
hours  will  be  likely  to  give  relief;  Apocynum  and  Helleborus  niif.  are 
also  remedies  that  may  be  employed  in  curing  this  trouble.  If  the 
heart  palpitates  severely,  give  Pulsatilla  or  Digitalis.  Diet  simple 
and  nutritious  and  free  from  any  exciting  stimulants. 

Chronic  Inflammation  of  tlie  Pericardium  has  similar  symptoms, 
but  not  so  severe.  It  often  attends  the  gout,  and  is  treated  with  the 
same  remedies.  Colchicum  is  a  valuable  remedy,  and  may  be  given 
three  times  a  day,  in  usual  doses.     Sulphur  is  often  useful. 

661 


T 


652 


DISEASES  OF   THE  ORGANS   OF  CIRCULATtON. 


Chronic  Perlcardltia  may  sometimes  be  cured  by  Calcarea  or  Ly- 
copodium.  Aurum  muriaticum  and  Spigelia  are  called  into  requisi- 
tion when  there  is  irregulatity  of  the  heart's  action,  Arsenicum  when 
there  is  a  burning  sensation  accompanying  the  pain.  Diet,  if  the 
stomach  will  bear  it,  may  be  quite  generous. 

Dilatation  of  the  Cavities  of  the  Heart. 

This  trouble  is  manifest  from  a  more  perceptible  action  of  the 
heart  than  is  normal;  its  motion  being  more  violen;  Lachesis  when 
there  is  a  disposition  to  sigh ;  Belladonna  if  there  is  a  tendency  of 
blood  to  the  head ;  Digitalis  if  there  is  a  quick,  full  pulse ;  or  Verat. 
viride;  Aconite  if  there  is  fever ;  Pulsatilla  if  there  is  rheumatism  of 
the  joints  at  the  same  time. 

Imperfect  Action  of  the  Valves  of  the  Heart. 

A  DIFFICULTY  such  as  this  is  not  denoted  by  any  one  set  of  symp- 
toms, but  it  may  give  rise  to  various  sufferings,  such  as  fainting, 
rush  of  blood  to  the  head,  apoplexy  and  convulsions.  Fainting  re- 
quires Pulsatilla,  China,  Bryonia  and  Rhus.  Rush  of  blood  to  the 
head,  Belladonna  ;  apoplexy.  Aconite,  Belladonna  and  cold  applica- 
tions to  the  head ;  convulsions  require  Chamomilla,  Belladonna,  Hyos- 
cyamus  and  Digitalis.  Whichever  remedy  is  selected  may  be  given 
every  half-hour  until  relief  is  obtained,  or  change.  Spasmodic  pains 
about  the  heart  from  some  sudden  excitement,  Qelsemium. 

Aneurism  of  the  Aorta. 

Thts  18  a  rupture  of  some  of  the  coats  of  the  great  artery,  and 
which  so  weakens  the  rest  that  they  lose  their  tenacity,  and  bulge 
out  so  as  to  impair  its  function.  It  often  is  very  painful  and  pulsates 
in  a  frightful  manner.  Aconite,  Bryonia,  Digitalis,  Zinc,  Lachesis 
and  Ehus  tox.  are  remedies  that  may  be  consulted.  Either  will  re- 
lieve, under  certain  eonditions.  Tl^d  usual  dose  may  be  repeated 
every  two  hours. 

Inflammation  of  tlie  Arteries  may  be  relieved  by  the  persistent 
use  of  Aconite,  and  inflammation  of  the  veins  by  Phosphorus,  Rama- 
melis  or  Rhus  tox.  Arteritis  and  phlebitis  are  both  formidable  dis- 
eases, and  require  the  attendance  or  care  of  a  physician. 


3ULAT!0N. 


red  by  Calcarea  or  Ly- 
ire  called  into  requisi- 
iction,  Arsenicum  when 
the  pain.     Diet,  if  the 


f  the  Heart. 

rceptible  action  of  the 
dolen ;  Lachesis  when 
there  is  a  tendency  of 
t,  full  pulse ;  or  Verat. 
there  is  rheumatism  of 


>  of  the  Heart. 

by  any  one  set  of  symp- 
ings,  such  as  fainting, 
ivulsions.  Fainting  re- 
Rush  of  blood  to  the 
onna  and  cold  applica- 
milla,  Belladonna,  Hyos- 
selected  may  be  given 
mge.  Spasmodic  pains 
b,  Q-elsemium. 

trta. 

if  the  great  artery,  and 
leir  tenacity,  and  bulge 
ery  painful  and  pulsates 
Digitalis,  2jinc,  Lachesis 
isulted.  Either  will  re- 
dose  may  be  repeated 

Lieved  by  the  persistent 
8  by  Phosphorus,  Hama- 
re  both  formidable  dis- 
i  physician. 


DISEASES  INVOLVING  THE  VAEI0U8 

ORGANS. 


Simple  Fever. 

This  disease  is  a  simple  accelemtion  of  the  pulse,  with  flushes  of 
heat ;  and  when  brought  on  by  fatigue,  give  four  globules  of  Ami- 
i-a ;  if  from  cold.  Aconite;  if  from  grief,  Ignatia ;  if  from  indiges- 
tion. Belladonna ;  if  from  dampness  and  chill,  Oelsemium  or  Rhus 
tax. 

Inflammatory  Fever. 

In  most  cases  this  disease  commences  with  pain  in  the  head  and 
full  pulse,  more  or  less  thirst,  loss  of  appetite,  constipation  of  the 
bowels  and  dry,  hot  skin.  One  drop  of  the  dilution,  or  four  globules, 
of  Aconite  may  be  given  in  the  first  stage,  every  hour,  until  the  skin 
becomes  moist,  and  the  pulse  somewhat  reduced.  Belladonna  may 
follpw  Aconite,  and  be  given  in  the  same  doses  and  intervals,  until 
there  is  a  mitigation  of  the  pain  in  the  head ;  or  if  the  patient  becomes 
weak  and  subject  to  aggravation  of  suffering  from  the  slightest 
motion,  give  a  drop,  or  four  globules,  of  Bryonia,  every  hour, 
until  there  is  a  change ;  with  restlessness  and  when  from  checked 
perspiration,  Mhus  tox.,  same  dose  as  Bryonia.  In  the  case  of  uri- 
nary obstruction  give  four  globules  of  Cantharis;  or  of  flatulent  colic, 
four  globules  of  Ohamomilla.  The  diet  should  be  farinaceous  gruel 
or  toast. 

Typhoid  Fever. 

In  general,  the  commencement  of  this  disease  is  denoted  by  lassi- 
tude, headache  and  considerable  acceleration  of  the  pulse.  Then  fol- 
low stupor  or  delirium,  coldness  of  the  surface  and  great  prostration. 
Four  globules,  or  one  drop,  of  Aconite  may  be  given  at  first,  every 
two  hours ;  to  reduce  the  pulse  and  moisten  the  skin  (by  many  Bap- 
tisia,  in  drop  doses,  hourly,  of  the  tincture,  is  preferred  to  Aconite'), 
Bryonia  may  be  used  after  Aconite,  a  dose  every  three  hours.  If  the 
patient  becomes  drowsy,  give  Rhus  tox. ;  cleanse  the  surface  of  the 
patient  daily  with  a  towel  wet  with  tepid  water ;  and,  if  he  will  take 
any  nourishment,  give  him  beef-tea  or  mutton-broth ;  milk  is  allow- 
able, and  rice  gruel.     When  convalescent,  allow  some  light  wine 

653 


654 


DISEASES   INVOLVING  THE   VARIOUS   ORGANS. 


three  times  a  ilay.     For  the  diarrhoea  of  typhoid,  Arsenicum^  four 
globules,  after  each  discharge,  is  good. 

Bilious  Remittent  Fever. 

This  disease  is  so  named  because  it  comes  on  by  considerable  gan- 
tric  derangement,  headache  and  fever,  which  appears  to  be  subject  to 
elevations  and  depressions,  without  any  distinct  intermissions.  In 
the  firat  or  inflammatory  stage,  pive  four  globules,  or  a  drop,  of  the 
dilution  of  Aconite,  and  follow  it  with  a  like  dose  of  Ipecacuanha,  and 
repeat  every  hour,  until  the  nausea  and  vomiting  are  bette/.  If  the 
bowels  are  constipated,  give  Nux  vomica  at  night, — a  single  dose  of 
four  globules.  If  there  is  colic,  give  Colocynth.  If  there  is  vomit- 
ing of  greenish  bilious  matter,  give  Bryonia  or  Pulsatilla.  Diet 
same  as  in  inflammatory  fever. 

Intermittent  Fever. 

The  symptoms  by  which  this  fever  is  distinguished  are  yawning, 
stretching,  shuddering  and  chilliness,  followed  by  heat,  pain  in  the 
back,  limbs,  head,  etc.;  and  afterwards  a  copious  perspiration,  and 
then  an  interim  of  complete  intermission.  Arsenicum,  where  the 
chilliness  and  heat  are  simultaneous,  and  where,  during  the  cold 
stage,  there  is  intense  thirst  for  cold  drinks ;  Arnica,  where  there  is 
soreness  of  the  flesh,  as  if  bruised;  Belladonna,  where  headache  and 
chilliness  down  the  back  ;  China,  where  there  is  ringing  in  the  ears ; 
Sulphur,  in  cases  of  long  standing,  where  much  Quinine  has  been 
given;  Bryonia,  where  there  are  glairy  vomitings  during  the  chill 
and  fever,  and  where  all  the  sufferings  are  aggravated  by  motion. 
Apis,  attacks  chronic,  and  preceded  by  nettle-rash,  —  followed  well 
by  Nat.  mur.,  either  to  be  given  three  times  daily.  All  the  medi- 
cines may  be  administered  in  drop  doses  of  the  dilutions,  or  four 
globules ;  and  repeated  every  two  hours  between  the  paroxysms. 

Yellow  Fever. 

Common  to  the  Southern  States  during  the  warm  season.  Nearly 
all  the  symptoms  of  an  ordinary  bilious  fever,  in  an  aggravated  form, 
characterize  this  disease ;  and  the  victims  become  so  sallow,  and  the 
surface  so  yellow,  as  to  give  rise  to  the  name  "  yellow  fever."  When 
the  stage  of  febrile  excitement  exists,  give  Aconite.  When  the  nose 
bleeds,  give  Belladonna.  When  vomiting  of  black  or  dark  bilious 
matters  occurs,  give  Arsenicum.  For  the  prostration  or  diarrhoea, 
give  Carbo  vegetabilis,  and  when  the  most  offensive  odor  comes  from 
the  breath,  give  Baptisia.  Arsenicum  and  Carlo  vegetabilis  are  the 
most  prominent  remedies.  The  usual  drop  or  four  globule  doses 
may  be  repeated  every  two  hours,  and  sometimes  every  hour.  Diet, 
— barley-water  and  gruel. 


iHlWIt'r'iMlflBHBlfctr'^ 


i   ORGANS. 

phoid,  Arsenicum,  four 

5ver. 

jn  by  considerable  gas- 
tppears  to  be  subject  to 
inct  intermissions.  In 
mles,  or  a  drop,  of  the 
ose  of  Ipecacuanha,  and 
;ing  are  better.  If  the 
ght, — a  single  dose  of 
ih.  If  there  is  vomit- 
ia  or  Pulsatilla.     Diet 

it. 

nguished  are  yawning, 
3d  by  heat,  pain  in  the 
(pious  perspiration,  and 

Arsenicum,  where  the 
vheve,  during  the  cold 
;  Arnica,  where  there  is 
na,  where  headache  and 
e  is  ringing  in  the  ears ; 
nuch  Quinine  has  been 
litings  during  the  chill 

aggravated  by  motion, 
le-rasb,  —  followed  well 
s  daily.  All  the  medi- 
f  the  dilutions,  or  four 
wreeu  the  paroxysms. 


le  warm  season.  Nearly 
r,  in  an  aggravated  form, 
scome  so  sallow,  and  the 
e  "yellow  fever."  When 
icdnite.  When  the  nose 
of  black  or  dark  bilious 
prostration  or  diarrhoea, 
ffensive  odor  comes  from 
Oarbo  vegetabilis  are  the 
p  or  four  globule  doses 
times  every  hour.     Diet, 


UISEASKS   INVOLVING  THE   VARIOUS   OUUANS.  656 


Eruptive  Fevers. 

Nettle*Rash  is  a  pale-red,  stinging  eruption,  that  sometimes  is  at- 
tended with  vomiting,  and  sometimes  with  some  other  derangement 
of  the  stomach.  Ipecac,  and  Nux  vomica  are  indicated  for  the  vom- 
iting, and  Apis  mellifica,  Rhus  tox.  and  Sulphur  for  the  burning,  itch- 
ing and  stinging  ;  Croton  tiff,  cures  nearly  all  cases,  a  favorite  remedy 
with  physicians.  Doses  as  usual,  and  repeated  every  hour  or  two 
hours  until  relieved. 

Scarlet-Rfish  is  the  roseola,  or  red  eruption,  and  is  much  like  the 
nettle-rash,  only  less  annoying.  Bryonia,  Pulsatilla,  are  the  ordinary 
remedies ;  and  either  may  be  given  in  doses  of  four  globules  every 
two  hours ;  A  jon.,  if  wakeful  and  restless. 

Scarlet-Fever  usually  begins  with  vomiting,  quick  pulse,  sore 
throat,  headache  and  great  restlessness.  Belladonna,  when  there  is 
a  bright,  scarlet  eruption ;  Galcarea  carhonica,  when  the  child  is  of  a 
scrofulous  habit ;  Arsenicum,  when  there  is  great  prostration ;  Helle- 
horus,  when  there  are  dropsical  symptoms ;  Bryonia,  when  the  erup- 
tion is  slow  coming  out.  Repeat  the  medicines  in  the  usual  doses 
every  hour.     Diet,  —  nourishing  drinks,  toast  and  tea. 

Measles  come  on  with  cough,  pain  in  the  head,  sneezing,  redness  of 
the  eyes,  and  sometimes  attended  with  nausea  and  vomiting.  Bryo- 
nia will  hasten  the  appearance  of  the  eruption  ;  Ipecac,  should  it 
disappear  too  suddenly,  with  consequent  increase  of  cough  or  vomit- 
ing ;  Phosphorus  will  obviate  the  inflammatory  effect  upon  the  lungs ; 
and  Drosera  will  cure  the  entailed  cough.     Diet,  simple  and  light. 

Erysipelas,  either  vesicular  or  phlegmonous,  is  denoted  by  a  red, 
Imrning  and  fiory  appearance  of  the  face,  and  sometimes  by  a  bullar 
eruption,  resembling  fly-blisters.  Rhus  tox..  Belladonna  and  Bryonia 
are  prominent  remedies, —  Belladonna,  vfh.QXi  the  head  and  face  are 
most  implicated;  Rhus  tox.,  when  there  is  eruption  on  the  extremities 
and  great  weakness ;  and  Bryonia,  when  the  suffering  seems  greatly 
aggiavated  by  motion;  Arsenicum,  should  there  be  great  prostration, 
thiist  and  restlessness,  —  one  of  the  best  remedies  in  severe  cases. 
Any  of  these  remedies  may  be  repeated  every  hour.  Diet,  —  barley- 
gruel,  rice-water,  beef-tea,  mutton-broth,  toast  and  tea. 

Chicken-Pox.  —  A  pustular  eruption,  attended  with  slight  fever 
and  gastric  derangement.  One  or  two  doses  of  Pulsatilla  will  gen- 
erally remove  all  the  suffering  attendant  on  this  disease. 

Varioloid  is  another  pustular  disease,  more  severe,  as  it  comes  on 
witli  pain  in  the  head  and  back,  as  if  the  latter  would  break ;  and,  be- 
ing a  near  relation  to  small-pox,  both  may  be  considered  under  the 
same  head. 


666 


DISEASES   INYOLVIKO  THE   VARIOUS  ORGANS. 


Small-Poz,  of  which  varioloid  in  a  modification,  comes  on  with  in- 
tense fever,  spitting,  pain  in  the  head  and  back  and  lower  extremi- 
ties. All  the  sufferings  are  intense.  Nux  vomica  will  remove  tlic 
pain  in  the  back ;  Bryonia  will  hasten  the  eruption ;  Pulmtilla  will 
aid  in  carrying  it  off.  As  soon  as  the  appetite  returns,  feed  the  pa- 
tient quite  generously.  In  the  small-pox  delirium,  you  can  give 
Stramonium ;  and  to  prevent  pitting,  break  the  pustules,  and  cover 
them  with  Styptic  Collodion. 

Rheumatic  Fevers. 

Inflammatory  l^heumatism  is  accompanied  by  pain  in  the  limlw 
inflammation  of  the  joints,  swelling  of  the  same,  and  great  pain  and 
difficulty  in  moving  about.  Aconite  reduces  the  fever  ;  Bryonia  re- 
lieves the  pain  in  moving  about ;  Pulsatilla^  the  inflammation  of  the 
knee-joints  ;  Colocynth,  that  of  the  hip-joints  ;  Nux  vomica,  the  pain 
and  rheumatism  of  the  back ;  and  Sulphur  and  Rhus,  the  stiffness 
that  ensues  during  convalescence  ;  Rhus  is  indicated  if  the  cause  be 
check  of  perspiration  or  exposure  to  wet.  Diet,  —  bread  and  butter, 
steak  and  other  meats  in  moderation. ' 

Chronic  Rheumatism  is  more  confined  to  the  muscles  than  tlie 
joints,  and  is  oft«n  the  sequel  of  the  acute  form.  Sulphur  is  one  of 
the  remedies  much  relied  upon  in  curing  this  disease.  Nux  vomica 
may  be  given  after  Sulphur,  when  there  is  pain  in  the  back  or  sciatic 
nerve,  and  Rhu^  tax.  when  there  is  a  general  stiffness  of  the  limbs. 
The  medicines,  in  the  usual  doses,  may  be  repeated  every  two  hours. 

Lumbago  is  simply  rheumatism  of  the  back,  in  the  lumbar  region, 
and  so  stiffens  one  that  he  cannot  stand  erect.  Sulphur,  four  glob- 
ules at  night,  and  Pulsatilla,  four  globules  in  the  morning,  will  gen- 
erally cure  this  trouble.  Cimidfuga  is  a  very  valuable  remedy,  given 
hourly,  in  water. 

Sciatica  is  simply  neuralgia  of  the  sciatic  nerve  and  may  be  cured 
in  a  short  time  by  a  galvanic  battery.  Rhus  is  often  useful.  Bella- 
donna,  or  its  active  principle,  Atropin,  is  a  valuable  remedy  to  ad- 
minister internally.  The  diet  in  all  forms  of  rheumatism,  whether 
acute  or  chronic,  may  be  generous. 


Toothache. 

When  caused  by  a  cold,  Nua;  vomica ;  when  from  caries  of  the 
tooth,  Mereurius  viv. ;  at  the  menstrual  period,  Pulsatilla  ;  neuralgic, 
Belladonna  or  Ohamomilla ;  Aconite  when  there  is  heat  in  the  gums. 
Dose  as  Tisual,  repeated  every  hour. 


-*  -^- Mitiii  I  '<ifiiinii 


itA'^ft-*\'- 


as  ORQANS. 

•fttion,  comes  on  with  in- 
ack  and  lower  extremi- 
vomica  will  remove  the 
iruption ;  Puhatilla  will 
ite  returns,  feed  the  pii- 
delirium,  you  can  give 
the  pustules,  and  cover 


PS. 

led  by  pain  in  the  limhs 
}ame,  and  great  pain  and 
I  the  fever  ;  Bryonia  re- 
,  the  inflammation  of  the 
bs  ;  Nux  vomica^  the  pain 
and  Rhus^  the  stiffness 
indicated  if  the  cause  be 
[)iet,  —  bread  and  butter, 

to  the  muscles  than  the 
form.  Sulphur  is  one  of 
hia  di8easi\  Nux  vomica 
>ain  in  the  back  or  sciatic 
ral  stiffness  of  the  limbs, 
epeated  every  two  hours. 

ick,  in  the  lumbar  region, 
ect.  Sulphur,  four  glob- 
in  the  morning,  will  gen- 
ry  valuable  remedy,  given 

B  nerve  and  may  be  cured 
%s  is  often  useful.  Bella- 
I  valuable  remedy  to  ad- 
I  of  rheumatism,  whether 


DISEASES    INVOLVING   TUK   VAKI0U8   ORGANS. 


657 


when  from  caries  of  the 
iod,  Puhatilla  ;  neuralgic, 
there  is  heat  in  the  gums. 


Diseases  of  the  Alimentary  Canal. 

Inflammation  of  the  Ton«ils  is  the  result  of  a  cold  which  affects 
this  locality,  and  causes  a  swelling  and  sometimes  a  suppuration  of 
these  parts.  When  they  fii-st  begin  to  inflame,  give  Aconite,  and  fol- 
low with  Belladonna;  repeat  every  two  hours.  Mercurius  viv., 
Lachesia  and  Mercurius  iodatus  are  also  good  remedies. 

Quinsy  is  the  same  as  tonsillitis,  and  requires  the  same  treatment. 

Putrid  Sore  Throat  comes  on  by  little  vesicles  making  their  aj)- 
pearance  in  the  mouth  and  fauces,  or  throat,  wliich  soon,  by  reiwon 
of  a  low  constitutional  fever,  change  color,  run  together,  and  consti- 
tute the  offensive  sore  mouth  which  we  denominate  putrid.  Arseni- 
cum, Mercurius  vivus.  Nitric  acid  and  Sulphur  or  Sulph.  acid,  will  gen- 
erally cure.     Dose  and  repetition  as  before. 

Canker  of  the  Mouth. 

This  troublesome  disorder  is  caused  by  a  disordered  condition  of 
the  stomach,  and  requires  Arsenicum  when  the  breath  is  foul,  the 
throat  diy,  and  attended  with  much  thirst ;  Carbo  vegetabilis,  when 
the  system  is  in  a  low  condition,  and  there  is  much  coldness  on  the 
surface  of  the  body ;  Dulcamara,  when  produced  by  a  cold ;  Hepar 
sulph.,  when  the  canker  seems  indolent  and  slow  in  coming  to  a  cri- 
sis ;  Natrum  muriaticum,  when  it  assumes  the  character  of  scurvy,  or 
Mercurius  viv. 

Dose  and  A^dministration. — Dissolve  fiom  two  to  five  drops  of  the 
dilution  in  half  a  tumbler  of  water,  and  give  a  teaspoonful  every  two 
hours.    Diet,  — •  avoid  salt  provisions ;  use  meat-broths,  toast  and  tea. 

Inflammation  of  the  Tongue. 

The  first  indications  of  this  difficulty  are  soreness  and  difficulty 
in  using  the  tongue  in  deglutition  or  eating.  When  caused  by  me- 
chanical injury,  or  from  accidental  biting  with  the  teeth,  give  Arnica, 
four  globules,  and  wash  the  mouth  with  a  dilution  of  ten  drops  of 
tmcture  of  Arnica  in  half  a  tumbler  of  water.  If  from  other  causes, 
give  Aconite  or  Belladonna  in  the  same  way.  When  inflammation 
*j^*he  tongue  takes  the  form  of  ulcere,  give  Arsenicum;  of  blisters, 
Mercurius  or  Lachesis ;  when  the  tongue  inflames  and  cracks,  give 
Nitric  or  Sulphuric  acid. 


Pharyngeal  Sore  Throat. 


This  is  an  inflammation  of  the  pharynx  or  of  the  opening  into  the 
upper  portion  of  the  passage  from  the  mouth  into  the  stomach.  It  is 
sometimes  quite  serious,  and  is  usually  termed  «  quinsy  sore  throat." 


^^^^^l^^^n»^^^^^^^^^!iSS^S^^^4^S^?^^S^^^!?^t^^^^^^^ 


058 


DISEASES   INV(iI,VIN(!   TIIK    VAKIOUH   OROANH. 


Aeonite  may  be  given  at  first,  and  thin  may  Ik)  ff)llowe(l  hy  Belladovvu, 
and  this  again  by  Mercuriun  viv.  Should  it  lx3come  ovident  that  8U|)- 
puration  mnst  take  place,  give  ffepar  mlph.  Whichevei  rem»;dy  ig 
given,  let  it  be  repeated  every  hour  until  amelioration  or  change. 
Baryta  carb.  is  often  the  specific. 

Dyspepsia,  Indigestion. 

Difficult  digestion,  whatever  form  it  assumes,  is  termed  dyspep- 
sia, and  must  be  treated  in  accordance  with  the  symptoms,  and  the 
cause  that  has  produced  them.  Dyspepsia  brought  on  by  intemper- 
ance in  drinking  intoxicating  liquors  requires  Nvx  vom.  ;  if  from  a 
cold,  and  the  patient  is  chilly  and  feverish.  Belladonna,  or  perhaps 
Bryonia  ;  if  from  eating  fat  meat  or  rich  food,  Pulsatilla  ;  if  from 
grief,  Ignatia.  Dose,  one  drop,  or  four  globules,  repeated  evety  three 
or  six  hours,  according  to  the  degree  of  suffering. 

Heartburn,  or  Waterbrash.  —  A  burning  at  the  pit  of  the  stomach, 
and  a  constant  inclination  to  regurgitJite  sour,  acrid  or  bilious  matter, 
is  termed  waterbrash,  and  is  but  a  form  of  dyspepsia,  and  indicates 
Mercurius,  Nux  vomica,  Pulsatilla,  Arsenicum,  Cimieifuga,  etc.,  given 
as  above. 

Cardialgia,  or  Qastralgia,  is  nearly  allied  to  the  above,  only  at- 
tended with  pain  in  the  stomach,  as  well  as  burning,  sour  or  acrid 
risings.  Arsenicum,  Nux  vomica,  Bryonia,  Calcarea,  Ohamomilla, 
Coffea,  Oolocynth,  and  Pulsatilla  are  remedies  indicated  in  this  diffi- 
culty ;  and  each  may  be  gfiven  and  repeated  every  hour,  iu  the  usual 
doses,  until  relieved. 

Dyspeptic  Headache  is  simply  a  sympathetic  action  of  the  stoma.:h 
upon  the  head,  causing  considerable  pain.  Bryonia,  Belladonna.  (Joe- 
cuius,  Nux  vomica  and  Arsenicum  constitute  the  group  of  remedies  to 
give  relief  or  cure.  When  cold  water,  taken  into  tjie  stomach,  is 
found  to  disagree  with  the  stomach,  either  Nux  vomica,  Arsenicum, 
Pulsatilla  or  China  will  afford  relief.  When  any  kind  of  food  disa- 
grees with  the  stomach,  causing  distress  and  headache,  give  either 
Ferrum,  Camphor,  Chamomilla,  Pulsatilla  or  Sulphur,  in  the  usual 
dose  of  one  drop  cr  four  globules.  If  caused  by  beer,  Colocynth ;  by 
milk,  Calcarea,  Pulsatilla,  Nux  vomica.  When  animal  food  proves 
difficult  of  digestion,  or  fat  meat,  gravies,  or  drawn  butter,  Pulsatilla, 
lynatia,  Nux  vomica,  Cocculus,  etc.  Dyspepsia  is  so  common  a  dis- 
ease, and  afflicts  so  great  a  variety  of  temperaments  and  habits,  we 
will  be  explicit  in  pointing  to  specific  treatment.  For  hypochondria- 
cal persons.  Sulphur,  Nux  vomica,  Ignatia  ;  for  hysterical  persons. 
Sepia,  Pulsatilla,  Hyoscyamux  and  Lachesis  ;  for  those  of  a  sanguine 
temperament,  Nux  vomica ;  for  the  8ymj)athetic,  Pulsatilla  ;  for  the 
bilious,  MercuritiM  viv.;  and  for  the  melancholic,  Nitric  and  Fhoii- 
phoriv  acid,  Aurum  metallicum,  etc.     When  those  of  a  nervous  tem- 


OUH   OROANS. 

0  followed  by  Belladnvmu 
become  oviuent  that  Hup- 
h.  Whichevex  reintuly  is 
L  amelioration  or  change. 


jtion. 

ssumes,  is  termed  dyspep- 
h  the  symptoms,  and  the 
broujifht  on  by  intemper- 
ires  Nux  vom.  ;  if  from  a 
,h,  Belladonna,  or  perhaps 
food,  Pulsatilla  ;  if  from 
jules,  repeated  every  three 
ffering. 

ig  at  the  pit  of  the  stomacli, 
ur,  acrid  or  bilioud  matter, 
if  dyspepsia,  and  indicates 
-wm,  Vimidfuga^  etc.,  given 

lied  to  the  above,  only  at- 
as  burning,  sour  or  acrid 
iia,  Calcarea,  Ohamomilla, 
iies  indicated  in  this  diffi- 
}d  every  hour,  in  the  usual 

uhetic  action  of  the  stoma  ih 
Bryonia,  Belladonna.  Hoc- 
be  the  group  of  remedies  to 
taken  into  tjie  stomach,  is 
ler  Nux  vomica,  Arsenicum, 
hen  any  kind  of  food  disa- 
and  headache,  give  either 
I  or  Sulphur,  in  the  usual 
ised  by  beer,  Colocynth ;  by 
When  animal  food  proves 
or, drawn  butter,  PulmtHU. 
Depsia  is  so  common  a  dis- 
mperaments  and  habits,  we 
atment.    For  hypochondria- 
tia  ;  for  hysterical  persons. 
«8  ;  for  those  of  a  sanguine 
:>athetic,  Pulsatilla  ;  for  the 
slancholic.  Nitric  and  Pho»- 
len  those  of  a  nervous  tero- 


mSKASES   INVOLVINC    TIIK   VARIorK   OHOaNS. 


(ir>9 


peniniont  are  afHictcd  with  dyspcpsiii,  we  find  I'nlcrian,  /fi/osrifamun, 
Pulmtilln,  lynatia  and  Moschus  good  n^mcdies  ;  tliose  of  a  Hcrofuhms 
habit  require  Calcarea,  Arsenicum  and  Sulphur;  students  atllictrd 
with  dyspepsia  require  Nux  vomica,  China  and  Ferrum.  Dose  and 
repetition  at}  before. 

5ea-5ickness. 

There  is  no  remedy  that  will  prevent  sea-sickness  and  no  condi- 
tion of  health  capable  of  always  resisting  it.  Hut  the  effects  of  the 
sickness,  which  are  often  distressing,  (fan  he  removed  by  Coceulus, 
Nux  vomica  and  Ignatia.  If  there  remains  an  inclination  to  retch 
after  the  sickness  has  passed,  give  Ipecac,  Petroleum  is  often  taken 
as  a  preventive  with  success. 

Mucous  Vomiting. 

This  is  simply  sickness  at  the  stomach,  which  may  arise  from  its 
irritable  condition,  and  result  in  vomiting  of  slime  or  mucus.  The 
remedies  that  will  obviate  the  difficulty  are  Ipecac,  Rheum,  Pulsa- 
tilla and  Veratrum.  ^  Usual  dose  and  repetition. 

Vomiting  of  Blood. 

This  may  be  caused  by  mechanical  injury  of  the  stomach,  and  re- 
quires Arnica;  if  caused  by  pregnancy,  Arsenicum  ;  if  from  retained 
menses,  Phosph.  or  Pulsatilla  ;  if  from  acrid  humore,  Arsenicum  or 
Ipecac. ;  if  from  suppressed  eruption,  Sulphur, 

Gastritis,  or  Inflammation  of  the  Stomach. 

This  is  indicated  by  severe  pain  in  the  stomach,  continuous  vom- 
iting, heat  over  the  region  of  the  stomach,  quick  and  feeble  pulse, 
cold  feet  and  pain  in  the  head.  The  remedies  for  gastritis  are  Acon- 
ite, Bism.  subnit.,  Arsenicum,  Belladonna,  Ipecac,  Tart,  emetic,  Vera- 
trum, Lobelia  and  Cocculus,  and  sometimes  Nux  vomica.  Dose  and 
repetition  as  usual. 

Qastrodynia,  or  Cramps  in  the  Stomach. 

A  PAIN  in  the  stomach,  with  cramp,  is  very  distressing  and  can- 
not be  mistaken  ;  for  the  cramp  is  a  sudden  spasmodic  action  of  the 
muscles  of  the  stomach,  which  seems  like  taking  the  breath  out  of 
one.  Pulsatilla,  Nux  vomica  and  Colocynth  are  the  remedies.  Any 
one  of  them  will  be  likely  to  afford  prompt  relief.  Dioscorca  is  use- 
ful. 


■ 


T^ri^sjgafc-iagBKSfeaMejaite'' 


G60 


DISBABr.8   INVOLVINO   THE   VAKIOUh   OltOANR. 


Inflammation  of  the  Bowels. 

A  SEVERE  pain  in  the  bowels,  with  diatention,  and  euch  soront-ss 
to  the  touch  that  weight  or  pressure  cannot  Im)  borne,  hetokenH  in- 
flaramation.  Anonite  may  be  given  in  the  usual  doHe,  every  half- 
hour  at  firet.  If  perHpiration  occurs  and  the  vomiting  continucM,  jrive 
Bryonia  in  the  same  way.  If  there  is  tympanitis,  or  distensiun,  mi 
that  percussion  upon  the  bowels  causes  them  to  sound  like  a  dniin, 
Terebinthe,  Araenvrum  and  MercuriuH  must  be  coiwulted.  If  the  dis- 
charges from  the  l)owels,  while  the  inflammation  lasts,  are  acrid,  give 
Arsenicuyn,  and  follow  with  'Bryonia.  If  there  is  strangury,  or  in- 
ability to  pass  urine,  Canthari».  It  would  be  better,  in  treatinj^  so 
formidable  a  disease  as  this,  to  drop  ten  drops  of  the  selected  remedy 
into  half  a  tumbler  of  water,  and  give  a  teaspoonfui  every  half-liour, 
or  hour,  until  amelioration  or  change.  Compresses  on  the  aklonien 
are  indicated. 

Chronic  Inflammation  of  the  BoweU. 

Acute  inflammation  of  the  bowels  sometimes  passes  off,  leaving 
them  susceptible  to  entailed  inflammation  from  trivial  causes;  the 
mucous  coat  may  have  l)een  left  in  a  semi-ulcerated  condition,  fioiii 
which  there  will  be  occasional  vomiting  and  muco-purulent  diarrlm-a. 
The  remedies  *or  this  disease  are  Nitric  and  Sulphuric  acid.,  Argeni- 
cum.  Sulphur  and  PhosphoruH.  The  doses  may  Ikj  as  usuP/l ;  but  the 
remedy  may  not  be  repeated  more  than  twice  a  day, 

Inflammation  of  the  Peritoneum. 

Peritoneal  inflammation  is  often  considered  in  connection  with 
inflammation  of  the  bowels,  and  requires  nearly  the  same  remedial 
treatment.  The  disease  is  known  by  the  extreme  sensitiveness  of  the 
abdomen  to  touch  ;  and  the  tenderness  is  so  great  as  to  be  unable  to 
bear  the  weight  of  bed-clothes.  Aconite  given  in  the  usual  doses 
every  half-hour,  until  the  skin  becomes  moist,  and  then  Belladonna 
or  Verat.  viride.  If  there  is  thxv^t.,  Arsenicum  ;  Pulsatilla;  ii  in  fe- 
males. Nux  vomica,  if  the  bowels  are  constipated.  If  dropsy  of  the 
abdomen  follow,  give  Hellehorus  nig.  or  Apis  mellifica.  Diet,  —  a 
very  light  gruel  of  corn-starch  or  farina. 

Diarrhoea. 

A  looseness  of  the  bowels,  which  may  be  watery,  bilious,  pappy, 
painless  or  Mrith  pain.  A  merely  relaxed  condition  of  the  bowels 
may  be  cured  by  a  single  dose  of  four  globules  of  Pulsatilla  ;  or,  if 
not  arrested  by  this,  give  Mercurius.  A  watery  diarrhoea  may  be  ar- 
rested with  Chamomilla,  Nux  vomica  or  Veratrum  ;  a  bilious  diarrhoja, 


I.. 


ova   UliOAMH. 


DISEASES  INVOLVINQ   THE   VAJtIOUS  0K0AN8. 


661 


Bowels. 

lention,  and  euch  Korcrn'Ms 
ot  Ihj  bonie,  hctokfiis  in- 
e  usual  dose,  every  lialf- 
j  vomiting  continues,  give 
npunitis,  or  diHtensiun,  so 
m  to  sound  like  a  drum, 
be  consulted.  If  the  dis- 
lation  lii8t«,  are  acrid,  give 
there  is  strangury,  or  in- 
be  better,  in  treating  so 
ips  of  the  selected  remedy 
ispoonfui  every  half-hour, 
mpresses  on  the  uklomen 

the  Bowels. 

letimes  passes  off,  leaving 
I  from  trivial  causes;  the 
-ulcerated  condition,  from 
i  muco-piuulent  diarrho'a. 
id  Sulphur h  acid,  Arseni- 
may  Ikj  as  usual ;  but  the 
ice  a  day. 

eritoneum. 

idered  in  connection  with 
nearly  the  same  remedial 
ctreme  sensitiveness  of  the 
jO  great  as  to  be  unable  to 
given  in  the  usual  doses 
loist,  and  then  Belladonna 
dcum ;  Pulsatilla,  ii  in  fe- 
stipated.  If  dropsy  of  the 
Apis  mellifica.     Diet,  —  a 


'  be  watery,  bilious,  pappy, 
i  condition  of  the  bowels 
Dbules  of  Pulsatilla;  or,  if 
ivatery  diarrhoea  may  be  ar- 
ratrum  ;  a  bilious  diarrhoea, 


with  Arsenicum  and  Mercurius ;  a  painless  and  involuntary  diarrhcea, 
with  Phosphoric  acid.  Diarrhcea  with  colic  requires  Chamomilla  and 
Colocynth  ;  tinged  with  blood,  Ipecac. ;  with  undigested  food,  Pulsa- 
tilla. From  fruit,  often  China.  The  dose  and  administration  must 
accord  with  the  case.  Either  of  the  remedies  may  Ihj  given  in  water, 
a  teaspoonful  every  hour ;  five  drops  of  the  dilution,  or  ten  globules 
in  half  a  tumbler  of  water,  may  be  the  mode  of  preparation.  The 
diet  for  persons  uffering  from  diarrhoja  may  be  mutton-broth,  beef- 
teu,  boiled  milk,  or  tuuut  uud  tuu,  uu  the  [mtiuut  may  alect. 

Dysentery. 

One  of  the  most  formidable  and  prostrating  diseases  is  dysentery. 
It  usually  begins  with  a  diarrhoea,  though  occasionally  with  constipa- 
tion, after  a  season  of  lassitude,  and  increases  until  mucous  discharges 
from  the  bowels  follow.  The  disease  is  characterized  by  much  strain- 
ing when  trying  to  evacuate  the  bowels.  This  straining  is  involun- 
tary and  painful.  Just  before  there  is  an  inclination  for  a  stool,  there 
is  usually  a  sharp  pain  in  the  lower  portion  of  the  abdomen.  Dysen- 
teric discharges  are  mucus  mixed  with  blood,  or  pure  blood,  or  no 
blood  at  all.  For  dysentery  with  no  blood  in  the  stools,  and  yet 
mu(!h  tenesmus.  Gamboge  ;  when  the  tenesmus  is  low  down.  Aloes  ; 
when  the  mucus  is  tinged  with  blood,  Mercurius  corrosivus,  the  leading 
remedy,  especially  if  the  tenesmus  is  painful.  To  aiTest  a  dysentery 
where  the  discharges  are  pure  blood,  and  very  painful  straining  and 
thirst,  Arsenicum.  For  much  tenesmus,  and  discharge  of  mucus 
mixed  with  blood.  Ipecac.  Whichever  remedy  is  administered,  let 
the  usual  dose  be  given  immediately  after  each  stool,  until  relieved. 
The  diet  in  this  disease  is  somewhat  important.  Water  cannot  be  al- 
lowed in  great  quantities,  but  small  bits  of  ice  may  be  held  in  the 
mouth  of  the  patient;  barley-water,  flavored  with  lemon,  may  be  al- 
lowed as  a  drink ;  rice-water ;  and,  if  the  patient  has  any  appetite, 
he  may  be  allowed  mutton-soup,  beef-tea  and  lamb-broth  ;  but  chicken- 
broth  must  be  entirely  prohibited.  Enemaa  of  cold  water  or  rice-water, 
after  each  diacharge,  are  beneficial. 


Chronic  Dysentery. 

Symptoms  much  like  those  of  the  acute,  but  occurs  frequently  as 
a  weakness  left  after  a  protracted  attack  of  the  acute  form.  Sulphur, 
Nulph.  acid,  Calcarea  carb.,  Ferrum  and  Carbo  vegetabilis  are  remedies 
employed  to  overcome  the  difficulty.  Sulphur  may  bo  given  in  daily 
doses  for  a  while,  and  then  Nitric  acid  or  Sulph.  acid  or  Calcarea,  un- 
til a  cure  is  completed.  Diet  in  chronic  dysentery  should  be  very 
sustaining,  and  wine  may  sometimes  be  allowed. 


mmm!^mim«j^fsm»:^imi>f^'f«'m!f!!^^ 


662 


DISEASES    INVOLVING    THE   VARIOUS    ORGANS. 


i:^^ 


Cholera  Morbus. 

This  disease  begins  with  severe  pain  in  the  stomach  and  bowels, 
and  then  severe  vomiting  and  purging,  until  seemingly  there  is  noth- 
ing left  to  be  discharged  from  the  system.  Arsenicum  and  Verat. 
alb.  are  the  leading  remedies ;  Nux  vomica  may  be  given  to  stop  the 
vomiting;  Ipecac,  Tart,  emetic,  Podophyllum  are  severally  good  rem- 
edies, and  any  one  of  them  may  complete  the  cure ;  four  globules 
may  be  given  every  fifteen  minutes  until  relief  is  obtained. 

Asiatic  Cholera. 

MOBK  formidable  than  cholera  morbus  is  asiatic  cholera,  as  its  at- 
jks  are  insidious :  first,  by  painless  uiarrhoea,  which  seems  to  indi- 
cate that  all  the  contents  of  the  alimentary  canal  are  in  a  soluble 
condition.  Floods  of  rice-water  discharges  pass  from  the  bowels  and 
the  same  matter  is  vomited  profusely.  After  a  time,  the  lower  ex- 
tremities begin  to  cramp,  and  then  the  cramps  come  in  the  abdomen ; 
and,  if  the  disease  is  not  arrested,  the  patient  soon  passes  into  collapse, 
and  then  to  the  grave.  The  treatment  of  this  disease  in  the  early 
stage  is  very  important.  Very  few  cases  need  to  prove  fatal,  if  timely 
resort  to  the  proper  treatment  is  had.  As  soon  as  the  patient  is  at- 
tacked with  diarrhoea,  let  him  go  to  bed,  and  take  Veratrum  alb.  If  he 
has  great  thiret,  let  him  take  Arsenicum.  If  without  pain,  Phospho- 
ric acid.  If  with  vomiting  and  purging  and  great  prostration,  Iris 
versicolor.  Other  remedies,  such  as  Materum,  Secale  comutum.  Cam- 
phor and  Mercurius  viv.  may  be  consulted.  Cuprum  acet.,  if  with 
violent  cramps.  The  medicines  may  be  administered  every  thirty 
minutes.  In  the  collapse  stage,  give  Muriatic  acid,  —  ten  drops  in 
half  a  tumbler  of  water,  a  teaspoonful  every  *-wenty  minutes.  But 
little  time  can  run  to  waste  at  any  stage  of  the  disease ;  every  mo- 
ment requires  vigilance  and  attention.  Should  the  disease  pass  over, 
and  the  patient  is  left,  he  must  fii-st  have  a  stimulating  diet,  and  then 
more  and  more  generous,  as  he  can  bear  it. 


Constipation  (Costiveness). 

A  CONFINED  condition  of  the  bowels  is  scarcely  a  disease  by  itself, 
but  a  symptom  that  attends  many  maladies.  In  a  torpid  state  of  the 
liver,  it  is  generally  manifest,  and  requires  a  treatment  tending  pri- 
marily to  affect  this  organ,  and  thence  the  bowels.  When  there  is  a 
sense  of  fullness  in  the  rectum,  Bryonia  ;  when  a  tedious  constipa- 
tion, that  indicates  ^vesA.  torpidity  of  the  bowels,  Lycopodium ;  a 
constipation  following  a  diarrhoea  requires  Mercurius  viv.  or  Sulphur ; 
a  constipation  resulting  from  a  collection  of  hardened  faeces  requires 
Sulphur  and  Nux  vomica,  or  Silicea.  Two  doses  a  day,  of  any  of  the 
remedies,  will  be  sufficient.     A  diet  for  those  addicted  to  habitual 


(>  • 


us   ORGANS. 


niSEASES   INVOLVING   THE   VAPIf.tUS  ORGANS. 


663 


he  stomaoh  and  bowels, 
seemingly  there  is  noth- 
.  Arsenicum  and  Verat. 
lay  be  given  to  stop  the 
I  are  severally  good  reni- 
the  cure ;  four  globules 
ief  is  obtained. 


L. 

asiatic  cholera,  as  its  at- 
na,  which  seems  to  indi- 
y  canal  are  in  a  soluble 
pass  from  the  bowels  and 
er  a  time,  the  lower  ex- 
ps  come  in  the  abdomen ; 
soon  passes  into  collapse, 
bhis  disease  in  the  early 
1  to  prove  fatal,  if  timely 
joon  as  the  patient  is  at- 
take  Veratrumalb.  If  he 
f  without  pain,  Phospho- 
id  great  prostration,  Iris 
m,  Secale  comutum,  Cam- 
[.  Cuprum  acet.,  if  with 
.dministered  every  thirty 
atic  acid,  —  ten  drops  in 
ry  <-wenty  minutes.  But 
f  the  disease ;  every  mo- 
uld the  disease  pass  over, 
stimulating  diet,  and  then 


^eness). 

carcely  a  disease  by  itself, 
,  In  a  torpid  state  of  the 
a  treatment  tending  pri- 
bowels.  When  there  is  a 
when  a  tedious  constipa- 
bowels,  Lycopodium;  a 
^ercuriu%  viv.  or  Sulphur ; 
f  hardened  fseces  requires 
doses  a  day,  of  any  of  the 
liose  addicted  to  habitual 


constipation  is  iniportiint :  corn-meal  mush,  i)rown-bread  or  bran- 
bread,  prunes,  apples  and  other  kinds  of  fruit  are  recommended. 
Give  the  new  remedies  now  being  used,  such  as  Alonin, 

In vermi nation  ( Worms). 

This  trouble  is  indicated  by  the  child  picking  its  nose,  and  by  vo- 
racious appetite,  restlessness  at  night,  colic  and  sometimes  diarrhoea 
an  pale  expression  of  the  face.  The  remedies  for  this  difficulty  are 
Santonin,  Cina,  Spigelia,  China  and  Sulphur.  Santonin  will  suit  bet- 
ter for  the  long  round  worms,  and  Cina,  Calcarea  and  Nux  vomica 
for  the  pin-worms.  Dose  and  administration  as  usual,  three  times  a 
day. 

Protrusion  of  the  Intestine. 

Falling  of  tlie  bowels,  as  the  protrusion  is  usually  termed,  is 
caused  by  protracted  diarrhoea,  and  stT.Ining  at  stool,  while  the  intes- 
tine is  weak  and  relaxed.  Podophyllum,  Merciirius  viv.,  Ignatia  and 
Aloes  are  remedies  that  will  cure  the  difficulty.  Either  may  be  given 
three  times  a  day. 

Inflammation  of  the  Liver  {Hepatitis)  Acute  or  Chronic. 

Denjted  by  pain  in  the  right  side,  below  the  ribs,  sometimes  se- 
vere and  at  others  dull.  If  there  is  fever,  give  Aconite  or  Verat.  vir- 
ide,  and  follow  with  Mix  vomica  in  acute  hepatitis,  and  repeat  every 
hour  until  relief  or  change.  If  much  thirst,  give  Arsenicum.  In  the 
chronic  form,  a  daily  dose  of  Sulphur  or  Sepia,  Mercurius  viv.,  Nux 
vomica,  Pulsatilla  or  Podophyllin,  will  do  as  much  for  the  patient  as 
any  treatment  in  the  world. 

Jaundice. 

When  the  gall-duct  of  the  liver  becomes  obstructed,  and  the  bile 
is  prevented  from  passing  oif  in  the  usual  way,  it  seeks  an  escape 
through  the  skin,  and  gives  it  a  yellow  color.  This  is  jaundice. 
Podophyllin,  Chelidonium,  Mercurius,  Dulcamara,  Leptandrin  and 
Nux  vomica  axe  competent  to  cure  the  severest  cases.  Carbo  vegetor 
hilis,  in  a  crude  foim,  may  be  given  in  massive  doses  when  an  offen- 
sive odor  comes  frcm  the  mouth  or  breath.  The  {)atient,  having  no 
appetite,  must  be  supplied  with  some  farina  or  rice,  cooked  in  the 
most  delicwte  way. 

Inflammation  of  the  5pleen. 

The  spleen,  being  an  associate  purificatory  organ  with  the  liv^r,  is 
liable  to  similar  alfections.  When  inflamed,  it  is  manifest  by  pain  in 
the  left  side,  below  the  ribs.    The  same  remedies  that  affect  the  liver 


.iiiBIKSlBSSW^^'"^"'- 


-'^'gg,^?5a8s»gra»flia«tf?i'^e^gg^ss 


664 


DISEASES   INVOLVING  THE   VARIOUS   0BGAN8. 


will  also  affect  the  spleen.  For  congestion  of  the  spleen  caused  by 
running,  immoderate  laughter,  etc.,  Chinos  a  single  ordinary  dose, 
will  answer. 

Painter's  Colic. 

The  effects  of  lead  upon  the  alimentary  canal  are  sometimes  disas- 
trous ;  and  painters  who  work  much  in  mixing  the  various  prepara- 
tions of  white  lead  are  liable  to  imbibe  sufficient  of  its  poisonous 
quality  to  give  them  a  most  distressing  colic :  hence  its  name.  The 
remedies  employed  in  antidoting  the  effects  of  the  lead  are  Opiun> 
and  Alumina,  or  Oolocynth.  Should  the  first-named  remedy  fail  to 
afford  relief,  try  the  next,  and  30  on,  in  doses  of  three  drops  of  tie 
dilution  in  a  spoonful  of  water.  Olive  oil,  a  wineglassful  every  three 
hours,  is  good. 

Piles  {Hemorrhoids). 

There  occurs  in  the  rectum  a  class  of  small  tumors,  caused  by 
congestion  of  the  hemorrhoidal  veins;  and  these  sometimes  become 
so  swollen  as  to  protrude  from  the  anus.  Sometimes  these  protrud- 
ing tumora  are  numerous,  and  resemble  a  bunch  of  grapes.  They  are 
exceedingly  painful,  and  destructive  of  comfort.  To  cure  them  is  of 
the  utmost  importance.  Constipation  being  often  one  of  the  proxi- 
mate causes,  such  remedies  as  overcome  this  condition  must  be  called 
into  use.  Nux  vomica,  taken  at  night,  has  often  proved  salutary. 
Sulphur,  when  the  tumors  are  painful  and  sting  and  burn  so  as  to  be 
almost  unbearable.  For  bleeding  piles,  Hamamelis  Virginica  is  par- 
ticularly recommended.  For  excessively  burning  piles,  Arsenicum ; 
and  for  those  of  a  blue  color,  Oonium  or  Muriatic  acid.  Each  of 
these  remedies  may  be  employed  in  the  liquid  form,  and  three  drops 
of  the  dilution  may  be  taken  in  a  spoonful  of  water  every  night. 
The  tincture  of  Podophyllum  is  also  a  valuable  remedy,  and  may  be 
administered  as  above ;  and  so  also  is  Collinsonia.  Hamamelis  sup- 
positories should  be  used  in  all  cases.  An  injection  of  moderately 
cold  water  will  often  give  relief  and  cure  the  most  obstinate  cases. 
Inject  a  quart,  night  and  morning.  Commence  with  a  small  amount 
at  first  and  gradually  increase  ;  should  be  used  with  caution  until  it 
is  found  to  agree  with  the  patient.  To  designate  an  appropriate  diet 
for  one  afflicted  with  piles  requires  a  little  care.  Salt  provisions 
must  generally  be  avoided.  The  free  use  of  stimulating  drinks  is 
pernicious.  Bran-bread  and  fruits  are  commendable.  Meats,  not 
highly  seasoned,  are  allowable,  and  most  kinds  of  vegetables. 

Itching  of  the  Anus,  which  sometimes  is  a  concomitant  of  piles 
and  sometimes  of  worms,  is  cured  in  the  first  instance  with  Sulphur 
and  in  the  latter  with  Oina.  The  usual  dose  should  be  given  night 
and  morning.  j 


rs   OKGANS. 


)f  the  spleen  caused  by 
a  single  ordinary  dose, 


,nal  are  sometimes  disas- 
ing  the  various  prepani- 
fficient  of  its  poisonous 
:  hence  its  name.  The 
of  the  lead  are  Opim> 
jfr-named  remedy  fail  to 
s  of  three  drops  of  tie 
wineglassful  every  three 

small  tumors,  caused  by 
these  sometimes  become 
lometimes  these  protrud- 
nch  of  grapes.  They  are 
fort.  To  cure  them  is  of 
;  often  one  of  the  proxi- 

condition  must  be  called 
s  often  proved  salutary, 
ting  and  burn  so  as  to  be 
mamelis  Virginica  is  par- 
urning  piles,  Araenieum; 
Muriatio  acid.     Each  of 
lid  form,  and  three  drops 
ul  of  water  every  night, 
able  remedy,  and  may  be 
limonia.     Hamamelis  sup- 
1  injection  of  moderately 
the  most  obstinate  cases. 
lence  with  a  small  amount 
used  with  caution  until  it 
ignate  an  appropriate  diet 
tie  care.     Salt  provisions 

of  stimulating  drinks  is 
)mmendable.  Meats,  not 
inds  of  vegetables. 

is  a  concomitant  of  piles 
irst  instance  with  Sulphur 
lose  should  be  given  night 


DISEASES  OP  VARIOUS  ORGANS 
AND  REGIONS. 


Passage  of  Qall-5tones. 

The  passage  of  gall-stones  is  attended  by  severe  pain  in  the  region 
of  the  stomach,  obliging  one  to  writhe  in  agony,  and  roll  from  side  to 
side.  The  strongest  men  become  subdued  when  suffering  from  the 
passage  of  these  concretions.  The  pain  resembles  an  intense  colic ; 
and  sometimes  the  agony  produced  by  biliary  calculi  goes  under  the 
name  of  bilious  colic.  In  addition  to  the  pain  occasioned  by  the  con- 
cretions, there  may  be  vomiting,  headache,  cold  extremities  and  sal- 
low complexion.  To  relieve  the  suffering,  resort  has  been  had  to 
Morphine  and  Opium  ;  but  these  sedatives  only  prolong  the  difficulty. 
They  afford  only  temporary  relief  from  pain  and  the  use  of  them  must 
be  discouraged.  Cathartics,  on  the  whole,  have  failed  of  accomplish- 
ing the  purpose,  and  only  weaken  the  patient.  Homoeopathic  reme- 
dies have  sometimes  afforded  prompt  relief ;  but,  as  a  general  thing, 
the  success  attending  the  most  perfect  affiliations  of  indicated  reme- 
dies has  not  been  great.  The  most  modern  treatment  for  biliary  cal- 
culi is  to  administer  to  the  patient  from  two  to  four  ounces  of  pure 
Olive  oil,  the  laxative  effect  of  which  has  gently  moved  the  bowels, 
and  brought  from  the  gall-duct  large  numbers  of  the  concretions, 
sometimes  a  dozen  or  more ;  after  which,  the  blackness  of  the  coun- 
tenance will  begin  to  disappear,  the  indurations  found  in  the  region 
of  the  liver  become  lessened,  and  the  appetite  returns.  When  attacks 
of  bilious  colic  occur,  it  is  not  always  certain  that  the  gall-duct  is  ob- 
structed with  stones.  Therefore,  Colocynth,  in  the  usual  dose,  may 
afford  prompt  relief ;  even  when  gall-stones  have  been  present,  and 
the  suffering  and  agony  are  indescribably  gfreat,  Pulsatilla  has  cured. 
When  there  is  severe  pain  and  induration  in  the  region  of  the  liver, 
a  dark,  sallow  countenance  and  black  circles  around  the  eyes,  much 
relief  has  been  obtained  by  the  use  of  Arsenieum.  When  there  re- 
main black  spots  or  discolorations  upon  the  face.  Sepia,  When  there 
is  much  vomiting  during  an  attack.  Ipecac.  External  applications 
sometimes  prove  useful.  Emollient  poultices  applied  to  the  region 
of  the  pain  have  proved  beneficial.  The  pain  attending  the  passage 
of  biliary  concretions  has  sometimes  been  mistaken  for  chronic  in- 
flammation of  the  stomach ;  and,  on  this  account  the  remedies  have 


tJSWWiVSS?' 


■MiaMitfiOWtfttCa^ia^iBfcgltBJl^waiBtWwWt^^  ^iimffx^r- 


i 


666 


DISEASES    OP   VARIOUS   ORGANS   AND   REGIONS. 


failed  to  control  the  suffering.  Very  many  persons  suffering  from 
chronic  liver-complaint  become  victims  to  the  suffering  produced  by 
gall-stones,  and  should  restrict  themselves  to  a  simple  but  nutritious 
diet.  After  an  attack,  the  olive  oil  should  be  taken  for  at  least  six 
months,  a  tablespoonful  on  retiring,  each  night. 

Cancer  of  the  Liver.  —  Schirrm. 

In  the  event  of  a  constant  suffering  in  the  right  side,  with  apparent 
hard  protuberances,  while,  at  the  same  time,  there  are  dark  circles 
around  the  orbits  of  the  eyes,  and  when  there  are  shooting  or  lancin- 
ating pains  darting  from  the  indurated  protuberances,  a  cancer  may 
be  suspected.  If  not  too  far  advanced,  it  may  be  cured  by  the  use 
of  Arsenicum^  when  there  is  much  thirst  and  dryness  of  the  mouth,  a 
white  coating  upon  the  tongue,  and  considerable  prostration.  Conium 
maculatum  nay  be  given  three  times  a  day  when  there  is  pain  in  the 
right  side,  as  if  constricted  by  a  band,  or  tearing  and  stretching  in 
the  region  of  the  liver,  and  colicky,  abdominal  spasms. 

Cancer  of  the  Stomach. 

This  formidable  disease  often  comes  on  insidiously  and  the  victim 
supposes  himself  to  be  a  sufferer  from  an  aggravated  form  of  dyspep- 
sia. Severe  anxiety  and  trouble  are  supposed  to  have  a  serious  in- 
fluence in  the  production  of  the  disease.  A  constant  irritation  of  the 
mucous  lining  of  the  stomach  may  terminate  in  the  difficulty.  The 
chief  symptoms  denoting  the  presence  of  cancer  in  the  stomach  are 
great  depression  of  spirits,  a  downcast  countentance,  a  pinched  ap- 
pearance of  the  nose,  with  the  corners  of  the  mouth  drawn  down,  and 
also  a  constant  inclination  to  retch  and  vomit  dark  matter,  somewhat 
resembling  coffee-grounds,  and  also  severe  cutting  or  shooting  pains 
in  the  stomach,  with  intense  thirst.  Nux  vomica  has  sometimes  cured 
cancer  of  the  stomach.  The  indications  for  its  use  are  intensely  bit- 
ter eructations,  and  spitting  up  of  dark  matter ;  and  also  when  the 
eructations  are  followed  by  vomiting  of  sanious  or  bloody  matter. 
When  the  patient  has  suffered  greatly  from  anxiety  and  d3rspepsia, 
l^natia  may  be  given,  instead  of  Nux  vomica.  When  the  tumor  can 
be  diagnosed  or  discovered  by  external  manipulation,  Arsenicum  and 
also  Oonium  may  be  given  twice  a  day.  Oocculus  also  may  be  given 
when  the  nausea  and  vomiting  are  similar  to  that  '-roduced  by  riding 
in  a  carriage,  or  sea-sickness.  When  one  has  su  ^ered  many  yeara 
from  dyspepsia,  and  then  begins  to  emaciate  and  spit  up  this  dark 
matter,  Nux  vomica  given  persistently  is  most  likely  to  be  of  service. 
The  patient  should  subsist  upon  broths,  beef-tea  and  the  most  deli- 
cate farinaceous  diet.  . 


b  " 


•  ^BK  flsK-iaiB^.iV. 


Jt.-'.  -    -.- 


1   REGIONS. 

[)er8on8  suffering  from 
suffering  produced  by 

i  simple  but  nutritious 
taken  for  at  least  six 

t. 

Schirrus. 

ight  side,  with  apparent 
there  are  dark  circles 
are  shooting  or  lancin- 
berances,  a  cancer  may 
ly  be  cured  by  the  use 
dryness  of  the  mouth,  a 
le  prostration.  Oonium 
hen  there  is  pain  in  the 
iring  and  stretching  in 
il  spasms. 

lach. 

aidiously  and  the  victim 
fravated  form  of  dyspep- 
d  to  have  a  serious  in- 
ionstant  irritation  of  the 
3  in  the  difficulty.     The 
icer  in  the  stomach  are 
itentance,  a  pinched  ap- 
mouth  drawn  down,  and 
b  dark  matter,  somewhat 
itting  or  shooting  pains 
lica  has  sometimes  cured 
its  use  are  intensely  bit- 
ktter ;  and  also  when  the 
mious  or  bloody  matter. 
L  anxiety  and  dyspepsia, 
I.     When  the  tumor  can 
ipulation,  Arsenicum  and 
ecultis  also  may  be  given 
( that  produced  by  riding 
has  su  ered  many  yeai-s 
;e  and  spit  up  this  dark 
St  likely  to  be  of  service, 
if-tea  and  the  most  deli- 


DI8EA8E8  OF   VAKIOUS   0B0AN8   AND  RKGI0N8.  GfiT 


Cancer  of  the  Intestines. 

The  symptoms  which  denote  the  presenlBfe  of  cancer  of  the  intes- 
tines are  constant  pain  in  the  bowe)  "'^  acrid  discharges  of  black- 
ish stools,  a  very  black  or  dark  appearance  of  the  countenance,  down- 
cast expression,  a  constant  inclination  to  relieve  the  pain  by  pressure 
of  the  hands  and  arms.     This  affection  generally  terminates  fatally, 

the  result  being  perforation  of  the  bowels.     When  autopsy,  or 

post-mortem  examination  reveals  the  fact,  it  is  then  called  to  mind 
that  the  victim  has  worn  the  expression  and  complained  for  a  long 
time  in  a  w.iy  that  might  have  excited  suspicion  of  the  trouble.  To 
note  these  symptoms  when  they  first  occur  may  suggest  a  treatment 
that  possibly  might  avert  a  fatal  termination.  Arsenicum  may  be 
given  when  the  patient  has  thirst,  burning  pain  in  the  bowels,  and 
hot,  acrid  stools ;  Oonium,  when  the  pains  appear  to  be  of  a  neural- 
gic character,  and  persistent ;  Belladonna,  when  there  is  painful  dis- 
tention of  the  abdomen.  The  diet  should  be  tlie  same  as  that  directed 
for  cancer  of  the  stomach. 

Cancer  of  the  5kin. 

When  inflammation  of  the  skin,  or  any  persistent  irritation,  ter- 
minates in  cancer,  there  is  a  rough,  hard  tumor  of  a  bluish  appear- 
ance, at  first  about  the  size  of  a  common  wart.  It  sometimes  grows 
into  the  shape  of  a  tumor,  and  is  the  seat  of  sharp,  shooting  pains. 
The  remedy  that  has  apparently  cured  this  affection  is  Silicea,  in 
daily  doses.  It  is  particularly  indicated  when  there  is  painful  sore- 
ness or  sensitiveness  of  the  skin,  and  an  itching  of  the  whole  body  ; 
and  also  when  there  is  stinging  in  the  sore.  To  prevent  cutaneous 
ulcers  of  the  skin  from  becoming  cancerous,  the  same  remedy  may 
be  used.  To  prevent  horny  excrescences  from  assuming  a  cancerous 
character,  Oonium  or  Oausticum  may  be  given  in  daily  doses.  Almost 
any  persistent  irritation  may  assume  the  character  of  a  cancer.  Icho- 
rous ulcers,  fetid  sor  .  malignant  boils  or  ulcers,  should  be  carefully 
treated  and  cured,  oi  otherwise  they  may  take  on  a  settled  or  consti- 
tutional schirrous  character.  The  skin  should  be  kept  clean  ;  a  flesh- 
brush  should  be  frequently  used,  and  exercise  in  the  open  air  is  com- 
mended.    Diet  free  from  condiments,  but  nutritious. 

Fig-Warts. 

These  are  excrescences  upon  the  skin  in  the  shape  of  a  fig,  and 
hence  their  name.  Nitric  acid  and  Thuja  are  remedies  for  these  ex- 
crescences. Thuja  is  more  particularly  indicated  when  they  bleed  ; 
Nitric  acid,  when  they  are  flat;  Nux  vomica,  when  they  are  dry. 
When  they  suppurate,  or  are  humid.  Thuja  ;  when  they  split  or 
crack,  Nitric  acid.     Of  the  remedy  selected,  give  a  dose  every  day. 


...^ 


r*wsa^ttWtsS««*^sini^pi^^ 


668 


DISEASES   OF  VARIOUS   ORGANS   AND   RKGI0N8. 


For  Common  Warts,  Thuja  is  also  the  chief  remedy,  and  should  be 
given  every  two  or  three  days. 

Qangrene. 

When  one  has  been  so  long  sick  as  to  acquire  bed-sores,  and  these 
become  black  and  fetid  and  deathlike,  they  are  said  to  be  gangrenous. 
They  indicate  a  low  condition  of  the  system,  and  generally  indicate 
the  employment  of  Amenicum  in  daily  doses,  or  else  Lachem.  For 
dry  gangrene,  give  Arsenicum.  For  that  which  is  humid,  give  Ohina. 
For  that  which  emits  an  oflFensive  odor,  give  Secale  cornutum.  This 
last  remedy  may  be  given  for  j.  angrenous  blisters.  The  patient,  if 
he  take  it,  should  have  a  generous  diet. 

Zona,  or  Shingles. 

In  some  cases,  there  is  a  zone  or  belt  of  vesicles,  four  or  six  inches 
in  width,  that  extends  half  way  round  the  body,  on  the  right  side, 
over  the  region  or  the  liver.  These  vesicles  appear  to  be  filled  with 
lymph,  and  are  prone  to  burn  and  itch  to  almost  an  unbearable  ex- 
tent. It  is  believed  to  be  a  concomitant  of  chronic  liver  complaint, 
and  indicates  an  exceedingly  low  condition  of  the  blood.  Rhu%  tox., 
in  daily  doses,  will  generally  cure  the  disease.  Graphites  may  be 
given  after  Rhus  tox.  When  there  is  pain  in  the  right  side  and  a 
sallow  complexion,  give  Merourius.  Bryonia  will  eliminate  the 
eruption,  and  aid  materially  in  the  invigoration  of  the  system.  If 
there  is  much  headache,  give  Belladonna.  If  the  patient  is  scrofu- 
lous, give  Arsenicum  or  Galcarea.  The  diet  of  the  patient,  if  his  ap- 
petite will  permit,  should  be  quite  generous.  A  little  wine  every 
day  is  recommended.  Beef  or  mutton  without  condiments,  and  the 
usual  vegetables,  are  allowed. 

Nasal  Polypus. 

This  fungous  growth  in  one  or  both  nostrils  someumes  proves  a 
serious  obstruction  to  respiration  through  the  nose,  and  can  be  cured, 
in  most  instances,  with  well-chosen  remedies.  When  both  nostrils 
are  affected,  give  a  dose  of  Calcarea  every  twenty-four  hours.  When 
the  polypus  is  in  the  right  nostril,  give  Pulsatilla ;  when  in  the  left, 
give  Sanguinaria.    If  the  nostril  seems  plugged,  give  Sepia  or  Silicea. 

Warts  on  the  Nose. 

Warts  on  the  nose  are  sometimes  quite  annoying,  as  they  not  only 
are  inconvenient,  but  often  painful.  It  is  diflScult  to  iet  one  of  these 
excrescences  alone ;  and,  by  constant  irritation,  it  may  become  can- 
cerous ;  therefore,  prompt  treatment  when  they  make  their  appear- 
ance is  requisite.  Caustieum,  given  at  first,  will  soon  relieve  the 
nose  of  this  appendage. 


REGIONS, 
remedy,  and  should  Ik; 


re  bed-sores,  and  these 
said  to  be  gangrenous, 
ind  generally  indicate 
or  else  Lachesis.  For 
is  humid,  give  China, 
'ecale  cornutum.  This 
sters. '   The  patient,  if 


cles,  four  or  six  inches 
dy,  on  the  right  side, 
ppear  to  be  filled  with 
lost  an  unbearable  ex- 
uonic  liver  complaint, 
the  blood.  Bhtts  tox., 
le.  Graphites  may  be 
1  the  right  side  and  a 
,ia  will  eliminate  the 
on  of  the  system.  If 
the  patient  is  scrofu- 
f  the  patient,  if  his  ap- 
A  little  wine  every 
it  condiments,  and  the 


ils  some  limes  proves  a 
nose,  and  can  be  cured. 
When  both  nostrils 
mty-four  hours.  When 
tilla  ;  when  in  the  left, 
i,  give  Sepia  or  Silicea. 

e. 

loying,  aa  they  not  only 
cult  to  let  one  of  these 
)n,  it  may  become  can- 
ley  make  their  appear- 
,  will  soon  relieve  the 


DISEASES   OF   VAUIOUS   ORGANS   AND   REGIONS.  669 


Warts  on  the  Hands. 

When  warts  on  the  hands  are  prone  to  grow  thick  and  large,  and 
appear  to  be  seedy,  Thuja  in  the  form  of  lotion  may  be  applied  exter- 
nally, while  the  usual  dose  of  the  same  may  be  taken  internally.  Cu- 
prum asceticum  also  may  be  taken  internally,  and  a  wash  of  Cuprum 
sulph.,  one  dram  to  half  a  pint  of  water,  may  be  applied  externally. 

Inflammation  of  Glands  under  the  Arms. 

A  SOBE  upon  the  back  of  the  thumbs,  and  sometimes  an  irritable 
sore  upon  the  backs  of  the  fingers  and  hands,  may  cause  soreness  and 
inflammation  of  the  glands  in  the  arm-pits ;  that  is,  the  inflammation 
may  be  transferred  to  this  locality  from  the  thumb,  fingers  or  hands. 
At  first,  a  slight  soreness  is  felt  under  the  shoulder  in  the  arm-pit, 
and  the  glands  will  swell  and  become  sore  to  the  touch ;  more  or  less 
fever  will  manifest  itself  at  the  time ;  and  not  infrequently  pain, 
throbbing  and  suppuration  supervenes  upon  the  inflammation.  Aco- 
nite may  be  given  to  subdue  the  fever  and  inflammation ;  ffepar  sul- 
phuris  may  be  given  to  promote  suppuration ;  Belladonna  or  Bryonia 
to  prevent  it.  Phytolacca,  also,  is  a  most  useful  specific,  given  every 
three  hours  until  relieved. 

Inflammation  of  the  Qroin,  Inguinal  Glands. 

The  inguinal  glands  are  situated  in  the  groin;  and  sometimes 
sores  of  an  irritable  character  upon  the  toes  may  operate  so  as  to 
transfer  these  influences  to  this  region,  causing  swelling  and  suppur- 
ation. If  taken  in  time,  this  soreness  may  amount  to  nothing  more 
than  an  uncomfortable  lameness,  rendering  it  difficult  to  walk.  If 
not  arrested,  the  inflammation  will  pass  into  suppuration.  Sores  or 
chancres  upon  the  integuments  of  the  penis  may  also  cause  inflamma- 
tion, swelling,  and  even  suppuration,  of  the  inguinal  glands.  When 
caused  by  sores  on  the  toes,  poultices  of  bread  and  milk  may  be  ap- 
plied to  them,  to  draw  the  inflammation  from  the  groin ;  and  Nux 
vomica  may  be  given  internally,  to  aid  in  curing  the  difficulty.  When 
this  inflammation  occurs  in  scrofulous  persons,  Arsenicum  may  be 
given  twice  a  day.  When  the  inflammation  proceeds  from  a  chancre, 
give  Merc.  iod.  three  times  a  day ;  when  from  suppressed  gonorrhoea, 
give  Sulphur.  Mercurial  ointment  may  be  applied  to  the  sores,  when 
of  syphilitic  origin.  If  they  occur  from  syphilis,  Merc.  iod.  may  be 
given  internally  three  times  a  day. 

Milk  Leg.  —  Phlegmasia  Dolens. 

This  affection  frequently  occurs  one  week  after  delivery.  It  con- 
sists in  a  swelled  condition  of  the  thigh  and  leg  of  either  the  right 


I 


.. 


670 


niHEASKW   OK    VAKI0U8   OKliANS    ANU    KKOIONH. 


or  left  side.  The  skin  Ixjcomes  tense,  sore  to  the  toucli,  cBdemalous 
or  dropsical,  and  very  sensitive.  It  rarely  affects  botli  limbs  at  tlio 
same  time,  although  in  some  instances  such  is  the  case.  It  inay 
sometimes  be  arrested  in  the  incipient  stage  by  a  single  dose  of  Aco- 
nite. In  a  more  advanced  stage,  Belladonna  will  have  a  curative  ac- 
tion ;  and,  wiien  there  is  great  sensitiveness  of  the  skin,  Jthun  tii.v. 
When  the  victims  of  milk  leg  have  been  aflUcted  with  dropsy  before 
confinement,  Arseaieum  may  be  given.  In  cases  where  women  aie 
suffering  from  rheumatic  pains  in  the  knees,  or  where  there  is  sup- 
pressed lochia,  Pulratilla.  When  the  bowels  are  constipated,  Lyco- 
podium  may  be  given,  and  not  repeated  for  several  days. 


j:; 


Stone  Bruise. 

By  a  stone  bruise  is  understood  an  injury  upon  the  plantar,  or  un- 
der surface  of  the  foot,  which  becomes  inflamed,  painful  and  siiji- 
purative.  It  mostly  occurs  with  boys  and  girls  who  run  barefooti'd 
thrdugh  the  warm  weather ;  and  it  is  believed  to  be  the  result  of  stej)- 
ping  forcibly  upon  pebbles  or  other  hard  substances.  Arnica  given 
once  or  twice  internally,  and  a  lotion  of  the  same  applied  externally, 
will  often  remove  the  pain  speedily ;  but,  after  suppuration  has  taken 
place,  the  sooner  the  matter  is  let  out  with  a  lancet  the  better. 


Bunions. 

These  protuberances  upon  the  joint  of  the  great  toe,  or  upon  the 
side  of  the  foot  immediately  back  of  the  little  toe,  frequently  grow 
so  large  as  to  interfere  with  the  wearing  of  a  shoe  or  a  boot,  and  so 
painful  ivs  to  interfere  with  the  comfort  of  the  patient.  In  order  to 
derive  any  benetit  from  treatment,  all  mechanical  interference  must 
be  removed,  the  boot  or  slioe  must  be  shaped  to  favor  the  tumor,  and 
then  wet  the  tumor  a  number  of  times  during  the  day  with  Amirn. 
Antimonium  crud.  may  be  gi\en  internally,  or  else  Calcarea,  Sepia  or 
Sulphur.  Give  but  a  single  dose  of  each  remedy ;  after  which,  wait 
with  patience.  If  the  bunion  is  very  painful,  give  Calcarea;  and  af- 
ter two  days,  give  Nitric  acid.  If  the  pains  are  stinging,  Lycopodium, 
Silicea  or  Sulphur.  Give  a  single  dose  of  either  remedy,  and  wait 
forty-eight  hours.  A  weak  solution  of  Nitric  acid  will  often  moder- 
ate the  severe  pain  of  a  bunion  in  dry  weather ;  Bryonia  will  do  the 
same  in  cold,  damp  weather.  Silicea  or  Rhus  tax.  will  afford  great 
relief  when  every  change  of  weather  aggravates  the  pain  and  suffer- 
ing. In  case  of  bunions  becoming  the  seat  of  neuralgic  pain,  Bella- 
donna may  be  given  ;  and  when  they  aie  made  sore  by  chilblains,  as 
in  scrofulous  persons,  Arsenicum  must  be  given.  The  patient  must 
not  walk  much,  but  keep  the  feet  dressed  and  warm  until  the  soreness 
disappears..  A  ])oultice  of  bread  aud  milk  will  softeu  and  mollify  tlie 
aching  during  a  sturni. 


ii^ 


1 


IV    UEOIONH. 

,o  the  touch,  (fidematnus 
Efects  botli  limbs  at  tho 
h  ia  the  case.  It  may 
by  a  single  dose  of  Aco- 

will  have  a  curative  ac- 
8  of  tho  skin,  Khux  tor. 
icted  with  dropsy  before 

cases  where  women  aie 
)8,  or  where  there  is  suii- 
is  are  constipated,  Lyco- 
ieveral  days. 


upon  the  plantar,  or  uii- 
iamed,  painful  and  sup- 
'irls  who  run  barefooted 
I  to  be  the  result  of  step- 
ibstances.     Arnica  given 

same  applied  externally, 
er  suppuration  has  taken 
a  lancet  the  better. 


he  great  toe,  or  upon  the 
ttle  toe,  frequently  grow 
a  shoe  or  a  boot,  and  so 
the  j)atient.  In  order  to 
lanical  interference  must 
d  to  favor  the  tumor,  and 
ing  the  day  with  Amim. 
or  else  Calcarea,  Sepia  or 
jmedy ;  after  which,  wait 
il,  give  Calcarea ;  and  af- 
are  stinging,  Lycopodium, 
■  either  remedy,  and  wait 
rie  acid  will  often  moder- 
iher  ;  Bryonia  will  do  the 
lhu8  tox.  will  afford  great 
v^ates  the  pain  and  suffer- 
,  of  neuralgic  pain,  Bella- 
lade  sore  by  chilblains,  as 
fiven.  The  patient  must 
id  warm  until  the  soreness 
vill  soften  and  mollify  the 


mSKASKS  UV   VAlilUUS   OUGAMti   AMD   KEUIUNU. 


671 


Hectic  Fever. 

The  importance  of  this  fever  is  so  great,  that,  instead  of  elabora- 
ting upon  it  under  the  head  of  "  fevers,"  it  is  introduced  here,  be- 
cause it  should  riot  be  confounded  with  other  febrile  diseases.  There 
is  a  common  impression  that  hectic  fever  and  consumption  are  one 
and  the  same  thing  ;  but  this  impression  will  be  corrected  when  we 
consider  briefly  the  origin  of  this  fever.  It  is  sometimes  intermit- 
tent, and  sometimes  remittent.  Often  a  slight  chilliness  is  felt  some 
time  during  the  day;  and  this  is  'oHowed  by  a  febrile  reaction,  more 
or  less  severe,  and  of  a  prostrating  character.  Extreme  debility  may 
cause  a  fever  of  this  kind  to  spring  into  existence  ;  and,  under  such 
circumstances,  it  may  take  the  form  of  a  low  nervous  fever,  very  slow, 
and  wearing  upon  the  nutritive  system.  But  hectic  fevers  show 
themselves  where  there  are  local  chronic  inflammations  and  suppura- 
tions, as  in  the  case  of  abscesses,  carbuncles,  etc.  They  are  some- 
times caused  by  grief,  or  emotions  of  any  kind.  They  are  caused  by 
the  loss  of  nimal  fluids ;  or  they  may  supervene  upon  any  pros- 
trated condition  brought  on  by  acute  disease.  They  result  also  from 
scrofula  and  syphilis,  and  from  the  poisonous  influences  of  Quinia  or 
mercurial  medicines.  It  is  probable,  therefore,  that  hectic  fever,  taken 
in  time,  is  curable,  provided  the  organic  lesions  on  which  it  depends 
are  not  of  a  fatal  or  incurable  kind.  That  which  usually  accompanies 
pulmonary  tubercles*  can  only  be  overcome  by  curing  the  tuberculo- 
sis of  the  lungs.  We  will  proceed  to  specify  the  treatment  according 
to  particular  indications.  Those  springing  from  debility,  and  with  a 
slow  nervous  fever,  require  the  use  of  China  and  Ansenicum.  Give 
the  China  every  time  the  fever  remits  or  intermits,  —  a  single  dose, 
(jive  Arsenicum  in  the  same  way  when  there  is  extreme  prostration 
and  thii-st.  Give  Phosphoric  acid  when  there  is  diarrhoea.  When  the 
fever  attends  local  inflammation,  Arsenicum  may  be  given,  when  there 
is  great  emaciation  and  debil'ty,  with  palpitation  of  the  heart,  hot, 
dry  skin,  and  night-sweats;  Calcarea,  when  there  is  constant  heat 
and  little  thirst,  frequent  flushes  of  heat,  especially  in  the  evening, 
with  red  cheeks.  Calcarea  is  also  indicated  when  there  is  loss  of  ap- 
petite, great  debility  and  emaciation,  and  also  paroxysms  of  anguish. 
China  is  indicated  when  there  is  great  paleness,  sunken  cheeks  and 
eyes,  great  listlessness,  dry  and  flaci  skin,  great  hunger  or  else  loss 
of  appetite,  and  a  tendency  to  diarrhoea.  For  hectic  fever  brought 
on  by  emotions  or  grief,  give  Phosphoric  acid,  followed  by  Capsict  n 
wlien  there  is  painless  diarrhoea,  sad,  oppressed  mood,  febrile  heat  in 
the  evening  and  sweat  towards  morning.  Give  Ignatia  when  the  pa- 
tient weeps  during  the  fever,  and  has  much  heat  in  the  palms  of  the 
hands.  Give  Graphites  when  the  patient  is  pale  and  the  heart  is 
prone  to  palpitate.  If  the  fever  is  produced  by  debilitating  losses, 
give  China  wher  from  hemorrhage ;  give  Nux  vomica  when  from  sex- 


•I 


i  uii.'.i|i,n,Hjma»'i 


f.72 


DIHKAHKS  OK  VARIOUS   ORGANS  AND   UKC.IONH. 


ual  oxcesscH  ;  Phosphoric  asid  wlien  from  diarrhoeii,  .\n<l  there  in  hc 
celerated  |)u1ho,  anguish,  and  HweutM  in  tlie  morning.  When  the  fever 
comes  on  after  dysentery  or  typhus  fever  or  cholera,  give  Araenieiitn, 
if  there  are  dysenteric  discharges,  and  if  the  patient  is  greatly  eniu- 
oiated,  and  has  laborious  breathing,  witli  debility  and  palpitation  and 
thirst,  obliging  him  to  drink  frequently.  Give  Oocculua  when  hectic 
fever  sets  in  after  typlius,  when  there  is  great  debility,  and  trembling 
after  the  least  exertion,  blue  margins  around  the  eyes,  dry  mouth, 
and  loss  of  appetite,  oppression  of  the  chest,  and  with  greiit  sadness 
and  anguish.  Give  Veratriim  album  when  hectic  comes  on  aftei' 
cholera,  if  there  is  great  weakness,  or  cramps,  or  pain  in  the  btick  dI' 
the  head  during  the  fever.  When  syphilis  is  attended  with  hectic 
fever,  and  if  the  imtient  has  taken  much  Merctiry,  give  Aurum  viur. 
or  iStannum^  when  there  is  great  emaciation,  and  pains  in  the  bones, 
and  loss  of  appetite.  Nitric  acid  may  be  given  when  the  hectic  fever 
has  been  brought  on  by  mercurial  medicines,  and  when  there  is  great 
dryness  of  the  throat  and  varices  of  the  tongue.  In  many  cases  of 
hectic  fever,  springing  up  like  those  named  above,  a  careful  selection 
of  the  remedy,  and  corresponding  adaptation  of  diet  and  regimen,  will 
bring  about  a  large  proportion  of  cures.  Persons  suffering  from  any 
form  of  hectic  fever  should  be  kept  in  an  atmosphere  of  uniform  tem- 
perature, —  from  68°  to  70°  Fahrenheit,  and  should  be  supplied  witli 
generous  food  when  the  appetite  will  take  it,  and  in  some  cases  the 
best  of  grape  wine. 

Night-Sweats. 

If  nightrsweats  break  out  in  particular  diseases,  they  do  not  require 
any  special  consideration,  unless  it  happens  to  be  one  of  the  most 
prominent  symptoms ;  in  which  case,  it  may  constitute  an  important 
indication  for  the  selection  of  a  remedy.  A  profuse  perspiration  of 
this  kind  which  affords  no  relief  indicates  Mereurius  or  China.  Ex- 
hausting night-sweats  in  the  case  of  peraons  that  have  become  weak- 
ened by  disease  or  other  causes,  point  to  Carbo.  vegetdbilis.,  Veratrum 
album.  Sulphur.  But  there  are  individuals,  who  appea^"  to  be  well 
enough  otherwise,  who  perspire  copiously  every  night,  and  sometimes 
so  profusely  as  to  wet  the  bed-clothing.  It  would  seem  that  sleep 
induced  some  kind  of  labor  that  wrought  the  system  up  to  this  pitch 
of  perspiration.  It  is  said  to  be  most  common  with  corpulent  per- 
sons. Such  cases  as  only  exhibit  the  one  symptom  of  sweating  for 
consideration,  must  be  treated  as  follows  :  When  one  begins  to  sweat 
as  soon  as  he  lies  down  to  rest  at  night,  Arsenicum,  may  be  adminis- 
tered. When  he  fails  to  sweat  so  long  as  he  keeps  awake,  give  Hepar, 
if  he  is  corpulent ;  or  Oalcarea  if  he  finds  the  sweats  to  diminish  his 
strength.  If  exercise  of  mind  sets  him  to  perspiring  after  gettin}? 
into  bed,  give  Niix  vomica,  if  there  is  a  sanguine  temperament.  If 
the  person  is  a  good  feeder,  and  eats  heartily,  and  has  these  prostrat- 
ing sweats  at  night,  let  him  eat  less,  and  take  Pulsatilla.    Exhausting 


n  —  '     '  ^ 


I)    IlKlilUNM. 

irrlKBa,  .ind  thero  is  ac- 
)rniiig.  When  the  fever 
L'holera,  give  Ar»enieum, 
I  patient  is  greatly  enia- 
ility  and  palpitation  and 
ve  Oocculus  when  hectii: 
b  debility,  and  trembling 
id  the  eyes,  dry  nioutli, 

and  with  great  sadness 
1  hectic  comes  on  afU-r 
8,  or  pain  in  the  back  nf 

is  attended  with  hectic 
injury,  give  Aurum  mm: 

and  pains  in  the  bones, 
en  when  the  hectic  fever 
,  and  when  there  is  great 
rigue.  In  many  cases  of 
vbove,  a  careful  selection 
of  diet  and  regimen,  will 
rsons  suffering  from  any 
nosphere  of  uniform  t«;ni- 
.  should  be  supplied  with 
b,  and  in  some  cases  the 


eases,  they  do  not  require 
1  to  be  one  of  the  most 
/  constitute  an  important 
k  profuse  perspiration  of 
Mercurius  or  China.  Ex- 
j  that  have  become  weak- 
irbo.  vegetahilii,  Veratrum 
J,  who  appeal-  to  be  well 
irery  night,  and  sometimes 
It  would  seem  that  sleep 
le  system  up  to  this  pitch 
mon  with  corpulent  per- 
symptom  of  sweating  for 
iVhen  one  begins  to  sweat 
rsenicum  may  be  adminis- 

keeps  awake,  give  Hepar, 
he  sweats  to  diminish  his 

perspiring  after  getting 
nguine  temperament.  If 
ly,  and  has  these  prostrat- 
le  PuUatilla.    Exhausting 


DIHKAHKB  09  VAItlOllS  OIUiANS  AND    KKOIONS. 


678 


night^tweats  that  occur  after  fatigue  require  Arnica  and  China.  If 
after  severe  mental  lal)or,  give  Cocculua  or  Nux  vomica.  If  from  no 
cause  that  can  be  determined,  Carbo.  animalit.  When  no  fever  pre- 
cedes one  of  thjse  exhausting  sweats,  and  there  is  great  debility 
after,  China,  Ferrum,  and  Oraphiten  are  appropriate  remedies.  For 
the  exhausting  night^weats  that  occur  after  masturbation,  China  is 
also  the  remedy.  If  there  is  uncomfortable  feeling  alwut  the  head,  — 
a  (hill  feeling,  —  give  Phonphoric  acid.  Those  nightrsweata  that  occur 
aftt^r  excessive  sexual  indulgence  require  China.,  Arsenicum,  and 
Qraphitea.  For  niorlud  sweats  in  general,  Arsenicvm.,  Arnica,  Bry- 
onia, China,  Ferrum,  Graphites,  Helleborus  niij.,  Hyoscyamus,  Ignatia, 
Mercurius,  Nux  vomica,  and  Sulphur  may  be  consulted. 

Pulmonary  Consumption. 

There  is  reason  for  a  distinct  monograph  upon  this  disease.  Much 
that  can  be  done  to  ward  off  the  disease  by  domestic  treatment  should 
be  done ;  and,  therefore,  to  point  out  a  plain  description  and  treat- 
ment of  the  incipient  stage  is  at  least  desirable.  The  cause  of  con- 
sumption may  be  hereditivry  taint  or  overpowering  influences  that 
break  down  the  strongest  constitutions.  When  hereditary,  it  fre- 
quently exists  as  a  predisponent  in  the  system  until  aroused  by  some 
exciting  cause.  It  is  therefore  of  the  fii-st  importance  to  become 
familiar  with  the  rrieans  of  protecting  one  thus  disposed  from  sur- 
rounding influences  that  may  develop  the  hereditary  taint.  When  a 
child  of  consumptive  parents  appeare  to  thrive  well  and  grow,  be- 
traying no  signs  of  disease,  it  is  well  to  keep  him  suriounded  by  such 
atmosphere,  food,  and  clothing,  as  contribute  to  his  healthy  develop- 
ment, until  the  age  of  puberty.  It  is  at  this  period  that  changes 
occur,  more  or  less  fraught  with  danger.  With  the  male,  there  is 
danger  of  arousing  any  latent  tendency  to  pulmonary  tubercles  ;  with 
the  female,  there  is  danger  of  the  menstrual  function  becoming  so 
feebly  developed,  that  it  acts  as  an  excitant  upon  any  latent  discrasia 
of  the  blood.  Treatment  is  therefore  required  at  this  period,  not 
only  to  ob\iate  any  derangement  consequent  upon  its  occurrence,  but 
to  aid  a  burthened  system  in  bringing  about  this  physiological  change, 
so  as  to  answer  all  the  demands  upon  it.  Separate  beds  should  be 
insisted  upon. 

For  males  at  the  age  of  puberty,  children  of  scrofulous  parents, 
give  a  dose  of  Calc.  carb.  tvdce  a  week,  and  restrict  them  to  a  strictly 
nutritious  diet,  free  from  fat  or  gravy.  In  case  of  their  being  chil- 
dren of  parents  who  had  tubercular  disease  of  the  lungs,  give  them 
Lycopodium  twice  a  week,  or  perhaps  Graphites,  and  direct  for  them 
a  good  diet  of  aniiral  and  vegetal  ^^  food;  let  them  avoid  exposure 
to  extremes  of  temperature  ; .  let  them  sleep  in  well-ventilated  apart- 
ments :  and  any  hereditary  tendency  to  consumption  can  be  overcome. 
Should  a  cough  ensue  upon  the  period  of  pubescence,  give  Lyco- 


J 


M. 


!.) 


674 


DIHEA8K8   OF   VARIOUS   OKCiANH   ANU    RKGI0N8. 


podium  or  Calcarea ;  if  a  short,  htvckiiig  cough,  give  Photphonm ;  if 
a  tickling  oough,  give  Pulmtilla  or  Sepia.  By  thus  watcliiiig  tlm 
first  development  of  cough,  and  by  giving  the  appropriate  remedy  at 
once,  the  same  can  be  cured.  In  funialus,  when  there  is  great  debility 
of  the  chest,  and  sometinios  a  slight  bleeding  occasionecl  by  a  trifling 
cough,  give  Sauro  cerasus.  Thus,  by  noting  the  slightest  (l«vel()|>. 
nient  of  cough  at  this  period,  and  by  being  prompt  in  selecting  the 
appropriate  remedy,  this  incipient  form  of  consumption  can  be  cured, 
and  sound  health  be  established,  and  will  remain  until  some  otliur 
revolution  occurs  to  unsettle  the  system.  Any  exccHSos  on  the  part 
of  the  male  must  be  avoided.  Whatever  weakens  or  deteriorates  any 
of  the  functions  may  prove  an  exciting  cause,  so  long  as  there  is  any 
predisposing  influence  in  the  system.  On  the  part  of  females,  there 
is  danger  at  the  period  of  the  first  pregnancy.  This  revohition  will 
either  make  further  improvements  in  the  direction  of  sound  health, 
or  it  will  arouse  unfavorable  influences  that  depress  and  ruin  it.  Thus 
it  may  seem  plain  that  consumption  may  be  successfully  treated  in 
its  incipient  stage,  whether  it  shows  itself  early  or  late  in  lift;.  If 
there  is  indication  of  its  approach  after  a  fever,  give  China  ;  if  after 
excessive  fatigue,  give  Lycopodium  or  Stannum.  If  excessive  venery 
causes  a  development  of  consumptive  symptoms,  give  Arsenicum  or 
China  ;  if  the  shock  of  labor  produces  depressing  effects,  give  Arnica, 
China,  and  ArBenicum  /  and  if  cough  ensues,  give  Bryonia  or  Pho»- 
phorus,  and  a  well-regulated  diet.  It  is  believed,  that,  in  a  majority 
of  instances,  hereditary  consumption  can  be  erased  from  the  family 
record  by  carefully  waging  a  warfare  upon  the  fitst  approach  of  the 
enemy. 

But  a  different  aspect  presents  itself  in  that  form  of  consumption 
which  comes  on  by  reason  of  a  good  constitution  having  been  over- 
taxed and  worn  out.  A  cold,  badly  treated,  may  leave  behind  a  per- 
manent irritation  even  upon  the  most  naturally  healthy  constitutions. 
A  cough  from  a  cold  is  not  to  be  trifled  with;  therefore,  attend  to 
the  slightest  cough.  Nux  vomica  may  remove  a  cough  brought  on  hy 
a  cold,  if  given  at  once  ;  a  dry,  hollow,  or  hoarse  cough  may  be  cured 
with  ffepar  sulph. ;  a  cough  with  heat  of  the  chest  and  soreness  of 
the  lungs  may  be  cured  with  Bryonia.  Long  exposure  to  cold  that 
chills  the  whole  system  may  be  followed  by  a  violent  fever  that  fixt : 
itself  upon  the  lungs,  producing  violent  inflammation ;  and  this,  if 
improperly  treated,  may  end  in  consumption.  Almost  any  acute  dis- 
ease, badly  treated,  m.ay  terminate  in  fatal  consuii^^ption ;  therefore, 
when  any  interruption  occurs  in  the  function  of  respiration,  it  is 
more  or  less  dangerous.  The  slighter  the  interruption  the  better, 
and  the  more  easily  can  it  be  removed.  But  it  must  not  be  neglected. 
An  exceedingly  slight  capillary  congestion,  if  neglected,  may  become 
chronic,  and  end  in  tuberculous  consumption ;  a  slight  bronchial  dis- 
turbance, not  properly  treated,  may  terminate  in  bronchial  consumj)- 
tion:  in  short,  any  of  the  ailments  of  a  trivial  character,  which  can 


II  m   i^iitkitmiu 


11)    UKOIONS. 

jph,  give  PhotphoruH;  if 
Ily  thus  watching  Uui 

10  appropriate  remedy  at 
leti  there  is  great  duhility 
^  oc(;asi()nt'(l  by  a  triiling 
ig  the  blightcHt  (leveloj)- 

prom[)t  in  selecting  tho 
Dusuniption  can  he  cun^l, 
remain  until  some  otlier 
Any  excesses  on  the  part 
lakens  or  deteriorates  any 
je,  so  long  as  there  is  any 
the  part  of  females,  there 
cy.     This  revolution  will 
Lirection  of  sound  health, 
depress  and  ruin  it.   Thus 
je  successfully  treated  in 
early  or  late  in  life.     If 
'ever,  give  China  ;  if  after 
iium.     If  excessive  venery 
ptoms,  give  Arsenicum  or 
essing  effects,  give  Arnica^ 
es,  give  Bryonia  or  Pho»- 
lieved,  that,  in  a  majority 
bo  erased  from  the  family 

the  fitst  approach  of  the 

that  form  of  consumption 
itution  having  been  over- 
jd,  may  leave  behind  a  per- 
rally  healthy  constitutions, 
with;  therefore,  attend  to 
lOve  a  cough  brought  on  hy 
hoarse  cough  may  !«  cured 
the  chest  and  soreness  of 
jong  exposure  to  cold  that 
)y  a  violent  fever  that  fixt ; 
inflammation;  and  this,  if 
on.  Almost  any  acute  dis- 
al  consu.i.ption ;  therefore, 
nction  of  respiration,  it  is 
de  interruption  the  better, 
ut  it  must  not  be  neglected, 
n,  if  neglected,  may  become 
tion ;  a  slight  bronchial  dis- 
inate  in  bronchial  consump- 
trivial  character,  which  can 


DISEASES   OK   VAKIOUH   0KQAN8   AND   KEOIONB. 


675 


bo  made  worse  by  neglect,  may  demand  the  most  careful  treatment, 
otherwise  they  may  terminate  in  consumption. 

Influenza,  or  Qrlppe,  comes  on  like  a  cold,  with  sneezing  or  snivel- 
ling, pain  in  tho  chest,  and  a  g((neral  appearance  of  catarrh.  Too 
froijuently  it  hiw  been  neglectecl  in  tho  firat  stage,  and  it  hiw  run  into 
tho  chronic  form  of  bronchitis,  and  thence  into  consumption.  Sn<;h 
l)eing  the  known  tendency,  it  is  well  to  seek  the  best  of  treatment 
f(»r  this  disease  at  once.  ArHenitmrn,'n\  the  incipient  stage,  will  re- 
Hcvo  some  of  the  symptoms :  it  will  relieve  the  thin  discliarge  from 
the  nose  and  eyes,  the  pain  in  the  liml)s,  and  general  aching  in  tho 
bonus.  Euphraxia  relieves  many  cases  in  the  beginning  wliich  re- 
semble Arseniruni.  MercuriuH  viv.  is  also  a  tine  remedy  for  tho  stop- 
page of  the  nose,  eyes,  and  general  restlessness  of  the  whole  system. 
Intluonza  has  been  reckoned  among  the  causes  of  consumption,  be- 
cause, in  many  instances,  it  has  been  the  means  of  calling  into  action 
certain  latent  tendencies  that  have  been  dormant  until  set  ui)on 
by  tl.io  exciting  cause.  Influenza  is  but  an  acute  form  of  bronchitis, 
and  as  such  it  must  be  treated.  Aconite  ma;  be  given  if  there  is  a 
quick,  full  pulse.  After  Aconite  has  softened  the  pulse,  and  pro- 
duced moisture  upon  the  skin,  if  the  head  continues  to  ache,  give 
Belladonna;  if  there  is  soreness  of  the  throat,  give  Merc,  viv.;  if 
much  thirat,  Ar»eni('um  ;  if  pains  in  the  back  and  loins,  Nux  vomica. 
In  females,  Puhatilla  may  remedy  many  of  the  derangements  which 
influenza  produces;  If  a  sudden  check  of  menstruation  su[)ervene8 
u[)on  an  attack  of  this  disease,  give  Aconite^  and  follow  with  Puhor 
tilla  ;  and,  finally,  if  influenza  shows  itself  in  an  epidemic  form,  and 
almost  every  man,  woman  and  child  become  victims.  Aconite^  Bella- 
doHiia,  Merourius,  and  Nux  vom.,  or  else  Arsenicum,  Apia  met.,  Bry- 
onia, Calcarea  carb..  Phosphorus,  and  Sulphur,  may  constitute  the 
group  from  which  is  to  be  selected  a  remedy,  according  to  symptoms. 
It  is  an  old  saying,  with  regard  to  diet,  "  to  starve  a  fever,  and  stuff  a 
cold;"  but  all  proverbs  are  not  true.  There  is,  in  every  cold,  some 
degree  of  fever  that  must  be  heeded,  because  a  too  generous  diet 
would  be  likely  to  do  harm.  A  moderate  diet  of  black  tea,  rice, 
barley,  toast,  and  fruit,  is  best.  Thus,  by  judicious  medication  and 
an  appropriate  diet,  there  need  be  no  sequel  that  causes  the  patient 
to  sink  rapidly  into  the  grave.  If  otherwise,  it  will  arouse  some  con- 
stitutional diathesis,  and  this  will  render  the  joint  action  formidable 
in  the  extreme.  As  in  tubercular  consumption,  or  rather  in  that 
which  is  hereditary,  a  constant  vigilance  is  required  to  put  in  action 
certain  antagonistic  influences  to  overpower  the  disease,  so  in  bron- 
chial consumption,  or  that  which  is  generated  by  a  succession  of 
ailments  that  implicate,  in  a  lesser  or  greater  degree,  the  mucous 
membrane  that  lines  the  bronchial  tubes,  an  effort  must  be  made  to 
bring  any  and  every  assault  upon  the  bronchia  to  a  successful  termi- 
nation, —  whether  a  common  cold,  a  trivial  cough,  a  slight  soreness 
upon  the  air-passages,  or  even  pneumonia:  let  each  be  treated  per- 


676 


DISEASES   OF   VARIOUS   ORGANS   AND   REGIONS. 


sistently,  acicordiiig  to  symptcns,  until  perfectly  cured,  so  as  to  leave 
no  entailment  in  the  form  of  a  sequel,  to  prey  upon  the  conatitution. 
Hygienic  ^treatment  must  correspond  with  the  administration  of 
remedies.  Well-ventilated  apartments,  sufficient  clothing,  and  good, 
nourishing  food,  cannot  fail  of  putting  the  system  in  a  favorable  con- 
dition for  recovery.  Regular  sleep,  regular  meals,  and  a  well-regu- 
lated temperature,  are  things  indispensable. 


Weakness  of  the  Sight.  —  Amblyopia. 

The  term  amblyopia  signifies  a  weakness  or  morbid  alteration  of 
sight ;  and  there  is  every  grade,  from  mere  dimness  of  vision  to  com- 
plete blindness.  A  sense  so  important  au  that  of  sight  is  entitled  to 
a  distinct  consideration,  inasmuch  as  a  variety  of  causes  may  operate 
to  impair  it.  The  difficulty  may  be  attended  with  many  morbid  con- 
ditions of  the  organism,  and  a  variety  of  remedies  may  be  required  to 
tr<3at  the  affection.  We  will  therefore  point  out  the  treatment  for 
the  various  grades,  in  order.  For  Simple  Weakness  op  Sight  in 
plethoric  persons,  give  Belladonna ;  for  scrofulous  individuals,  Cal- 
carea ;  for  weak  or  debilitated  individuals,  China  ;  for  nervous  per- 
sons, Hyoicyamua.  For  those  whose  sight  is  impaired  from  biliary 
derangement,  Sepia  or  Sulphur.  For  Incipient  Amaurosis,  Aurum, 
Sepia,  Sulphur.  For  Complete  Amaurosis,  not  incurable,  give 
Belladonna  to  persons  of  full  habit;  Calcarea  to  persons  who  have  a 
scrofulous  tendency ;  Mercurius,  for  those  suffering  from  hepatic  de- 
rangement; Phosphorus,  for  those  suffering  from  catarrhal  affections; 
and  for  those  subject  to  sick  headache,  Sepia.  For  Torpid  Weak- 
ness OP  Sight,  Phosphoric  acid.  For  weakness  of  sight  brought  on 
by  fine  work,  give  Belladonna  or  Ituta.  For  that  which  occurs  from 
old  age,  give  Baryta  curb.,  Opium  or  Secale  comutum.  Where  weak- 
ness of  vision  occurs  after  suppression  of  the  menses,  or  hemorrhoids, 
give  Pulsatilla  or  Lycopodium.  For  that  occasioned  by  suppression 
of  measles,  Causticum,  Stramonium  or  Sulphur.  For  that  supervening 
upon  rheumatism,  give  Belladonna,  Pulsatilla  or  Bhus  tox.  For  that 
attendant  on  gout,  give  Nux  vom.  or  Colchicum.  For  that  caused  by 
the  abuse  of  mercury,  give  Nitric  acid.  For  that  caused  by  worms, 
give  Cina.  For  that  occasioned  by  diarrhoea,  give  Merc.  viv.  For 
that  brought  on  by  loss  of  blood,  China.  For  that  produced  by  scrof- 
ula, give  Arsenicum,  Calcarea  or  Nitric  acid.  When  produced  by  cold 
in  the  eyes.  Dulcamara  or  Niix  vomica.  That  produced  by  blows  or 
concussions  requires  Arnica,  Ruta,  Euphrasia.  The  remedies  chosen 
must  not  be  repeated  oftener  than  once  a  day.  When  weakness  of 
sight  is  attended  with  nervous  headache,  give  Aurum,  Belladonna, 
Bryonia,  Sepia  or  Sulphur.  If  by  congestion  of  blood  to  the  head, 
give  Belladonna,  China  and  Phosphorus.  For  that  attendant  on 
deafness  or  noises,  give  Ciouta,  Nitric  acid  or  Pulsatilla.  The  reme- 
dies need  not  be  repeated  more  frequently  than  once  or  twice  in 


ND   REGIONS. 


DISEASES   OF  VARIOUS   ORGANS   AND   REGIONS. 


677 


ictly  cured,  so  as  to  leave 
ey  upon  the  conatitutioii. 
li  the  adiniuistratioii  of 
icient  clothing,  and  good, 
ystem  in  a  favorable  coii- 
•  meals,  and  a  well-regu- 


—  Amblyopia. 

or  morbid  alteration  of 
dimness  of  vision  to  com- 
hat  of  sight  is  entitled  to 
ety  of  causes  may  operate 
d  with  many  morbid  con- 
aedies  may  be  required  to 
nt  out  the  treatment  for 
Weakness  of  Sight  in 
I'ofulous  individuals,  Calr 
China;  for  nervous  per- 
is impaired  from  biliary 
lENT  Amaubosis,  Avrum, 
osis,  not  incurable,  give 
rea  to  persons  who  have  a 
suffering  from  hepatic  de- 
from  catarrhal   affections; 
m.    For  Torpid  Weak- 
ikness  of  sight  brought  on 
or  that  which  occurs  from 
g  comutum.    Where  weak- 
le  menses,  or  hemorrhoids, 
occasioned  by  suppression 
hur.  For  that  supervening 
ilia  or  JRhva  tox.    For  that 
icum.     For  that  caused  by 
'or  that  caused  hy  worms, 
•hoea,  give  Merc.  viv.     For 
i'or  that  produced  by  scrof- 
.    When  produced  by  cold 
hat  produced  by  blows  or 
sia.     The  remedies  chosen 
day.     When  weakness  of 
give  Aumm,  Belladonna, 
tion  of  blood  to  the  head, 
For  that  attendant  on 
or  Pulsatilla.     The  reme- 
tly  than  once  or  twice  in 


twenty-four  hours.  If  weakness  of  vision  is  attended  by  gastric  or 
abdominal  ailments,  give  Cocoulun,  Nux  vom.,  Ignatia  or  Pulsatilla. 
If  attended  by  derangements  of  the  womb,  give  Calcarea  or  Sepia. 
If  by  pulmonary  complaints,  give  Phosphorus,  Lycopndium,  Calearea 
and  Sulphur.  If  by  disease  of  the  heart,  Laehesis,  Phosphorus,  Pul- 
satilla, Sepia  and  Spiijelia.  If  by  epilepsy,  spasm  or  hysteria,  Ht/os- 
cyamiis.  Opium,  Stramonium  or  Sulphur.  The  remedy  may  be  re- 
peated, if  necessary,  every  twenty-foift"  houi'S. 

The  particular  indications  for  several  of  the  remedies  may  be  stated 
as  follows :  Aurum,  for  black  spots  or  scintillations,  or  half-sighted- 
ness,  or  tensive  pain  in  the  eyes,  or  in  case  of  sudden  attack  after 
scarlet  fever,  or  during  confinement  after  delivery.  Belladonna  for 
dilated  pupils  or  insensible  pupils,  spasmodi'  ^witching  of  the  lids,  or 
mist  befora  the  eyes,  aching  and  distensiv  pains  in  the  orbits  and 
forehead,  and  red  face.  Calcarea,  for  mistiness  of  sight,  as  if  gauze 
were  before  the  eyes,  especially  when  reading;  for  dilated  pupils,  and 
for  pressure  or  feeling  of  coldness  in  the  eyes.  Causticum,  for  sud- 
den and  frequent  loss  of  sight,  with  sensation  as  if  something  wert 
stretched  over  the  eyes,  or  for  dimrsiffhtedness,  as  if  looking  through 
a  veil  or  mist.  China,  for  weak  sight :  the  patient  only  sees  the  out- 
lines of  things  near  him;  letters  look  pale,  and  appear  to  be  sur- 
rounded by  white  borders ;  dilated  and  not  very  sensitive  pupils ; 
dimness  of  the  cornea,  as  if  the  eyes  were  filled  with  smoke  or  black 
motes.  The  eyes  feel  better  after  sleeping.  Cicuta  is  indicated 
when  the  sight  frequently  vanishes,  and  when  there  is  vertigo  or 
absent-mindedness,  or  aching  pains  in  the  orbits.  Cina,  for  dimness 
of  sight  improved  by  wiping  the  eyes,  and  for  pressure  in  the  eyes 
when  reading,  as  if  sand  had  got  in.  Cimicifuga,  when  there  is  ach- 
ing pain  in  the  centre  of  both  eyeballs,  and  black  specks  before  the 
eyes.  Drosera,  for  frequent  vanishing  of  sight,  or  when  the  eyes  are 
dazzled  with  the  glare  of  light  or  of  fii-e.  Gelsemium,  when  there  is 
a  thirst  for  light  after  apoplexy  or  congestion  of  the  brain.  Hyoscy- 
amus,  for  squinting,  illusory  sight  and  stupefying  pains  over  the 
eyes.  Merourius,  for  paroxysms  of  momentary  blindness,  sensitive- 
ness of  the  eyes  to  light  or  the  glare  of  fire.  Nux  vomica,  for  red 
face  and  sensitiveness  of  the  eyes  to  light  only  in  the  morning. 
Phosphorus,  for  paroxysms  of  sensations  as  if  things  are  covered 
with  a  gray  veil.  Pulsatilla,  for  paleness  of  the  face,  and  disposition 
to  vomit,  and  a  sensation  as  if  dimness  of  sight  could  be  removed  hy 
wiping;  for  frequent  and  copious  flow  of  tears,  and  contraction  of 
the  pupils.  Buta,  for  mistiness  of  sight,  and  boring  pains  in  the  or- 
bits, and  the  filling  of  the  eyes  with  water  in  the  open  air.  Sepia, 
for  dimness  of  sight  when  at  work,  stripes  before  the  eyes  and  aching 
pains  in  the  eyel^lls,  with  sick  headache.  Silicea,  paroxysms  of  sud- 
den obscuration  of  sight,  as  if  a  colored  veil  were  before  the  eyes. 
Sulphur,  for  general  mistiness  of  sight,  as  if  looking  through  feather- 
dust  or  black  gauze ;  great  dryness  of  the  eyes.     Veratrum  album. 


! 


II  <mtmm*)m'rm'mt^ 


J 


\ 


m 


678 


DISEASES   OF   VARIOUS   ORGANS   AND   REGIONS. 


for  profuse  shedding  of  tears,  or  the  copious  filling  of  the  eyes  with 
water.  Verntrum  viride,  when  walking  brings  on  blindness,  with 
fainting  vertigo  iind  dilated  pupils.  When  any  one  of  the  remedies 
is  indicated,  let  the  dose  be  repeated  only  once  in  twenty-four  hours. 
In  all  affections  of  the  sight,  the  patient  should  avoid  hearty  meals 
or  excessive  overloading  of  the  stomach;  he  should  l)e  regular  in  his 
habits,  and  free  as  possible  froiji  mental  anxiety ;  and,  above  all,  his 
habits  should  be  strictly  temperate,  and  late  hours  should  Ih)  avoided. 
In  most  cases  of  defective  sight,  the  eyes  require  rest.  An  atteniiit 
to  exercise  them  in  reading  in  any  defective  light  is  pernicious ;  ami 
so  is  prolonged  reading  in  any  light. 

Paralysis  of  the  Eyelids,  —  Blepharoplegia. 

This  affection  sometimes  occurs  in  children,  but  very  rarely  in 
adults,  and  requires  remedial  treatment.  The  best  remedies  are  Bel- 
ladonna^ Spigelia,  Sepia  and  Stramonium.  Belladonna,  if  there  is  red- 
ness of  the  face;  Spigelia,  if  there  is  any  sign  of  spasms ;  Sepia,  if  it 
follows  severe  headache  and  sickness  of  the  stomach ;  Stramonium, 
if  there  is  pale  face,  and  inclination  to  sleep.  Gavsticum  for  chronic 
cases. 

Whooping-Cough.  —  Tussis  Spasmodica. 

Among  the  diseases  of  children,  we  find  this  malady  quite  com- 
mon. The  cause  is  only  conjectured.  As  it  is  a  disease  much 
dreaded  by  parents,  we  shall  not  only  be  particular  in  describing  the 
disease,  but  also  in  pointing  out  the  remedies  for  the  various  stages 
and  complications.  The  cough  begins  in  the  form  of  an  ordinary 
catarrh  arising  from  a  cold.  The  child  has  f^ryza  and  coughs;  the 
mother  or  nurse  may  be  aware  that  the  di.^  jtvoo  commences  in  this 
way,  and  their  fears  may  be  that  it  will  turn  out  whooping-cougli. 
The  catarrhal  stage  may  last  ten  days  or  two  weeks,  and  then  a  dif- 
ferent and  characteristic  cough  sets  in.  This  co'Jgh  comes  on  in 
paroxysms,  in  which  a  number  of  rapid  expirations  lollow  each  other, 
as  in  the  act  of  coughing,  and  with  m'ach  violence,  and  without  any 
intervening  inspiration,  till  the  patient  turns  black  in  the  face,  and 
seems  on  tlie  point  of  being  suffocated;  then  one  long-dn;.wn  act  of 
inspiration  takes  piace,  attended  with  that  peculiar  rough,  crowing 
noise,  which  is  denouiinated  a  whoop,  and  gives  the  disease  its  name. 
Immediately  after  this  long-drawn  inspiration,  a  series  of  short  expir- 
atory coughs,  repeated  'ii  the  breath  is  almost  exhausted;  and 
then  a  second  whoop,  unti:  ?<■  white,  glary  mucus  is  thrown  up,  and 
this  ends  the  paroxysm.  After  a  lapse  of  some  little  time,  the  par- 
oxysm will  be  repeated.  During  the  urgency  of  some  of  these  par- 
oxysms, the  face  becomes  red  and  swollen,  the  nose  bleeds,  the  eyes 
start  from  the  sockets,  the  little  sufferer  stiimps  with  impatience,  and 
clings  to  some  object  near  him ;  and  tliis  frenzy  continues  till  vomit- 


ND   REGIONS. 


DISEASES  OF   VARIOUS  ORGANS  AND   REGIONS. 


679 


1  filling  of  the  eyes  with 
ings  on  blindness,  with 
any  one  of  the  remedies 
ice  in  twenty-four  hours, 
ould  avoid  hearty  meals 

should  1)6  regular  iu  his 
iety ;  and,  above  all,  his 
liours  should  l)e  avoided. 
quire  rest.     An  attempt 

light  is  pernicious ;  and 


Blepharoplegia. 

dren,  but  very  rarely  in 
he  best  remedies  are  Bel- 
'elladonna,  if  there  is  red- 
^n  of  spasms  ;  Sepia,  if  it 
e  stomach ;  Stramonium, 
Cauaticum  for  chronic 


s  Spasmodica. 

I  this  malady  quite  com- 
Ls  it  is  a  disease  much 
,rticular  in  describing  the 
es  for  the  various  stages 
the  form  of  an  ordinary 

pnryza  and  coughs;  the 
.  jtvoj  commences  in  this 
urn  out  whooping-cougli. 
wo  weeks,  and  then  a  dif- 
This  co'igh  comes  on  in 
rations  loUow  each  other, 
.riulenca,  and  without  any 
IS  black  in  the  face,  and 
len  one  long-dn:.wn  act  of 
,  peculiar  rough,  crowing 
[ives  the  disease  its  name. 
)n,  a  series  of  short  expir- 

almost  exhausted ;  and 
nucus  is  thrown  up,  and 
some  little  time,  the  par- 
ficy  of  some  of  these  par- 
the  nose  bleeds,  the  eyes 
imps  with  impatience,  and 
enzy  continues  till  vomit- 


ing or  expectoration  ends  the  paroxysm.  The  victim  pants  a  little 
wiiile,  and  appears  quite  well  again,  and  begin.s  to  have  a  craving  for 
food.  The  number  of  paroxysms  that  occur  every  twenty-four  hours 
varies  in  different  subjects.  Children  are  very  susceptible  to  the  dis- 
ease, and  it  spreads  by  contagion.  The  ordinary  duration  of  the  dis- 
ease! is  from  six  weeks  to  three  months ;  but  it  may  run  its  couree  in 
thi*ee  weeks,  and  sometimes  not  for  four  or  five  months. 

As  long  as  this  disease  is  uncomplicated,  —  unmixed  with  inflam- 
mation, and  therefore  without  fever,  or  with  that  slight  inflammatory 
condition  proper  to  a  mild  catarrh,  —  it  is  not  a  dangerous  disease. 
Iu  all  probability,  it  will  run  its  course  under  the  most  favorable  cir- 
cumstances. How  much  it  can  be  abridged  by  appropriate  remedies 
is  yet  a  question,  but  the  violence  of  tliC  disease  may  be  moderated, 
its  sequel  may  be  guarded  against,  and  its  complications  may  be  tem- 
pered, by  the  right  use  of  remedies.  The  most  favorable  season  for 
the  disease  to  rage  is  in  the  spring,  when  the  weather  is  becoming 
warmer.  The  most  unfavorable  is  late  in  the  fall,  when  the  weather 
is  augmenting  in  coldness.  Cold  or  damp  weather  is  thought  to  pro- 
tract the  disease,  and  warm  weather  to  abridge  it.  We  have  thus 
been  somewhat  particular  in  describing  this  malady,  in  order  to  facil- 
itate its  treatment  by  mothers  and  nurses.  We  will  now  proceed  to 
direct  the  use  of  appropriate  remedies.  In  the  catarrhal  stage,  give 
Aconite.  If  there  is  fullness  of  the  nose,  and  headache,  give  Bella- 
donna. In  case  of  asthmatic  breathing,  give  Ipecac.  Aconite  is  the 
remedy  for  a  dry,  wheezing  cough,  with  fever  or  burning  pain  in  the 
larynx  or  windpipe.  Belladonna  is  the  remedy  for  severe  paroxysms, 
with  coDgoation  of  blood  to  the  head,  expectoration  of  blood,  and 
bleeding  from  the  nose,  the  eyes  appear  congested,  involuntary  stool 
and  urine,  and  also  when  the  paroxysm  is  announced  with  crying, 
which  arises  from  pain  in  the  stomach,  but  not  accompanied  by  vom- 
iting. Also,  in  the  first  stage,  Carbo  veg.  may  be  given  when  the 
cough  is  convulsive,  especially  in  the  evening,  and  when  there  is 
great  exhaustion  after  each  coughing-spell.  Dulcamara  is  a  good 
remedy  when  the  cough  is  moist  from  the  commencement.  Ipecac. 
for  the  incipient  stage,  when  the  child  has  coughing-spells  so  rapid 
as  not  to  be  able  to  get  his  breath,  and  when  the  open  air  is  requisite 
to  relieve  him.  Pulsatilla  is  useful  when  the  cough  is  loose  from 
the  beginning,  and  worse  towards  evening.  In  the  second  stage, 
after  whooping  sets  in,  with  vomiting,  and  bleeding  from  the  nose 
and  mouth,  give  Caulophyllum.  If  without  bleeding  at  the  nose,  give 
Drosera.  If  the  children  suddenly  become  rigid,  give  Cina.  This 
remedy  is  specific  when  children  are  affected  with  the  usual  worm 
symptoms,  and  the  paroxysm  is  followed  by  a  gurgling  noise  from 
the  abdomen.  Corallia  rubrum  is  believed  to  be  a  sure  remedy  for 
violent  spasmodic  cough  ;  short,  barking  cough  all  day,  and  towards 
evening  becoming  violent  and  spasmodic.  Cuprum  is  indicated  when 
every  paroxysm  is  attended  with  cataleptic  fits,  so  that  in  most  every 


; 


680 


DISEASES   OF  VARIOUS   ORGANS  AND  REGIONS. 


paroxysm  the  child  appeai«  as  dead.  Veratrum  is  very  suitable  after 
Cuprum.  Droaera  is  the  remedy  when  the  paroxysms  come  on  at 
midnight,  and  cease  before  noon,  and  are  very  severe  and  suffocating, 
Veratrum  album  is  indicated,  after  Droaera  and  Cuprum  have  been 
employed,  when  the  patient  is  very  feeble,  quick  pulse,  and  with  a 
sort  of  hectic  fever,  and  cold  sweat  upon  the  forehead,  and  great 
thirst ;  and  also  when  the  coughing  causes  an  emission  of  urine,  and 
pain  in  the  chest  and  loins,  and  when  the  patient,  between  the  par- 
oxysms, is  in  a  comp,tose  state,  and  cares  not  either  to  move  or  con- 
verse ;  and  also  when  there  is  excessive  weakness  of  the  neck,  so  that 
the  victim  is  scarcely  able  to  keep  the  head  erect ;  and  also  wlien 
there  is  rash  over  the  body,  or  face  and  hands.  For  the  most  severe 
or  convulsive  stage  of  whooping-cough,  give  Belladonna^  when  there 
is  pain  in  the  head,  or  convulsions ;  give  Bryonia  when  the  child 
coughs  immediately  after  eating  or  drinking,  and  vomits  what  he  has 
eaten,  and  returns  immediately  to  finish  hi^  meal,  and  then  coughs 
and  vomits  again ;  give  Chamomilla  when  the  cough  and  vomiting  are 
more  frequent  during  a  meal,  fretful  disposition,  and  worse  at  night ; 
give  Caustieum  when  the  cough  is  better,  and  when  it  is  dry  and  hol- 
low ;  give  Hyoicyamus  when  the  patient  is  worse  lying  down,  and  bet- 
ter on  sitting  up ;  give  Arnica  when  the  patient  feels  sore  from 
coughing.  After  the  cough  subsides,  and  there  is  any  sequel  left 
behind,  give  whatever  remedy  is  indicated,  as  Aconite  for  fever,  Nux 
vom.  for  constipation.  Phosphorus  for  catarrh,  China  for  extreme  weak- 
ness, etc.  If  there  is  no  loss  of  appetite,  allow  a  substantial  diet  in 
all  the  stages  of  the  disease.  Change  of  air  is  very  beneficial,  even  if 
but  a  short  journey  from  home,  especially  to  the  searshore. 


Diphtheria. 

An  exudative  inflammation  of  the  throat,  during  the  progress  of 
which  a  dirty,  grayish  membrane  is  exuded  upon  the  tonsils,  and 
often  upon  the  pharynx  and  posterior  nares.  The  disease  is  com- 
monly ushered  in  by  the  following  symptoms :  chilliness,  headache, 
pains  in  the  back  and  limbs,  excessive  prostration,  fever,  some  diffi- 
culty in  swallowing,  though  not  always,  and  offensive  breath.  Later 
appear  acrid  lainning  from  the  nostrils,  or  bleeding,  as  rather  an  un- 
favorable indication ;  swelling  of  the  external  throat ;  and  sometimes, 
in  very  severe  cases,  vomiting  or  hoarseness,  and  other  indications 
that  the  disease  is  invading  the  larynx  or  trachea. 

This  disease  is  now  almost  universally  considered  in  some  degree 
contagious,  and  for  this  reason  the  patient  should  be,  so  far  as  possi- 
ble, isolated  from  those  who  are  not  in  charge  of  the  case.  All  his 
excreta  should  be  disinfected  with  a  strong  solution  of  Sulphate  of 
Iron  at  once.  The  room  should  be  well  aired  constantly.  The  throat 
should  be  gargled,  to  prevent  decomposition,  with  glycerine  and 
water  mixed,  one  part  of  glycerine  to  seven  of  water,  to  be  used 


ND  REGIONS. 

um  is  very  suitable  aftt'r 
paroxysms  come  on  at 
y  severe  and  suffocating'. 
and   Cuprum  have  betMi 
quick  pulse,  and  with  a 
the  forehead,  and  great 
m  emission  of  urine,  and 
)atient,  between  the  par- 
fa  either  to  move  or  con- 
cness  of  the  neck,  so  that 
id  erect ;  and  also  when 
is.     For  the  most  severe 
>  Belladonna,  when  there 
Bryonia  when  the  child 
•;.  and  vomits  what  he  has 
;•  meal,  and  then  coughs 
3  cough  and  vomiting  are 
tion,  and  worse  at  night ; 
id  when  it  is  dry  and  hol- 
i-orse  lying  down,  and  bet- 
patient  feels  sore  from 
there  is  any  sequel  left 
as  Aconite  for  fever,  Nux 
,  China  for  extreme  weak- 
llow  a  substantial  diet  in 
is  very  beneficial,  even  if 
o  the  seashore. 


it,  during  the  progress  of 
ed  upon  the  tonsils,  and 
es.  The  di&eaae  is  com- 
)m8 :  chilliness,  headache, 
(stration,  fever,  some  diffi- 
d  offensive  breath.  Later 
bleeding,  as  rather  an  un- 
lal  throat ;  and  sometimes, 
jss,  and  other  indications 
rachea. 

onsidered  in  some  degree 
should  be,  so  far  as  possi- 
rge  of  the  case.  All  his 
g  solution  of  Sulphate  of 
id  constantly.  The  throat 
tion,  with  glycerine  and 
ven  of  water,  to  be  used 


DISEASES   OF   VARIOUS   ORGANS   AND   REGIONS. 


681 


ever  *^wo  hours,  or  oftener  in  severe  cases.  Small  pieces  of  ice  al- 
loweu  to  dissolve  in  the  mouth  have  a  favorable  influenci;.  The  pa- 
tient's strength  should  he  sustained  by  nourishing  liquid  food,  such 
as  broth  of  beef,  lamb,  mutton  or  fowl;  milk,  or  milk  and  raw  egg; 
oatmeal  gruel;  oystere,  in  cold  weather,  are  allowable.  Stimulant^j 
are  not  recommended,  except  as  a  gargle,  as  much  as  formerly ; 
though  in  severe  cases,  with  alarming  sinking  of  vitality,  brandy  in 
small  doses  may  do  good,  when  repeated  often. 

Dangerous  symptoms  have  resulted  fi-om  the  patient  being  allowed 
to  sit  up  too  soon.  The  membrane  should  begin  to  disappear  on  or 
before  the  fifth  day,  else  grave  symptoms  may  be  apprehended,  such 
as  delirium,  epistaxis,  vomiting,  croup,  or  paralysis  of  the  heart.  The 
urine  should  be  watched  carefully,  as  albuminuria  is  generally  pres- 
ent in  a  mild  form,  and  sometimes  complicates  convalescence,  induc- 
ing dropsical  swellings,  etc. 

In  severe  cases  the  patient  should  exercise  care  against  a  relapse 
for  at  least  three  months. 

Be  sure  that  your  house  is  properly  drained.  Local  filth  is  the 
most  common  exciting  cause  of  this  dread  and  fatal  disease. 

For  the  benefit  of  those  who  cannot  secure  the  advice  of  a  compe- 
tent physician  in  this  grave  disease,  the  following  brief  but  trust- 
worthy indications  for  its  treatment  are  given :  — 

For  the  premonitory  symptoms,  such  as  chilliness,  flushed  face, 
headache,  backache  and  fever,  Gehemium,  ten  drops  in  half  a  tum- 
blerful of  water,  a  teaspoonful  every  half-hour  until  the  fever  uub- 
sides.  Should  there  be  no  improvement  in  twelve  hours,  give  Cimi- 
cifuga  in  the  same  way.  This  remedy  has  proved  of  great  service  in 
the  hands  of  physicians  of  both  schools.  For  the  throat  symptoms, 
the  most  frequently  indicated  remedies  are  the  several  preparations 
of  Mercuriua,  the  Mercurius  hiniod.  taking  preference,  in  water,  and 
repeated  hourly.  This,  or  the  Mercurius  cyanuretum,  may  be  alter- 
nated with  Cimicifuga  or  Gehemium,  or,  later,  in  obstinate  continu- 
ance of  the  membranous  exudate,  with  Phytolacca  decandra.  When 
the  breath  is  very  putrid  early  in  the  attack,  and  the  membrane  of- 
fensive, with  fever,  darkly  flushed  face,  delirium,  Baptisia  is  better 
than  Gehemium  or  any  other  remedy.  Should  the  tonsils  swell  rap- 
idly, and  the  throat  and  external  face  have  a  puffy  appearance.  Apis 
mel.  is  indicated,  in  place  of  the  mercurial  preparations.  It  should 
be  given  in  water,  hourly.  Should  croupous  symptoms  begin,  indi- 
cated by  hoarseness,  whistling  breathing,  dusky  complexion  or  doughy 
pallor,  croupy  cough,  Spongia  or  lodium  will  be  the  main  reliance, 
together  with  the  inhalations  of  the  vapor  of  boiling  water.  Lache- 
sis  has  saved  cases  of  a  grave  type,  which  have  resisted  the  before- 
mentioned  remedies.  When  bleeding  from  the  nose  becomes  trouble- 
some and  alarming,  the  best  remedy  is  Carbo  veg.,  together  with  a 
free  local  use  of  ice.  The  remedies  should  not  be  changed  oftener 
than  once  in  twelve  houra,  as  it  is  a  disease  slow  to  show  improve- 
ment. 


-'•^«---»«r'.B«fK^-  ^tm^tif .ttrnMi* 


(Ks*r— (^""^ 


682 


DISEASES   OF    VAKI0U8   OHGANS    AND    KEGIONB. 


Homoeopathic  Treatment  of  Diphtheria. 

Two  views  have  been  taken  with  regard  to  the  intimate  nature 
and  cause  of  diphtheria.  Most  physicians  regard  it  as  an  essential 
fever,  and  are  of  the  opinion  that  the  local  affections  of  the  throat 
and  air  passages  are  secondary,  and  are  but  local  manifestations  of 
the  special  condition  of  the  system,  and  that  they  have  the  same  ic- 
lation  that  the  local  affections  of  the  skin  and  mucous  menibiiuics 
have  to  the  eruptive  fevers.  They,  however,  admit  that  the  general 
disorder  is  increased  and  intensified  by  the  absorption  of  the  septic 
mattera  of  the  local  disorder,  thereby  producing  the  blood-poisoning 
of  septicaemia. 

The  other  view  is  what  is  called  the  germ  theory.  According  to 
this  view,  the  disease  is  caused  by  a  vegetable  organization,  whiili 
naturalists  call  sphero-bacteria  or  micrococci,  which,  finding  access  to 
the  throat  through  the  nostrils  and  the  mouth,  fasten  upon  the  mu- 
cous membranes  of  the  tonsils  and  fauces,  and  produce  an  infiani- 
mation  which  is  characterized  by  the  effusion  of  a  fibrinous  exu- 
dation called  diphtherite.  This  is  not  all :  under  the  conditions 
favorable  for  their  life  and  growth  they  possess  an  enormous  power 
of  reproduction.  From  this  centre  of  infection  these  germs  find 
their  way  into  the  different  tissues  of  the  body,  and  acting  as  fer- 
ments, give  rise  to  deleterious  chemical  products  which  destroy  life. 
These  vegetable  parasites,  according  to  this  theory,  are  as  inseparable 
from  the  diphtheritic  process  as  the  bacteria  of  decomposition  are 
from  putrefaction  and  decay.  Without  bacteria  there  can  be  no 
diphtheria.  In  grave  cases,  these  parasites  are  found  everywhere,  in 
the  smallest  patches  of  membrane,  and  in  immense  numbers  in  the 
different  tissues  of  the  body.  They  are  the  cause  of  embolism,  of 
metastatic  abscess,  and  the  intensity  of  the  disease  increases  with 
their  number.     These  are  the  theories  of  diphtheria. 

The  duration  of  the  disease  depends  upon  its  severity.  The  period 
of  incubation  occupies  from  two  to  eight  days.  In  mild  cases  the 
membrane  commences  to  be  shed  on  the  fourth  day ;  in  severe  cases 
not  before  the  tenth  or  twelfth  day,  and  it  may  take  four  or  more 
days  to  finish  it. 

The  membrane  is  detached  in  the  same  way  as  any  sloi\gh  or  ne- 
crotic tissue,  by  the  process  of  suppuration.  Whatever  theory  is 
adopted,  the  local  treatment  is  of  primary  and  equal  importance  ;  for 
the  mucous  membrane  of  the  throat,  if  it  is  the  avenue  through  which 
germs  find  entrance  to  the  body,  is  also  the  generator  of  those  irritant 
poisons,  the  absorption  of  which  contaminates  the  system  and  de- 
stroys life.  The  object  of  the  treatment  is,  fij:st,  to  put  a  stop  to  the 
spread  of  the  disease,  and  to  bring  about  a  retrogression  of  the  in- 
flammatory process,  with  the  removal  of  the  membrane ;  secondly,  by 
the  most  perfect  disinfection  and  antiseptic  cleansing  of  the  moutli 


D    UKGI0N8. 


DISEASES   OF   VARIOUS   ORGANS   AND    REGIONS. 


683 


f  Diphtheria. 

to  the  intimate  nature 
egard  it  as  an  essential 
affections  of  the  throat 

local  manifestations  of 
t  they  have  the  same  ic- 
and  mucous  membranes 
',  admit  that  the  general 
absorption  of  the  septic 
cing  the  blood-poisoning 

a  theory.  According  to 
able  organization,  which 
,  which,  finding  access  U> 
th,  fasten  upon  the  mu- 
and  produce  an  inflani- 
sion  of  a  fibrinous  exu- 
l:  under  the  conditions 
sess  an  enormous  power 
fection  these  germs  find 
body,  and  acting  as  fer- 
ducts  which  destroy  life, 
theory,  are  as  inseparable 
ria  of  decomposition  are 
)acteria  there  can  be  no 
are  found  everywhere,  in 
immense  numbers  in  the 
he  cause  of  embolism,  of 
le  disease  increases  with 
phtheria. 

I  its  severity.  The  period 
days.  In  mild  cases  the 
arth  day ;  in  severe  cases 
t  may  take  four  or  more 

(vay  as  any  slough  or  ne- 
lon.  Whatever  theory  is 
,nd  equal  importance ;  for 
the  avenue  through  which 
generator  of  those  irritant 
nates  the  system  and  de- 
,  first,  to  put  a  stop  to  the 
a,  retrogression  of  the  iu- 
B  membrane ;  secondly,  by 
c  cleansing  of  the  mouth 


and  throat,  to  prevent  the  absorption  of  injurious  products  of  decom- 
position from  the  surfaces  of  the  diseased  tissues. 

In  order  to  accomplish  the  above  results,  the  local  treatment  by 
the  application  of  disinfectant  and  antiseptic  remedies  is  now  in  vogue. 

Cauterizing  substances  are  considered  hurtful  and  but  seldom  used. 
I'lie  most  common  remedies  now  resorted  to  are  carbolic  acid,  sali- 
cylic acid,  permanganate  of  potash,  chloral  hydrate,  sulphite  of  soda, 
benzoate  of  soda  and  chlorate  of  potash.  These  various  substances 
iiave  be(!n  applied  in  solutions  by  means  of  a  sponge  or  a  brush,  in 
the  foiin  of  spray,  and  in  the  form  of  a  powder,  taken  dry  into  the 
mouth  combined  with  sugar. 

I  think  that  the  best  way  to  treat  the  throat  is  by  the  frequent  in- 
halation of  a  liot  steam,  applied  in  hourly  sittings  of  about  fifteen 
minutes'  duration.  These  may  be  medicated  with  chloride  of  sodium, 
or  the  chlorate  of  potash,  about  twenty  grains  to  the  ounce.  Such 
fluids,  steadily  flowing  over  the  surfaces  of  the  mucous  membranes, 
wash  away  masses  of  mucus,  remnants  of  food  and  other  products  of 
decomposition.  They  assist  nature's  work  of  promoting  suppuration, 
which  is  the  legitimate  way  in  which  these  pseudo-membranes  are 
shed  ;  and  by  combining  this  treatment  with  the  use  of  strong  gar- 
gles, composed  of  the  solution  of  any  of  the  above  disinfecting  sul>- 
stances,  we  more  completely  prevent  septic  absorption  than  by  any 
other  treatment  ever  used.  The  steam  may  be  generated  in  any  or- 
dinary kettle,  and  conducted  to  the  patient's  mouth  through  any 
suitable  tube.  Being  careful  not  to  have  it  too  hot,  an  atomizer  is 
much  better.  The  general  treatment  of  the  patient  is,  aa  in  every 
other  infectious  disease,  to  be  sustaining. 

Tonics,  sucli  ?is  sulphate  of  quinine  and  the  tincture  of  the  muriate 
of  iron,  are  also  always  indicated. 

It  has  been  claimed  tliat  alcohol  conjoined  with  quinine,  given 
freely  from  the  firet,  is  an  effective  curative  agent.  Alimentation  is 
an  essential  part  of  the  treatment.  The  diet  should  be  highly  nutri- 
tious ;  milk  and  animal  broths  are  of  this  class. 

Patients  affected  with  this  disease  should  be  at  once  isolated. 
Thorough  disinfection  of  the  dejections,  and  of  all  articles  which 
have  have  been  in  contact  with  patients,  and  of  the  apartments  which 
they  have  occupied,  is  to  be  recommended,  and  all  defects  of  drain- 
age must  be  remedied. 

In  case  of  an  attack  of  diphtheria  no  time  should  be  lost,  but  a 
physician  should  be  called  at  once.  In  first  stages  I  would  advise  a 
trial  of  the  Anti-Toxine  treatment. 


DROPSIES,  HYDROPSIES. 


A  GENERAL  swelling  of  the  whole  exterior  snviace  of  the  hody, 
and  a  sensation  of  weakness,  is  termed  general  dropsy,  because  the 
water  infiltrates  into  the  cellular  or  subcutjineous  tissue  all  over  tlie 
body.  Local  dropsies'  may  affect  the  chest,  abdomen,  head,  womb 
and  testes. 

General  Dropsy,  Anasarca. 

This  is  caused  by  cellulitis  and  infiltration  of  water  into  the  areo- 
lar tissue,  causing  one  to  swell  all  over  the  body.  There  is  generally 
some  thirst  and  fever  that  ushers  in  general  dropsy.  Arsenicum  m 
the  usual  dose  may  cure  the  disease  when  it  seems  to  arise  trom  a 
low  state  of  the  system.  When  it  is  the  sequel  of  scarlatina  or  ery- 
sipelas,  give  Hellehorm  nig.  three  times  a  day.  If  after  a  bilious 
fever,  give  Mercunm  viv.    Following  scarlet  fever,  Apu  or  Terebinth. 

Dropsy  of  the  Belly.  —  Ascites. 
When  inflammation  of  the  peritoneum  terminates  in  dropsy  of  the 
abdomen.  Apis  mellifica  may  be  given,  (3very  three  or  four  hours,  for 
several  days.  If  it  fails  of  effecting  a  cure,  Apocynum  may  be  given 
in  the  same  way,  and  in  like  manner,  Bryonia,  Hellehorus  mg.  and 
Arsenicum.  Tapping  is  sometimes  necessary,  when  the  peritoneal 
sack  is  filled  with  water,  and  does  not  yield  to  remedies. 

Dropsy  of  the  Chest,  or  Hydrothorax. 

The  cause  of  this  affection  is  intlammation  of  the  pleura,  causing 
an  accumulation  of  serum  in  the  pleural  cavity.  Apis  mellifica  in  the 
usual  doses,  repeated  at  intervals  of  three  or  four  hours,  will  otteu 
effect  a  radical  cure,  and  so  will  Apocynum.  If  these  fail,  use  ^ui- 
phur. 

Dropsy  of  the  Heart. 

This  is  an  accumulation  of  water  around  the  heart,  in  the  cavity 
of  the  pericardium.  Spigelia  or  Apis  mellifica  will  generally  cure. 
Sulphur  is  efficient  in  many  cases.     Bryonia,  if  from  pericarditis  or 

rheumatism. 

681 


-O 


DROPSY,   IIYbKOPS. 


685 


PSIES. 


IT  surface  of  the  body, 
sral  dropsy,  because  the 
leous  tissue  all  over  the 
;,  abdomen,  head,  womb 

sarca. 

n  of  water  into  the  areo- 
ody.  There  is  generally 
L  dropsy.  Arsenicum  in 
b  seems  to  arise  from  a 
[uel  of  scarlatina  or  ery- 
day.  If  after  a  bilious 
fever,  Apia  or  Terebinth. 

—  Ascites, 

rminates  in  dropsy  of  the 
'  three  or  four  hours,  for 

Apocynum  may  be  given 
mia,  Hellehorus  nig.  and 
,ry,  when  the  peritoneal 

to  remedies. 

iydrothorax. 

)n  of  the  pleura,  causing 
ity.  Api%  melUfica  in  the 
or  four  hours,  will  often 
.     If  these  fail,  use  Sul- 

art. 

[  the  heart,  in  the  cavity 
lifica  will  generally  cure. 
a,  if  from  pericarditis  or 


Dropsy  of  the  ^tsAn.— Hydrocephalus. 

Inflammation  of  the  brain  may  terminate  in  an  effusion  of  serum 
in  the  arachnoid  cavity,  and  is  often  fatal,  ffi/ogci/amua  in  the  usual 
dose,  repeated  four  or  five  times  a  day,  may  prove  beneficial.  Apin 
mellifiea  has  been  employed  in  the  same  way,  also  Hellehorm. 

Dropsy  of  the  \Womh,—Hydrometra. 

Inflammation  of  the  womb  often  terminates  in  this  affection. 
Belladonna,  Apis  mellifiea.,  Arsevicum  and  Hellehorus  nig.  have  been 
eipployed  against  it. 

Dropsy  of  the  SctoiMm.^  Hydrocele. 

This  consists  in  the  scrotum  becoming  filled  with  serum  or  water, 
after  inflammation  and  swelling  of  the  testes.  It  may  be  caused  by 
gonorrhoea  or  it  may  be  the  sequel  of  scarlet  fever.  The  same  reme- 
dies employed  in  other  local  dropsies  may  be  employed ;  or,  these 
failing,  the  water  may  be  drawn  off,  and  a  weak  solution  of  iodine 
may  be  injected  into  the  sack  by  a  surgeon. 

Ovarian  Dropsy. 

Inflammation  of  the  ovaries  is  the  cause  of  this  diflficulty.  Ar- 
senicum yiSS.  generally  have  a  good  effect,  and  so  will  Gonium  and 
also  Apis  melUfica  and  Pulsatilla  ;  either  remedy  in  the  usual  dose 
may  be  administered  every  three  tours,  with  the  prospect  of  relief. 


"■aMHMimJ  t-'a».g""a-'' 


"_!■■ 


1/    •',■:"" 


INSIDIOUS  DISEASES. 


Malignant  Pustule. 

There  is  sometimes  a  low  and  vi  Jated  state  of  the  blood,  and  so 
powerfully  predisposed  to  take  a  malignant,  if  not  a  fatal  tendency, 
that  a  very  slight  exciting  cause  will  arouse  a  disturbance  not  easily 
quelled.  Such  is  believed  to  be  the  origin  of  what  is  iisually  termed 
"  the  Malignant  Pustule,  a  small  pimple  upon  the  face,  regarded  of 
little  account  by  the  person,  who,  unconscious  of  the  vitiated  condi- 
tion of  his  blood,  pinches  it  and  irritates  it.  It  begins  to  inflame  ;  a 
determination  of  all  the  subtle  impurities  of  the  fluid  takes  place  at 
this  spot ;  and  a  malignant  and  disorganizing  fever  pervades  the  en- 
tire economy,  and,  if  not  arrested,  it  runs  a  rapid  course,  and  termi- 
nates fatally  often  in  a  single  day,  or  before  any  remedial  agent  can 
be  brought  to  bear  to  arrest  the  process.  Pimples  upon  the  face 
should  never  be  pinched  or  squeezed,  for  fear  of  inviting  inflamma- 
tion to  the  spot,  that  might  react  in  calling  up  or  setting  fire  to  a 
discrasia  of  a  malignant  quality.  Individuals  apparently  well  in  the 
morning  have  gone  to  business,  and,  ere  another  morning  came  round, 
have  found  themselves  fatally  prostrated  by  this  disorder.  As  soon 
as  suspected  give  Arsenicum  every  hour  for  three  or  four  hours,  and 
then  follow  with  Nitric  acid  ;  and,  if  there  is  any  indication  of  change 
for  the  better,  well ;  if  not,  give  Muriatie  acid,  or  Lachesis.  Just  as 
soon  as  any  pustule  upon  the  face  begins  to  inflame  like  a  boil,  and 
there  are  chilly  rigors  running  down  the  back,  retire  to  bed,  take 
Arsenicum,  and  a  chp.nge  in  the  febrile  condition  may  take  place  for 
the  better,  and  the  life  of  the  patient  may  be  saved.  When  the  face 
begins  to  swell  and  there  is  delirium,  give  Belladonna  every  half- 
hour  to  hold  in  check,  if  possible,  the  tendency  to  the  brain.  After 
Belladonna,  give  Ithus  tax.  Very  many  cases  of  "Malignant 
Pustule  "  have  been  cured  by  a  timely  resort  to  proper  remedies. 
But  celerity  of  action  is  required  ;  one  moment's  unnecessary  delay 
may  be  too  hazardous  for  the  patient.  It  is  believed  that  the  brain 
and  nervous  centres  elsewhere  are  most  liable  to  speedy  implication. 
A  resort  to  such  remedies  as  will  guard  against  these  will  undou^* 
edly  furnish  the  best  protection.  Consult  Arsemcu/my  Apis  iruv., 
Bell.,  Graphites,  Merc,  Gonium,  and  Sidphur. 

68fi 


u 


>aic>.iSK 


INSIDIOUS   DISKAUKS. 


687 


18E8. 


le. 

ate  of  the  blood,  and  bo 
if  not  a  fatal  tendency, 
I  a  disturbance  not  easily 
oi  what  is  usually  termed 
)on  the  face,  regarded  of 
lus  of  the  vitiated  condi- 
It  begins  to  inflame  ;  a 
f  the  fluid  takes  place  at 
ig  fever  pervades  the  en- 
rapid  course,  and  termi- 
I  any  remedial  agent  can 
Pimples  upon  the  face 
ar  of  inviting  inflamma- 
ig  up  or  setting  fire  to  a 
vis  apparently  well  in  the 
ther  morning  came  round, 
r  this  disorder.     As  soon 
three  or  four  hours,  and 
1  any  indication  of  change 
cid,  or  Lachem.     Just  as 
0  inflame  like  a  boil,  and 
back,  retire  to  bed,  take 
dition  may  take  place  for 
36  saved.     When  the  face 
fe  Belladonna  every  half- 
lency  to  the  brain.     After 
ly   cases    of    "  Malignant 
esort  to  proper  remedies. 
»ment's  unnecessary  delay 
is  believed  that  the  brain 
ible  to  speedy  implication, 
gainst  these  will  undou^^* 
lit  Arsenictm^  Apis  tn^i'-, 
ur. 


Spotted  Fever.  —  Fehris  Petechialis, 

This  fever  usually  begins  with  great  lassitude  ;  the  patient  feels 
fatigued,  and  unable  to  l)e  about ;  and  then  a  headache  ensues,  without 
much  fever ;  the  pulse  is  not  much  accelerated,  the  tongue  is  coated 
with  a  dark  or  brown  coating,  nutrition  becomes  interrupted,  and 
rapid  emaciation  takes  place.  After  a  while,  the  patient  begins  to 
Buffer  from  intense  pain  in  the  back  and  limbs;  a  cold  chill  comes 
over  him,  and  a  febrile  reaction,  that  is  cliamcterieed  usually  by  great 
thirst,  entire  loss  of  appetite,  and  inclination  to  vomit.  During  the 
fel.ile  excitement,  the  skin  becomes  discolored,  and  red  or  purple 
8i)ois  appear  in  great  numbers  upon  the  surface  of  the  body.  This 
is  believed  to  be  the  crisis,  and  affords  an  indication  of  the  malignant 
character  of  the  disease.  For  the  most  part,  the  patient  lies  in  stu- 
por, or  perhaps  at  times  evinces  a  low,  muttering  delir  \m,  and 
inclination  to  pick  the  bed-clothes.  The  cause  of  this  fever  is  sup- 
posed to  be  some  malaiious  poison  acting  upon  the  blood.  The  prog- 
nosis, or  prospect  of  the  result,  is  by  no  means  favorable ;  yet  many 
such  cases  recover  under  proper  treatment.  In  the  first  stiage,  when 
the  patient  is  complaining  of  great  weariness  and  lassitude,  give  Arnica 
every  three  hours.  When  the  head  begins  to  ache,  give  Belladonna, 
and  especially  if  there  is  any  twitching  of  the  muscles,  or  redness  of 
the  eyes.  If  there  is  any  derangement  of  the  kidneys,  following 
checked  perspiration,  give  Rhus  tox.  For  the  intense  pain  in  the 
back,  give  Belladonna,  and  follow  with  Verat.  viride.  When  the  cold 
chill  ensues,  and  the  countenance  looks  pallid  and  sunken,  give  Carbo 
vegetahilis.  When  the  fever  appears,  and  there  is  thirst,  and  incli- 
nation to  vomit,  give  Arsenicum,  or  perhaps  Veratrum  album,  and 
repeat  the  remedy  every  three  hours.  When  the  low,  muttering  de- 
lirium shows  itself,  give  Stramonium.  Let  the  surface  of  the  body 
be  rubbed  gently  with  a  crash  or  Turkish  towel,  and  wet  with  tepid 
water.  If  the  patient  becomes  quiet,  and  the  spots  gradually  begin 
to  disappear,  and  the  coating  upon  the  tongue  begins  to  break  up, 
and  a  normal  secretion  upon  the  tongue  begins  to  show  itself, — 
these  are  signs  of  convalescence  ;  and  then  it  is  well  to  give  China, 
and  supply  the  patient  with  beef-tea  or  broth  in  moderate  quantities, 
and  then  with  something  more  substantial,  as  he  can  bear  it. 

Cold  Fever. 

In  some  parts  of  the  country,  there  has  prevailed  endemically  a 
kind  of  fever  which  at  first  makes  its  appearance  with  general  pros- 
tration and  coldness  of  the  surface  of  the  entire  body.  The  face  ap- 
pears as  cold  as  marble,  the  nose  pinched,  the  eyes  sunken  in  their 
sockets,  the  tongue  covered  with  a  thiijk  white  coating,  no  appetite, 
Itut  intense  thirst.  This  cold  stage  lasts  for  a  longer  or  shorter 
period;  and  then  it  is  followed  by  a  febrile  reaction,  and  the  entire 


r>88 


INfliniOUS   DIBRASRS. 


h(»(ly  becomes  intensely  heated,  the  pulae  becomes  quick  and  feeble, 
the  head  and  back  bticomu  the  seat  of  pain  for  a  while;  and  then  all 
these  symptoms  disappear,  and  another  cold,  sunken  condition  of  the 
system  ensues,  and  sometimes  the  body  is  covered  with  a  cold  perspira- 
tion, which  lasts  for  an  indefinite  period,  and  then  a  more  fierce  febrile 
reaction  conies  on  again,  and  elevates  the  pulse  and  temperature  of 
the  skin,  giving  a  flushed  appearance  of  the  countenance,  redness  of 
the  eyes,  and  heat  of  the  head;  when  a  warm  perspiration  terminattis 
the  febrile  heat,  and  then  there  gradually  appears  the  coldness  of  the 
surface  again.  These  alternations  of  the  extremes  of  temperature 
upon  the  surface  go  on  until  a  crisis  occurs  that  terminates  the  life 
of  the  patient,  or  the  disease  begins  to  wane.  But,  to  mitigate  the  sev- 
erity of  the  disease  by  treatment,  in  the  cold  stiige,  give  Carho.  ve(/. 
every  four  hours  until  the  reaction  commences,  and  then  give  Bryonia 
or  Rhus  ;  and  these  remedies  raay  moderate  the  reaction.  If,  in  the  cold 
stage,  the  patient  is  stupid,  y\\Q  Belladonna ;  after  Carlo  veff.,  and 
and  for  the  cold  perspiration,  ^rive  Carbo  animalia.  At  the  recurrence 
of  the  fever  upon  the  surface,  give  Arsenicum  and  Bryonia.  If  the 
patient  has  much  heat  in  the  liead,  and  is  delirious,  give  Belladonna ; 
and,  until  the  coating  upon  the  tongue  begins  to  disappear,  do  not 
thrust  any  food  other  than  light  gruel  upon  the  patient,  but  as  soon 
as  the  natural  secretion  of  saliva  appears  upon  the  tongue,  give  beef- 
tea  or  good  mutton  soup,  a  little  wine,  and  other  nutritious  stimu- 
lants ;  and  as  the  appetite  returns,  increase  the  strength  of  the  diet. 
The  same  process  of  rubbing  must  be  employed  as  in  the  Spotted 
Fever.  If  the  urine  is  turbid,  give  iVkc  vom.  If  the  feet  swell  dur- 
ing the  convalescence,  give  Artenioum,  Apia  met,,  or  Eellebore. 


Putrid  Fever. 

This  fever,  as  its  name  implies,  emits  an  unpleasant  or  fetid  odor. 
It  comes  on  much  like  those  just  described,  only  the  breath  appeal's 
to  be  tainted  with  something  of  a  putrid  character,  and  very  often 
there  are  patrid  discharges  from  the  bowels.  The  urine  has  a  putrid 
odor  ;  and  when  there  is  any  perspiration  upon  the  surface,  it  has  the 
same  smell.  The  disease  comes  on  unobserved,  and  is  attended  with 
lassitude  and  inappetency.  There  is  seldom  any  noticeable  cold 
stage,  and  yet  there  is  very  little  if  any  heat  upon  the  surface. 
The  tongue  becomes  coated  with  a  dark  brown  coating,  and  sordes 
collects  upon  the  teeth  in  large  quantities.  The  pulse  is  feeble  and 
quick  ,  the  skin,  for  the  most  part,  is  dry  and  of  low  vitality.  There 
is  often  more  or  less  pain  in  the  bowels,  and  a  distension  of  the  ab- 
domen. The  urine  is  thick  and  high  colored,  and  of  an  offensive 
odor.  The  patient  rejects  all  kinds  of  food  and  drink,  except  water ; 
and  this  uniformly  has  to  him  a  disagreeable  taste.  His  nose  is  dry 
and  sore,  and  his  lips  become  dt  md  cracked  ;  and  sometimes  a  black 
or  dark-colored  saliva  runs  out  ux  the  corners  of  his  mouth,  which  dis- 


-i^AMftMUitaMi^ 


iNflimons  msKA8E& 


689 


ecomes  quick  and  feeble, 
for  a  while ;  and  then  all 
,  sunken  condition  of  the 
irered  with  a  cold  perspini- 
[  then  a  more  fierce  febrile 
julse  and  temperature  of 
i  countenance,  redness  of 
m  perspiration  terminattts 
)pear8  the  coldnes-s  of  the 
extremes  of  temperature 
that  terminates  the  life 
But,  to  mitigate  the  sev- 
)ld  stiige,  give  Carho.  veij. 
jes,  and  then  give  Bryonia 
)he  reaction.  If,  in  the  cold 
%a ;  after  Carho  veg.,  and 
umalis.    At  the  recurrence 
rum  and  Bryonia.     If  tlu; 
ielirious,  give  Belladonna ; 
egins  to  disappear,  do  not 
n  the  patient,  but  as  soon 
pon  the  tongue,  give  beef- 
id  other  nutritious  stimu- 
the  strength  of  the  diet, 
ployed  as  in  the  Spotted 
»m.     If  the  feet  swell  dur- 
it's  mel,^  or  Sellehore, 


a  unpleasant  or  fetid  odor, 
id,  only  the  breath  appeai-s 
character,  and  very  often 
Is.  The  urine  has  a  putriel 
ipon  the  surface,  it  has  the 
3rved,  and  is  attended  with 
idom  any  noticeable  cold 
ly  heat  upon  the  surface. 
brown  coating,  and  sordes 
i.  The  pulse  is  feeble  and 
md  of  low  vitality.  There 
md  a  distension  of  the  ab- 
)lored,  and  of  an  offensive 
)d  and  drink,  except  water; 
ble  taste.  His  nose  is  dry 
ced  ;  and  sometimes  a  black 
ers  of  his  mouth,  which  dis- 


colors them,  and  gives  to  his  pale  and  sunken  countenance  a  distress- 
'"K  appearance.  The  progress  of  this  fever  is  slow  and  low,  and 
often  terminates  in  ulceration  of  the  bowels.  There  is  from  the  first 
a  labored  respiration  and  a  putrid  breath.  For  the  conuuencing 
stage  give  Arnica  ;  if  this  fails  to  relieve  the  symptoms  in  twenty-four 
hours,  give  Baptisia ;  when  the  mouth  becomes  dry  and  the  lips 
(tracked,  and  the  sordos  collects  upon  the  teeth,  give  Nitric  acid,  and 
follow  with  Argenicum ;  when  the  patient  complains  of  pain  in  the 
bowels,  and  there  are  putrescent  discharges  from  them,  give  Phos- 
phorus ;  if  there  is  involunttvry  and  painless  diarrha-a,  give  Phos- 
phoric acid  ;  in  case  of  great  prostration,  give  Arsenicum,  followed  in 
twelve  hours,  if  no  relief,  by  Muriatic  acid.  Putrid  fevers  are  often 
fatal,  and  especially  where  a  putrid  diarrhoea  is  kept  up  by  the  fever. 
For  the  distension  of  the  abdomen,  give  Nux ;  for  the  thick  and  of- 
fensive urine,  Sulphur,  Carbo  vet/.,  or  Arsenicum  ;  should  the  putrid 
stiige  pass  off,  leaving  the  patient  prostrate,  give  China,  wine,  egg- 
nog,  and  even  a  little  brandy  to  keep  up  the  vitality  of  the  system. 
The  sooner  any  one  recovering  from  this  fever  can  take  light,  solid 
aliments,  tho  better. 


-.,-»::.  ij^-i:  ..'TtOf 


MISCELLANEOUS  DISEASES. 


Relapsing  Fever. 

A  FEVER  has  lately  made  its  appearance  in  some  of  our  large 
cities,  having  all  the  characteristics  of  a  common  typhoid  tha.  appar- 
ently passes  through  all  its  stages,  and  then  reproduces  itself, 
and  the  same  round  occurs  again.  7  ach  siege  lasts  about  se. 'en 
davs  Several  of  these  in  succession  make  the  condition  ot  the  pa- 
tient precarious,  and  the  prognosis  unfavorable.  The  treatment  is 
with  stimulants,  and  the  usual  remedies  for  low  fevers,  such  as  Ars., 
Carbo  vegetabilis,  Bryonia,  and  Rhus  tox.  Doses  as  usual,  and  repe- 
tition of  the  remedy  selected,  every  three  hours.  A  stimulating  diet 
always  required. 

Black  Tongue. 

In  warm  climates  and  in  a  low  country,  there  are  biliary  derange- 
ments, accompanied  with  low  fever,  and  a  black  coating  upon  the 
tongue.  This  is  what  is  termed  the  Black  Tongue.  Carho  veg.  has 
been  given  freely,  even  the  crude  powder,  a  teaspoonful  at  a  dose. 

Black  Vomit. 

This  is  another  bilious  disease,  that  results  from  superabundance 
of  carbon  in  the  blood,  and  a  wretched  derangement  of  the  liver  and 
stomach,  which  causes  copious  vomitings  of  black  bile.  ArBmicum, 
given  every  hour,  has  remedied  this  difficulty.  After  the  vomiting  is 
arrested  by  the  use  of  Arsenicum,  give  Carbo  veg.,  China,  Khm,  or 
Bryonia.  Whichever  remedy  is  selected  by  the  indications  should 
be  repeated  every  hour  or  two  hours,  until  complete  recovery  takes 
placef  As  soon  as  the  patient  can  take  nourishment,  give  beet-tea 
and  other  nourishing  soups,  and  then  more  solid  aliments. 

Nightmare.  —  Incubus. 

The  characteristic  symptoms  of  this  distressing  condition  are  semi- 
consciousness, and  a  sense  of  inability  to  extricate  one  s  sell  trom 
some  imaginary  weighs,  or  seizure.     It  may  be  caused  by  some  detect 

690 


MISCELLANEOUS   DISEASES. 


691 


8EASE8. 


r. 

ce  in  some  of  our  large 
imon  typhoid,  that  appar- 
then   reproduces   itself, 
siege  lasts  about  se^'en 
!  the  condition  of  the  pa- 
rable.    The  treatment  is 
low  fevers,  such  as  Ars., 
Doses  as  usual,  and  repe- 
ours.    A  stimulating  diet 


there  are  biliary  derange- 
,  black  coating  upon  the 

Tongue.  Carbo  veg.  has 
J,  teaspoonful  at  a  dose. 


lilts  from  superabundance 
angemen\;  of  the  liver  and 
f  black  bile.  ArsHnicim, 
ty.  After  the  vomiting  is 
hrbo  veg.,  China,  Rhus,  or 
by  the  indications  should 
1  complete  recovery  takes 
[lourishment,  give  beef-tea 
3  solid  aliments. 

cuhus. 

ressing  condition  are  semi- 
extricate  one's  self  from 
y  be  caused  by  some  det'ei;l 


in  the  circulation  or  indigestion.  The  sufferer  is  generally  supposed 
to  be  asleep ;  but  in  some  cases,  he  knows  when  persons  are  about 
him,  and  yet,  unless  he  is  spoken  to  or  moved,  or  by  effort  himself 
can  voluntarily  move  his  foot  or  hand,  he  is  liable  to  remain  spell- 
bound, under  a  sense  of  weight  or  oppression.  To  relieve  one  when 
thus  affected,  turn  or  shake  him.  The  remedies  that  may  be  em- 
ployed to  prevent  nightmare  are  Aconite,  when  there  is  a  feverish 
condition  of  the  system  ;  Nux  vomica,  when  there  is  indigestion ;  and 
also  Pulsatilla  and  Sulphur, 

Hysteria. 

This  is  a  name  applied  to  a  great  variety  of  nervous  derangements, 
that  for  the  most  part  are  dependent  upon  nervous  debility.  It  may 
manifest  itself  in  an  irresistible  inclination  to  weep  or  laugh ;  some- 
l/iraes  in  fainting  and  spasms,  shortness  of  breath,  screeching  and  a 
sensation  of  choking.  Aconite  will  sometimes  quiet  the  nerves ;  Ig- 
natia,  if  there  is  an  inclination  to  weep  ;  Hyo»cyamu»,  if  inclined  to 
laugh  ;  Pulsatilla,  if  connected  with  the  menstrual  period.  For  hys- 
teric mania,  Hyoscyamus,  Stramonium  or  Belladonna.  Either  of  the 
remedies  may  be  given  in  the  usual  dose,  and  repeated  every  two  Ox 
three  houi-s  until  relief  is  obtained ;  and  it  is  also  recommended  that 
such  persons  ride  out  in  the  open  air  and  seek  change  of  scene. 

Hydrophobia.  —  Babies. 

The  bite  of  rabid  dogs  is  productive  of  this  disease.  The  poison 
communicated  by  the  bite  may  remain  in  the  system  for  an  indefinite 
period ;  and  then  all  at  once,  the  sight  of  water  or  some  polished 
meta^  will  throw  the  victim  into  indescribable  distress  and  madness, 
which  are  apt  to  increase  and  terminate  in  death.  A  dread  of  water 
is  an  unmistakable  sign  of  the  disease.  When  one  is  bitten  by  a  rab- 
id animal,  the  effect  may  be  extinguished  by  an  immediate  resort 
to  cauterization.  A  heated  poker  brought  as  near  to  the  wound  as 
possible  without  contact  is  l^lieved  to  be  effectual  in  destroying  the 
poison ;  or  the  application  of  Nitrate  of  Silver  immediately  may  also 
have  the  same  effect.  Hydrophobia  has  been  cured  by  the  persistent 
use  of  Belladonna  in  the  usual  dose,  repeated  every  hour  or  two 
hours  for  several  days ;  Hyoscyamus  may  also  be  employed  in  the 
same  wp"  ;  Cantharis  has  been  recommended  as  an  antidote  to  rabies. 
Lachesis,  and  even  copious  draughts  of  whiskey,  have  been  found 
useful.  Nothing  however,  has  been  found  more  salutary  as  an  im- 
mediate resc.  t  than  dry  or  radiating  heat,  unless  the  patient  is 
immediately  under  the  Pasteur  treatment,  which  operates  on 
theory  that  rabies  is  a  germ-disease,  and  has  proved  very  successfi.. 
Tliere  is  a  special  hospital  for  the  Pasteur  treatment  in  New  York 
City 


( 


AFFECTIONS  OF  THE  MIND. 


It  is  well  known  to  physiologists,  that  soundness  of  mind,  as  well 
as  entire  soundness  of  body,  indicates  a  condition  of  perfect  health. 
The  two  are  so  intimately  blended,  that  one  can  hardly  exist  without 
the  other,  and  vice  versa.  An  unsound  condition  of  the  physical  sys- 
tem is  often  attended  with  manifest  unsoundness  of  mind.  It  is  not 
intended  to  include  the  mental  phenomena  frequently  attendant  on 
acute  fevers,  as  in  nervous,  scarlet  and  other  fevers,  but  such  only  as 
appear  to  exist  as  the  chief  symptom  of  disturbance  in  the  entire  sys- 
tem ;  and  we  will  begin  with  simple 

Mental  Derangement. 

What  is  understood  by  mental  derangement  is  a  disordered  mind, 
which  may  have  been  occasioned  by  one  or  more  of  a  variety  of  causes. 
It  is  indicated  by  irrational  expressions  of  illusory  notions,  incoherent 
ideas,  strange  fancies,  and  not  infrequently  by  vicious  inclinations. 
There  is,  nevertheless,  some  specific  cause  for  every  case  of  mental 
alienation  that  occurs ;  and  the  treatment  has  to  be  adapted  with 
reference  to  the  cause,  when  there  is  a  chain  of  circumstances  that 
indicates  it.  Nevertheless,  the  cause  is  not  always  apparent,  and 
therefore  particular  symptoms  must  be  our  guide  in  affiliating  reme- 
dies. When  insanity  takes  the  form  of  rage,  and  the  patient  appears 
to  be  governed  by  angry  and  revengeful  feelings,  and  is  inclined  to 
utter  imprecations  and  threats  towards  his  best  friends,  give  Aconite 
in  daily  doses.  If  his  face  appeai-s  flushed,  an^  his  eyes  suffused,  and 
exhibit  a  fiery  red  appearance,  give  Belladonna.  If  in  a  scrofulous 
subject,  give  Caloarea.  If  strange  fancies  seem  to  beset  the  patient, 
or  complaints  are  made  of  illusory  sights,  give  Hyo%cyamu».  If  the 
patient  is  inclined  to  run  away  from  home,  or  hide  in  soi-ic  secret 
place,  give  a  dose  of  Sulphur,  and  follow  with  a  few  doses  of  Stra- 
moniwm  every  three  or  four  hours.  If  the  patient  seems  depressed, 
and  sighs  frequently,  give  Laehesis.  If  much  distress  is  evinced, 
and  there  is  defective  nutrition,  give  Nux  vomica.  For  violent  rage, 
followed  by  soporific  sleep,  give  Opium.  If  the  patient  laughs  and 
talks  continually,  give  Hyoscyamus  ;  or  if  given  to  crying,  sobbing  or 
constant  weeping,  give  Ignatia.     If  the  patient  is  subject  to  cold 

692 


.1^,:', 


AFFECTIONS   OF  THE   MIND. 


693 


[E  MIND. 


undness  of  mind,  as  well 
dition  of  perfect  health, 
can  hardly  exist  without 
ition  of  the  physical  sys- 
iness  of  mind.  It  is  not 
frequently  attendant  on 
r  fevers,  but  such  only  as 
irbance  in  the  entire  sys- 


lent. 

lent  is  a  disordered  mind, 
lOre  of  a  variety  of  causes, 
lusory  notions,  incoherent 
r  by  vicious  inclinations, 
for  every  case  of  mental 
has  to  be  adapted  with 
lin  of  circumstances  that 
lot  always  apparent,  and 
guide  in  affiliating  renie- 
B,  and  the  patient  appears 
jlings,  and  is  inclined  to 
best  friends,  give  Aconite 
m^  his  eyes  suffused,  and 
m,na.  If  in  a  scrofulous 
seem  to  beset  the  patient, 
rive  Hyo%cyamu8.  If  the 
I,  or  hide  in  sOiie  secret 
ith  a  few  doses  of  iitra- 
patient  seems  depressed, 
luch  distress  is  evinced, 
omica.  For  violent  rage, 
f  the  patient  laughs  and 
iven  to  crying,  sobbing  or 
atieut  is  subject  to  cold 


sweats,  give  Veratrum.  If  thirsty,  give  Arsenicum.  If  there  is  great 
weakness  and  prostration,  give  China.  If,  during  p-iroxysms  of  rage, 
there  is  intense  perspiration,  give  Mercurius.  Disposition  to  suicide, 
Aurum.  None  of  the  medicines  need  be  repeated  oftener  than  twice 
a  day.  Great  care  should  be  taken  to  keep  the  stomach  of  the  pa- 
tient at  ease,  by  furnishing  for  it  light  but  nutritious  food. 

Mania  ProduceU  by  Depression  of  Spirits. 

Protracted  Qrief.  —  Extreme  mortification  or  chagrin,  or  intense 
anger,  may  end  in  mental  derangement.  When  grief  wears  out  the 
^ind,  and  strange  fancies  begin  to  show  themselves,  give  Ignatia. 
When  great  mortification  on  account  of  some  exposure  to  censure  or 
on  account  of  some  humbling  of  family  pride,  give  Pho».  acid.  When 
disappointment  unsettles  the  mind,  and  chagrin  gives  rise  to  insane 
imaginings,  give  Pulsatilla  ;  or,  if  there  is  a  manifest  inclination  to 
hide  away  from  friends,  give  Sulphur,  and  follow,  in  four  or  six 
hours,  with  a  dose  of  Hyoscyamus.  If  the  face  is  red,  and  the  temples 
beat  and  throb,  give  Belladonna.  When  excessive  anger  and  general 
moroseness  of  spirit  ensue,  with  general  antipathy  towards  every  one, 
give  Sulphur^  and,  in  six  hours,  follow  with  a  few  doses  of  Nux  vomica. 

Mania  from  Excited  Emotions.    . 

The  mind  is  often  beset  with  emotions  of  one  kind  or  another,  that 
often  tend  to  unsettle  and  derange  it.  Anguish  or  foreboding  often 
has  this  disastrous  effect,  and  one  of  the  principal  remedies  is  Aconite. 
If  there  is  an  attending  inclination  to  weep,  give  Ignatia.  If  there  is 
dullness  or  stupor,  give  Opium,  or  if  in  females,  give  Pulsatilla.  If 
mania  is  produced  by  fright,  give  Aconite,  Coffea  or  Nux  vom.  When 
fear  unsettles  the  mind,  give  Lachesis,  Hyoscyamus,  Gelsemium,  Opium 
or  Pulsatilla.  When  excessive  joy  produces  derangement  of  the  men- 
tal faculties,  and  gpives  rise  to  strange  fancies,  give  Coffea,  Opium  or 
Punatilla.  When  homesickness  unsettles  the  mind,  give  Phos. 
acid.  When  fancied  neglect  of  friends  distracts  the  imagination, 
give  Causticum  or  Capsicum.  For  unhappy  love,  and  the  derange- 
ment of  mind  consequent  thereon,  give  Hyoscyamus,  Ignatia  or  Pho»^ 
phoric  acid,  or,  perhaps,  Coffea  or  Nux  vom. 

If  disappointed  affection  or  any  cause  produces  the  mania  of  sui- 
cide, give  Aurum.  If  excessive  jealousy  ends  in  mania,  give  Hyos- 
cyamus.  If  rage  ensues  upon  insults,  give  Veratrum  alb..  Belladonna 
or  Chamomilla ;  if  upon  contradiction,  give  Aconite,  and  afterwards 
Ignatia  or  Nux  vom.  For  thj  concomitant  symptoms  of  insanity 
from  excited  emotions,  give  Aconite  when  there  is  headache,  feverish 
heat  or  tendency  of  the  blood  to  the  head.  Give  Belladonna  when 
there  is  loss  of  consciousness,  or  constant  anxiety,  with  fear,  weeping, 
howling  and  malice  (in  children),  and  also  when  Aconite  and  Opium 


J 


694 


AFFECTI0K8  OF  THB   MIND. 


had  proved  insufficient  for  the  consequences  of  flight  Gi^  3  Bryonin 
when  there  is  chilliness  and  shuddering  over  tlie  whole  body,  gieat 
tendency  to  vehement  anger,  loss  of  appetite,  nausea,  vo  iting  und 
bilious  state  in  consequence  of  anger.  Give  Cajmeum  fo-  sleepless- 
ness caused  by  homesickness,  with  heat  and  redness  of  iie  cheeks. 
Give  Chamomilla  when  anger  produces  bitter  taste  of  lae  mouth, 
nausea,  disposition  to  start,  and  vomiting  of  bilious  mati;er.  Give 
Coffea  when  there  is  much  nervous  excitement  after  great  joy.  Give 
Ooloeynth  when  chagrin  or  mortification  produces  spasmo^nc  colic  or 
cramps.  Should  this  condition  persist,  give  Causticum.  »  Hve  Hyo»- 
cyamui  when  fear  produces  stupefaction  or  convulsions, :' nvoluntaiy 
laughter  during  sleep,  or  a  desire  to  run  away.  Give  Ignatia  for 
grief,  disappointment,  or  unhappy  love,  when  there  is  deep,  gnawing, 
irresistible  grief,  vomiting,  headache,  vertigo,  pale  face,  convulsions 
or  epilepsy,  and  in  children  when  they  occur  from  the  sho'k  of  fright 
or  fear.  When  homesickness,  fright  or  mortification  is  atl '.  nded  with 
great  anguish,  restlessness  and  trembling,  or  sudden  stii  ting  from 
sleep,  or  accelerated  circulation  on  the  least  exertion,  si  aplessness 
and  inability  to  bear  the  warmth  of  the  bed,  great  ner  /ousness,  a 
disposition  to  be  quarrelsome,  and  to  complain  of  everyl  ody  as  being 
hateful,  and  the  patient  takes  a  dislike  to  his  own  family,  and  wishes 
to  leave  them,  and  also  when  there  is  shivering  and  night-sweats, 
give  Mercurius.  Give  Nux  vomica,  when,  after  an  angry  fit,  there  is 
chilliness'without  heat.  Give  Opium  when  diarrhoea  follows  exces- 
sive joy  or  fear,  or  when  a  sudden  start  or  fright  produces  sudden 
and  involuntary  diarrhoea,  with  heaviness  of  the  abdomen.  For 
chronic  diarrhoea  from  fright,  Oehemium.  Give  Phosphoric  acid  in 
all  cases  after  deep  grief,  homesickness,  or  unhappy  lov<^.  when  the 
patient  is  taciturn,  dull  or  listless, and  has  a  constant  de^  .le  to  sleep, 
and  has  night-sweats  towards  morning,  after  hectic  fever  sa  the  even- 
ing. Give  Pulsatilla  when  fear  produces  cold  hands  and  feet.  Give 
Veratrum  album  when  any  emotional  excitement  produces  diarrhoea 
or  involuntary  evacuations  from  the  bowels,  with  coldness  of  the 
whole  abd.omen. 

Morbid  Emotions. 

A  CELKBRATED  writer  on  insanity  considers  all  morbid  emotions 
under  this  head,  £.nd  for  this  reason :  that  all  morbid  states  of  the 
mind  may  become  so  augmented  as  to  result  in  complete  mania  or 
monomania.  It  is,  therefore,  well  to  understand  the  best  method  of 
bringing  remedial  action  to  bear  upon  the  first  departure  from  sound 
health  of  any  faculty  or  emotion  of  mind.  For  anguish  or  anxiety, 
no  remedy  seems  better  adapted  than  Arsenicum,  to  be  given  morn- 
ing and  evening,  or  perhaps,  Pulsatilla  for  females  at  the  menstrual 
period,  or  Veratrum  album  for  very  weak  and  exhausted  persons. 
For  apprehension  or  fear,  give  Aconite  morning  and  evening,  espe- 
cially if  the  ^ufEerer  is  a  plethoric,  full-blooded  person.     Give  Bdlor 


IND. 


AFFECTIONS   OF   THE   MIND. 


695 


of  fright.  Gi\  iBryoin'ii 
er  the  whole  body,  git'at 
te,  nausea,  vo  iting  iiiid 
e  Capsurum  fo-  sleepless- 
d  redness  of  tie  cheeks, 
tter  taste  of  me  mouth, 
of  bilious  maioer.  Give 
ent  after  great  joy.  Give 
)duces  spasmo'-ic  colic  or 

Causticum.    <  Hve  Hyos- 

convulsions,  involuntary 

away.     Give  Ignatia  for 

m  there  is  deci),  gnawing, 

JO,  pale  face,  convulsions 

r  from  the  sho'k  of  fright 

tification  ia  ati'.  nded  with 

or  sudden  stii  ting  from 

ist  exertion,  si  oplessness 

bed,  great  ner  .'ousness,  a 

ain  of  everyl^ody  as  being 

is  own  family,  and  wishes 

ivering  and  inght-sweats, 

after  an  angry  fit,  there  is 

diarrhoea  follows  exces- 
r  fright  produces  sudden 

of   the   abdomen.     For 

Give  Phosp^tric  acid  in 
[•  unhappy  lov -.  when  the 
a  constant  de  .ve  to  sleep, 
r  hectic  fever  va  the  even- 
sold  hands  and  feet.  Give 
ioment  produces  diarrhea 
els,  with  coklness  of  the 


IS. 

iders  all  morbid  emotions 
;  all  morbid  states  of  the 
ult  in  complete  mania  or 
rstand  the  best  method  of 
first  departure  from  sound 
,  For  anguish  or  anxiety, 
miavm,  to  be  given  mom- 
'  females  at  the  menstrual 
k  and  exhausted  persons, 
orning  and  evening,  espe- 
oded  person.     Give  Bfll<tr 


donna  to  one  who  suffers  much  from  ht-adache,  or  rush  of  blood  to 
the  head ;  or  Bryonia  if  there  is  anxiety,  with  heat  of  the  chest  and 
difficult  respiration ;  or  Hyoscyamus  for  anxiety  about  one's  safety,  or 
religious  anxiety;  or  Opium  for  a  kind  of  anguish  and  depression  of 
spirits  that  confuses  one's  ideas,  and  is  attended  by  a  stupidity  and 
headache.  When  one  is  constantly  vexed  and  irritable,  it  may  be  in- 
ferred that  a  corresponding  physical  condition  requires  Arsenicum 
once  or  twice  a  day,  or  perhaps  Nux  vomica.  Jynatia  is  suitiible  when 
there  is  a  tendency  to  be  vexed,  and  to  Aveep  on  account  of  trifles. 
For  one  always  in  hiiste  to  get  angry  without  reason,  give  Aurum  or 
Sulphur.  When  one  is  morbidly  suspicious  and  distrustful,  and,  in 
fact,  is  a  hater  of  his  fellow-men,  and  wishes  to  avoid  every  one,  and 
to  spend  his  time  in  seclusion,  give  Arsenicum^  Hyoscyamus,  Pulsa- 
tilla or  Rhus  tox.  For  nervous  excitement,  which  may  lead  to  men- 
tpl  derangement,  give  Aconite  or  Pulsatilla;  and  especially  if  there 
is  great  tendency  to  start.  For  a  morbidly  malicious  disposition, 
give  Belladonna^  Hyoscyamus  and  Lachesis.  For  a  disposition  to  kill 
somebody,  or  to  commit  acts  of  violence,  give  Stramonium,  Bella- 
donna or  Veratrum  alburn^  morning  and  evening  until  a  change.  For 
a  morbid  disposition  to  be  audacious  or  impertinent,  give  Ignatia, 

Opium  or  Sulphur.  For  headstrong  obstinacy  and  disposition  to  be 
quarrelsome,  give  Belladonna,  Nux   vomica,  Ignatia,   Lachesis   and 

Veratrum.  For  an  artful  disposition  or  an  involuntary  disposition 
to  practise  deception  with  no  definable  motive,  give  Lachesis  and 
Nux  vomica.  When  the  mind  is  either  beset  with  fancies  or  fixed 
ideas,  give  Belladonna,  Cocculus,  Stramonium  or  Sulphur.  For  sad 
and  melancholic  fancies  and  forebodings,  give  Calcarea,  China  or 
Pulsatilla,  and  Petroleum.  For  a  morbidly  serious,  silent  and  un- 
talkative  disposition,  give  Belladonna,  Hyoscyamua  and  Pulsatilla. 
For  morbid  indifference  and  apathy,  give  Arsenicum  morning  and 
evening,  or  else  Phosphoric  acid.  Sepia  and  Sulphur,  in  daily  doses. 
Moaning  and  lamenting  without  any  special  cause  indicates  a  degree 
of  insanity  that  demands  prompt  attention ;  and  Hyoscyamus  may  be 
given  three  times  a  day,  or  else  Chamomilla,  Coffea  or  Ignatia.  De- 
spondency, despair  and  being  tired  of  life,  as  well  aa  an  inclination 
to  suicide,  are  severally  affections  of  the  mind  that  are  subject  to 
medical  treatment.  Arsenicum  may  be  given  morning  and  evening 
for  despair.  Lachesis  for  despondency,  especially  where  there  is  sigh- 
ing, as  if  something  awful  was  weighing  upon  the  mind.  For  incli- 
nation to  commit  suicide,  give  Aurum  and  Arsenicum,  especially  if 
there  is  great  anguish,  melancholy  and  morbid  disgust  of  life.  For 
one  simply  tired  of  life,  and  anxious  to  get  out  of  this  world  by  natu- 
ral death,  give  China.,  Lachesis  or  Nitric  acid.  For  illusions  and  illu- 
sory notions,  showing  mental  difficulties,  give  Lachesis,  China  or  Pul- 
satilla. Many  of  these  mentjvl  difficulties  are  the  result  of  selfishness 
or  mortified  self-love,  and  can  be  overcome  by  strong  determination 
of  the  will  and  moral  training,  which,  of  couree,  involves  more  or 
less  of  self-denial. 


\ 


696 


AFFECTIONS    OF   TllK    MIND. 


» 


Religious  Mania. 

Tms  mental  affection  is  simply  a  morbid  excitation  of  religious 
sentiment  and  feelings,  producing  strange  and  fanciful  ideas  of  God, 
heaven  and  the  importance  of  certain  missions  to  which  the  victims 
believe  themselves  specially  called.  Religious  mania  is  characterized 
by  morbid  inclination  to  be  always  singing,  praying,  preaching  and 
performing  religious  rites,  out  of  time  and  place,  and  in  a  discon- 
nected and  incoherent  manner.  The  cause  of  this  mental  affection 
may  be  excitement  upon  religious  t-opics,  or  during  what  is  ordinarily 
tenned  religious  revivals.  The  effect  of  anything  of  the  kind  is  to 
unsettle  the  healthy  condition  of  the  nerves  and  that  of  the  nutritive 
system.  For  religious  mania  in  general,  give  Hyoscyamus  or  Stra- 
monium ;  for  that  which  is  attended  with  indigestion,  give  Nux  vom- 
ica; for  that  which  is  accompanied  by  torpidity  of  the  liver  and  mel- 
ancholic temper,  give  Arsenicum,  Mercuriv%,  Podophyllin  and  Ignatia. 
Let  the  patient  avoid  all  surroundings  calculated  to  unsettle  the  mind 
or  emotions. 

Hypochondria.  —  Hypochondriasis. 

Pixel  classes  hypochondria  among  the  various  forms  of  insanity, 
as  it  is  characterized  by  morbid  imaginings  concerning  one's  health. 
Sometimes  the  victim  imagines  himself  void  of  strength,  or  sadly  dis- 
eased at  the  heart ;  he  fancies  he  sees  death  staring  him  in  the  face, 
and  believes  himself  often  in  a  dying  condition,  when,  in  fact,  there 
is  not  the  slightest  reason  for  such  apprehension.  In  the  future,  all 
is  darkness :  the  next  hour,  the  next  day,  week  or  year,  is  believed  by 
him  to  be  pregnant  with  something  awful.  He  never  enjoys  a  laugh, 
for  everjrthing  is  'clothed  in  gloom.  If  the  subject  is  of  a  bilious 
temperament,  and  has  black  hair  and  eyes,  give  Mcrcurius  ;  if  of  a 
lymphatic  temperament,  and  inclined  to  obesity,  give  Pulsatilla ;  if 
of  a  sanguine  temperament,  and  has  red  hair  and  blue  eyes,  g^ive  Nux 
vom.  ;  if  addicted  to  the  use  of  intoxicating  liquors,  give  Arsenicum 
or  Nuz  vom.  ;  if  of  a  downcast  countenance,  and  subject  to  indiges- 
tion, give  Ifux  vomicoj  Lycopodium  or  Petroleum.  If  caused  by  sex- 
ual abuse,  give  China  or- Sulphur  ;  when  caused  by  sedentary  habits, 
Nux  vomica  and  Sulphur,  or  if  by  derangement  of  the  abdominal  func- 
tions and  constipation,  give  Calcarea,  Lachesis  or  Lycopodium  ;  for 
one  suffering  from  languor,  mental  dullness,  or  mental  distress  and 
discouragement,  give  China.  If  the  victim  has  the  fixed  idea  that 
he  is  unhappy  and  has  no  friends,  and  imagines  himself  surrounded 
by  enemies,  China  is  also  the  remedy.  For  a  hypochondriac  troubled 
with  weak  digestion  and  distension  of  the  abdomen,  ill-humor  and 
indolence  after  eating,  give  China  ;  when  he  laments  on  account  of 
the  future,  and  desires  to  be  alone,  give  Natrum  muriaticum  ;  when 
he  is  beset  with  ill-humor,  despondency  and  aversion  to  life,  give  Nux 


AFFECTIONS   OF   THK    MIND. 


697 


excitation  of  religious 
i  fanciful  ideas  of  God, 
18  to  which  the  victims 
I  mania  is  characterized 
praying,  preaching  and 
place,  and  in  a  discon- 
►f  this  mental  affection 
aring  what  is  ordinarily 
thing  of  the  kind  is  to 
nd  that  of  the  nutritive 
ve  Hyo»cyamu8  or  Stra- 
ligestion,  give  Nux  vom- 
ity  of  the  liver  and  mel- 
°odopkyllin  and  Ignatia. 
«d  to  unsettle  the  mind 


ondriasis. 

nous  forms  of  insanity, 
loncerning  one's  health, 
of  strength,  or  sadly  dis- 
staring  him  in  the  face, 
ion,  when,  in  fact,  there 
sion.  In  the  future,  all 
k  or  year,  is  believed  by 
le  never  enjoys  a  laugh, 

subject  is  of  a  bilious 
^ive  Mereurius  ;  if  of  a 
38ity,  give  Pulsatilla;  if 

and  blue  eyes,  give  Nux 

liquors,  give  Arsenicum 
!,  and  subject  to  indiges- 
\eum.  If  caused  by  sex- 
ised  by  sedentary  habits, 
it  of  the  abdominal  func- 
e%is  or  Lycopodium  ;  for 
,  or  mental  distress  and 

has  the  fixed  idea  that 
ines  himself  surrounded 
k  hypochondriac  troubled 

abdomen,  ill-humor  and 
3  lamfents  on  account  of 
itrum  muriatioum  ;  when 
aversion  to  life,  give  iVkr 


vomica  ;  when  with  painful  anxiety  of  mind  and  lowness  of  spirits. 
Sulphur  ;  when  he  has  great  dread  of  death,  and  is  in  restless,  whin- 
ing mood,  give  Aurum;  if  indifferent  about  his  business  or  his  own 
family,  give  Sepia.  Any  of  the  remedies  named  may  be  given  three 
times  a  day. 

Weak  Memory. 

There  are  many  conditions  of  the  physical  system  that  may  oper- 
ate to  impair  the  memory ;  the  most  prominent  of  which  are  those 
that  produce  debility,  —  such  as  loss  of  blood  and  other  animal  fluids, 
and  intense  application  of  the  mind.  When  occasioned  by  the  former, 
give  China,  Nux  vom.  and  Sulphur,  in  daily  doses  ;  when  by  the  lat- 
ter, Nux  vom.,  Pulsatilla  or  Sulphur;  if  caused  by  external  injuries. 
Arnica  or  Rhus;  if  by  inebriation,  Arsenicum,  Opium  or  Nux  vom.; 
if  caused  by  violent  emotions,  as  fright,  grief  or  anger,  give 
Aconite,  Opium,  Phos.  acid ;  if  caused  by  dampness,  give  Oarbo  vc;/., 
Rhus,  Veratrum  album;  if  by  rush  of  blood  to  the  head,  give  Bella- 
donna. In  nearly  all  instances  of  weakness  of  the  memory,  it  is  con- 
nected with  some  form  of  debility.  That  following  epileptiform  dis- 
ease requires  Sulphur;  that  following  childbirth  requires  China;  and 
also  weakness  of  memory  following  an  acute  fever,  or  any  other 
prostrating  disease,  requires  China,  Ignatia,  Nux  vom,  and  Arsenicum. 
Give  the  remedy  selected  twice  a  day. 

Hysteric  Derangement. 

The  ordinary  forms  of  hysteria  sometimes  degenerate  into  insan- 
ity. The  nervous  system  becomes  shattered,  and  such  patients  be- 
come tormented  with  all  kinds  of  fancies,  —  sometimes  sexual,  frivo- 
lous and  even  foolish.  For  hysteric  insanity  in  general,  give  Ignatia, 
Phosphorus  or  Platina ;  or,  if  attended  with  uterine  derangement, 
give  Aurum,  Crocus  or  Sepia;  for  those  tormented  with  excessive 
sexual  fancies,  give  Phosphorus,  Pulsatilla  or  Platina  ;  if  the  patient 
acts  foolishly,  with  much  frivolity  and  levity,  give  Apis  mel.;  if  fitful, 
laughing  at  one  time  and  crying  at  another,  give  Crocus  or  Stramo- 
nium; if  there  are  marked  heavings  of  the  chest,  give  Phosphorus; 
and  if  the  bowels  are  constipated,  persistant  and  tedious,  give  Lyco- 
podium; if  in  any  way  connected  with  the  menstrual  function,  give 
Pulsatilla  ;  if  the  patients  are  prone  to  lie  and  deceive,  give  Veror 
trum-  album;  wlien  they  evince  an  insane  paasion  for  work,  give 
Lachesis  and  Hyoscyamus  ;  when  full  of  suspicion  and  distrust,  give 
Hyosnyamus,  Mereurius  and  Pulsatilla  ;  if  excited  excessively  in  body 
and  mind,  give  Aconite  and  then  Nux  vomica,  after  which  give  Phos- 
phorus or  Lachesis  ;  if  disposed  to  be  imperious,  and  exliibit  a  passion 
to  order  their  friends  about,  give  Lycopodium  or  Cuprum;  if  they 
betray  a  tricky  and  malicious  disposition,  give  Nux  vom.  ;  if  there  is 
great  obstinacy,  give  Belladonna,  Ignatia ;  if  disposed  to  hide  or  be 


I 


698 


AFFECTIONS   OF   THK   MIND. 


alone,  give  Calcarea  ;  if  on  the  contrary  there  is  a  mania  for  company, 
and  a  dread  of  being  alone,  give  Arsenieum^  Lycopodium,  Phoaphorun 
and  Belladonna ;  for  great  loquacity,  give  Stramonium;  if  excessive 
mirthfulness,  give  Hyoscyamus  ;  if  there  is  a  disposition  to  obscenity, 
and  a  great  want  of  modesty,  give  HyoHeyamus,  Phosphorun  or  Vera- 
trum;  if  there  is  a  great  disposition  to  sing,  warble  or  whistle,  give 
Belladonna  or  Stramonium  ;  if  there  is  a  disposition  to  make  faces 
and  cut  antics,  give  Cuprum  or  Stramonium  ;  if  there  is  a  disposition 
to  scold  or  swear,  give  Lycopodium  ;  if  given  to  self-importance  and 
pride,  give  Cuprum  to  men  and  Platina  to  women.  Let  whatever 
remedy  is  selected  be  administered  twice  a  day.  Diet  should  be 
moderate,  and  easy  of  digestion. 


Imbecility. 

Loss  of  mind,  as  well  ais  the  derangement  of  its  faculties,  comes 
under  the  head  of  mental  difficulties.  There  are  several  causes  that 
may  operate  to  destroy  the  intellect.  Epileptic  fits  will  in  time  ren- 
der the  brain  an  unfit  organ  for  the  mind,  and  consequently  there  can 
be  but  little  power  or  force  in  the  mental  manifestation.  A  soften- 
ing of  the  brain  that  may  supervene  upon  inflammation  is  also  at- 
tended with  imbecility.  Self-pollution  is  also  a  fruitful  source  of 
mental  weakness.  Congenital  idiocy  results  from  causes  not  possible 
to  describe ;  but  many  a  bright  child  has  become  the  victim  of  idioiy 
by  the  mal-treatment  it  has  had  in  tlie  nursery.  To  quiet  crying 
children  resort  has  been  had  to  a  variety  of  sedatives,  instead  of  ex- 
ercising patience,  to  initiate  them  into  sleep  and  quietness.  How  of- 
ten do  nurses  give  poppy  or  lettuce-tea,  to  put  a  crying  infant  to 
sleep,  little  dreaming  that  they  inflict  a  permanent  injury  upon  the 
mind  of  the  child.  The  effect  of  paregoric,  soothing-sirup  and  poppy- 
cordial  is  often  disastrous,  and  the  source  of  spasms,  fits  or  convul- 
sions that  impair  the  tender  textures  of  the  brain  so  much,  that,  even 
if  the  children  live,  they  are  apt  to  be  the  victims  of  imbecility. 
Fear  and  fright  also  are  causes  of  imbecility.  If  epilepsy  is  the  cause, 
give  Cuprum  or  Sulphur  in  daily  doses,  or  else  Belladonna^  Ifelleborus, 
Lachesis,  Hyoscyamus  or  Opium.  If  caused  by  a  softening  of  the 
brain,  there  is  not  much  hope  of  the  patient  deriving  much  benefit 
from  remedies.  There  is  only  a  bare  possibility  that  the  difficulty 
may  be  arrested.  Hyoscyamus,  Sulphur  and  Apis  mel.  may  do  some- 
thing to  ward  off  total  and  hopeless  idiocy.  When  imbecility  is 
caused  by  onanism,  give  Arsenicum  or  China  twice  .a  day  ;  when  by 
sexual  excesses,  give  Nux  vomica  every  evening,  and  Sidphur  every 
morning ;  when  from  the  effects  of  opium,  a  persistent  coui-se  of  I'e- 
storative  treatment  must  be  decided  upon.  Give  Coffea,  in  usual 
doses,  every  three  hours  ;  give  also  Sulphur,  in  the  full  strength  of 
the  tincture,  in  drop  doses  ;  also,  give  Ammonia  curb.,  and  when  from 
the  use  of  other  narcotics,  give  J^ux  vomica  or  Jgnatia, 


ND. 

3  is  a  mania  for  compiiny, 

Lycopodium,  Phosphorus 

Stramonium;  if  excessive 

i  disposition  to  obscenity, 

mu8,  Phosphorus  or  Vera- 

T,  warble  or  whistle,  give 

lisposition  to  make  faces 

;  if  there  is  a  disposition 

en  to  self-importance  and 

o  women.     Let  whatever 

a  day.     Diet  should  be 


nt  of  its  faculties,  comes 
sre  are  several  causes  that 
eptic  fits  will  in  time  ren- 
id  consequently  there  can 
manifestiition.     A  softeu- 
.  inflammation  is  also  at- 
also  a  fruitful  source  of 
3  from  causes  not  possible 
jcome  the  victim  of  idiocy 
lursery.     To  quiet  crying 
f  sedatives,  instead  of  ex- 
p  and  quietness.    How  ol- 
io put  a  crying  infant  to 
jrmanent  injury  upon  the 
soothing-sirup  and  poppy- 
of  spasms,  fits  or  convul- 
)  brain  so  much,  that,  even 
the  victims  of  imbecility. 
y.   If  epilepsy  is  the  cause, 
ihe  Belladonna^  ffelleborus, 
jed  by  a  softening  of  the 
int  deriving  much  benefit 
isibility  that  the  difficulty 
id  Apis  mel.  may  do  sorae- 
ocy.      When  imbecility  is 
ina  twice  .a  day  ;  when  by 
/ening,  and  Sidphur  every 
,  a  persistent  coui-se  of  re- 
on.     Give  Coffea,  in  usual 
Mr,  in  the  full  strength  of 
monia  curb.,  and  when  from 
?a  or  Jgnatia, 


AFKKCTI0N3  OK  TIIK  MIND. 


Monomania. 


699 


This  term  signifies  insanity  upon  a  single  matter,  when  in  every 
other  respect  the  mind  is  sound.  ♦When  a  single  idea  seizes  the  mind, 
and  morbidly  dwells  there,  however  erroneous,  it  is  difficult  to  dis- 
lodge it.  Sometimes  a  most  singulaf  and  absurd  idea  will  be  cher- 
ished ;  as  that  one  is  dead.  Dr.  William  Rush  once  had  a  patient  in 
Pennsylvania  hospital,  who  claimed  to  be  dead ;  and,  after  exhaust- 
ing his  ingenuity  to  convince  him  of  the  contrary,  he  told  him  ab- 
ruptly that  he  was  dead,  and  should  be  buried ;  for  he  would  not 
have  his  stinking  remains  there  to  pollute  the  room  any  longer.  This 
had  the  tendency  to  fire  up  the  anger  of  the  pretended  dead  man ; 
and,  on  cooling  down,  this  singular  illusion  left  him.  The  treatment 
of  monomania  is  for  the  most  part  moral.  It.  is  never  prudent  to  con- 
tradict the  patient,  or  to  show  disfavor  to  any  absurd  idea  that  may 
be  besetting  him,  but  rather  to  indulge  him  in  it.  A  celebrated 
French  writer  on  this  malady  says  of  a  case  at  the  Mnison  des  Inva- 
lides,  that  he  fancied  that  if  he  urinated,  it  would  cause  a  flood ; 
and,  after  finding  that  the  patient  must  die  unless  there  was  an  evac- 
uation of  the  bladder,  the  attendant  hit  upon  the  idea  of  crying 
"  Fire  !  "  and  exclaiming  at  the  top  of  his  voice  that  the  city  was  on 
fire,  and  wanting  in  water  to  extinguish  it,  said  to  the  patient,  "  to 
let  the  flood  come  "  ;  it  was  wanted  to  save  the  city  from  ruins ;  and 
this  appeal  had  the  desired  effect.  For  a  mania  to  kill  some  one  per- 
son, under  the  idea  that  it  must  be  done,  Arsenicum  has  apparently 
proved  to  be  a  remedy.  In  a  case  quite  similar,  Lachesis  proved  of 
great  service.  For  some  of  the  fixed  ideas  in  monomania,  remedies 
may  have  a  good  effect.  When  one  has  the  idea  of  being  great  above 
all  created  beings,  give  Aconite  or  Conium.  When  orte  has  an  idea 
that  he  is  hated,  and  his  mind  appears  sound  in  other  respects,  give 
Aurum  or  Ignatia.  When  he  is  tormented  with  the  idea  that  his 
family  or  friends  are  all  conniving  against  him,  and  appears  sane  on 
other  subjects,  give  Sulphur  and  then  Nux  vom.  If  he  seems  right 
on  all  questions,  except  that  his  mind  is  cogitating  theft,  so  that  he 
has  an  irresistible  inclination  to  steal  when  occasion  offers,  give  Sul- 
phur^ Pulsatilla. 


SURGICAL  DISEASES. 


Concussion  of  the  Brain. 

This  is  the  result  of  a  fall  or  blow,  and  may  be  relieved  by  Arnim, 
usual  dose,  and  repeated  if  necessary.  Should  stupor  and  uiability 
to  retain  food  persist,  try  Glonoin. 

Concussion  of  the  Chest. 

This  may  be  produced  bysome  sudden  mechanical  injury.  If  there 
is  fever,  give  Aconite  every  three  hours.  If  from  having  been  com- 
pressed mechanically,  Arsenicum  may  prove  serviceable  ;  and  so  may 
Arnica,  PuUatilla,  and  Nux  vomica,  Bryonia,  and  Ohma.  Any  ot  the 
remedies  selected  may  be  given  in  the  usual  dose  every  three  houi-s. 
In  all  cases  let  the  diet  be  simple,  and  use  friction  externally;  and 
when  there  has  been  a  blow  upon  the  head  causing  the  concussion, 
pour  a  stream  of  cold  water  from  a  small  pitcher  or  cofiee-pot  tor 
thirty  or  forty  seconds. 

Sprains. 

A  SPRAIN  may  be  more  or  less  severe.  Sometimes  it  may  impli- 
cate only  the  muscles,  and  at  others  the  ligaments,  involving  the  ap- 
paratus of  the  joints.  A  sprain  of  the  wrist  requires  Arnica,  inter- 
nally and  externally  at  first,  and  then  a  compress  of  tepid  water, 
covered  with  a  dry  bandage.  A  sprain  of  the  hip-joint  or  shoulder- 
joint  requires  Ledum,  with  a  lotion  of  the  same  of  twenty  drops  to 
half  a  tumbler  of  water,  applied  by  means  of  wetting  with  it  a  com- 
press, covered  with  a  dry  bandage.  A  sprain  of  the  knee-joint  should 
be  treated  with  Arnica,  externally  and  internally,  as  above,  and  also 
with  Pulsatilla  after.  Sprains  of  the  ankles  are  soonest  cured  by 
applying  compresses  of  cold  wat«r,  and  dry  bandages  over  them,  and 
by  the  administration  of  Ledum  internally.  Should  this  fail,  use 
Bryonia. 

Injury  of  a  Nerve. 

The  place  which  Arnica  has  in  surgery  in  the  treatment  of  ordinary 
bruises  and  sprains  is  of  no  greater  importance  than  that  of  Hypen- 

700 


8UKOICAL    DI8KASE8. 


701 


ASE8. 


Brain. 


nay  be  relieved  by  Arnim, 
luld  stupor  and  inability 


Chest. 

lechanical  injury.  If  there 
[f  from  having  been  coni- 
3  serviceable  ;  and  so  may 
I,  and  China.  Any  of  the 
x\  dose  every  three  hours. 

friction  externally;  and 
,d  causing  the  concussion, 

pitcher  or  coffee-pot  for 


Sometimes  it  may  impli- 
jaments,  involving  the  ap- 
ist  requires  Arnica,  inter- 
compress  of  tepid  water, 
the  hip-joint  or  shoulder- 
same  of  twenty  drops  to 
of  wetting  with  it  a  com- 
m  of  the  knee-joint  should 
ernally,  as  above,  and  also 
ties  are  soonest  cured  by 
■f  bandages  over  them,  and 
ly.     Should  this  fail,  use 

rve. 

a  the  treatment  of  ordinary 
bance  than  that  of  Hyperi- 


sionlf'f '''"'t?  ''PP^''^  ^"'^""^^y  ^  ^"J""««  involving  the  nerves 
Shocks  upon  the  nervous  system,  injuries  to  the  sninf,  or  fronTex 

ruTdCandluor  ^  ^^^^^'-^  ^"^-"^  -^  «--4"in  the 

Wounds. 

WotjNDs  are  of  various  kinds  ;  such  as  incised,  lacerated  Duno- 
tured,  gun-shot  wounds,  etc.  A  simple  incised  wound  Ss  on Ivtht 
sides  pressed  together,  and  compressed  with  a  strirT  adhes  ve 
planter.     The  application  of  Calendula  externally  will^acilitate    he 

T^T    ^\"^.r'r^  ^'"""l^«  ^'^^"'^^  «"^«f"l  adjusLent  and  dressing 
and  then  let  the  Iressing  be  wet  frequently  with  a  dilute  tinctuTof 
Oalefula;  and  where  it  is  supposed  the  trunks  of  ne^es  are -mP" 
cated  use  Ilypencum.  Any  of  these  remedies  may  be  used  intemX 
in  the  usual  dose,  three  times  a  day.     Contused  wounds  reSe  com 

cZZ^^^i'"'-'^'  ^""^  ^m^ca/ while  Arnica,  Muta,  ^TLpZ- 
cum  may  be  administered  in  the  usual  form  internally.  ^^ 

Hemorrhage  from  Wounds. 

nJ^/^J^^I  protracted  hemorrhage  from  wounds,  give  Amicd  or 
(7afeni«/a  internally,  and,  with  a  lotion  of  forty  dr^p^  of  eiTher  L 
half  a  tumbler  of  water,  wet  compresses,  and  apply  externally 

Hernia,  or  Rupture. 

There  are  two  kinds  of  rupture  met  with  among  peraons  One  is 
termed  the  femoral,  and  is  near  the  groin;  and  fnSr  i^  termed 
umbilical,  and  is  near  the  navel.  There  is  a  third  kind  whme  the 
Trnif  T.^  into  the  scrotum;  and  it  is  temed  scrSl  or tig^^^^^^^ 
hernia  When  either  has  been  of  long  standing,  well-adjusted  trusses 
must  be  worn  or  else  for  scrotal  hernia,  a  susp;nsoiy  £kg^ 
recent  inclination  to  rupture.  Aconite  will  subdue  any  inflammato^ 
symptoms.  Arnica,  if  caused  by  a  strain  ;  Nux  vomica  TZl.?f 
constipation  of  the  bowels.  The^emedies  ^sSca  ed  i;  be^ven 
m  the  usual  dose  three  or  four  times  a  day.  For  stranguTted  hSZ 
iVk...m  every  half-hour;  and  if  this  affords  no  relif,^^^^^ 
same.  Lycopodzum  and  Sulphur  follow  these  well,  given  thfeeTiiZ 
daily.    Ihe  patient  should  be  in  a  recumbent  post^fe  uporflhe  Zt. 

Luxations,  or  Dislocations. 

These  consist  in  the  removal  of  the  head  of  the  bone  from  its  cor- 

a  th?i?"^  "t'J'/'i"".  *^"  ^''^'-     ^f*-  dislocatToilsT 
duced,  the  joint  may  be  bathed  with  a  lotion  of  forty  drops  of  the 

tincture  oi  Aconite  in  half  a  tumbler  of  water,  whi  Jfour^gloUes 

may  be  used  internally  to  allay  any  febrile  excitement. "  Arnica  lotion 


'  '.iiafe«ajfi!««*se'«- 


».*•,-»•-'■■—■ 


702 


SURGICAL  DIHKASES. 


' 


prepared  and  used  in  the  same  way  will  relieve  the  soreness.  The 
usual  dose  of  this  remedy  may  be  administered  internally,  and  re- 
peated two  or  three  times  a  day.  To  remove  the  pain  and  suffering 
of  luxations  in  general,  Arnica,  Aconite,  and  Rhus  tox.  may  be  given 
-  as  required. 

Fractures. 

When  there  is  a  separation  of  bony  fibres,  either  simple  or  com- 
plicated, and  the  fracture  has  lieeu  properly  reduced  and  bandaged, 
and  splints  have  been  culled  into  requisition  to  aid  the  system  in  re- 
covery from  the  shock,  give  two  or  three  doses  a  day  of  Arnica  in- 
ternally, and  wet  the  bandages  with  a  lotion  of  the  same.  If  there  is 
fever,  give  Acoriite  or  Bryonia. 

% 

Bums  and  5calds.  , 

By  a  bum  is  understood  a  sore  or  blister  caused  by  dry  heat.  By 
scald  is  understood  that  produced  by  some  heated  fluid,  as  water, 
spirits  or  oil.  The  former  is  soonest  relieved  by  the  application  of 
cotton,  provided  the  skin  is  not  broken.  The  latter  by  cotton  dipped 
in  lime-water.  If  the  skin  is  broken,  it  will  be  necessary  to  use,  in 
each  instance,  a  salve  made  of  lard  and  finely  preiwired  carbonate  of 
lime.  In  all  cases  of  burns  or  scalds,  internal  remedies  are  required; 
Aconite,  in  case  of  much  fever ;  Arsenicum,  or  Qantharia,  if  there  is 
much  burning,  smarting,  and  thirst;  Apis  mel.,  if  there  is  swelling, 
and  inflammation  following  as  a  sequel. 

• 

5nakc  Bites. 

These  are  to  be  treated  somewhat  after  the  manner  of  the  bites 
of  rabid  animals :  that  is  by  dry  or  radiating  heat  at  first,  and  then 
by  cauterization  ;  internally,  Lacheais,  Apis  mellifica  and  Hyoscyamus. 
Either  may  be  given  every  two  hours ;  at  the  same  time,  there  is 
good  authority  for  drinking  copiously  of  whiskey  or  other  alcoholic 
spirits.  Several  drops  of  tincture  of  Iodine,  repeated  every  fifteen 
minutes,  have  saved  some  cases. 

Stings  of  Insects. 

Aconite,  Belladonna,  Merc,  viv.,  are  remedies  for  internal  adminis- 
tration, either  of  which  may  be  given  three  times  a  day  ;  Arnica  lo- 
tion, weak  solution  of  Nitric  acid,  or  Lemon  juice,  may  be  applied 
externally.     Dilute  Aqua  ammonia  is  a  good  antidote  iis  a  lotion. 

The  Removal  of  Tumors. 

Nearly  all  tumors  require  removal  with  the  knife.  It  is  not  our 
purpose  to  specify  tne  nature  of  the  operation,  but  rather  to  point  out 


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IMAGE  EVALUATION 
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Photographic 

Sciences 

Corporation 


•/ 


23  WEST  MAIN  STREET 

WEBSTER,  N.Y.  14580 

(716)  872-4503 


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Collection  de 
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Canadian  Institute  for  Historical  MIcroreproductions  /  Instltut  Canadian  de  microreproductlons  historlques 


i^_^ 


SURGICAL  DISEASES. 


703 


a  treatment  to  be  pursued  after  their  removal.  When  cancerous 
tumors  are  removed,  Arsenicum  should  be  persistently  given,  every 
three  or  four  hours,  with  the  view  of  preventing  the  cancerous  dia- 
thesis, or  condition  from  reproducing  the  same.  Where  fibrous  tu- 
mors are  cut  out,  give  Calendula  three  or  four  times  a  day,  and  apply 
it  to  the  wound.  Adipose  tumors  require,  after  their  removal,  Pul- 
satilla, three  or  four  times  a  day.  Fungous  tumors  require,  after  re- 
moval, Oaioarea.  The  fungoid  or  medullary  tumors  are  mainly 
subject  to  medical  treatment,  and  various  remedies  may  aid  in  curing 
them.  Oonium,  Arsenicum,  Sulphur,  Cuprum  met,  and  Calcarea  may 
be  consulted.  Encysted  tumors  are  embedded  in  the  skin,  and  re- 
quire dermic  treatment.  Nitrum,  Natrum  muriaticum,  and  Natrum 
carh.  may  be  employed,  internally  and  externally.  Scrofulous  tu- 
mors require  Arsenieum,  Graphites,  Juglans  regia,  and  Calendula, 
The  two  last  named  may  be  used  internally  and  externally.  Scrof- 
ulous tumors  require  Arsenicum,  Graphites,  and  Calendula.  The 
two  last  named  may  be  used  internally  and  externally,  several  times 
a  day. 

Lumbar  Abscess. 

A  VERY  malignant  sore,  that  discharges  a  cheesy  matter,  and  from 
which  very  few  recover.  Calendula,  Hepar  sulph.  and  Mereurius 
may  be  given  internally,  and  Calendula,  Baptisia,  and  Arnica  may 
be  used  in  the  form  of  lotions,  to  apply  externally. 

Ulceration  of  the  Bone. 

Fob  bone  ulcers,  Aurum  met.,  Silicea,  and  Calcarea  may  be  g^ven  in 
daily  doses,  —  one  remedy  only  at  a  time:  Aurum  met,  for  bone 
ulcers  caused  by  syphilis ;  Silicea,  if  from  injury ;  Calcarea,  if  from 
scrofula.  For  idceration  of  the  hip-joint,  Arsenicum,  three  times  a 
day ;  of  the  knee-joint.  Sulphur,  or  perhaps  Pulsatilla,  twice  a  day. 

Rickets. — Rachitis. 

DisOBDEB  of  the  nutritive  functions  may  end  in  distortion  of  various 
parts  of  the  S3r8tem,  and  give  rise  to  various  deformities  of  the  head, 
trunk,  and  extremities.  Remedies  directed  to  the  digestive  system 
must  first  be  employed,  in  order  that  a  healthy  nutrition  may  be  es- 
tablished. Nux  vomica,  Pulsatilla,  Ferrum  and  China,  either  of  which 
may  be  given  in  the  usual  dose  three  times  a  day  ;  after  which,  Cal- 
carea carh.  may  be  given  in  daily  doses  peioiatently,  followed  by 
Silicea  Good  animal  food  may  be  allowed  ?a  a  diet.  Frequent 
bathing  with  s<alt  water,  and  friction,  are  also  to  be  commended. 

White  Swelling. 

This  is  a  form  of  scrofula,  and  requires  the  same  remedies  used  in 
other  scrofulous  complaints.    Arseniown,  Jodium,  Calcarea  and  Sul- 


704 


SURGICAL  DISEASES. 


phur  may  be  employed ;  and  whichever  remedy  is  selected  may  be 
gfiven  twice  in  twenty-four  hours.  Pulsatilla,  Bryonia  and  Nux  vom., 
in  like  manner,  may  be  gfiven,  one  at  a  time,  and  repeated  every  four 
hours,  when  there  is  any  pain  in  the  affected  joints. 

Dropsy  of  the  Joints. 

Friction  externally,  and  some  kind  of  soap  liniment,  and  then  the 
application  of  compresses.  Apia  meUifica  may  be  given  internally, 
every  four  hours,  or  else  Pulsatilla,  Arsenicum,  Bryonia  or  Conium, 

5tiff  Joints. —  Anchylosis. 

This  diffioully  involves  the  tendons,  ligaments,  and  bones,  which 
in  some  instances  become  united  at  their  extremities.  These  joints 
may  be  showered  with  cold  water,  rubbed  with  a  stiff  brush,  bathed 
witili  soap  liniment ;  while  Sulphur,  in  daily  doses,  may  be  given  in- 
ternally, or  else  Aurum  mur..  Nitric  acid,  or  Jodium. 

Aneurism. 

Aneitbisms  are  pulsating  tumors  formed  of  arterial  blood.  Aconite 
is  a  good  remedy  to  administer,  three  or  four  times  a  day ;  Digitals, 
also,  in  the  same  way ;  Valerian,  in  the  usual  dose,  when  the  tumor 
appears  to  be  in  the  abdomen.  For  Vabicosb  Aneurism,  bandaging 
is  required,  while  Samamelis  virg.  may  l^e  administered  internally. 

Varicose  Veins. 

When  lihe  entire  lower  extremities  are  involved,  bandaging  with 
a  roller,  or  lace  stocking,  must  be  employed,  while  Hamamelis  Virg. 
is  administered  several  times  a  day,  internally.  Pulsatilla,  for  preg- 
nant women  thus  affected,  and  follow  with  Lycopodium,  after  three 
weeks. 

Qoitre.  —  Bronchocele. 

This  is  an  enlargement  of  the  thyroid  gland,  and  causes  a  swelling 
of  the  neck.  Jodium,  externally  and  internally,  is  said  to  be  a  sure 
remedy.  Kali  hydriodicum,  the  usual  dose  three  or  four  times  a  day, 
may  also  be  used.  Spongia  is  also  a  valuable  remedy,  and  so  also  are 
Merc,  tod.,  Merc,  hiniod.  The  remedies  must  be  used  persistently 
until  the  goitre  disappears. 

Wry  Seek.  — Torticollis. 

Tma  is  owing  to  the  contraction  of  some  of  the  cervical  muscles. 
Stimulating  liniments  may  be  employed  externally,  while  Nux  vom,, 
Rhus,  Sulphur,  Bryonia^  or  PuttatiUa  may  be  administered  inter- 
nally. 


^sEa 

r  remedy  is  selected  may  be 
satiUa,  Bryonia  and  Nuz  vom.^ 
time,  and  repeated  every  four 
:eoted  joints. 

Joints. 

)f  soap  liniment,  and  then  the 
fica  may  be  given  internally, 
aenioum,  Bryonia  or  Conium. 

inchylosis. 

,  ligaments,  and  bones,  which 
sir  extremities.  These  joints 
jed  with  a  stiff  brush,  bathed 
daily  doses,  may  be  given  in- 
d,  or  Jodium. 

n. 

aed  of  arterial  blood.  Aconite 
r  four  times  a  day  ;  JDigitalk, 
i  usual  dose,  when  the  tumor 
BI0O8E  Aneurism,  bandaging 
\>e  administered  internally. 

eins. 

are  involved,  bandaging  with 
iloyed,  while  Hamamelis  Virg. 
emally.  Fulaatilla,  for  preg- 
Mrith  Lyoopodium,  after  three 

ichocele. 

d  gland,  and  causes  a  swelling 
internally,  is  said  to  be  a  sure 
dose  three  or  four  times  a  day, 
luable  remedy,  and  so  also  are 
3S  must  be  used  persistently 


SURGICAL  DISEASES. 


Fistula  in  Ano. 


705 


This  difficuliy  requires  Silicea,  Calcarea,  or  Sulphur,  in  daily 
doses.  If  an  operation  has  been  performed,  and  the  Sphincter  ani 
has  been  divided,  Arnica  may  be  given  three  or  four  times  a  day,  or 
perhaps  Calendula  ;  after  whioh,  consult  Pulsatilla  and  Niix  vom. 


'^orticollis. 

some  of  the  cervical  muscles. 
1  externally,  while  Nux  vom^ 
I  may  be  administered  inter- 


:.  Iri 


DISEASES  OP  INFANTS. 


Crying. 

When  a  youtiff  infant  is  inclined  to  cry  continually,  and  sleeps 
but  little,  give  it  one  or  two  globules  of  Uoffea  or  Chamomtlla  and 
repeat  every  four  hours. 

Colic. 

FoK  infantile  colic,  which  maybe  caused  by  flatulence,  give  Cham- 
omilla;  put  one  or  two  globules  upon  its  tongue.  If  this  does  not 
relieve,  give  a  globule  of  Nux ;  if  restless,  and  throws  up  its  food, 
after  th^  Nux,  give  a  globule  of  Coffea.  (Terat  album  is  an  excellent 
remedy  for  infantile  colic,  and  Dio^corea  has  a  great  reputation. 

Infantile  Diarrhoea. 

There  will  generally  be  a  diarrhoea  after  an  infant  has  nursed  the 
first-fruits  of  the  breast.  If  excessive,  give  one  or  two  globules  of 
Puluatilla;  if  attended  with  colic,  give  the  same  of  ChamomtUa  ;  it 
the  diarrhoea  is  acrid  or  scalding,  give  Arsenicum,  one  or  two  glo- 
bules ;  if  with  excessive  vomiting,  give  Ipecac. 

infantile  Dysentery. 

When  young  infants  are  observed  to  strain,  and  have  frequent 
stools,  and  sometimes  pass  mucus  and  blood,  give  Ipecac.,  one  globule, 
or  else  Mercurius.  If  they  cry  out  after  each  stool,  and  the  intestine 
protrudes,  give  one  or  two  globules  of  Ignatia  If  they  refuse  the 
Ct,  giy!  Aconite.     In  case  of  heat  in  the  head,  give  Belladonna. 

Inability  to  take  the  Breast. 

Some  infants  are  congenitally  opposed  to  nursing  the  breast;  and 
all  the  coaxing  and  trying  which  a  patient  perseverance  can  supply 
avails  but  Uttle.  Such  infants  require  to  l^  fed;  and  to  devise  toi 
them  a  good  and  wholesome  nourishment  is  sometimes  ditticu  t. 
The  nursing-bottle  must  taKe  the  place  of  the  breast,  and  the  child 

706 


^ 


DISEASES   OF   INFANTS. 


707 


IPANTS. 


cry  continually,  and  sleeps 
Ooffea  or  (Jhamomilla  and 


jd  by  flatulence,  give  Clmmr 

tongue.     If  this  does  not 

38,  and  throws  up  its  food, 

V'erat.  album  is  an  excellent 

has  a  great  reputation. 

'hcea. 

fter  an  infant  has  nursed  the 
rive  one  or  two  globules  of 
the  same  of  Chamomilla  ;  if 
Arsenicum^  one  or  two  glo- 
Ipecac. 

itery. 

o  strain,  and  have  frequent 

lod,  give  Ipecac.,  one  globule, 

each  stool,  and  the  intestine 

Ignatia.     If  they  refuse  the 

the  head,  give  Belladonna. 

he  Breast. 

d  to  nursing  the  breast ;  and 
!nt  perseverance  can  supply 
bo  l>e  fed ;  and  to  devise  foi 
went  is  sometimes  difficult, 
of  th3  breast,  and  the  child 


must  be  nourished  by  it.  One  of  the  best  preparations  of  food  for 
young  infants  is  a  thin  gruel  made  of  a  tiible-spoonfiil  of  unbolted 
flour  to  a  quart  of  water,  to  he  boiled  half  an  hour,  and  then  strained 
through  a  tine  strainer,  sweetened,  and  put  into  a  nursing-bottle  suf- 
ficiently thin  to  flow  through  the  tube.  This  food  may  be  enriched 
with  a  little  good  milk,  as  the  child  requires  it.  Nothing  has  so  uni- 
formly answered  as  a  substitute  for  the  breast,  though  many  of 
the  so-called  Infants'  Foods  are  good,  such  as  Mellin's  or  Nestl^'s.  It 
is  often  necessary  to  try  several  before  one  is  found  that  will  per- 
fectly agree  with  the  infant. 

Infantile  Jaundice. 

Young  infants  sometimes  become  yellow,  and  their  skin  affords 
evident  signs  of  jaundice.  One  or  two  globules  of  Mercurim  viv., 
followed  by  one  or  two  of  Pulsatilla,  will  change  this  condition.  If 
frequent  discharges  from  the  bowels  occur  after  these  remedies,  give 
one  or  two  globules  of  Arsenicum. 

Snuffles. 

In  cold  weather,  young  infants  are  prone  to  take  cold  easily,  from 
the  slightest  change ;  and  they  will  show  it  by  sneezing  and  snuff- 
ling :  occasionally  there  will  be  indications  of  fever,  and  heat  in  the 
head.  One  or  two  globules  of  Aconite  may  be  given  tirst,  and  then 
one  or  two  of  Nux  vomica.  If  there  is  thin  discharge  from  the  nose, 
give  a  globule  or  two  of  Arsenicum.  Sambucus,  twice  daily,  is  a  good 
remedy. 

Sore  Mouth.  — Aphthae. 

Considerable  uneasiness  is  manifest  in  young  children  from  a  per- 
ceptible inflammation  of  the  mucous  membrane  of  the  mouth.  It 
will  look  red  and  inflamed,  and  there  will  be  perceptible  some  little 
points  or  pimples  of  a  whitish  character.  Give  one  or  two  globules 
of  Mercurius  or  Bryonia,  and  wash  the  mouth  with  warm  tea,  or 
milk  and  water.  Some  have  introduced  into  their  mouths  a  little 
powdered  Borax.  This  difficulty  is  generally  of  brief  duration,  and 
is  but  a  trifling  malady. 

Thrush. 

This  is  also  a  sore  mouth  to  which  infants  are  subject,  and  a  little 
more  serious  in  its  character.  The  child  first  has  fever,  and  then 
refuses  to  take  its  food.  On  examining  the  mouth,  it  is  found  to 
contain  a  number  of  white  blisters  that  have  a  sore  and  inflamed 
appearance.  One  or  two  globules  of  Phosphorus  will  often  cure  the 
trouble.  Bryonia  has  also  been  used.  Mercurius  viv.  may  also  be 
used.    A  decoction  of  black  tea  may  constitute  a  wash ;  also  a  weak 


if!;  :    H 


708 


mSKASlS   OF   INFANTS, 


solution  of  Borax.  Good  nursing,  and  care  to  prevent  taking  cold, 
are  essential.  If  with  this  kind  of  sore  mouth  there  is  diarrhoea,  give 
one  or  two  globules  of  Arsenicum.  If  the  child  cries  much  from 
colic,  one  or  two  globules  of  Ooloeynth  may  afford  relief. 


Red  Qum. 

When  an  infant  is  one  or  two  days,  or  a  week  old,  there  occurs 
an  eruption  all  over  the  body  of  a  bright  red  appearance,  that  prob- 
ably itches,  and  causes  the  child  some  suffering.  A  couple  of  glob- 
ules of  Pii/satt'^^a  night  and  morning  will  suffice  to  cure  the  difficulty. 

Retention  of  Urine  in  Young  Infants. 

This  difficulty  occasionally  is  observed,  and  is  attended  with  much 
restlessness  and  inquietude.  An  infant  should  urinate  eight  or  ten 
times  in  twenty-four  hours ;  and,  when  there  is  a  failure  in  this  le- 
spect,  give  one  or  two  globules  of  Hyoscyamus,  and  repeat  every  three 
or  four  hours  until  the  derangement  is  obviated.  When  Hyo»cyamu% 
fails,  give  a  globule  or  two  of  PuhatiUa  or  AconiU. 

Teettiing,  Dentition. 

Whxn  an  infant  has  attained  the  age  of  four  or  six  months,  the 
period  of  teething  commences.  The  child  begins  to  drool,  and  is  rest- 
less and  uneasy,  and  frequently  cries  out  with  pain.  At  times  the 
cheeks  will  be  red,  and  the  head  will  be  hot ;  or  else  there  will  be 
diarrhoea,  and  the  food  will  pass  the  bowels  undigested.  The  child 
is  geuiBrally  fretful  and  uneasy.  The  most  effectual  remedy  for  the 
restlessness  and  irritative  fever  is  Chamomilla.  Two  or  three  glob- 
ules may  be  given  three  times  a  day.  When  the  head  is  hot,  and 
the  child  thrusts  its  fingers  into  its  mouth,  give  it  two  globules  of 
Belladonna ;  when  the  food  passes  undigested,  give  two  globules  of 
PuhatiUa.  When  there  is  a  general  heat  of  the  body,  and  demnged 
condition  of  the  stomach,  give  two  globules  of  Aconite  ;  if  this  fails 
to  relieve  in  twenty-four  hours,  give  Qimicifuga  every  hour. 

Summer  Complaint,  Cholera  infantum. 

During  the  heat  of  the  summer,  teething  children  are  proue  to  be 
affected  with  a  prostrating  diarrhoea,  sometimes  watery,  at  others 
dysenteric,  when  the  stools  are  tinged  with  blood.  In  the  first  stage, 
when  there  is  considerable  fever  and  watery  discharges  from  the 
bowels,  two  or  three  globules  of  Aconite  may  arrest  the  difficulty,  fol- 
lowed by  Tartar  emetic  ;  if  the  discharges  are  profuse  and  frequent, 
Veratrum  album  ;  if  there  is  much  thirst,  Arsenicum.  For  discharge 
of  mucus,  gfive  Mercurius;  when  tinged  with  blood,  give  Ipecac. 
The  dose  of  either  is  two  globules.  When  there  is  coldness  of  the  face 


DISEASES   OF   INFAKTS. 


709 


and  extremitieB,  give  Carlo  veg.  If,  in  spite  of  these  remedial  meas- 
ures, the  disease  nonti»iues,  let  t.ho  child  be  taken  into  the  open  air,  or 
into  the  country,  or  better,  to  the  seanshore.  A  trip  upon  salt  water  in 
a  steamboat  has  frequently  resulted  in  a  favorable  change  in  the  con- 
dition of  the  child.  The  diet,  aside  from  nursing,  should  be  mutton- 
broth  and  beef'tea,  or  perhaps  arrowroot  or  farina  gruel. 

Marasmus,  Extreme  Emaciation. 

FKOMthe  combined  effects  of  teething  and  interrupted  nutrition,  and 
aleo  from  diarrhoea,  the  child  will  lose  its  flesh  in  a  remarkable  degree, 
and  nearly  all  the  adipose  or  fatty  tissues  will  soon  disappear.  The 
bones  of  the  face  will  become  prominent ;  the  eyes  will  sink  into  their 
sockets ;  the  skin  will  be  shrivelled  and  loose  over  the  entire  body,  and 
very  marked  upon  the  upper  and  lower  extremities.  The  most 
prominent  feature  of  the  disease  is  interrupted  nutrition ;  and  often 
the  cnild's  stomach  rejects  the  simplest  kind  of  food.  When  there 
is  continual  retching,  give  Ipecac..,  to  allay  the  irritable  condition  of 
the  stomach ;  and  then  give  Calcarea  ;  or  if,  at  first,  there  is  no  nau- 
sea, but  thirst,  give  Aneniemn.  Svlphur  is  a  valuable  remedy,  and 
also  Ferram.  When  either  beef-tea,  or  barley-gruel,  or  any  other 
kind  of  light  soup  or  g^el,  fails  of  being  retained  upon  the  stomach, 
a  gruel  made  of  the  flour  of  the  yelk  of  a  hard-boiled  Qgg  has  supplied 
the  want  of  nourishment,  and  promoted  the  recovery  of  marasmus 
pctients.  When  the  child  is  old  enough  to  feed  himself,  the  yelk, 
boiled  hard,  may  be  broken  in  a  saucer,  and  seasoned  with  a  little 
salt ;  and  the  child  will  pick  it  up  a  little  at  a  time  and  eat  it.  But 
if  otherwise,  to  a  pint  of  boiling  water  add  a  half-pint  of  fresh  milk 
and  the  flour  of  one  yelk,  seasoned  with  salt,  and  sweetened.  This 
makes  a  gruel  that  will  flow  through  a  nursing  tube. 

Hiccous^h.  —  Singultus. 

This  annoying  difficulty  reisults  from  the  irritation  of  the  dia- 
phragm and  the  oesophagus,  or  passage  from  the  mouth  to  the  stomach. 
Nux  vomica.  Ipecac,  Pulsatilla,  and  Sambueus,  have  been  employed 
as  remedies.  A  single  dose  of  two  globules  of  either  may  be  admin- 
istered when  infanta  are  so  affected. 


Convulsions,  Fits. 

Thebe  may  be  various  causes  of  these  convulsions  in  infants.  A 
fever,  an  irritable  stomach,  teething,  or  cold,  may  produce  them ; 
when  from  fever,  give  two  globules  of  Aconite,  and  in  two  hours  fol- 
low with  a  dose  of  two  globules  of  Belladonna.  When  from  an  ill- 
conditioned  stomach,  give  Ohamomilla,  Ipecac.,  or  Ignatia  ;  when  from 


710 


DISEASES  OP   INFANTS. 


colli,  Nux  vomica,  or  Sulplmr.  When  tho  convulsion  comea  on  with 
vomiting,  Ipecac. ;  when  from  colir,  Puhatilla  or  Colocynth ;  wlien 
with  inclination  t(>  sleep,  Opium,o  perhaps  Stramonium  :  when  from 
the  sudden  disappearance  of  any  rush  or  eruption.  Cuprum. 

Excoriations. 

The  tender  and  delicate  skin  of  infants  is  liable  to  become  excori- 
ated from  the  slightest  causes.  To  relieve  the  pain  and  suffering 
attendant  upon  it,  give  two  globules  of  Chamomilla,  Menrurius  viv., 
or  Pulsatilla  internally,  and  wash  them  with  a  weak  solution  of  Arn- 
ica or  Uamamelit  externally.  Should  this  condition  persist,  give 
Sulph  daily. 

Soreness  behind  the  Ears. 

When  a  chil(^  is  teething,  and  there  is  considerable  of  the  fever  of 
dentition,  an  eruption  is  liable  to  show  itself  behind  the  ears ;  and, 
although  this  eruption  is  believed  to  be  effectual  in  preventing  more 
serious  disease  of  the  head,  it  is,  nevertheless,  an  uunecessary  disease. 
Graphites  may  be  given  to  remedy  the  difficulty,  a  single  dose  in 
twenty-four  hours;  and,  in  like  manner,  Arsenicum^  Calearea,  and 
Baryta  Carb.^  may  be  employed. 

Prickly  Heat. 

DURIKG  intensely  hot  weather,  children  are  liable  to  break  out 
with  prickly  heat.  The  stomach  at  first  seems  slightly  deranged, 
and  the  eruption  upon  the  surface  appears  to  be  an  elimination  of 
some  internal  disorder.  There  is  sometimes  much  fever  and  head- 
ache ;  for  this,  give  two  globules  of  Aconite.  If  the  child  is  teething, 
give  Chamomilla.  If  the  surface  becomes  red  and  inflamed  give  Ehu» 
tax.  If  burning  and  smarting,  give  Arsenicum.  In  case  of  severe  itch- 
ing, give  Sulphur.  When  children  are  taken  out  by  their  nurses  on  a 
hot  day,  they  must  not  be  exposed  to  the  heat  of  the  sun :  shade 
should  be  sought  for  them,  where,  if  any  air  is  stirring,  they  can  get 
the  benefit  of  it. 

Millc-Crust.  —  Porrigo. 

This  is  a  scabious  eruption  upon  the  scalp  of  nursing  infants,  which 
at  first  appears  to  be  a  hurtiid  scurf.  It  collects  as  a  slight  humor, 
and  begins  to  enlarge,  involving  more  and  more  of  the  surface,  until 
that  of  the  scalp  is  entirely  covered.  It  is  a  source  of  annoyance  to 
mothers  and  nurses.  There  appears  to  be  great  difficulty  in  keeping 
the  affected  surface  clean,  and  consequently  a  hasty  resort  to  some 
drying  wash  has  wrought  disastrous  effects.  When  milk-crust  is 
suppressed,  the  irritation  is  apt  to  fall  upon  internal  organs,  and 
produce  worse  affections.     The  tar  and  sulphur  ointments,  which 


DI8EASE8  OF  INFANTS. 


711 


have  l)een  too  frequent  a  reaoi-t,  have  had  the  effect,  in  some  measure, 
to  diHsipate  the  eruption ;  but  the  usual  sequel  to  this  are  convul- 
sions, or  fatal  brain  diseases.  It  is,  therefore,  recommended  as  the 
most  prudent  course,  to  depend  upon  the  internal  administration  of 
riMnedies  such  as  eliminate  the  humor,  and  keep  it  upon  the  surface. 
The  purer  the  blood  can  be  kept,  the  sooner  will  the  disease  disap- 
pear. If  no  attention  is  paid  to  the  use  of  external  agents,  the  en- 
tire difficulty  will  be  eliminated  and  dissipated  in  the  course  of  a  few 
months.  Two  globules  of  Aconite  may  be  given  when  there  is  fever, 
and  this  may  be  followed  for  a  while  with  daily  doses  of  Mhux  tox. 
and  Bryonia.  In  scrofulous  cliildren,  give  Calcarea,  Arsenicum,  or 
Sulphur.  In  debilitated  constitutions,  give  Oraphites,  Ferrum,  Hepar 
sulph.  and  China.  Lycopodium,  three  times  daily,  has  cured  most 
obstinate  cases.  All  oily  food  should  be  withheld.  Butter  is  not 
allowable.  After  children  have  been  weaned,  and  still  tlie  milk-crust 
remains,  a  farinaceous  food  is  best. 

Scurf  of  the  Head. 

This  is  an  accumulation  upon  the  scalp,  of  an  oily  and  dirty 
appearance,  which,  in  many  cases,  is  the  result  of  not  being  particu- 
lar in  washing  and  wiping  the  head  dry.  Soap  should  never  be  used 
upoa  the  scalp,  and  strong  alkaline  solutionf,  are  injurious.  Water 
softened  with  corn  or  rye  meal  will  answer  all  the  purposes  for  cleanli- 
ness. As  the  difficulty  does  not  penetrate  below  the  external  skin, 
Rhi»  tox.,  Pulsatilla,  Calcarea,  and  Silicea  are  remedies,  either  of 
which,  in  daily  doses,  will  be  all  that  is  required. 

Scrofulous  Swelling:  of  the  Salivary  Glands. 

This  is  a  disease  somewhat  common  to  children  of  scrofulous  par- 
ents ;  and  it  is  of  the  utmost  importance  to  understand  well  its  charac- 
ter and  treatment.  When  these  child).-en  take  cold,  the  glands  are 
apt  to  become  excited,  and  there  is  a  perpetual  flow  of  saliva  from 
the  mouth ;  at  the  same  time  there  will  be  soreness  of  the  throat,  stiff- 
ness of  the  neck,  and  swelling  of  the  glands  externally.  Sometimes 
children  will  carry  their  heads  to  the  right  or  left  shoulder,  when 
laboring  under  the  difficulty ;  and,  in  spite  of  the  best  efforts  to  re- 
lieve them  of  suffering,  they  will  continue  indisposed  a  long  time. 
Two  or  three  globules  of  Aconite  will  subdue  the  initial  fever.  Mer- 
eurius  viv.  may  then  be  given  two  or  three  times  a  day.  If  this  fail 
to  arrest  the  salivation,  give  Nitric  acid  for  a  day,  at  intervals  of  six 
houra.  Belladonna  also  may  be  given  to  remove  any  congestion  of 
the  throat.  Silicea  may  be  given  afterwards  to  aid  in  softening  the 
glands.  Also,  Nuz  vomica  and  Sulphur  may  prove  to  be  useful  rem- 
edies. The  children  should  be  kept  in  a  room  of  moderate  tempera- 
ture, and  not  be  allowed  at  any  time  to  be  exposed  to  extremes  of 
heat  and  cold  until  they  have  fully  recovered. 


■I  1 


712 


DISEASES   OF   INFANTS. 


Sleeplessness  of  Infants. 

Infants  are  sometimes  Hinitteii  with  inability  to  sleep,  as  well  as 
adults.  The  cause  is  not  always  known.  It  is  believed,  however, 
to  be  the  result  of  some  disorder  acting  upon  thdir  delicate  nerves ; 
suck  as  indigestion,  excoriation,  or  overloading  their  stomachs.  If 
from  an  irritable  stomach,  give  them  Chamomilla  or  Coffea  every 
night.  If  from  any  excoriated  surface,  that  burns  and  smarts,  give 
two  globules  of  Arsenicum,  and  then  "apply  to  the  excoriated  surface 
a  little  rye-flour,  or  Lyeopodium  powder,  aud  soothe  them  to  sleep  in 
a  quiet  and  noiseless  room.  If  the  sleeplessness  is  produced  by  re- 
tention of  urine,  give  Hyo»cyamu»;  if  by  worms,  Cina.  If  the  head 
is  hot,  give  Belladonna.  If  the  sleeplessness  is  from  feeding  the 
child  too  much,  give  two  globules  of  Pulsatilla,  if  from  constipa- 
tion of  the  bowels,  give  Nux  vomica  or  Lycopodium  at  night.  Tf 
these  remedies  fail,  a  tepid  bath  will  often  consummate  the  desired 
result. 


DISEASES  OP  WOMEN. 


Deratig:enient  of  the  Function  of  Menstruation. 

From  the  age  of  puberty  until  the  change  of  life,  the  health  of 
the  female  system  depends  upon  regular  menstruation,  varying  in 
intervals  from  twenty-six  to  twenty-nine  days.  With  this  standard 
in  view,  the  irregularities  as  to  time  are  easily  noted.  By  the  period 
of  puberty  is  understood  the  age  capable  of  bearing  children,  which 
is  denoted  by  menstruation  taking  place. 

Ailments  at  the  Ag:e  of  Puberty. 

Immediately  preceding  the  first  menstmal  period  the  breasts 
inci-ease  in  size,  the  voice  is  changed,  the  system  becomes  rapidly 
developed  and  the  wind  matured.  There  may  be  headache,  dullness 
of  the  eyes,  pains  in  the  lower  abdomen,  lassitude,  capricious  appe- 
tite, and,  not  unfrequently,  a  premonitory  leucorrhoea.  To  relieve 
these  ailments.  Aconite ;  four  globules  may  be  given  first ;  Puha- 
tilla  may  be  given  after  Aconite,  to  remove  the  pains  in  the  abdomen, 
and  to  promote  menstruation.  If  there  is  much  pair  and  the  func- 
tion is  tardy  in  making  its  appearance,  give  Calcarea  or  Sulphur,  and 
then  follow  with  Puhatilla  every  four  or  six  hours  until  the  period 
commences.  In  case  of  considerable  leucorrhoea,  give  Sepia,  or  per- 
haps Qraphites.  When  the  periods  become  established  they  should 
last  from  three  to  five  days.  If  scanty  at  first,  give  Ferrum,  and 
follow  with  Puhatilla  ;  if  there  is  intense  headache  give  Belladonna  ; 
if  there  is  hysteria  and  much  agitation  and  suffering,  give  Hyoscya- 
mu8 ;  and  during  the  interim  let  the  youag  lady  take  strengthening 
food  until  signs  of  the  recurrence  of  another  period.  If  it  comes  on 
normally,  it  is  well ;  but  if  tardy  or  painful,  resort  again  to  Puha- 
tilla, Hyoioyamus,  Belladonna  and  Graphites,  as  they  may  be  indi- 
cated ;  and  continue  this  treatment  from  time  to  time  until  regularity 
is  established.    If  tardy,  with  pains  in  the  back,  Kali  carb. 

Interrupted  Mens''    nation. 

This  may  be  caused  by  cold,  fright,  fovers,  diarrhoea  and  dysen- 
tery, and  by  pregnancy.     When  by  cold  or  getting  the  feet;  wet^ 

713 


■"fF- 


714 


DISEASES  OF  .WOMEN. 


Aconite,  at  first,  to  remove  any  febrile  excitement  or  neadache,  and 
then  Pulsatilla.  If  this  fail  to  remove  the  obstruction,  give  Calcarm, 
and  follow  with  Nux  mosehata ;  should  this  fail,  try  Sulphur. 
When  menstruation  is  interrupted  by  fright,  and  there  is  intense 
headache,  give  Aconite,  and  follow  with  Belladonna  or  Ignatia,  and 
finally  with  Pulsatilla.  When  fevers  weaken  and  depress  the  system, 
so  as  to  interrupt  the  function,  first  .educe  the  fever,  and  then,  by 
properly  nourishing  the  patient,  the  period  may  return.  The  same 
rule  may  be  observed  ia  treating  the  interruption  caused  by  diar- 
rhcea  or  dysentery.  These  diseases  should  be  treated  and  cured  by 
appropriate  remedies,  and  the  period  will  be  likely  to  return  sponta- 
neously. If  otherwise,  resort  may  be  had  to  Pulsatilla,  Belladonna, 
Sepia,  Oalearea,  and  other  remedies,  according  to  indications. 

Excessive  Menstruation. 

When  the  flow  is  excessive  or  weakening.  Ipecac,  and  China  may 
be  employed,  —  the  first  to  regulate,  the  last  to  strengthen  the  sys- 
tem ;  and  this  treatment  will  be  found  necessary  at  each  period,  until 
duly  regulated.  Calcarea  should  be  given  once  daily  between  the 
periods. 

Menorrhagia,  or  Profuse  Bleeding  from  tlie  Womb. 

This  indicates  a  want  of  tone  in  the  uterus,  if  not  a  state  of  dis- 
ease, and  is  usually  attended  with  fainting,  pain  in  the  back,  nausea, 
and  hysteria.  When  from  a  want  of  tone,  or  debility,  China  or 
Ferrum  may  arrest  the  diificulty;  if  from  disease  or  inflammation, 
Belladonna  or  Arsenicum  ;  when  there  is  fainting  and  nausea.  Ipecac.; 
pain  in  the  back,  Nuz  vomica,  Nux  moschata,  or  Ignatia,  especially  if 
the  flow  is  dark  or  almost  black,  with  fainting  and  drowsiness ;  for 
hysteria  give  Hyoscyamus.  The  patient  should  lie  in  bed  until 
relieved,  and  should  begin  sitting  up  with  great  caution.  A  generous 
diet,  easy  of  digestion,  should  be  supplied  patients  of  this  description. 
When  the  strength  will  permit,  this  class  of  patients  should  seek 
fresh  air,  and  should  avoid  warm  baths.  Bathing  with  tepid  water 
is  far  better. 

Painful  Menstruation. — Dysmenorrhoea. 

Some  ladies  suffer  intensely  at  every  menstrual  period.  They 
have  chills,  headache,  fever,  colic,  and  most  excruciating  pains  in  the 
womb.  Aconite  must  be  given  for  the  fever.  Belladonna  for  the 
chills  ?ud  headache,  Colocynth  for  the  colic,  and  for  the  pains  in  the 
uterus,  Hyoscyamus,  Pulsatilla,  Oimieifuga,  or  Rhus. 

Ailments  attending  Change  of  Life. 

This  occurs  about  the  forty-fifth  year  of  life,  and  is  denoted  by 
irregularities,  -—  profuse  menstrual  periods,  great  irregularities,  pain 


' I 


.V 


HM 


DISEASES   OF   WOMEN. 


716 


in  the  head,  melancholy,  mania,  loss  of  memory,  and  great  nervous 
depression.  For  profuse  menstruation  at  this  period,  give  Arnica  or 
Lachem;  for  headache.  Belladonna  or  Sepia;  for  intense  pains  in  the 
womb,  Arsenicum  and  Conium  ;  for  Melancholy,  Lachem,  or  per- 
haps Petroleum;  for  mania,  /Stramonium;  for  loss  of  memory, 
Sulphur,  China,  or  Qalcarea. 

Ailments  during  Pregnancy. 

Some  ladies  are  troubled  much  with  morning  sickness  in  the  early 
stage  of  pregnancy,  and  this  is  often  cured  with  Oooculu%  or  Nvx 
vomica;  if- with  heartburn,  Oimicifuga  or  MercuriouB  viv. ;  if  with 
water-brash  of  a  hot  or  acrid  nature,  Arsenicum.  Sometimes  these 
derangements  are  so  stubborn  that  no  remedies  seem  to  relieve. 
pimple  syrup,  by  the  wineglassful,  has  been  taken  by  some,  chamr 
pagne  wine  by  others,  ,i,ard  cider  by  others.  The  simple  resort  will 
sometimes  relieve ;  and  at  others  nothing  seems  to  afford  relief. 
Discharge  of  blood  from  the  uterus  may  be  cured  with  China. 
Leucorrhcea,  very  profuse  and  debilitating,  requires  Sepia  twice  a 
day;  corroding  discharges,  Calcarea  twice  a  day;  for  rheumatic 
pains,  Caulophyllum ;  for  paiinful  breasts,  bathe  with  Phytolacca; 
for  threatened  miscarriage.  Ipecac.,  Sabina,  China,  Arsenicum,  and 
Belladonna;  for  sleeplessness,  Nux  vomica  or  Ars.,  and  a  light  diet 
at  night ;  for  nose-bleed,  Carho  veg..  Aconite,  Belladonna,  Lacheaia^ 
and  Mercurim,  a  dose  of  any  one  of  them  twice  a  day. 


vJ 


■■■I 


LABOR,  PARTURITION. 


False  Pains. 

These  is  a  kind  of  pain  that  afflicts  parturient  women,  thai? 
simply  aggravates  and  unsettles  the  nerves.  Cimieifuga  or  Cavlo- 
phyllum  will  usually  control  this.  When  true  labor  pains  commence, 
they  may  be  regarded  as  normal  if  they  come  at  regular  intervals, 
and  increase  in  force  and  frequency  as  the  labor  progfresses.  No 
medicine  is  needed ;  and  waiting,  with  patient  labor,  will  accomplish 
the  object.  After  the  child  is  born,  a  dose  of  Fuhatilla  will  aid  in 
expelling  the  placenta.  If  there  is  hemorrhage,  elevate  the  hips  and 
depress  the  head,  and  give  a  dose  of  Secale  comutum ;  if  anything 
more  complicated  occurs,  call  on  an  experienced  midwife. 

Milk  Fever. 

About  the  third  day  after  labor,  there  is  a  struggle  in  the  system 
to  fill  the  breasts  with  milk,  attended  with  fever.  Give  Bryonia  or 
PulaatUla  ;  if  the  milk  is  tardy  in  coming,  give  Oaloarea. 


Difficult  Urination. 

After  labor,  there  may  be  a  difficulty  in  passing  u-ine,  which 
Arsenicum  or  Hyoscyarmis  will  usually  relieve,  if  aided  with  cloths 
wrung  out  of  warm  water  applied  to  the  region  of  the  bladder ;  or 
else  Aconite  may  be  used  instead  of  Hyosoyamus,  and  sometimes 
PiUaatilla,  or  Oantharis. 

Soreness  after  Delivery. 

A  PAINFUL  soreness  of  the  muscles  after  delivery  may  be  relieved 
by  the  internal  administration  of  drop  doses  of  Amiea  in  a  spoonful 
of  water,  while  at  the  same  time  a  towel  wet  with  Arnica  tincture 
may  be  applied  to  the  abdomen.  If  there  is  soreness  of  the  vagina, 
forty  drops  of  the  tincture  of  Calendula,  in  half  a  pint  of  tepid  water, 
may  be  used  as  an  injection. 

716 


..M? 


LABOR,  PARTURITION. 


717 


Constipation  of  the  Bowels. 

This  condition  after  labor  may  be  removed  by  one  or  two  doses  of 
Nvs  vomica,  or  perhaps  by  the  use  of  Lycopodium  ;  if  they  fail,  the 
bowels  should  be  moved  by  an  enema  of  warm  salt  water. 

Excoriated  Nipples. 

Soon  after  the  breasts  fill  with  milk,  and  the  child  begins  to  nurse, 
tlie  nipples  are  apt  to  become  r^'itive,  and  sometimes  exceedingly 
sore.  For  a  little  sensitivent^s,  or  slight  irritation,  bathing  the 
breasts  with  a  solution  of  Arnica  will  help  them ;  or  perhaps  a  solu- 
tion of  powdered  Borax  will  do  as  well.  If  the  soreness  amounts 
to  a  decided  inflammation,  and  the  exterior  of  the  nipples  crack  and 
bleed,  a  more  careful  and  efficient  treatment  is  needed.  When  put- 
ting the  child  to  the  breast  excites  great  pain  in  the  gland,  and 
severe  after-pains  at  the  same  time,  the  internal  administration  of 
Belladonna  is  necessary,  —  two  or  three  doses  during  twenty-four 
hours  ,■  and,  at  the  same  time,  wet  a  compress  with  Amida  tincture^ 
and  apply  to  the  nipple.  Arnica  also  may  be  given  internally. 
When  Belladonna  faik,  Bryonia,  when  the  pains  are  worse  in  damp, 
cold  weather.  As  an  external  application,  a  decoction  of  Oak-bark 
has  been  found  useful,  and  also  the  same  of  the  Apple-tree  root.  A 
solution  of  Alum,  Tannin,  or  Sulphate  of  zinc,  has  been  employed ; 
but  if  the  skin  is  cracked,  and  blood  oozes  out  every  time  the  child 
nurses,  it  is  of  little  service.  A  weak  solution  of  Mtric  acid  is 
better,  two  drops  to  an  ounce  of  water.  The  best  external  applica- 
tion for  healing  the  cracks  is  the  CHycerole  of  aloes,  which  is  made 
by  dissolving  one  ounce  Aloe»  in  four  .ounces  of  Glycerine.  This  is 
the  best  preparation  known  to  heal  an  inflamed  and  cracked  surface 
on  any  part  of  the  body.  At  the  same  time,  Sulphur,  Hepar  mi- 
phuris,  Oalcarea,  and  Nitric  acid  may  be  administered  internally.  It 
is  hardly  necessary  to  add,  that  whatever  lotion  is  used  externally 
must  be  carefully  washed  off  with  ^arm  milk  before  the  child  is  al- 
lowed to  nurse. 

Suppression  of  the  Milk. 

After  the  breasts  have  once  filled  with  milk,  and  it  disappears,  a 
return  may  be  promoted  by  the  internal  use  ol  Oalcarea  carhonica, 
followed  with  Ptdeatilla,  or  Phytolacca,  while  the  patient  is  required 
to  drink  chocolate,  or  table-bee  m. 


Induration  of  the  Breasts. 

When  the  breasts  cake,  or  portions  of  them  seem  hard,  like  a  po- 
tato, rub  them  well  with  lard,  and  give  mtemally  Oarbo  aninuUi*. 


I 


718 


LABOR,  PARTURITION. 


In  a  majority  of  instances,  these  hard  cakes  will  disappear  if  care- 
fully attended  to.  When  lard  fails  to  soften,  try  dry  rubbing  with 
the  hand.  If  the  breasts  ache,  give  Belladonna ;  if  there  is  fever, 
Aconite^  or  Phytolacca.  If  inflammation  sets  in,  and  cannot  be  scat- 
tered, give  Hepar  mlph.  to  hasten  it  to  a  crisis.  Poultices  of  flax- 
seed meal  may  also  be  applied  to  hasten  suppuration.  If  it  is  found 
necessary  to  lance  the  abscess,  let  it  be  done  with  an  opening  in  the 
direction  of  the  milk-ducts,  and  not  across  them ;  for,  when  once 
severed,  the  parts  never  unite  perfectly  again.  After  the  matter 
has  discharged,  some  emollient  calve  spread  on  chamois  skin  may  be 
applied,  for  the  double  purpose  of  protecting  the  breasts  and  healing 
the  sore. 

Suppression  of  the  Lochia. 

The  flowing  after  delivery  is  termed  "  lochia,"  and  should  con- 
tinue for  ten  days  or  two  weeks.  If,  through  any  unfavorable  influ- 
ences, the  flow  is  suppressed,  'he  whole  system  will  be  more  oi  less 
disturbed.  If  simply  arrested,  Pulsatilla  may  be  given  every  two 
hours,  for.at  least  a  day ;  and,  if  there  is  no  return,  give  Secale  cor- 
nutum.  If  stiil  the  suppression  seems  stubborn,  and  the  head  begins 
to  feel  light,  and  the  nerves  become  unstrung,  give  ffyoseyamus,  and 
repeat  every  three  houra  until  better,  or  there  is  indication  of  a 
change.  Sulphur  will  sometimes  remove  the  difficulty.  If  the  light- 
headedness be  very  marked  and  maniacal,  and  there  is  no  inclination 
to  sleep,  a  decided  advantage  mv  >  be  found  in  the  use  of  Belladonna, 
If  the  lochia  should  finally  ret.  rn,  and  be  of  offensive  odor,  give 
Rhvx  tox. ;  if  much  thirst  and  dr}  ss  of  the  throat,  Arsenicum  ;  in 
case  of  diarrhoea,  Arsenicum  and  Jh..  ourius  viv.,  repeated  every  two 
hours.  The  application  of  tepid  cloths  to  the  abdomen  is  recom- 
mended, until  the  lochia  returns.  Should  the  lochia  continue  too 
long,  —  that  is,  beyond  the  seventeenth  day,  —  Bhu*. 

Child-bed  Fever. 

A  LOW  form  of  fever  frequently  sets  in  about  the  fourth  or  fifth 
day  after  confinement,  sometimes  severe  enough  to  prostrate  the  pa- 
tient for  weeks.  Every  day  she  will  suffer  from  pain  in  the  head 
and  copious  perspiration ;  the  hair  falls  out.  This  fever  sometimes 
continues  until  a  diarrhoea  sets  in,  and  the  patient  sinks  into  a  typhus 
and  expires.  Therefore,  at  the  first  manifestation  of  this  fever, 
Bryonia  should  be  given  every  three  hours ;  and  this  may  be  fol- 
lowed with  Rhus  tox.,,  in  the  same  manner.  In  case  of  diarrhoea  and 
prostration,  give  Arsenicum  or  Veratrum  album.  If  there  is  sallow- 
ness  of  the  complexion,  give  Mercurius  viv.  A  very  light  mutton- 
broth  may  be  given  for  nourishment.  Should  there  be  a  general 
pain,  and  aching  of  the  whole  body,  give  Phosphorus  two  or  three 
times,  and  especially  if  the  diarrhoea  should  be  dark  and  watery.    If 


^PW'Hwi^a—niw 


'••••••••••^^^'''iiiii'i'iiiiiiiiii^immmmmmmmmmmmmmmmm 


LABOR,  PARTURITION. 


719 


the  fever  should  be  subdued  and  convalescence  established,  allow  the 
patient  a  little  wine  and  water,  beef-tea,  and  a  gradual  ajjproach  to 
more  substantial,  aliments.  Should  the  above  remedies  fail,  and  ty- 
phoid symptoms  present  themselves,  Baptisia,  hourly. 

Leucorrhoea  after  Confinement. 

A  FLTTX  of  this  kind  may  result  from  general  debility,  and  requires 
for  its  removal  a  good  nourishing  diet.  China  may  be  given  three 
or  four  times  a  day  at  first,  and  afterwards  Sepia  or  Calcarea. 

Falling  of  the  Womb. 

In  some  cases,  after  child-birth,  there  will  be  falling  of  the  womb. 
This  may  be  the  result  of  a  weakened  condition  of  the  muscles  that 
retain  the  womb  in  its  place.  When  this  trouble  is  of  an  aggravated 
form,  and  is  attended  with  copious  leucorrhoea,  Niix  vomica  may  be 
given  every  evening.  The  patient  should  allow  herself  to  be  as  little 
upon  the  feet  as  possible, —  rest  being  one  of  the  essential  conditions 
for  gaining  strength  and  for  obviating  the  diflBculty. 

Hemorrhoids,  or  Piles. 

Fob  the  piles  consequent  upon  a  tedious  labor,  Amioa  may  be 
given  every  morning  and  evening,  or  perhaps  ffamamelis,  if  they  are 
inclined  to  bleed;  also  Ntix  vomica  and  Sulphur,  when  there  is  severe 
constipation  and  hemorrhage  at  every  stool.  Sulphur  in  the  morn- 
ing, and  Nux  vomica  in  the  evening.  In  all  cases  use  ffamamelis 
suppositories.  Stewed  prunes,  Graham  toast,  and  chicken  soup,  may 
enter  into  the  diet. 


m 

1 

i  4j 

i 


SPECIFIC  INDICATIONS  FOB  BEMEDIES 

IN  FEVERS. 


Tn  giving  speoiflo  indications  for  the  selection  of  remedies  in 
fevers,  a  large  ground  is  covered,  inasmuch  as  nearly  all  the  dis- 
eases to  which  flesh  is  heir  are  attended  by  some  specifically  charac- 
terized fever,  which  calls  for  the  proper  remedy.  It  is  therefore 
deemed  important  to  state,  in  connection  with  the  names  of  the  im- 
portant remedies,  the  particular  characteristic  symptoms  that  they 
represent. 

Aconite  is  indicated  for  violent  heat  and  chill,  heat  about  the  head 
and  face ;  and  red  cheeks,  palpitation  of  the  heart,  pleuritic  stitches, 
anguish,  sadness  or  ill-humor,  despondency,  and  dread  of  death,  bodily 
restlessness. 

Antlmonium  is  indicated  when  there  is  little  thirst,  yellow  ooat^ 
ing  upon  the  tongue,  bitter  taste  in  the  mouth,  eructations,  nausea, 
loathing,  vomiting,  and  other  gastric  derangements ;  constipation  or 
diarrhoea. 

Arnica  is  indicated  when  there  is  thirst  before  the  chill,  and  when 
the  chill  comes  on  in  the  evening  after  considerable  aching  of  the 
bones ;  and  also  when  there  is  constant  desire  to  change  one's  posi- 
tion during  the  fever ;  for  apathy,  and  pains  in  the  stomach ;  for 
want  of  appetite,  and  aversion  to  meat  when  the  fever  has  gone  off. 
It  is  particularly  indicated  when  there  is  weariness,  listlessness,  yel- 
low color  of  the  skin,  and  bitter  taste,  and  following  a  blow  or  con- 
cussion. 

Arsenicum  album  is  called  for  when  the  chill  and  heat  set  in 
simultaneously,  or  when  they  rapidly  alternate  with  each  other,  or 
when  there  is  internal  chilliness  and  external  heat,  and  vice  versa; 
also  for  burning  heat,  as  if  boiling  water  was  flowing  through  the 
veins ;  no  sweat  until  the  commencement  of  sleep,  oppression  of  the 
chest,  anguish  and  uneasiness,  pressure  in  the  head,  vertigo,  pains  in 
the  liver  and  spleen,  great  debility,  burning  pain  in  the  stomach,  and 
disposition  to  vomit,  great  uneasiness  and  anguish  in  the  region  of 
the  heart,  violent  psdns  and  lameness  of  the  extremities,  and  tendency 
to  dropsy. 

790 


BPEOIFIO   INDICATIONS  FOR   REMEDIES   IN  FEVERS. 


721 


Belladonna,  when  the  fever  comes  on  with  violent  headache  with 
stupefaction,  marked  chilliness  and  slight  heat  or  the  opposite ;  red- 
ness of  the  face,  with  heat  and  throbbing  of  the  temporal  arteries  and 
carotids ;  entire  absence  of  thirst,  or  the  reverse ;  and  also  when  the 
patient  is  irritable  and  in  a  whining  mood. 

Bryonia,  for  coldness,  chill  with  red  cheeks,  heat  about  the  head, 
and  yawning ;  or  when  the  heat  prevails  with  subsequent  chilliness, 
heat  of  the  chest  with  slight  pains  indicating  pleurisy  ;  or  when  there 
is  a  coated  tongue,  or  headache  and  vertigo  during  the  heat,  nausea 
and  faintness  on  sitting  up. 

Calcarea  carbon ica,  for  heat  in  the  face,  then  chills;  or  with  cold 
hands,  heaviness  of  the  head  and  limbs,  pains  in  the  small  of  the  back, 
and  restlessness  ;  cold,  sour-smelling  sweat  on  the  head. 

Capsicum,  when  there  is  thirst  during  the  chill  and  fever,  and 
much  mucus  in  the  mouth,  throat  and  stomach ;  also  when  there  is 
diarrhoea  with  slimy  and  burning  evacuations ;  and  when  the  patient 
in  irritable,  anxious  and  oppressed  during  the  chill,  and  when  the 
chill  begins  in  the  back. 

Carbo  veg.,  when  the  chill  occurs  in  the  evening  or  at  night;  thirst 
during  the  chill  only,  which  is  foUov/^ed  with  fever  and  copious  sweat 
and  chilliness ;  afterwards  rheumatic  pains  in  the  teeth  and  limbs 
before  or  during  the  fever ;  and  when  there  is  vertigo,  nausea  and 
red  face  during  the  heat. 

Chamomilla,  when  there  is  pressure  in  the  pit  of  the  stomach,  hot 
sweat  on  the  forehead,  despair,  tossing  about  or  bilious  vomiting, 
diarrhoea  and  colic, — the  thirst,  heat,  and  sweat  prevailing,  frequent 
urination. 

China  is  indicated  when  there  is  nausea,  canfne  hunger, headache,  an- 
guish, palpitation  of  the  heart,  or  other  ailment  previous  to  the  parox- 
ysm; when  there  is  thirst  generally  before  or  after  the  chill  and  heat, 
or  during  the  sweat;  when  there  is  no  thirst,  but  tendency  of  blood  to 
the  head,  headache,  red  face,  uneasy  sleep  and  yellow  complexion. 
China  is  also  indicated  when  there  is  drowsiness,  pains  in  the  liver  and 
spleen,  bilious  or  dropsical  symptoMS,  or  enlargement  of  the  liver 
and  spleen. 

Cina,  for  vomiting  and  canine  hunger,  both  before  and  after  the 
paroxysm  of  fever ;  the  face  is  pale  during  the  fever,  and  a  tendency 
to  emaciation  exists,  and  dilated  pupils. 

Ferrum  is  indicated  when  the  fever  comes  on  with  chill  and 
thirst,  headache  and  tendency  to  congestion  of  various  orgfans ;  swell- 
ing of  the  external  veins,  swelling  of  the  face,  especially  around  the 
eyes ;  great  debility,  vomiting  of  the  food  when  partially  digested, 
and  laborious  breathing. 


722 


SPECIFIC   INDICATIOKR   VOK   KKMKDIE8   IN   FEVRKS. 


Isnatia,  when  there  is  thirst  only  during  the  chill,  and  when  tluM 
is  moderated  by  external  heat,  or  when  there  is  external  heat  with 
partial  internal  shuddering ;  nauseu  and  vomiting,  pale  color  of  the 
skin,  and  pains  in  the  back  during  the  chill ;  and  also  when  there  is 
no  thirst,  with  headache,  vertigo  and  delirium,  and  particularly  when 
there  is  paleness  of  the  face,  or  else  alternately  pale  and  red,  or  only 
one  cheek  red  during  the  heat ;  great  lang"or,  deep  sleep,  with  snor- 
ing ;  after  or  during  the  fever,  eruption  ou  the  lips  and  in  the  comers 
of  tiie  mouth.  This  remedy  is  also  indicated  for  the  fever  attending 
nettle  rash  and  other  eruptions  of  the  skin. 

Ipecacuanha  is  indicated  for  a  fever  of  much  chilliness  and  little 
heat,  or  vice  versa,  and  when  the  chill  is  increased  by  external  heat, 
or  when  there  is  little  or  no  thirat  during  the  chill,  and  great  thirst 
during  the  heat ;  and  also  when  there  is  nausea  and  vomiting,  and 
other  gastric  symptoms,  previous  to,  or  during  and  between,  the 
paroxysms  of  fever;  and  when  there  is  a  coated  tongue  and  an 
oppression  of  the  chest. 

Lachesis  is  particularly  indicated  when  chills  occur  after  a  meal 
in  the  latter  part  of  the  day,  with  violent  pains  in  the  limbs,  and 
pleuritic  stitches,  oppression  of  the  chest,  and  •  convulsive  motions ; 
and  when  there  is  violent  headache  during  the  heat ,  delirium,  burn- 
ing thirst,  red  face,  restlessness,  internal  shudderings  during  the 
heat,  livid  complexion,  debility,  prostration  between  the  paroxysms, 
heat  especially  at  night,  sweat  after  the  heat,  and  when  the  fever  is 
easily  excited  by  eating  lemons  or  other  sour  things. 

riercurius  is  indicated  when  heat  and  sweat  appear  together,  and 
when  there  is  violent  thirst,  pains  in  the  right  side,  acid  stomach,  and 
regurgitation  of  sour  or  bilious  matter  from  the  stomach ,  and  when 
there  are  pains  in  the  bones,  and  an  aching  of  the  limbs. 

Nux  Vomica  is  suitable  for  a  fever  that  comes  on  with  great  debil- 
ity, then  chill  and  heat ;  constant  desire  to  be  covered,  even  during 
the  heat  and  sweat  j  and  when,  during  the  chill,  the  skin,  hands, 
feet  and  face  are  blue ;  and  when  there  are  pains  in  the  chest  and 
abdomen,  back,  and  particularly  in  the  small  of  the  back,  or  drawing 
in  the  limbs ,  and  when  there  is  headache,  buzzing  in  the  ears,  dis- 
tress in  the  chest,  heat  about  the  face,  red  cheeks  and  thirst  during 
the  chill  and  heat ;  and  also  when  there  are  gastric  or  bilious  symp- 
toms, vertigo,  anguish,  and  constipation. 

Opium  is  called  for  when  there  is  sleep  during  the  heat,  and  even 
during  the  chill,  with  snoring  respiration  with  the  mouth  open ;  con- 
vulsive twitchings,  warm  sweat,  suppression  of  the  secretions.  This 
remedy  is  suitable  for  old  people  and  children. 

Pulsatilla  is  wanted  when  there  is  no  thirst  during  the  fever,  or 
thirst  only  during  the  heat,  and  when  there  is  an  aggravation  in  the 
afternoon  or  evening,  with  headache,  anguish,  and  oppression  during 


\A' 


SPECIFIC   mriOATlONS  FOR   RKMEPIKB    IN    FEVKHB. 


723 


hen  this 
5at  with 
r  of  the 
there  is 
rly  when 
,  or  only 
ith  snor- 
B  corners 
attending 

• 

ind  little 
nal  heat, 
eat  thirst 
ting,  and 
veen,  the 
)  and  an 

«r  a  meal 
Lmbs,  and 
motions ; 
um,  burn- 
uring  the 
aroxysms, 
e  fever  is 

ether,  and 
tnach,  and 
and  when 

reat  debil- 
en  during 
in,  hands, 
chest  and 
)r  drawing 
B  ears,  dis- 
rst  during 
ious  symp- 

and  even 
open ;  con- 
Dns.     This 

le  fever,  or 
tion  in  the 
ion  during 


the  entire  period  of  the  fever ;  and  when  there  is  a  rod  and  bloated 
face,  sweat  in  the  f^'-e,  'i:iti  bliuclderinE'  aa  soon  .in  the  palieiil  recov- 
ers himself;  and  also  when  there  are  gastric  or  bilious  symptoms, 
bitter  taste  in  the  mouth,  bilious,  slimy,  or  sour  vomitings,  or 
diarrhoea,  alternating  with  constipation,  oppression  of  th3  chest,  moist 
cough,  or  headache.  Puhatilla  is  frequently  suitable  after  Lachesia, 
or  when  the  fever  comes  on  ^gain  after  overloading  the  stomach  in 
any  way.     Often  beneficial  after  the  abuse  of  Quinine. 

Rhus  tox.  is  suitable  for  an  evening  or  night  fever,  when  the 
chilliness  and  heat  both  make  their  appearance  simultaneously,  and 
a  copious  sweat  comes  on  after  midnight  or  towards  morning;  and 
when,  during  the  chill,  there  are  pains  in  the  limbs, headache,  vertigo, 
or  toothache ;  or  when,  between  the  paroxysms,  there  are  convulsive 
twitchings  of  the  limbs,  nettle-rash,  colic,  diarrhoea,  and  gastric  de- 
rangement; or  when  there  is  jaundice,  sleeplessness,  and  tossing 
about,  thirst  at  night,  palpitation  of  the  heart,  with  anguish  and 
pressure  in  the  pit  of  the  stomach. 

Veratrum,  when  there  are  external  chill  and  cold  8wer\  or  inter- 
nal heat,  with  dark-red  urine,  delirium,  and  flushed  face ;  or  when 
there  is  chill,  with  nausea,  vertigo,  pains  in  the  small  of  the  back  and 
back ;  or  when  there  is  chill  alternating  with  heat,  constipation,  or 
vomiting  with  diarrhoea ;  and  when  there  is  thirst  during  the  chill 
and  heat 

With  the  above  remedies,  or  any  of  them,  the  following  remedies 
maybe  employed:  as  CantJiaris,  when  the  urinary  passages  are  in- 
volved ;  or  Goceulus,  when  the  patient  is  nervous  and  threatened 
with  spasms,  cardialgia,and  constipation.  When  the  fever  for  which 
any  of  the  remedies  are  indicated  is  in  sensitive  persons,  made  rest- 
less by  great  nervousness,  give  Coffea  ;  and  especially  when  there  is 
sweat  with  thirst,  soft  stools,  or  diarrhoea.  Give  Droaera,  when  there 
is  violent  chilliness  with  cpld  face,  icy  cold  hands  and  feet,  nausea 
and  bilious  vomiting,  headache  and  spasmodic  cough  during  the  heat, 
and  gastric  symptoms  between  the  paroxysms.  Give  Jlepar,  when 
the  patient  has  coryza,  cough,  or  distress  in  the  chest,  or  chill  and 
thirst,  preceded  by  bitter  taste,  followed  by  heat  and  sleep.  Give 
Hyo»cyamu9^  when  the  fever  is  atteided  by  cough  at  night,  or  even 
epileptic  attacks.  Mercurius,  sour  and  fetid  sweat,  with  palpitation 
of  the  heart.  Sulphur,  when  the  fever  is  from  suppressed  Itch,  with 
chilis  every  evening,  heat  and  sweat  towards  morning,  fever  with 
palpitation  of  the  heart,  and  violent  thirst  even  before  the  chill. 

In  case  of  any  fever  occurring  with  symptoms  described  as  being 
particular  indications  for  the  employment  of  any  one  remedy,  always 
select  that  remedy ;  and,  iu  all  probability,  but  few  doses  will  be  re- 
quired to  effect  a  cure,  provided  the  patient  is  placed  in  the  most 
favorable  condition  for  recovery ;  for  this  is  as  essential  as  the  em- 
ployment of  remedies. 


r 


724 


SPECIFIC   INDICATIONS   FOK    REMEDIES   IN   FEVERS. 


In  many  instances,  only  a  single  symptom  may  present  itself,  while 
in  other  respectx  the  patient  may  lie  well.  A  brief  oonsideration  of 
some  of  these  may  be  useful ;  as,  — 

Aversion  to  Food.  —  Anwexia. 

When  this  exists  as  a  mere  symptom,  or  dislike  for  food,  give 
Tart,  emetic.  If  after  gastric  affections,  give  China.  For  aversion 
to  food,  accompanied  with  hunger,  give  Bryonia  or  Rhu9  tox.,  or  elsu 
Ignatia  or  Nnx  vomica.  For  complete  loathing  of  food*  give  Ipecac. 
or  Pulaatilla. 

.  Loss  of  Smell.  —  Anosmia. 

This  S3rmptom  may  show  itself  independently,  and  consists  in  a 
mere  insusceptibility  of  the  olfactory  nerves,  which  may  be  quickened 
by  one  or  two  doses  of  Belladonna,  Calcarea,  or  Sanguinaria.  If 
from  paralysis  of  the  olfactory  nerves,  give  Nux  vomica  or  Sepia.  If 
from  catarrh,  give  Calcarea,  Separ,  Silicea,  or  Sulphur. 

Loss  of  Taste. — Agustia. 

Fob  the  absense  of  this  sense,  independently  of  other  affections, 
give  Natrum  mur.  and  Silicea.  For  loss  of  taste  from  purely  nervous 
causes,  such  as  paralysis  of  the  gustatory  nerves,  give  Hyo»cyamu», 
Nux  vom.,  or  Sepia.  For  the  same  attended  with  catarrh,  coryza, 
and  other  effects  of  cold,  give  Pulsatilla  or  Sulphur,  or  else  Hepar  or 
Sepia.  Give  the  usual  dose,  and  repeat  twice  a  day  as  long  as  is 
necessary. 

For  alterations  of  taste,  viewed  as  mere  symptoms,  the  following 
remedies  may  be  employed ;  Aconite,  Arsenicum,  Belladonna,  Bry- 
onia, Mercurius,  Rhua,  Pulsatilla,  etc.  For  bitter  taste,  g^ve  Aconite, 
Bryonia,  Mercurius,  or  Nux  vomica.  For  the  taste  of  blood,  give 
Ipecac,  or  Sulphur.  For  the  taste  of  i^us,  Pulsatilla.  For  clayey 
taste,  China,  Hepar,  Pulsatilla.  For  flat,  watery  taste,  or  insipid, 
give  Bryonia  or  China.  For  the  taste  of  bad  eggs,  cheese,  etc.,  give 
Arnica,  Rhus,  or  Sulphur.  For  greasy  taste,  Caustieum.  For  metal- 
lic taste,  give  Calc,  Lachesis,  Nux  vomica,  or  Rhus.  For  clammy  or 
slimy  taste,  Arnica  or  Belladonna.  For  rancid  taste,  give  Bryonia 
or  Ipecac.  For  salt  taste,  Arsenicum,  Carho  veg.,  or  Sulphur.  For 
sour  taste,  give  Calc,  China,  Nux  vomica,  or  Sulphur.  For  other 
forms  of  illusory  or  bad  taste  in  general,  give  Nux,  Pulsatilla,  or 
Sepia.  For  sweetish  taste,  give  Belladonna,  Bryonia,  China,  Merc, 
or  Pulaatilla.  When  food  tastes  bitter,  give  Colocynth.  For  bitter 
taste  after  eating  and  drinking,  Bryonia,  China,  Pulsatilla.  When 
food  has  a  salty  taste,  give  Carho  veg.  When  it  tastes  sour,  give 
Calc.  or  China.  When  there  is  a  sour  taste  after  eating,  Nux  vom.  or 
Pulsatilla.     Sour  taste  after  drinking.  Sulphur.     If  after  drinking 


'mrmnnmn^ 


BPKOIFIC   INDICATIONS   rOK    RKMEDIEB   IN   FEVERS. 


milk,  Nux  vomica.  When  bread  tastes  sweet,  give  Mercuriiia,  When 
those  w'lo  use  tobacco  imagine  that  it  has  an  acid  taste,  Staphytagria. 
VVhen  there  is  an  illusory  taste  of  sweetness  of  h^fur,  Pul»atilla. 
For  nauseous  taste,  Ipecac.  A  single  dose  of  the  remedy  indicated 
for  illusions  of  taste  will  generally  correct  the  disorder.  Nearly  all 
these  departures  i-ora  the  normal  condition  of  the  sense  mey  be  indic- 
ative of  some  peculiar  derangement  of  the  animal  or  organio  func- 
tions, that  the  chosen  remedy  may  avert  or  correct.  The  value  of 
th.  }  isolated  symptoms  in  pointing  to  remedies  that  may  be  used 
as  timely  preventives  of  more  serious  derangements  can  hardly  be 
appreciated.  As,  for  instance,  a  bitter  taste  may  forebode  a  serious 
biliary  derangement,  that  Aconite  may  prevent.  And  so  with  all  the 
other  varieties  of  illusory  taste :  what  might  follow,  if  neglected,  no 
one  can  tell.  It  is  better  to  prevent  than  to  cure  a  malady :  and 
when  the  sentinels  of  taste  and  smell  stand  ready  to  guard  against 
the  approach  of  diseases,  it  is  always  best  to  give  need  to  their 
admonitions. 


POISONS  MD  THEIK  ANTIDOTES. 


SUBSTANOES  which  derange  the  vital  functions,  and  produce  death 
by  an  action  not  mechanical,  are  denominated  poisons;  and  distin- 
guished writers  have  noted  three  classes  of  these  substances,  which 
may  be  noted  as  follows :  -  - 

Ist.  Irritant  Poisons,  or  those  which  produce  irritation  or  inflam- 
mation, as  mfneral  acids,  Arsenic,  Copper,  etc. 

2d.  Narcotic  Poisons,  or  those  which  produce  stupor  or  delirium, 
and  other  affections  of  the  brain  and  nervous  system,  as  Opium, 
Prussia  acid,  etc. 

8d.  Narcotic-acrid  Poisons,  or  those  which  sometimes  produce  irri- 
tation, and  sometimes  narcotism ;  sometimes  both  together.  These 
are  all  derived  from  the  vegetable  kingdom ;  as  Strychnia,  Nux  vom- 
ica, etc. 

As  almost  everybody  is  obliged  to  be  so  situated,  that,  through  mis- 
take or  accident,  poison  of  one  or  another  of  these  classes  may  be 
taken  into  the  system,  it  seems  desirable  to  be  well  instructed  in  the 
use  of  antidotes,  and  the  treatment  of  the  supervening  irritation  or 
inflammation. 

If,  through  mistake  or  accident,  either  sulphuric,  nitric,  or  hydro- 
chloric add  is  taken  into  the  stomach  in  poisonous  doses,  give  Chalk 
or  Magnesia  ;  or,  if  this  is  not  at  hand,  beat  down  the  plaster  from  the 
wall,  and  make  into  a  thin  paste  with  water,  and  give  this.  Soap-suds  is 
another  antidote.  Drink  freely  of  any  mild  fluid,  or  milk,  both  before 
and  after  the  antidote  is  administered.  For  the  supervening  inflam- 
mation, such  remedies  may  be  employed  as  in  Gastritis  from  any 
other  cause:  Aconite,  in  case  of  much  fever;  Bryonia,  if  glairy 
vomitings ;   Nux  vomica,  if  there  is  sense  of  weight,  etc. 

In  case  of  Oxalic  acid  being  taken  into  the  stomach  by  mistake, 
as  this  may  occur  from  its  resemblance  to  Epsom  saltu,  it  will  be  nec- 
essary to  excite  vomiting  at  once  by  tickling  the  throat  with  a 
feather,  or  by  an  emetic  ;  and,  after,  to  administer  Chalk  or  Magnesia 
in  large  doses  suspended  in  water.  These  not  being  at  hand,  break 
off  the  plaster,  and  make  a  paste  as  before.  Alkalies  will  not  answer, 
as  they  would  only  form  neutral  salts.  For  the  after-symptoms, 
give  Aconite  dissolved  in  water,  —  a  tablespoonful  after  every  par- 
oxysm of  vomiting,  until  they  cease ;  and  give  the  victim  at  the 

726 


P0IBON8,   ANI>   THKIK   ANTinOTKS. 


727 


giiine  timo,  frooly,  inuoilagiiioiis  drinks,  uiid  iilmi  ('ojfnt  iiikI  Opium 
UN  luitidotes. 

For  /witoniiit/  with  Arnenie^  tho  lirnt  thing  ne(!OHHary  is  to  thor- 
(»ii|,'lily  evacuate  tho  8toiimch ;  and,  for  this  purport*!,  give  an  onietiu, 
mid  then  follow  with  iron-runt,  or  the  Senqui-oxld  of  Iron,  hugely  dif- 
fused in  water;  and  let  tho  patient  drink  freely  of  inucilaginouH, 
furiiiaceous,  or  albuminous  drinks,  and  milk.  The  suljsequent  in- 
tlanimation  must  Iw  treate<l  with  Aaonitf,  —  a  dose  every  two  hours 
until  the  nausea  entirely  disappears  ;  Nux  vomira,  also,  for  the  inflam- 
mation and  soreness  of  the  gastric  region ,  Bri/onia,  if  the  slightest 
motion  produces  pain  ;  and  Pulmtilla  or  Nux  vom„  if  the  most  deli- 
cate kinds  of  food  aggravate  the  suffering. 

For  Poiaoniiuj  ivith  Mennirif,  and  Corronive  Sublimate.  —  This  is 
the  usuid  form  oi  Mercury  employed  for  committing  suicide ;  and,  as 
it  is  used  for  hed-^  \  poison,  it  is  liable  to  be  taken  through  careless- 
ness or  mistake.  It  is  therefore  requisite  to  point  out  some  antidote 
the  nearest  at  hand,  (live  whiten  of  egija  in  abundance,  or  Oluten  if 
eggs  cannot  Iw  haa,  )r  else  milk.  The  most  usual  form  of  the  sup- 
ervenuig  irritation  is  salivation  or  mercurial  fever.  For  these,  give 
Nitric  acid,  Hepar  sulph,,  and  obtain  for  the  patient  fresh  air  and 
a  nourishing  diet  as  soon  as  possible. 

For  Poitoniny  with  Copper.  —  The  blue  vitriol,  or  Sulphate  of 
Copper,  and  Verdigris,  are  the  forms  in  which  this  poison  is  most 
common  ;  and,  when  tivken  into  the  system,  the  most  ready  antidote 
is  tlie  white  of  eggs.  Great  care  should  be  taken  to  exclude  vinegar, 
for  tiiis  acid  would  Kid  virulence  to  the  poison.  To  allay  or  cure 
the  remaining  irritation,  give  Sulphur  twice  a  day. 

Poisoning  with  Antimony  o,  fart,  emetic,  is  liable  to  occur,  as  this 
suljsUmce  is  somotimes  used  in  medicine  as  an  emetic.  When  given 
to  excess,  it  produces  vomiting,  attended  with  burning  pain  at  the 
pit  of  the  stomach,  followed  by  [)urging  and  colic,  stricture  of  the 
throat,  and  cramps.  As  an  antidote,  give  large  draughts  of  warm 
water,  and  tickle  the  throat  with  a  feather  to  induce  vomiting ;  also 
the  decoction  of  any  bark  containing  tarmin,  as  oak,  hemlock,  or 
cherry-tree  bark.  For  the  subsequent  ailments,  give  Sulphur,  China, 
Nux  vomica,  or  Opium. 

For  Poisoning  toith  Zinc,  or  white  vitriol,  which  is  denominated  by 
violent  vomiting,  sunken  eyes,  and  pale  face,  cold  extremities,  and 
fluttering  pulse,  give  the  infusion  of  any  of  the  substances  contain- 
ing tannin,  and  feed  the  patient  with  cream,  butter,  and  chalk  quite 
freely. 

For  Poisoning  with  Lead.  —  Red  lead  and  white  lead,  aa  well  as 
sugar  of  lead,  are  liable  to  be  taken  by  mistake  ;  and  their  poisonous 
effects  are  denoted  by  obstinate  colic,  spasms  of  the  muscles,  and 
sometimes  apoplexy.  As  an  antidote,  give  water  of  ammonia,  or 
hartshorn,  or  pearlash-water,  or  any  of  the  earthy  sulphates,  as  lime, 
etc.  For  lead  paralysis,  give  Sulphur,  and  afterwards  Nux  vomica. 
For  colic.  Opium. 


■iri 


728 


POISONS,   AND   THEIR  ANTIDOTES. 


^or  Poisoning  with  Cantharides,  which  is  denoted  by  intense  burn- 
ing in  the  pit  of  the  stomach,  and  pain  in  the  lower  abdomen,  feeble 
voice,  laborious  breathing,  strangury,  and  tenesmus  of  the  bladder, 
headache,  and  delirium.  To  remove  the  Cantharis  from  the  stomach, 
excite  vomiting  in  the  quickest  and  most  speedy  way,  —  by  tickling 
the  throat  with  a  feather,  or  drinking  a  strong  mustard-tea,  or  by 
taking  snuff  upon  the  tongue.  Give  Aconite  to  allay  the  fever ;  give 
Nux  vomica  and  Pulsatilla  to  allay  the  irritability  of  the  stomach,  and 
Arnica  to  relieve  the  tenesmus,  or  straining;  or  else  spirits  of  Camphor. 
This  is  believed  to  be  the  best  antidote. 

For  Poisoning  with  Morphine,  which  is  denoted  by  giddiness  and 
stupor,  the  person  becomes  motionless,  and  insensible  to  external  im- 
pressions, breathes  slowly,  and  -lies  quite  still,  with  the  eyes  shut  and 
the  pupils  contracted,  the  whole  expression  of  the  countenance  being 
that  of  perfect  repose.  As  the  poison  advances,  the  features  become 
ghastly,  the  pulse  feeble  and  imperceptible,  the  muscles  excessively 
relaxed ;  and,  unless  assistance  is  speedily  called,  death  soon  ensues. 
The  first  thing  necessary  is  to  remove  the  poison  from  the  stomach, 
which  is  by  inducing  vomiting  If  soon  after  taking  the  morphine, 
give  mustard-wate^  freely,  or  injaot  in  the  stomach  some  Sulphate  of 
Zinc,  if  the  patient  is  too  insensible  to  take  it  otherwise.  After 
vomiting  is  induced,  arouse  the  victim,  make  him  walk  up  and  down 
the  room  for  hours,  until  the  in<ilination  to  sleep  is  superseded  by 
nausea,  headache,  and  vomiting,  and  then  give  him  strong  coffee  ;  and 
afterwards  to  remove  the  entailed  symptoms,  give  Nux  vomica. 

For  Poisoning  with  Prussic  Aeid,  when  not  fatal,  resort  to  cold 
shower-bath,  and  inhalation  of  diluted  water-of-ammonia  vapor ;  give, 
also,  solution  of  Carbonate  of  potash. 

For  Poisoning  with  Charcoal  0-as,  as  from  the  fumes  of  burning 
charcop.l  m  a  close  room,  resort  to  cold  affusion,  and  give  Aconite,  in 
drop  doses,  in  a  spoonful  of  water.  The  same  treatment  may  be 
resorted  to  in  case  of  poisoning  with  any  of  the  poisonous  gases,  as 
svlphureted  hydrogen  and  carbonic  add. 

Poisoning  by  Strychnia,  or  Nux  vomica,  is  denoted  by  convulsions, 
with  much  anxiety  and  agitation  during  the  fits.  The  whole  body 
is  stiffened  or  straightened ;  the  legs  pushed  out  and  forced  wide 
apart;  no  pulse  or  breathing  can  be  perceived;  the  face  and  hands 
livid,  and  the  muscles  violently  convulsed.  Nux  vomica,  or  Strychnia, 
in  poisonous  dosee,  generally  proves  fatal,  in  spite  of  treatment.  If 
emetics  are  given,  and  the  stomach  is  made  to  disgorge  its  contents 
sufficiently  early,  and  the  patient  is  not  attacked  with  convulsions  in 
two  hours,  he  will  generally  be  safe. 

In  treating  any  case  of  poisoning,  two  things  are  required :  1st,  re- 
moval of  the  exciting  cause ;  2d,  treatment  of  the  effects  that  remain. 
The  removal  of  the  poison  should  be  done,  if  possible,  with  little  vio- 
lence, and  by  the  simplest  and  most  innocent  method,  either  with  the 
finger,  or  in  case  the  poison  has  been  a  long  time  swallowed,  excite 


i.i.'Wi;»a.'i'ii 


POISONS,   AND   TUEIK  ANTIDOTES. 


729 


vomitir^  or  stool  by  the  simplest  means.  Copious  administration  of 
tepid  water,  irritating  the  fauces  by  means  of  a  leather,  or  something 
similar,  or  by  salt,  mustard,  and  snuff,  or  injections  of  tobacco-smoke; 
and  neutralize  the  poisons  by  means  of  albumen,  vinegar,  lemonrjuice, 
coffee,  camphor,  milk,  oil,  soap,  mucilaginous  drinks,  tea,  wine,  sugar, 
or,  as  it  has  been  seen,  with  ammoniacal  gax,  ironrrust,  charcoal, 
kitchen  salt,  Epsom  salt,  potash,  and  starch. 

It  is  well  to  be  familiar  with  these  antidotes  of  poisons,  and  to 
bear  in  mind  the  particular  indications,  or  poisonous  substances  that 
call  for  them,  as  follows :  — 

Albumen,  or  whites  of  eggs,  antidotes  such  metallic  substances  as 
quicksilver,  '  orrosive  sublimate,  verdigris,  tin,  lead  %nd  Sulphuric 
acid,  when  1  victim  complains  of  violent  pains  in  tie  stomach,  with 
tenesmus,  or  diarrhoea,  and  pains  at  the  anus. 

Vinegar  antidotes  alkaline  poisons,  and  obviates  the  ill  effects  of 
aconite,  opium,  poisonous  mushrooms,  belladonna,  etc. 

Coffee.  —  Strong  black  coffee,  made  of  the  berry  lightly  roasted, 
and  drunk  hot,  is  an  antidote  to  opium,  nux  vomica,  belladonna,  nar- 
cotics, mushrooms,  poisonous  sumac,  bitter  almonds,  and  all  those 
substances  containing  prussic  acid.  It  must  be  borne  in  mind,  how- 
ever, that  the  cause  must  be  removed,  if  possible,  first. 

(7ampAor  antidotes  the  ill  effects  of  poisonous  insects,  and  especially 
cantharis,  whether  administered  internally  or  externally.  Camphor 
also  antidotes  the  toxical  effects  of  phosphorus,  spigelia,  and  santonin. 
It  is  also  useful  for  the  after-effects'  of  acids,  salts,  metals,  etc.,  after 
the  poisonous  substance  itself  has  been  removed  from  the  stomach  by 
means  of  vomiting,  etc. 

Milk  is  frequently  alluded  to  as  an  antidote  for  poisons ;  but  it  has 
no  real  merit.  Mucilaginous  substances  are  better,  and  much  to  be 
preferred. 

Olive  Oil  ranks  with  milk,  and  is  much  less  useful  than  is  believed. 
It  is  useless  in  metallic  poisons,  and  even  hurtful  in  poisoning  with 
arsenic.  It  is  of  some  service,  however,  in  case  of  poisoning  either 
with  Nitric,  Sulphuric,  or  Phospho'  j  add.  Olive  oil  and  vinegar, 
administered  in  alternation,  has  proved  lerviceable  in  cases  of  poison- 
ing with  alkalies. 

Soap. —  Castile  soap,  dissolved  in  four  times  its  bulk  of  hot  water, 
and  drunk,  will  antidote  many  cases  of  poisoning  with  Corrosive  sub- 
limate and  also  with  arsenic,  or  with  any  of  the  numerous  forms  of 
lead.  Soapsuds  is  likewise  a  valuable  antidote  for  poisoning  with 
Sulphuric  and  Nitric  acid.  Soap  is  hurtful  in  cases  of  poisoning  with 
alkalies. 

Sugar,  or  sugar-water,  is  quite  as  good  as  any  of  the  antidotes,  and 
much  to  be  preferred  in  cases  of  poisoning  with  paint,  verdigfris,  cop- 
per, sulphate  of  copper,  alum,  etc.  In  cases  of  corrosive  sublimate, 
in  solution,  being  taken  into  the  stomach  by  mistake,  as  it  has  been, 
8ugar*water  iu^y  be  given  before  the  white  of  an  egg.    Sugar  is  also 


730 


POISONS,  AND  THEIR  ANTIDOTKS. 


an  excellent  antidote  in  cases  of  poisoning  with  Arsenie.  The  other 
antidotes  are,  — 

Ammoniacal  gas,  or  the  volatile  odor  of  spirits  of  hartshorn,  for 
poisoning  with  alcohol,  bitter  almonds,  or  prussic  acid. 

Iron-rust,  or  the  sesqui-oxide  of  iron,  for  poisoning  with  arsenic, 
freshly-prepared. 

Epsom  salt,  for  the  various  alkaline  poisons. 

dharooal,  for  poisoning  with  putrid  fish,  meat,  mushrooms,  or 
mussels. 

Kitchen  salt,  for  poisoning  with  nitrate  of  silver,  and  poisonous 
wounr  . 

Magnesia,  for  poisoning  with  any  of  the  mineral  acids. 

Potash  and  Sweet  Almond  oil  are  also  good  antidotes  for  acids. 

Starch,  in  solution,  is  the  best  antidote  for  poisoning  with  iodine. 

Strong  tea  is  a  good  antidote  for  poisoning  with  honey ;  and  so  is 

Wine,  for  noxious  vapors  and  poisonous  mushrooms. 

And  here  it  may  be  repeated,  that  the  first  thing  we  have  to  do, 
in  treating  cases  of  poisoning,  is  to  remove  the  poison  by  vomiting, 
and  then  to  administer  the  suitable  antidotes.  In  case  we  should 
not  be  able  to  ascertain  what  kind  of  poison  has  been  swallowed,  we 
should  first  administer  the  white  of  egg ;  and  in  case  there  should  be 
stupor,  give  coffee,  quite  strong,  made  of  the  lightly-roasted  kernel. 
But  if  we  should  know  the  poison  to  be  mineral  or  metallic,  the  first 
resort  may  be  to  white  of  Q^g,  sugar-water,  soap-water,  or  soap-suds, 
and  for  the  remaining  effects  Hve  Sulphur,  which  has  been  ascer- 
tained to  be  a  real  antidote  to  tae  effects  of  metallic  poisons.  If  it 
should  be  kuown  that  acids  or  corrosive  substances  have  been  taken, 
give  Castile  soap  mixed  with  four  times  its  bulk  in  warm  water,  or 
magnesia  dissolved  in  water,  or  powdered  chalk  stirred  up  in  water, 
or  a  solution  of  saleratus,  pearlash,  or  super-carbonate  of  soda,  in 
spoonful  doses,  after  each  paroxysm  of  vomiring,  as  long  as  it  con- 
tinues; and  afterwards  give  mucilagino'is  drinks,  and,  alternately, 
coffee  and  opium,  in  the  form  of  homoeopathic  remedies ;  and  for  the 
remaining  ailments,  give  Pulsatilla.  After  the  antidotes  have  been 
administered,  give  Pulsatilla  for  sulphuric  acid,  Bryonia  for  muriatic 
acid,  and  Aconite  for  other  acids,  and  especially  for  crab-apple  vin- 
egar. In  case  it  should  be  known  that  alkaline  substances  have  been 
swallowed  in  poisonous  quantities,  vinegar  and  water  may  be  given 
in  large  quantities,  and  also  lemon-juice  or  cranberry-sauce,  without 
sugar,  or  sour  milk  ;  and  for  the  secondary  effects  of  poisoning  with 
potash,  give  Ooffea  or  Oarho  veg.  If  the  poisoning  is  known  to  be 
the  effects  of  spirits  of  hartshorn,  give  ffepar  sulph. ;  if  it  should  be 
known  the  patient  had  been  inhaling  noxious  vapors,  bathe  the 
patient  freely  with  vinegar  and  water,  and  let  him  inhale  the  vapor 
of  a  solution  of  hydrochloric  acid;  and,  after  a  return  to  full  con- 
sciousness, give  a  strong  decoction  of  partially-charred  coffee,  or  a  few 
doses  of  Opium  or  Belladonna. 


■Twr — ; — •^SFT 


POISONS,  AND  THEIB   ANTIDOTES. 


781 


The  vapors  of  coal,  when  having  a  poisonous  effect,  may  be  anti- 
doted  by  copious  draughts  of  vinegar  and  water ;  and  for  poisoning 
by  any  substance  not  mentioned,  first  follow  the  rule  of  removing  the 
poison  from  the  stomach  by  vomiting,  and,  for  the  irritation  or  in- 
flammation left  behind,  affiliate  any  homoeopathic  remedy  that  may 
meet  the  case.  If  there  is  much  fever  or  arterial  excitement,  give 
Aconite,  every  hour ;  if  severe  burning  at  the  stomach,  and  thirst, 
give  Arsenicum  or  Mercurius ;  if  there  is  great  soreness  of  the  mus- 
cles, give  Arnica,  and  let  the  patient  be  bathed  with  a  lotion  of  the 
same;  if  it  is  known  that  any  of  the  animal  poisons  have  been  taken 
into  the  stomach,  give  a  teaspoonful  of  powdered  charcoal  in  half  a 
tumbler  of  water  at  a  dose,  and  i  ^  after  each  vomiting  until  the 
stomach  becomes  quiet ;  and  if  jison  of  this  kind  fias  come  in 
contact  with  the  eyes,  give  Aconite;  and,  finally,  to  guard  against  the 
infection  of  poisonous  wounds,  when  torched  with  the  fingers  or 
hand,  let  them  be  held  in  strong  heat,  as  strong  as  it  can  be  borne, 
for  ten  or  fifteen  minutes,  and  afterwards  wash  them  with  soap. 


lU:' 


jmmm 


^F^ 


PB0CE88E8  OP  THE  HYDEOPATHIC 
TREATMENT. 


Fob  the  description  of  the  hydropathic  appliances  contained  in  the 
following  pages,  I  am  indebted,  in  substance,  to  the  "  Hydropathic 
Family  Physician,"  by  Joel  Shew,  M.  D.,  author  of  several  popular 
works  upon  the  principles  and  practice  of  hydropathy.  I  have  not 
uniformly  adopted  his  exact  language,  which  is  not  always  the  best 
he  might  have  chosen  to  express  his  thoughts. 

Priessnitz  is  admitted  to  have  been  the  originator  of  the  hydro- 
pathic modes  of  treating  diseases.  He  was  an  unlearned  man,  though 
he  had  origina,l  powers  of  mind ;  and,  imperfect  as  the  treatment  is, 
he  benefited  his  race  by  conferring  it  upon  the  worid. 

At  first,  and  for  some  time,  baths  were  made  too  cold,  and  were 
continued  too  long ;  the  result  was  much  injury  to  the  patient  in 
many  cases.  Time  and  experience  have  brought  a  better  adaptation 
of  the  temperature  and  continuance  of  the  water  appliances  to  the 
symptoms,  constitution,  and  temperament  of  each  patient.  Formerly, 
weak,  exhausted,  and  nervous  persons,  not  less  than  the  full-blooded 
and  strong,  were  put  into  the  wetsheet  pack,  and  reduced  near  to 
death's  door;  and  there  is  reason  to  believe  that  in  some  cases  where 
the  practice  is  in  ignorant  hands,  this  barbarity  is  not  wholly  discon- 
tinued. The  practice,  however,  is  now  mainly  in  better  hands ;  and 
although  I  by  no  means  admit  its  sufficiency  as  a  system  of  remedial 
agencies,  I  am  persuaded  it  is  doing  some  good.  Used  in  connection 
with  the  ancient  system  of  regular  medicine,  which  is  the  joint  prod- 
uct of  time,  science,  and  experience,  the  water  treatment,  moulded 
and  modified  to  the  circumstances  and  strength  of  the  patient,  is  an 
auxiliary  of  no  mean  power.  As  such,  I  accept  it.  As  such,  it  is  re- 
ceived by  hundreds  and  thousands  of  regrular  practitioners  through- 
out the  world.  Further  than  this,  it  never  can  or  will  be  generally 
received.  By  pushing  it  beyond  this,  its  rightful  and  honored  sphere, 
its  friends  only  limit  its  progress  and  injure  its  influence. 

.    Division  of  Baths. 

On  no  one  subject  connected  with  hydropathy  has  there  been  more 
"confusion  of  tongues,"  than  concerning  the  temperature  of  baths. 

73a 


L5iB»^..ja.=.^VAj^:L^4^<■i:^^*jittf^ir^'o^^;£j.^'l>:^tfaMaik;'aK 


PR0CE88K8   OP   THE   HYDROPATHIC   TREATMENT. 


733 


Both  in  books  and  in  popular  language,  among  physicians  as  well  as 
laymen,  have,  words  been  used,  sometimes  confusedly,  and  at  other 
times  without  any  meaning  whatever.  Orthodox  medical  works,  as 
well  as  the  unorthodox,  come  under  the  same  category  of  error.  A 
few  simple  explanations  on  this  head,  properly  made,  will  be  sufficient 
for  all  practical  as  well  as  scientific  purposes. 

The  simplest  and  most  natural  division  of  baths  is  into  cold,  tepid, 
warm,  and  hot.  These  are  all  terms  of  every-day  life,  and  are  fully 
sufficient  to  guide  us  in  the  selection  of  any  and  aU  the  multiform 
uses  of  water  which  hydropathy  teaches.  I  admit,  however,  that 
when  we  wish  to  be  especially  explicit,  the  actual  thermometrical 
temperature  should  be  mentioned.  Sot  baths,  I  maintain,  have  no 
proper  place  in  hydropathic  practice.  He  who  resorts  to  them  either 
does  not  at  all  understand  the  true  principles  of  the  Water-Cure,  or 
is  guided  merely  by  the  whims  or  caprices  of  those  who  employ  him. 

But  whatever  words  we  use  to  designate  the  different  baths,  there 
is  one  objection,  which  is,  that  all  such  terms  are  necessarily  arbitraiy 
in  a  greater  or  less  degree.  What  appears  to  one  person  cold,  may 
to  another  appear  tepid,  or  warm,  or  even  hot.  Thus  it  is  said  that 
on  a  road  over  the  Andes,  at  about  half  way  between  the  foot  and 
the  summit,  there  is  a  cottage  in  which  the  ascending  and  descending 
travelleis  meet.  The  former,  who  have  just  quitted  the  sultry  val- 
leys at  the  base,  are  so  relaxed,  that  the  sudden  diminution  of  tem- 
perature produces  in  them  a  feeling. of  intense  cold ;  while  the  latter, 
who  left  the  frozen  summit  of  the  mountain  are  overcome  by  dis- 
tressing sensations  of  extreme  heat.  If  on  a  cold  winter's  morning 
we  go  from  a  warm  bed  to  a  bath  of  sixty  to  seventy  degrees  Fahr., 
the  water  appears  cold.  If  we  then  plunge  immediately  into  water 
which  is  at  about  the  freezing  point,  and  then  return  again  to  the 
water  at  sixty  to  seventy  degrees  Fahr.,  it  appears  warm.  When  the 
temperature  of  the  atmosphere  is  at  fifty-five  degrees  Fahr.,  in  No- 
vember or  October,  in  this  latitude,  and  the  body  of  a  comfortable 
degree-of  warmth,  and  we  take  three  basins  of  water  at  sixty,  seventy, 
and  eighty  degrees  Fahr.,  placing  one  hand  in  the  water  at  sixty  de- 
grees, the  other  in  that  at  eighty  degrees,  letting  them  remain  thii-ty 
seconds  in  each,  and  then  immerse  them  both  in  the  water  at  seventy 
degrees,  it  appears  to  one  cold,  to  the  other  warm. 

But  we  can  arrive  at  rules  which  approximate  so  nearly  to  the  ac- 
tual truth,  that  they  will  serve  us,  as  before  remarked,  for  guides  in 
all  practical  and  scientific  purposes. 

The  Cold-Bath.  —  With  a  majority  of  persons,  and  at  most  seasons 
of  the  year,  water  at  from  seventy  to  eighty  degfrees  Fahr.  downward, 
gives,  when  immersed  in  it,  a  sensation  of  coldness.  The  spring- 
water  of  all  countries  furnishes  what  may  therefore  be  called  a  cold- 
bath,  although  there  will  be  a  i-ange  of  many  degrees  variation  in 
what  we  term  oold. 


734 


l'liOCE88E8   OF   MIK   HYUKOPATHIO   TKEATMENT. 


The  Tepid  Bath.  —  The  word  tepid  is  from  the  Latin  tepeo,  to  be 
warm.  The  true  English  meaning  of  the  term,  however,  is,  according 
to  Mr.  Webster,  moderately  warm,  or  lukewarm;  in  other  words, 
water  which,  when  a  person  is  immersed  in  it,  gives  a  kind  of  inde- 
fini '  ^1  sensation,  o^ie  which,  coming  properly  under  the  term  neither 
eol  "arm,  is  said  to  be  tepid.    This  temperature  will  be  found 

to  1.         at  from  eighty  to  ninety-two  degrees  Fahr. 

The  ^arm  Bath.  —  The  term  warm  is  generally  well  understood. 
It  means  that  temperature  of  water  which  is  peculiarly  agreeable  to 
the  sensations.  Fresh-drawn  milk  or  blood  we  say  are  warm.  The 
temperature  of  water  which  will  cause  this  sensation  varies  from 
ninety-two  to  ninety-eight  degrees  Fahr. 

The  Vapor  Bath.  —  The  temperature  of  the  vapor  of  simple  water 
varies  from  about  ninety  degrees  Fahr.  upward,  according  to  the  heat 
of  the  water,  and  the  space  through  which  the  vapor  passes. 

The  Hot  Bath.  —  The  term  hot  is  also  expressive  of  ifs  proper 
meaning.  If  the  body  is  immersed  in  water  above  blood-heat,  it 
causes  an  uncomfortable  sensation,  which  we  designate  as  hot.  Hot 
water  is  a  disturber  of  the  vital  functions,  particularly  if  the  whole 
body  is  immersed  in  it.  Hot  baths,  therefore,  should  be  used,  if  ever, 
only  in  a  most  urgent  necessity.  Hot  water,  iu  no  form  whatever, 
entered  into  any  part  of  Priessnitz's  treatment. 

Having  thus  explained  the  temperatures  of  the  different  divisions 

of  the  bath,  it  is  proper  to  state  them  in  a  tabular  form,  the  better  to 

aid  the  memory.     They  are  as  follows :  — 

Oold-bath,  from  freezing  point,       .        .  32  to  85°  F. 

Tepid   " 80  to  92° 

Warm  " 92  to  98° 

Vapor  " 90°  and  upward. 

Hot      " above  98°. 

I  now  propose  to  explain  somewhat  minutely,  and  at  the  same  time 
with  a  due  regard  to  the  needs  of  the  non-professional  reader,  the 
physiological  effects  of  each  of  the  several  kinds  of  bath,  and  I  here 
respectfully  premise  that  any  one  who  attempts  to  practise  the  water 
treatment  without  having  in  his  mind  clear  notions  upon  this  subject 
is,  to  say  the  least,  as  much  a  "groper  in  the  dark  "  as  he  who  attempts 
the  practice  of  drugs  of  which  he  knows  nothing,  upon  the  living 
body  of  which  he  knows  less.  How  can  a  man  be  trusted  in  water 
treatment  if  he  cannot  tell  beforehand  what  effect  a  bath  is  to  have; 
and  this  he  cannot,  if  he  does  not  fully  understand  the  meaning  of 
the  terms  which  I  have  here  explained. 

Effects  of  the  Cold  Bath. — The  effects  of  the  cold  bath  are  properly 
spoken  of  under  two  heads,  the  primary  and  the  secondary.  The 
terms  are  sufficiently  expressive  of  their  meaning.  The  first  are 
those  which  take  place  at  the  time  of  the  immersion ;  the  second, 
those  that  occur  later,  constituting  what  we  understand  by  the  term 
reaction. 


L.'jAV.-JiiS3t'.'.;5i^.^- 


i  ■^^M^M^fMB*mtti*\itLj^'ih9,x-A^*\'t\\*s^'.^:iii^^  Y . 


J(*3fc*.'h-  Mil^alU!Mi;fAt;lBjic>«w.^ 


PK00E8SE8   OF   THK   HYDROPATHIC   TKKATMKNT. 


735 


Immediately  on  immersion  in  cold  water,  the  bather  experiences 
some  acceleration  of  respiration  and  the  heart's  action,  .although  the 
pulse  becomes  at  the  same  time  smaller  and  weaker.  Very  soon, 
liowever,  the  panting^  if  I  may  so  call  it,  passes  off ;  the  temperature 
of  the  body  is  found  diminiahed,  tlie  surface  paler  tlian  natural,  tlie 
skill  taking  on  that  form  of  appearance  known  as  "goose-flesh." 

The  first  effect  of  cold  water  applied  to  the  l>ody,  generally,  is  to 
abstract  a  certain  amount  of  heat  from  the  surface,  to  constringe  the 
capillary  vessels,  and  to  force  the  blood  inward.  Now,  as  the  living 
body  possesses  the  remarkable  property  of  maintaining  its  tempera- 
ture at  very  nearly  the  same  point,  whether  it  is  in  a  colder  or  hotter 
medium  than  itself,  the  vitals  at  once  set  to  work  in  restoring  the 
caloric  abstracted  by  the  contact  of  the  water ;  and  as  the  functions 
of  circulation  and  calorification  go  necessarily  together,  the  vital 
power,  acting  through  the  heart  and  blood-vessels,  attempts  a  return 
of  the  blood  that  had  been  forced  inward  by  the  coldness  of  the 
water. 

This  is  what  we  call  reaction.  If  the  individual  is  8u£Sciently 
strong  and  well  stocked  with  vitality,  the  blood  is  quickly  returned 
to  the  surface  and  to  the  extremities  (which  are  always  most  liable 
to  become  cold,  being  farthest  from  the  heart),  constituting  what  is 
termed  good,  or  vigorous  reaction.  But  if  the  surface  and  extremities 
continue  to  remain  unwarmed  by  this  return  of  the  blood  to  them, 
as  happens  in  the  case  of  feeble  persons,  there  is  said  to  be  poor,  or 
imyfficient  reaction.  It  would  then  be  necessaiy  to  give  some  warm- 
ing medicine  to  start  the  blood  circulating. 

Effects  of  the  Tepid  Bath.  —  The  tepid  bath,  which  we  have  seen 
mnges  from  eighty  to  ninety-two  degrees  Fahr.,  produces  effects 
analogous  to  those  of  the  cold  bath,  only  not  so  lasting  and  perma- 
nent. It  is  especially  useful  in  the  treatment  of  infants  and  children, 
and  in  all  cases  where  the  reactive  energy  is  feeble.  If  in  any  case 
we  are  in  doubt  as  to  whether  the  cold  bath  is  admissible,  the  tepid 
form  will  be  a  milder  measure,  and  at  the  same  time  serve  as  a  test 
in  venturing  upon  the  cold.  The  tepid  bath  may  be  continued  longer 
at  a  time,  which  in  some  cases  will  be  found  an  advantage. 

Effects  of  the  Warm  Bath.  —  There  is  among  hydropathic  physi- 
cians, if  I  am  not  mistaken,  too  gi-eat  a  fear  of  warm  applications  on 
the  part  of  some,  while  others  go  to  the  opposite  extreme,  Mark,  I 
speak  of  warm  applications.  Hot,  as  before  remarked,  have  no  proper 
place  in  hydropathy,  —  a  rule  to  which  the  exceptions  are  few. 

The  warm  bath,  as  before  remarked,  ranges  from  ninety-two  to 
ninety-eight  degrees  Fahr.  It  is  not  the  most  useful  of  the  hydro- 
pathic resources,  but  one  of  the  most  useful,  aa  I  shall  endeavor  here- 
after to  show. 

Among  the  ancient  Romans  the  warm  l)ath  was  not  considered  as 
a  means  of  luxurious  indulgence  that  tended  to  weaken  the  vital 


U 


i 


i 


Jf  ^i 


:;ii 


asm 


■wi 


736 


PROOESSKS   OF  THE   HYDROPATHIC  TREATMENT. 


powers,  but  a  means  of  refreshment  for  the  wearied  traveller,  and  of 
preparing  him  for  the  repast  and  the  enjoyment  of  other  rites  of 
hospitality.  -The  effect  of  the  warm  bath  is  not  one  of  debility,  as 
many  suppose,  but,  on  the  contrary,  it  is  a  sedative,  lowering  the 
heart's  action  and  the  circulation,  and  tending  to  repose  rather  tbaii 
excitement. 

Effects  of  the  Hot  Bath.  —  The  hot  bath,  l)efore  remaiked,  is  one 
whioh  is  above  the  temperature  of  the  blood,  ninety-eight  deprives 
Fahr.  It  was  laid  down  as  a  precept  by  Hippocrat^es,  that  a  bath  en- 
feebles when  the  heat  exceeds  that  of  the  body  immersed  in  it.  The 
truth  of  this  precept  has  often  been  verified  in  practice. 

I  do  not  wish  to  be  understood  as  aflBVming  that  hot  applications 
can  never  be  made  with  benefit  to  the  body ;  on  the  contrary,  heat 
applied  to  a  part  locally  may  be  of  service,  although  I  am  inclined  to 
believe  that  even  in  those  cases  where  heat  acts  in  a  beneficial  way, 
some  other  form  of  hydi-opathio  appliance  can  be  used  more  bene- 
ficially. I  make,  it  will  be  remembered,  a  broad  distinction  between 
the  terms  hot  and  warm. 


Sea-Bath  ins;. 

As  regards  temperature,  sea-bathing  comes  under  the  general  head 
of  cold  baths.  Sea-water,  however,  at  those  seasons  of  the  year  when 
sea-bathing  is  resorted  to,  is  of  a  moderate  degree  of  coldness,  vary- 
ing in  this  latitude  not  much  from  seventy  degrees  Fahr. 

In  order  to  appreciate  fully  the  effects  of  sea-bathing  upon  the  sys- 
tem, a  number  of  things  are  to  be  considered. 

Sea-water  differs  in  its  effects  from  common  water  by  its  possessing 
greater  density.  This  circumstance,  however,  is  not  of  so  great  im- 
portance as  that  of  the  stimulating  nature  of  the  minerals  it  contains. 
The  saline  ingredient  is  a  powerful  stimulant  and  even  irritant  of  the 
skin.  On  account  of  this  property,  it  is  found  that  an  exposure  to  the 
action  o'  ^alt  water  is  not  so  liable  to  cause  ill  effects  as  that  to  fresh. 
The  sail  causing  a  degree  of  heat  upon  the  surface  somewhat  higher 
than  that  of  the  natural  state,  the  system  is  for  the  time  shielded 
from  the  action  of  cold.  It  does  not  follow  from  this,  however,  that 
a  pei-son  could  live  longer  immersed  in  sea  than  in  common  water, 
any  more  than  it  follows  that  because  alcohol  for  a  time  increases  the 
animal  temperature,  life  can,  under  circumstP^ces  of  great  exposure 
to  cold,  be  the  longer  preserved.  This  it  is  now  well  known,  is  not 
the  case. 

An  advantage  of  sea-bathing  in  the  hot  season  is,  that  the  air  at 
the  sea-shore  is  cooler  than  on  land.  That  our  climate  in  summer  \s 
too  hot  for  the  most  favorable  development  of  health  is  proved  by 
the  great  increase  of  mortality,  not  only  in  our  cities,  but  in  othei' 
parts,  during  the  hot  season.  The  European  cities,  with  all  their 
numbers   of   inhabitants,   dampness,  narrow  streets,  intemperance, 


\u.iiiittJmi£^Li^j.:>Cj&iuiuM.:  t  niiix.iit.uytbtiiigiuvk,- jkiljil-^ 


PKO0K88E8  OF  THE  HYDROPATHIC  TBKATMENT. 


737 


pauperism,  etc.,  would  naturally  be  expected  to  show  a  higher  range 
of  mortality  than  our  American  cities,  but  such  is  not  the  fact.  Even 
New  York,  with  all  its  natural  advantages,  is  as  sickly,  probably,  as 
any  of  the  British  or  European  cities.  This,  it  is  agreed  on  all 
hands,  must  be  owing  in  great  part  to  the  intense  heat  of  our  summer 
months. 

The  manner  of  taking  the  salt-water  bath  has  some  peculiarities 
which  are  favorable  to  health.  It  is,  in  the  first  place,  in  the  open 
air,  which,  if  the  weather  is  favorable,  that  is,  neither  too  hot  nor  too 
cold,  is  always  a  great  advantage.  Other  things  being  equal,  a  bath 
in  the  open  air  is  always  attended  with  a  betterreaction  and  a  greater 
degree  of  invigoration  than  one  within  doors. 

In  the  second  place,  sea-bathing  is  usually  and  almost  necessarily 
conn  :cted  with  exercise  both  before  and  after  the  bath,  circumstances 
which  are  always  highly  favorable  to  the  action  of  cold  water.  So 
beneficial,  indeed,  is  exercise  taken  in  this  way,  that  it  would  be  dif- 
ficult to  determine  which  of  the  two  —  the  exercise  or  the  bathing  — . 
is  the  more  beneficial.  In  connection,  the  two  act  reciprocally  upon 
each  other,  each  rendering  the  other  doubly  beneficial. 


Injections. 

The  term  injection  implies  the  act  of  throwing  a  fluid  into  some 
cavity  of  the  body. 

In  Water-Cure  we  inject  water  more  frequently  into  the  bowels 
than  any  other  cavity.  This  kind  of  injection  is  also  called  enema^ 
or  clyster. 

Most  people  have  so  little  confidence  in  simple  water,  that  if  a 
clyster  is  administered  to  them,  thay  have  no  idea  that  it  can  operate 
in  so  effectual  a  way  as  it  usually  does.  Years  ago,  when  the  water 
treatment  was  much  less  known  than  at  the  present  time,  I  have 
been  suspected  of  having  secretly  put  some  cathartic  substance  in  the 
water,  "  for,"  said  the  patients,  "  how  is  it  possible  for  water  to  act  in 
this  way?" 

A  gi-eat  variety  of  injection-instruments  have  been  invented.  Some 
of  these  are  very  convenient  and  useful ;  others  are  got  up  on  mere 
speculation,  and  are  but  little  worth.  Every  family,  at  least,  ought 
to  have  a  good  injection-instrument.  A  lady's  toilet  is  never  com- 
plete without  it.  A  gfood  article  is  either  manufactured  or  sold  by 
most  surgical-instrument  makers  and  druggists. 


M 


Modus  Operandi  of  Water. 

It  is  often  objected  to  hydropathy,  that  water,  being  but  one  agent, 
cannot  be  made  useful  in  all  diseases.  I  propose  here  to  make  some 
remarks  on  the  modus  operandi  of  water.,  in  which  I  shall  endeavor  to 
explain,  not  only  to  the  scientific  scholar,  but  to  the  ordinary  reader, 


788 


PR0CK8HKS   OF  TIIK   HYDKOPATIIIC  TRKATMENT. 


that  water  is  capable  of  being  iiiiulu  available  iim  a  remedy, —  uiid 
that  powerfully  too,  —  in  a  great  variety  of  ways.     It  then  acts:  — 

1.  By  its  Presence.  —  Water,  as  we  have  seen  elsewhere,  com- 
poses  the  larger  part  of  the  living  l)ody,  and  that  without  its  prcsoiicj 
in  a  large  proportion  in  the  living  syti'cem,  the  vital  processes  cannot 
for  a  moment  go  on. 

2.  By  its  Coldness.  —  Cold,  within  proper  limits,  preserves  tmd 
ttugmenta  life,  while  heat  tends  to  debility  and  decay.  In  propdrtidii 
as  tlie  animal  heat  is  diniiniHhed  in  the  different  classes  of  aiiiiniils, 
the  less  is  the  want  of  air  felt.  If  in  a  puppy  the  eighth  pair  of 
nerves  be  divided,  producing  a  closure  of  the  glottis  so  that  no  air 
can  ent«r  ita  lungs,  the  animal  dies  in  half  an  hour,  if  kept  at  an  or- 
dinary temperature.  But  if  the  animal  is  benumbed  with  cold  it 
survives  the  operation  for  a  whole  day.  Frogs,  in  the  summer,  when 
the  temperature  of  water  is  elevated,  are  obliged  to  come  often  to  the 
surface  for  air.  But  in  winter,  when  the  water  is  colder,  they  live 
almost  entirely  under  its  surface.  A  cholem  patient  in  collapse,  a 
person  who  has  been  stifled  by  foul  gases,  one  in  the  sinking  stage  of 
a  fever,  or  fainting  from  loss  of  blood,  or  in  any  way  asphyxiated, 
desires  always  coldness  rather  than  heat.  It  may  not  be  possible  in 
the  present  state  of  science  to  explain  these  phenomena;  but  luide- 
niably  we  have  the  facts. 

3.  By  Endosmosis  and  Exosmosis.  —  Animal  membranes  have  the 
power  of  absorbing  liquids,  —  called  enc^osmom,  or  imbibition^  and  of 
throwing  them  out,  exosmosis,  or  transudation. 

If  we  take  a  portion  of  the  intestine  of  a  chicken,  tie  one  end, 
nearly  fill  it  with  milk,  then  tie  the  other  end,  and  lastly  immerae  it 
in  a  tumbler  or  other  vessel  of  pure  water,  we  find  that  in  a  sliort 
time  the  milk  passes  out  of  the  intestine  into  the  water,  and  the 
water  inwardly  mingling  with  the  milk.  This'  process  goes  on  till 
the  fluid  within  and  without  the  intestine  becomes  one  and  the  same. 
This  is  a  familiar  illustration  of  the  principle  in  question- 

4.  By  Dilution.  —  Water  is  the  greatest  diluent  in  nature.  There 
is  no  substance  which  is  at  all  comparable  to  it  for  penetrating  the 
myriads  upon  myriads  of  capillaries  that  exist  in  all  parts  of  the 
living  structure.  When  the  fluids  become  thick,  viscid,  and  filled 
with  impure  matters,  as  is  usually  the  case  to  a  greater  or  less  ex- 
tent, in  disease,  it  is  an  important  object  to  dilute  these  matters. 
For  this  purpose  water  is  the  only  available  remedy. 

6.  By  its  Tonx  Effect.  —  Water  is  the  greatest  of  all  tonics,  and 
possesses  the  valuable  property,  not  of  wearing  out,  but  of  increasing 
in  its  good  effects. 

0.  By  its  Excitant  or  Electrical  Power.  —  A  man  feels  dull  and 
stupid  from  excessive  bodily  or  mental  labor,  from  excessive  alinien- 


'M^msSKtiTsmmm 


«■ 


PKOCKH8KW  OK  THK  HYnKOPATHIO  TRKATMRNT. 


739 


ly,— ami 
acts:  — 

lere,  com- 
lea  caimot 

srves  and 
)r<»p(irti()ii 
[  animuls, 
Lh  pair  of 
liat  no  air 
t  at  an  or- 
th  cold  it 
mer,  when 
f  ten  to  the 
,  tliey  live 
collapse,  a 
ig  stage  of 
phyxiated, 
possible  in 
but  unde- 

es  have  the 
ion,  and  of 

3  one  end, 
immerae  it 
in  a  short 
5r,  and  the 
[oes  on  till 
I  the  same. 

re.  There 
trating  the 
arts  of  the 
and  filled 
or  less  ex- 
je  matters. 

tonics,  and 
increasing 

lis  dull  and 
jive  alimen- 


tjiti<tii,  or  spirit,  "P  tea  and  coflfoc  drinking,  with  the  blood  all  crowd- 
ing up  into  bin  head.  We  apply  the  well-wrung  rubbing  wet  sheet 
one,  two,  or  three  times,  to  his  surface,  according  ivs  he  may  need, 
and  he  at  once  perceives  a  most  wonderful  change  for  the  better.  Or 
a  man  feels  of  a  morning  dull  and  stupid,  with  his  muscles  sore ;  he 
has  the  rubbing  wet  sheet,  the  plunge,  shower,  or  douclie,  and  in- 
st4intly  his  troubles  vanish.  Or  he  may  have  a  lumbar  abscess,  which 
has  run  him  down  so  low  that  when  he  wakes  in  the  moniing  he  finds 
ho  cannot  walk.  Two  or  three  gallons  of  cold  water  are  poured  over 
him,  upon  which  he  walks  readily.  Now  these  elfecta  of  water,  re- 
markable as  they  are,  arise  simply  from  its  excitant  or  electrical 
power. 

7.  By  it«  Temperature.  —  In  acute  disease,  in  all  fevers  and  in- 
flammations, of  whatever  name  or  grade,  the  great  power  of  water  to 
regulate  the  temperature  of  the  body  is  one  of  the  most  striking  of 
all  the  phenomena  cognizable  by  man.  By  the  use  of  cold  water  we 
can  always  vary  the  heat  of  the  body  and  the  velocity  of  the  heart's 
action  to  any  desirable  extent. 

8.  By  Purifying  tlie  Blood.  —  Water  accomplishes  one  thing  which 
no  drug,  no  other  substance  in  nature  can.  It  purijies  the  blood.  It 
does  this  because  it  penetrates  every  lane  and  alley  of  the  system, 
however  minute.  No  capillary  is  so  delicate  that  it  does  not  pene- 
trate lis  smallest  possible  paii;.  It  purifies  the  blood,  because  as  long 
as  the  vital  principle  lasts,  the  tendency  of  nature  is  to  preserve  the 
vital  fluid  in  a  healthy  state;  and  penetrating  every  tissue  of  the 
body  as  water  does,  it  assists  nature  in  the  purifying  process  as  no 
other  substance  can. 

9.  By  AuKmenting  the  Vital  Pofce. — No  fact  in  science  is  better 
established  than  that  water  possesses  the  power  of  actually  increas- 
ing the  amount  of  vitality  in  the  system.  This  is,  in  fact,  the  prime 
effect  of  water.  It  aids  the  system  in  throwing  ofic  disease  in  the 
same  way  that  inci-easing  a  merchant's  cepital  aids  him  in  throwing 
of?  debt. 

The  foregoing  propositions  are  sub.aitted  as  elucidating  some  of 
the  leading  principles  concerned  in  the  action  of  water  upon  the  liv- 
ing body.  I  do  not  claim,  however,  that  the  whole  of  the  philosophy 
of  the  effects  of  water  is  yet  understood  by  any  one.  Doubtless 
those  who  know  most  about  it  have  yet  much  to  learn. 

Rules  for  Using:  Water. 

The  Time  of  Day.  —  In  general,  the  more  powerful  applications 
should  be  made  in  the  early  part  of  the  day.  At  this  time  the  calor- 
ific powers  and  the  circulation  are  more  vigorous,  and,  consequently, 
the  body  more  able  to  resist  powerful  applications  of  whatever  kind. 

The  Meals.  —  Ordinarily,  no  powerful  bath  shoiUvl  be  taken  within 


,i 


f/c-'it'i 


740 


PR00R88ES  OF  THX   RYDHOPATHIO  TKRATMKMT. 


tihree  to  foui'  Iioufh  iiftcr  a  meal.  A  full  stomnch  and  cold  water  do 
not  at  all  agree.  Hut  in  certain  diseaHed  oonditiomi,  as  feverislinciH, 
intlanimatiou,  colic,  cramp  in  the  Htuniiich,  cholera  morbus,  and  utliur 
sudden  attacks,  water  appliances  are  to  be  commenced  without  refer- 
ence to  hours  or  meals.     The  syniptoniH  then  are  oiir  only  guide. 

The  Lighter  Baths. —  If  there  is  doubt  as  to  which  application  to 
make,  the  well-wrung  rubbing  wet  sheet,  the  tepid  shallow  bath,  or  u 
warm  bath  should  first  be  taken. 

Reaction.  —  Within  a  reasonable  time  after  a  bath,  the  body  in  all 
its  parts  should  become  naturally  warm.  If  the  feet  and  hands  re- 
main cold,  and  the  nails  and  lips  blue,  the  bath  has,  to  say  the  least, 
done  no  good.  In  some  cases  of  fevers  and  other  inflammatory  dig- 
eases,  it  is  better  to  keep  the  body  chilly  than  to  allow  it  to  become 
too  warm. 

Ulceration.  —  If  any  part  of  the  body,  as  the  extremities,  lungs, 
bowels,  etc.,  is  undergoing  any  considerable  ulceration,  veiy  cold 
baths  are  inadmissible. 

NervousnesA.  — With  some  persons  who  are  highly  nervous,  and 
part^^<".ularly  with  nervous  females,  much  cold  bathing,  althougli  it 
appears  to  agree  well,  and  to  be  the  best  for  a  time,  is  in  che  end 
ht^mful,  rendering  the  nervousness  and  general  debility  worse. 

Exercise.  —  For  the  douche,  plunge,  cold  sitz,  and  foot  hatha,  and 
all  others  that  abstract  a  lai'ge  amount  of  caloric  from  the  system, 
the  body  should  be  fully  warm,  and  the  circulation  somewhat  acceler- 
ated by  exercise.  Exercise  should  also  be  taken  after  the  bath, 
until  the  heat  and  circulation  are  fully  restored.  But  if  exercise  is 
impracticable  either  before  or  after  the  bath,  friction  should  be  made 
to  take  its  place. 

Increased  Heat. — Elevation  of  temperature  constitutes  no  objec- 
tion to  bathing,  provided  the  body  is  not  excessively  fatigued.  The 
reason  why  overheated  persons  sometimes  lose  their  lives  by  plunging 
into  or  drinking  largely  of  cold  water,  is,  that  the  vital  force  has 
been  too  much  exhausted.     Mere  heat  is  an  advantage. 

Perspiration.  —  Neither  does  this  constitute  an  objection  to  bath- 
ing or  water-drinking,  if  the  foregoing  rules  are  observed. 

The  Air.  —  Bathing  in  the  open  air  is  always  preferable  to  in-doors, 
provided  the  extremes  of  heat  and  cold  are  avoided. 

The  Head.  —  It  is  well  always  to  wet  the  head  with  cold  water, 
both  before  and  after  a  bath.  Douches  and  the  shower  should  never 
be  taken  on  this  part  Simple  pouring  or  affusion  is  the  only  mechan- 
ioal  force  of  water  that  .should  be  allowed  on  the  head. 

Pregnancy.  —  This,  as  abundant  experience  proves,  forms  no  ob- 
jection to  bathing,  or  any  form  of  properly  regulated  water  treat- 


KaMadjSj^.; 


.-jji8m3i«m!.ja&!KaaMiaaBaaiM 


.^     ^- 


I 


l>R0OKH8KS  or  Till   HYDROPATHIC   TKItATMRNT. 


741 


1  Wllt«'l  lid 

/emliiusM, 
uiid  otlit'i- 
iiout  refer- 
guide. 

lication  to 
Uith,  or  u 

body  in  all 
I  hands  re- 
r  the  least, 
aatory  dig- 
to  become 

ties,  lungs, 
very   cold 

TV0U8,  and 
ithough  it 
in  the  end 
rcTse. 

baths,  and 
;he  system, 
bat  acceler- 
the  bath, 
exercise  is 
d  be  made 

a  no  objec- 

ued.     The 

y  plunging 

force  has 

)n  to  bath- 

X)  in-doors, 

jold  water, 
ould  never 
ly  mechan- 

pms  no  ob- 
^ater  treat- 


ment.    Cold  Imthing  iiiul  wat«r-driiiking  lire  of  tlie  greatCMt  aervice 
(luring  this  period. 

The  Season.  —  If  the  liingH  are  not  extensively  disoasod,  and  if 
there  is  no  considerable  ulceration  going  on  in  any  part  of  the  Hys- 
teni,  the  cool  and  cold  seasons  are  preferable  for  a  coui-se  of  bathing. 
W'itli  right  luanagemeiit,  a  patient  gains  two  or  three  timeH  as  much 
ill  a  given  time  during  the  cold  months  as  he  does  in  the  hot. 

Days  of  Reat.  —  One  day  in  seven  water-treatment  sliould  h&  dis- 
continued, with  the  exception  of  u  simple  ablution  in  the  morning. 
Six  days'  treatment  in  the  week  is  worth  more  than  seven,  because  it 
Ih  a  law  of  nature  that,  if  a  remedy  is  continued  steadily  and  without 
change,  it  loses  much  of  its  good  effect.  This  is  as  true  of  water  as 
of  any  other  agent.  Those  who  do  wisely  will  omit  the  treatmen 
on  Sunday,  whatever  their  religions  convictions  may  be. 

Internal  Use  of  Water.  —  The  same  general  rules  apply  here  as  in 
the  external  applications.  Thirst  should  for  the  moijt  part  be  grati- 
fied whenever  it  is  experienced.  Aa  a  rule,  the  less  water  drank  at 
meals  the  better.  For  the  tonie  effect,  it  is  to  be  taken  while  tlie 
stomach  is  empty,  and  it  is  better  that  exercise  should  accompany  it. 
From  six  to  twelve  tumblers  per  diem  is  a  fair  allowance  for  average 
patients. 

Quality  of  Water.  —  For  all  remedial  as  well  as  hygienic  purposes 
water  should  be  as  pure  and  soft  as  can  be  obtained.  With  proper 
care  and  ingenuity  in  the  construction  of  cisterns,  filters,  etc.,  this 
desirable  end  can  be  everywhere  accomplished.  Lead,  and  lead 
pipes,  should  be  avoided,  except  where  the  water  runs  freely  and 
constantly. 

The  Swev.tlnir  Process.  —  Formerly  it  was  much  in  vogue  to  sweat 
patients  in  the  blanket  pack,  but  latterly  the  practice  has  quite  gone 
into  disrepute.  For  several  years  of  the  latter  part  of  Priessnitz's 
career  he  was  vory  averse  to  using  the  process.  It  was  a  remark  of 
his,  that  the  cures  by  sweating  were  not  permanent. 

Wet  Bandas:es,  Compresses,  etc. 

These,  as  we  have  already  seen  under  the  head  of  wounds  and  in- 
juries, are  of  great  value  in  water  treatment.  They  are  used  of  any 
desirable  size,  upon  any  part  of  the  body,  and  produce  different  effects 
accordingly  as  they  are  used.  Cooling  wet  compresses  are  such  iis 
are  changed  or  rewet  frequently,  and  for  the  most  are  left  uncovered. 
The  warming  or  stimulating  are  covered  and  left  upon  the  part  until 
it  becomes  as  warm  or  warmer  than  natural.  Warm  fomentations  are 
useful  in  certain  cases,  but  the  hot  should,  as  a  rule,  be  discarded. 

The  wet  girdle  is  one  of  the  most  useful  of  all  medical  appliances. 
Two  and  a  half  or  three  yards  of  good  toweling,  with  tapes  arranged 
at  one  end,  the  comers  of  which  have  been  turned  over  and  sewed  so 


vA 


'  V: 


^ 


ii^ii,^ 


742 


PROCESSES   OF  THE   HYDROPATHIC   TREATMENT. 


as  to  form  a  point,  forms  a  good  girdle.  It  should  pass  usually  three 
times  about  the  body,  one-half  having  been  wet.  This  brings  two 
thicknesses  of  wet  on  the  abdomen  and  one  upon  the  back.  At 
Graefenberg,  this  application  was  worn  by  every  patient,  and,  as  a 
rule,  all  of  the  time.  It  is  useful  in  a  great  variety  of  ailments,  both 
acute  and  chronic.  The  same  form  of  application  is  also  useful  for 
thd  arms,  legs,  etc.,  the  tapes  being  used  in  preference  to  pins. 

The  wet  jacket,  or  chest  wrapper,  is  also  a  valuable  resort  in  dis- 
eases of  the  chest.  Oiled  silk  and  other  similar  articles,  as  I  have 
elsewhere  observed,  are  not  to  be  used  upon  these  local  applications. 

The  following  is  the  substance  of  Dr.  Show's  description  of  hydro- 
pathic appliances. 

The  Wet-Sheet  Pack. 

In  this  process  a  coarse  linen  or.cotton  sheet  is  used,  long  enough 
to  reach  from  the  patient's  bead  to  the  soles  of  his  feet,  and  al)out 
two  yards  in  width.  The  bed  is  stripped  of  all  its  covering,  one  or 
two  pillows  only  being  left  for  the  head.  One  or  two  comforters  are 
then  spread  upon  it,  and  over  these  the  same  number  of  woollen 
blankets,  which  are  less  injured  by  wet  than  cotton  comfortables. 
The  sheet  having  been  pretty  well  wrung  out  of  cold  water, — always 
pure  and  soft,  if  such  can  be  had, —  is  then  spread  out  smoothly  upon 
the  blanket.  The  patient  being  undressed,  lays  himself  upon  the 
sheet,  and,  his  arms  being  held  up,  an  assistant  laps  one  side  of  it 
over  the  body  and  lower  limbs ;  when,  the  arms  being  dropped  at  the 
side,  the  other  part  of  the  sheet  is,  in  like  manner,  lapped  over.  The 
blankets  are  then,  one  by  one,  brought  over  the  person  in  the  same 
way,  and  tucked  under  from  head  to  foot.  Comfortables  may  be  added, 
if  necessary.  • 

It  is  always  best  to  place  a  wet  towel,  covered  with  a  dry  one,  on 
the  patient's  head  while  he  is  packed.  If  too  much  chill  is  not  pro- 
duced, the  dry  one  may  be  left  oflP. 

This  is  the  ordinary  way  of  taking  a  pack  in  chronic  disease. 

The  wet  sheet  is  one  of  tho  most  soothing  and  agreeable  of  all  the 
water  appliances.  Hence  it  is  that  it  is  so  often  misu'^ed.  It  is  so 
delightful,  and  tends  so  much  to  produce  slumber,  that  the  patient 
never  feels  ready  to  get  out  of  it  But  this  slumber,  —  ■  so  profound 
and  sweet  as  it  often  is,  —  he  should  remember,  may  be  only  an  apo- 
plectic stupor,  which  leaves  him  with  a  swimming  head,  attended  with 
faintness,  perhaps,  and  ending  in  a  severe  headache ;  giving  him,  in 
short,  a  congestion  of  the  brain.  All  this  happ)enB  in  consequence  of 
robbing  the  skin  too  long  of  the  air  it  should  breathe. 

There  has  bden  a  notion  at  some  of  the  establishments  that  the 
wet  sheet  is  to  be  used  for  sweating ;  and  to  this  end,  the  patient  has 
been  literally  stewed  hour  after  hour,  in  some  cases,  even  four,  five, 
and  sir  hours  in  succession,  with  the  view  of  sweating  him.  All 
such  practice  is  hurtful.    If  the  patient  gets  better  under  it,  it  is  in 


,::!-l!Maa!iii!K^,;:,,  . —rSaSH 


SBS^flSWBi  Vi'niaiii'iiisti^eajJtliMIW 


^^^m 


PROCESSES   OF  THE    IIYPROPATHIC   TREATMENT. 


743 


consequence  of  the  good  effects  of  water  used  in  other  ways,  coui>]ed 
with  the  ever-important  adjuncts,  air,  exercise  and  diet.  In  later 
times,  Priessnitz  never  sweat  patients  at  all,  much  less  in  wet  sheets. 
If  a  man  must  sweat,  leave  off  the  wet  sheet  assuredly,  as  that  only 
hindere  the  operation.     Use  the  blanket  pack  or  the  vapor  bath. 

How  Long  shall  the  Pack  Contiiue? — Here,  too,  there  has  been, 
and  still  is,  much  error  in  hydropathic  practice.  "Stay  in  the  pack 
till  ycu  get  warm,"  has  been  the  old  doctrine.  But  some  get  warm 
at  firat,  and  afterward  get  cold ;  —  so  at  least  they  feel.  What  is  to 
1)6  done? 

One  of  Priessnitz's  improvements  was  to  give  short  packs.  "  Re- 
main enveloped  for  fifteen  or  twenty  minutes  only,"  he  said.  "  If  you 
are  not  able  to  bear  the  pack  in  that  way,  take  the  rubbing  wet  sheet 
and  the  lighter  processes  until  you  are."  In  some  cases  he  gave  two 
or  three  of  these  short  packs  in  succession,  the  patient  rising  between 
each  to  take  an  airing,  a  rubbing  wet  sheet,  or  other  bath,  and  then 
returning  to  the  pack. 

Thus  far  the  wet  sheet  has  been  spoken  of  as  used  in  chronic  dis- 
eases. In  acute  attacks  it  is  managed  differently,  according  to  the 
case.  If  the  object  be  to  abstract  caloric  from  the  body,  we  cover  the 
sheet  but  little,  —  with  a  single  dry  sheet,  or  a  blanket  or  two,  or,  per- 
haps, with  none  of  these. 

We  know  that  if  we  keep  a  wet  towel  about  a  keg  of  water  on  a  hot 
day,  the  water  will  be  made  cooler  by  evaporation.  In  the  same  way, 
when  a  patient  is  hot  and  feverish,  we  keep  one,  or,  still  better,  two 
wet  sheets  around  him,  without  other  covering,  and  thus  bring  down 
the  heat  and  circulation  to  any  desirable  degree.  We  sprinkle  water 
upon  the  sheets,  or  rewet  them  as  often  as  is  necessary, —  in  some 
extreme  cases  of  fever  continuing  them  a  whole  week  or  more.  Ex- 
perience teaches  that  the  continuous  application  of  the  wet  linen  is, 
in  such  cases,  a  most  serviceable  application,  and  one  that  tends  most 
powerfully  to  induce  in  the  dermoid  structure  its  natural  and  health- 
ful state. 

The  Wet  Sheet  Acts  by  Absorption.  —  It  draws  morbific  matter 
out  of  the  body,  as  any  one  may  see  who  applies  the  sheet  for  a  short 
time,  and  then  washes  it.  Observe,  too,  wiiat  an  odor  comes  from 
the  sheet  when  a  diseased  patient  has  been  packed.  At  the  same 
time,  it  absorbs  the  pure  water  into  its  finest  tissues  on  a  large  scale, 
thus  supplying  that  fluid  which  of  all  substances  the  system,  under 
such  circumstances,  most  needs.  This  moist  warmth  of  the  sheet  also 
acts  as  a  most  soothing  poultice. 

The  Wet  Dress. 

A  MODIFICATION  ©f  the  wet  sheet,  and  in  some  respects  an  improve- 
ment, is  the  "wet  dress,"  so  called. 
A  coarse  linen  or  cotton  dress  is  made  with  large  arms,  so  that  one 


"■5 


744 


PK0CESSE8  OF   THE  HYDBOPATHIO  TREATMENT. 


may  take  the  application  without  help.  The  dress  being  wet  and  ap- 
plied,  the  patient  lays  himself  upon  blankets,  in  which  he  wraps  him- 
self just  sufficiently  to  become  comfortable.  Or,  he  may  have  dry 
flannel  dresses  to  put  on  over  the  wet  one,  and  then  lie  in  a  common 
bed.  In  this  application,  the  air  is  not  excluded  from  the  surface  to 
anything  like  the  same  extent  as  in  the  common  tight  pack.  Hence, 
a  patient  may  remain  in  it  a  half,  or  the  whole  of  the  night,  if  he 
choosos,  —  being  careful  to  becomo  neither  too  warm  nor  too  cold. 
Rewetting  once  or  twice  in  the  night  will  be  of  service.  Often  in  a 
single  night  a  bad  cold  may  be  thrown  off  in  this  simple  way. 

The  Half  Pack. 

Many  patients  have  so  little  reactive  energy,  that  while  they  can 
bear  a  half  pack,  so  called,  the  entire  sheet  woidd  abstract  so  much 
caloric  from  the  body  as  to  injure  them.  In  such  cases,  the  sheet  is 
to  be  applied  so  as  to  extend' only  from  the  arm-pit,  or  at  most,  from 
the  neck  to  the  hips,  leaving  the  lower  extremities,  as  it  were,  in  the 
dry  pack.  Sometimes  the  sheet  is  allowed  to  extend  to  the  ankles, 
not  including  the  feet  Packing  the  trunk  of  the  body  in  wet  towels 
acts  upon  the  same  principle  as  the  partial  or  half  pack,  and  is,  ux 
many  cases,  a  valuable  preliminary  measure.  It  is  well  to  take  these 
preparatory  steps  when  a  patient  who  has  suffered  long  from  chronic 
disease  is  beginning  with  the  envelopment. 


The  Folded  Wet  Sheet. 

In  domestic  practice,  a  modification  of  the  wet  sheet  may  be  had 
by  folding  four-double  a  common  coarse  sheet,  for  enclosing  the  trunk 
from  the  armpits  down.  Two  thicknesses  of  this  are  wet  in  cold 
water  to  come  next  the  body. 

This  is  a  valuable  application  in  a  host  of  ailments,  as  pleurisy, 
inflammation  of  the  lungs,  inflammation  of  the  bowels,  colic,  cholera, 
cholera  morbus,  rheumatism,  painful  menstruation,  after-pains,  etc. 
This  remedy,  which  can  be  applied  in  five  minutes,  will  often  soothe 
a  patient  quietly  to  sleep,  whose  lot,  without  it,  would  be  a  night  of 
agony.  One  advantage  of  this  application  is,  that  if  a  patient  is  too 
weak  to  lise,  the  sheet  may  be  opened  in  front,  so  that  fresh  water 
may,  when  needed,  be  sprinkled  upon  it,  and  wet  towels  inay  be 
added  under  it  upon  the  abdomen,  if  necessary. 

In  all  the  methods  of  applying  the  wet  sheet,  there  can  be  no  pos- 
sible objection  to  using  warm  bricks,  bottles,  et^j.,  for  the  feet  when 
cold. 

Bath  after  the  Pack.  —  It  is  the  practice  generally  to  take  some 
form  of  the  bath  after  the  pack.     If  the  patient  is  too  feeble  to  rise, 


-^mMMMSB::' 


iiiiiiijjiii.ia.iiii    m(>i«Mn|i  Jill 


PROCESSES   OF  THE   HYDROPATHIC   TREATMENT. 


746 


an  ablution  is  performed  while  he  is  in  bed.  In  other  cases,  a  wet- 
sheet  rubbing,  shallow,  plunge,  towel,  or  other  bath,  is  resored  to, 
but  not  strictly  of  necessity.  It  is  better  however,  as  a  rule,  to  make 
the  process  a  compound  one,  tliat  is  to  take  some  form  of  bath  after 
the  pack.  This  should  also  be  followed  by  exercise  in  the  open  air, 
if  it  can  possibly  be  taken.  A  pack,  followed  by  a  faithful  turn  at 
work,  or  by  exercise  in  the  open  air,  is  always  worth  much  more 
than  when  followed  by  rest  witiun  doors. 


The  Rubbing  Wet  Sheet. 

The  rubbing  wet  sheet,  too  little  appreciated,  and  too  seldom  used, 
is  one  of  the  most  valuable  of  all  the  hydropathic  resources.  There 
is  probably  no  other  single  application  of  water,  in  all  the  multiform 
modes  of  hydropathic  medication,  that  can  be  made,  on  the  whole,  as 
useful  as  this.  It  is  a  tonic,  a  stimul&nt,  a  sedative,  an  antispasmodic, 
a  derivative,  or  a  febrifuge,  according  to  the  circumstances  under 
which  it  i«  applied. 

We  take  a  coarse  linen  sheet,  —  although  cotton  answers  a  very 
good  purpose, — large  enough  to  throw  around  the  body  like  an  In- 
dian's blanket.  It  is  wrung  more  or  less,  according  to  the  demands 
of  the  case.  Thereupon,  it  is  thrown 
quickly  around  the  patient's  body,  who,' 
if  strong  enough,  is  in  the  standing  pos- 
ture ;  and  then  both  patient  and  assistant 
set  vigorously  to  work,  rubbing  over  the 
sheet,  not  with  it,  as  some  do,  three,  four, 
or  more  minutes,  until  the  surface  becomes 
thoroughly  warm  (Fig.  188). 

If  there  is  fever,  less  friction  is  required. 
After  the  ivet  sheet,  comes  a  dry  one,  to  be 
used  in  the  same  manner.  Those  who  have 
suflScient  reactive  energy, — and  most  have, 
—  may  dry  the  body  simply  by  fanning  it 
with  the  drj'-  sheet,  the  windows  at  the 
same  time  being  open.  TTiis  sort  of  air-bath  exerts  a  highly  pleasurable 
efPect  upon  the  skin.  Instead  of  giving  one  a  cold,  it  helps  greatly 
to  ward  it  off.  This  method  of  drying  the  body  was  one  of  Priess- 
nitz's  later  improvements. 

The  rubbing  wet  sheet,  it  should  be  remembered,  is  not  a  tingle 
application,  capable  of  producing  only  one  effect.  It  is  used  in  three 
different  gradations,  and  to  produce  very  different  results.  It  is  well 
wrung,  or  only  modemtely  wrung,  or  left  quite  wet  and  dripping. 
If  a  person  is  fatigued,  or  has  a  low  degree  of  reactive  energy,  the 
first  form  is  the  one  to  adopt;  if  there  is  not  much  fatigue,  and  good 
reactive  energy,  the  second ;  and  if  the  patient  is  feverish,  and  the 


FlO.  188. 


■*M^II< 


746 


PU0CK88ES  OP  THE  HVUnOPATHIC  TREATMENT. 


object  is  to  alwtiact  heat  simply,  we  use  the  sheet  quite  wet  and  drip- 
ping; and  we  repeat  it  as  many  times  in  succession  as  the  case  may 
need.  One  great  advantage  is,  that  we  give  it  before  or  after  a  wet 
pack,  when  no  bath  is  at  hand ;  we  also  give  it  in  connection  with 
any  other  bath  wo  may  choose. 

See  how  admimble  a  remedy  the  rubbing  wet  sheet  is,  when  prop- 
er V  understood!  A  patient,  —a  child,  perhaps, — is  so  feeble  in  the 
reactive  power,  that  almost  any  form  of  bath  we  can  give  it  sends 
the  blood  from  the  surface,  making  the  lips  and  nails  pale  or  blue,  and 
the  extremities  cold,  showing  congestion  of  the  internal  organs. 
When  a  bath  produces  such  effects,  it  is  very  apt,  to  say  the  1  t,  to 
do  more  harm  than  good.  But  we  can  apply  the  rubbing  wet  sheet 
in  such  a  way  as  to  cause  none  of  these  ill  effects ;  besides,  it  may  be 
repeated  many  times  in  the  day,  so  as  to  give  tlie  patient  the  advan- 
tage of  a  strong  treatment ;  for  a  light  treatment,  which  can  be  easily 
borne,  is  made  a  %tr<yn^  one  by  the  frequency  of  its  repetition. 

A  wet  sheet,  well  wrung,  holds  perhaps  a  pint  of  water ;  or,  at 
most,  a  quart.  Now,  it  must  appear  plain,  that  a  pint  or  quart  of 
cold  water,  spread  over  so  large  a  surface  as  the  whole  skin,  must 
become  very  easily  warmed  by  the  body's  heat.  Besides,  if  there  is 
ireM  delicacy  of  constitution,  we  may  wring  the  sheet  out  of  water 
at  seventy,  eighty,  or  even  ninety  degrees,  gradually  lowering  it  as 
the  patient  can  bear  it. 

The  domestic  availability/  of  this  application  is  also  to  be  spoken 
of.  In  every  dwelling,  however  humble,  there  is  the  coarse  sheet, 
and  the  bucket  of  water.  How  useful,  therefore,  as  a  resort,  in 
home  practice! 

The  rubbing  wet  sheet  appears  a  tiifling  application,  —  one  which 
is  not  capable  of  producing  any  great  result.  But  when  we  remem- 
ber the  myriads  of  nerves  of  animal  life,  spread  over  the  skin,  and 
derived  from  the  brain  and  spinal  cord,  it  need  not  surprise  us  that 
its  application  should  so  invigorate  the  body,  take  off  bodily  and 
mental  depression,  remove  languor  and  fatigue,  expel  flatus  from  the 
bowels,  remove  thirst,  gfive  appetite,  and  cause  a  feeling  of  calmness 
and  relief  which  can  be  appreciated  only  by  those  who  experience  it. 
A  minister,  for  example,  preaches  three  times  on  ^  Sunday,  and  gets 
his  brain  so  excited  that  he  cannot  sleep.  A  cold  bath  would  be  too 
powerful,  and  opiates  would  only  act  as  stimulants,  making  the  mat- 
ter worse.  Two  or  three  successful  applications  of  the  rubbing  wet 
sheet,  with  powerful  friction,  bring  the  blood  so  much  to  the  surface, 
that  his  brain  becomes  relieved,  and  he  very  soon  falls  into  a  soimd 
and  refreshing  sleep.  So,  too,  when  a  man  has  been  long  wet  and 
drenched  on  a  rainy  day,  and  comes  home,  virith  the  surface  and  ex- 
tremities cold,  and  the  blood  pressing  hard  upon  the  brain  and  other 
internal  organs,  —  the  well-wrung  rubbing  sheet  is  applied,  with  plen- 
tiful friction,  and  at  once  the  oppressed  organs  are  set  free. 

In  using  the  rubbing  wet  sheet,  as  in  all  other  forms  of  general 


PBOCEB8E8   OF  THE   HYDROPATHIC  TBBATMENT. 


747 


bath,  it  is  well  to  wwsh  the  hands  and  face  in  cold  water,  both  before 
and  after  it.  There  is  no  need  of  throwing  it  over  the  head,  as  some 
have  thought  it  necessary  to  do.  A  patient  needs  to  breathe  freely 
when  he  takes  a  bath. 

This  application  is  not  always  the  most  pleasant  one.  It  does,  in 
fact,  require  a  good  degree  of  moral  courage  to  enable  one  to  endure 
the  first  shock.  The  sensations  produced  by  it  are  worse,  if  possible, 
than  those  from  a  plunge  into  cold  water ;  I  mean  the  first  touch  of 
the  sheet  to  the  body.  Nervous  ladies  sometimes  tell  us  they  cannot 
take  the  rubbing  wet  sheet,  when,  at  the  same  time,  they  take  the 
cold  plunge,  which  is  far  more  powerful,  and  perhaps  too  powerful 
for  their  case.  This  unpleasant  feeling  does  no  harm,  for  it  vanishes 
in  a  moment  or  two  after  the  sheet  touches  the  body. 


rm 


■  i 


■  J 


The  Douche  Bath. 

This  is  the  most  powerful,  but  not  the  most  useful  of  all  the 
hydropathic  appliances.  A  common  douche  consists  of  a  stream  of 
water  from  one  to  two  inches  in  diameter,  with  a  fall  of  five  to  ten 
feet.    But  douches  may  be  arranged  of  any  desirable  size  and  height. 

(Fig.  189.) 

This  remedy  is  useful  in  paralysis,  stiff  joints,  gout,  rheumatism, 
tumors,  and  old  swellings  of  various  kinds.  Those  who  have  weak 
limgs,  stomach,  or  other  abdominal  organs,  should  not  resort  to  the 
douche  without  the  best  of  medical  advice. 

The  Shower  Bath. 

This  is  also  one  of  the  more  powerful  of  the  hydropathic  appli- 
ances, and  needs  judgment  in  its  use.  It  consists  in  fact,  of  a  vast 
number  of  small  streams  or  douches,  and  hence  is  a  powerful  refrig- 
erant, as  well  as  excitant,  to  the  system.  It  is  useful  to  commence 
this  bath,  for  a  time  at  first,  only  upon  the  limbs.  It  is  used  by  all 
gymnasts. 

The  Cataract  Bath. 

This  also  is  one  of  the  more  powerful  of  the  hydropathic  processes, 
and  is  to  be  classed  with  the  two  preceding  baths.  Like  them  it  may 
be  said  to  be  stimulant,  tonic,  and  alterative,  while  it  is  also  highly 
sedative  as  far  as  animal  heat  is  concerned. 


The  Hose  Bath. 

Through  the  modem  improvements  in  Indiarrubber,  gutta-percha, 
leather,  etc.,  it  is  easy,  whenever  there  is  a  small  fall  or  head  of 
water,  to  arrange  what  is  called  a  hose-bath.     It  is  in  principle  a 


I 


^>i  : 


■^^ 


^ 


748 


PK00ES8ES  OF  THE   HYDKOPATHIO  TBEATMENT. 


(louche,  with  the  additional  advantage  that  it  can  be  made  to  act 
upon  any  part  of  the  body,"  and  from  whatever  direction  we  choose. 
Rightly  applied,  the  hose  bath  is  a  valuable  remedy.     (Fig.  190.) 


FlO.  189. 


FlO.  190. 


The  Pail  Douche. 

The  process  which  passes  under  this  name  is  taken  thus:  The 
patient  seats  himself  in  an  empty,  shallow,  or  other  bathing-tub,  and 
crosses  his  hands  over  his  chest.  As  many  pails  of  water  as  are 
ordered  are  then  dashed  over  him  suddenly,  one  after  another,  before 
and  behind  alternately,  —  not  poured,  but  thrown  with  some  force, 
by  first  a  backward  and  then  a  forward  motion  of  the  pail. 

A  better  method  of  using  it  is,  for  the  patient  to  stand  in  an 
empty  bathing-tub,  while  an  assistant  takes  two  pails  of  water,  one 
ten  degrees  warmer  than  the  other,  and  empties  the  warmer  half  upon 
the  chest  and  half  upon  the  back,  and  then  bestows  the  colder  pailful 
in  the  same  manner ;  and  then  dries  with  friction. 

The  Wave  or  Sluice  Bath. 

Tras  is  taken  at  the  sluice-way  of  an  undershot  mill-wheel,  or  in 
any  similar  place.  The  patient  takes  hold  of  a  rope,  or  something  by 
which  he  can  maintain  his  position,  and  then,  lying  down,  subjecte 
his  body  to  the  action  of  the  water.  This  is,  on  the  whole,  a  pleasant 
and  agreeable  bath,  and  in  its  effects  somewhat  resembles  the  douche, 
being,  however,  milder  and  safer. 

The  Half  Bath. 

This  bath  may  be  used  as  one  of  the  mildest  of  the  water-cure 
processes,  or  as  one  of  the  most  powerful.  An  ordinary  bathing-tub 
is  a  very  good  apparatus  for  the  purpose.  A  good-sized  washing-tub 
will  answer  very  well,  if  there  is  nothing  else  at  hand.  The  water 
should  generally  be  quite  shallow  in  this  bath,  — from  three  to  six 


1 


PKOOESSES   OF  THE   UYDKOPATHIO  TREATMENT. 


749 


inches.  Priessmta's  half-baths  were  made  of  wood,  four  or  five  feet 
long,  about  two  and  a  half  feet  wide,  and  twenty  inches  deep.  This 
simple  contrivance  is  one  of  his  most  powerful  remedial  means, — 
that  by  which  some  of  his  highest  triumphs  are  achieved. 

The  water  is  generally  used  of  moderate  temperature,  at  sixty  to 
•  seventy  degrees  Fahr.,  and,  when  long  continued,  is  changed,  as  it 
becomes  warm  from  t\).e  heat  of  the  body. 

This  bath  may  be  used. 

First,  as  a  means  of  cooling  the  mass  of  the  circulation  in  the  hot 
stages  of  fever,  and  in  inflammatory  attacks  of  every  kind. 

Secondly,  as  a  revulsive,  or  means  of  drawing  blood  in  congestions 
or  inflammations  of  the  nobler  organs,  the  brain,  lungs,  stomach, 

liver,  etc. 

Thirdly,  as  a  means  of  r(  suscitation  in  the  shock  of  serious  acci- 
dents, sun-stroke,  and  before,  during,  or  after  apoplectic  and  other 
fits.  In  drunkenness  and  delirium  tremens,  the  half  bath  is  a  sover- 
eign remedy. 

Fourthly,  as  a  middle  means^  and  preparatory  to  the  general  bath 
in  weak  constitutions. 

In  the  latter  of  these  indications,  the  bath  is  generally  used  but  for 
a  few  minutes  after  the  wet  sheet,  or  at  other  times,  as  may  be  de- 
sired. In  the  former,  much  practical  knowledge  is  necessaiy  in  order 
to  proceed  always  with  safety,  and  to  obtain  the  best  results.  Thus, 
six,  or  even  nine  hours  may  be  required,  with  the  greatest  persever- 
ance, the  patient  being  thoroughly  rubbed  over  the  whole  surface, 
and  this  to  be  kept  up  constantly  by  relays  of  assistants,  the  pa- 
tient's head  and  shoulders,  meanwhile,  being  supported. 

The  Plunge  Bath.  . 

In  sea,  river,  and  lake,  as  well  as  by  artificial  means,  and  as  a 
matter  of  luxury,  religious  observance,  purification,  and  the  preven- 
tion and  cure  of  disease,  the  plunge  bath  has,  in  all  periods  of  time, 
and  in  all  parts  of  the  world,  been  a  favorite  resort.  So  efficacious, 
indeed,  has  this  simple  means  proved  in  healing  the  sick,  that  not  a 
little  superstition  has  been  mingled  with  it.  Springs  and  wells  have 
often  been  supposed  to  possess  some  mysterious  power,  and  for  that 
reason  has  been  named  after  some  patron  saint.  In  tJiis  respect,  the 
world  has  loved  mystery  and  inarvellousness  rather  than  the  pure  and 
simple  truth. 

In  hydropathic  practice,  the  plunge  is  much  used;  but  many  pa- 
tients are  not  able  to  bear  it.  Those  who  are  not  sufficiently  strong 
for  it  at  first,  should  practise  the  lubbing  wet  sheet,  the  half-bath, 
drinking,  exercise,  etc.,  until  the  pi  unge  can  be  borne.  It  is  :i  favorite 
remedy  at  0.II  the  establishments,  to  be  taken  directly  on  coming  from 
the  wet-sheet  pack. 


■■■I 


■Hi 


760 


PB00K8UES  OP  TUB  HYDROPATHIC  TUKATMENT. 


The  Head  Bath. 

FboM  time  immemorial,  oooling  applications  to  the  head  have  been 
much  depended  upon  in  that  violent  and  dangerouu  disease,  inflam- 
mation of  the  brain.  All  other  known  means  failing,  certain  o))sti- 
nate  affections  of  the  head  have  been  known  to  give  way  to  affusion 
of  cold  water  upon  the  part.  In  headache,  drunkenness,  delirium 
tremens,  the  delirium  of  fever,  epilepsy,  rheumatism  of  the  head,  dis- 
eases of  the  eye,  earache,  deafness,  loss  of  smell  and  taste,  and  in 
nose-bleed,  this  highly  energetic  remedy  is  brought  to  bear.  In 
taking  it,  the  patient  lies  down,  placing  the  back  of  his  head  in  a 
shallow  dish,  filled  only  an  inch  or  two  with  water.    (Fig.  19l.) 


no.  193. 


no.  in. 


The  Leg  Bath. 

This  is  useful  in  cases  of  ulcers,  swellings,  eruptions,  gout,  rheu- 
matism, sprains,  wounds,  etc.,  of  the  leg  or  thigh.  The  relief  and 
strength  obtained,  often  by  a  single  application  of  this  remedy,  is 
truly  wonderful.  A  variety  of  apparatus  may  be  contrived  for  ad- 
ministering the  leg  bath.  A  common  wooden  tub,  contrived  for  the 
purpose,  l&e  that  represented  in  Fig.  192,  answers  a  good  purpose. 
In  such  a  vessel,  he  covei's  the  inflimaed  limb  iutroduoed,  and  cools 
the  blosd  flowing  to  it. 

The  Sitz-Bath. 

CoKVENiEKT  tubs,  woodcu  or  metallic,  are  constructed  for  this 
bath,  but  an  ordinary  wash-tub  answers  very  well.  The  vessel  should 
be  la'  enough  to  permit  the  motion  of  the  arms  in  rubbing  the 
abdot^mdn,  sides,  and  hips,  first  with  one  hand,  and  then  with  the  other. 
Water  enough  should  generally  be  used  to  pretty  nearly  cover  the 
belly.  The  more  movement  and  friction  while  in  this  bath  the  better. 
It  is  more  conveniently  administered  when  the  tub  is  elevated  two 
or  three  inches  from  the  floor.  Some  undress  the  patient  completely, 
and  place  a  blanket  or  sheet  over  the  upper  part  of  the  body ;  but 


a^aSgwgawwttia 


PROCESSES  OF  THK  HYDROPATUIO  TREATMENT. 


751 


hftve  been 
\se,  iuflam- 
"tain  olwti- 
to  affusion 
3,  delirium 
I  head,  dis- 
te,  and  in 
bear.  In 
head  in  a 
.  191.) 


oftener  only  those  parts  are  uncovered  which  are  to  be  exposed  to  the 
water.    (Kig.  198.) 

In  a  variety  of  ailments,  this  bath  is  highly  valuable.  It  may  be 
made  one  of  the  most  powerful  of  all  the  hydropathic  modes.  Like 
uU  other  powerful  applications,  it  should  be  taken  only  when  diges- 
tion is  nearly  or  quite  completed. 

As  a  tonic  to  the  stomach,  liver,  bowels,  womb,  spine,  etc.,  this 
bath  is  highly  useful.  In  constipation  and  other  irregularities  it  is 
famous.  Those  of  sedentaiy  habits  will  find  its  use  of  rare  service. 
For  the  tonic  effect,  ten,  twenty,  twenty-five,  or  thirty  minutes.  If 
continued  for  some  length  of  time  the  water  is  to  be  changed  once  or 
more,  as  it  would  otherwise  become  too  warm. 


\ 


PlO.  US. 


ria.  iM. 


jout,  rheu- 
relief  and 
remedy,  is 
ed  for  ad- 
red  for  the 
1  purpose, 
and  oools 


)d  for  this 
3sel  should 
ibbing  the 

the  other. 

cover  the 
the  better. 
vated  two 
ompletely, 
body;  but 


The  Wash-Tub  Bath. 

Under  a  great  variety  of  circumstances,  the  wash-tub  bath  is  an  inval- 
uable remedy.  For  example,  a  patient  is  feverish ;  by  setting  him  in 
a  wash-tub  half  filled  with  water,  and  at  the  same  time,  if  we  choose, 
putting  his  feet  in  a  pail  of  water,  cold  or  warm,  according  to  the 
case,  we  may  give  him  any  desirable  amount  of  cooling.  We  cannot, 
indeed,  too  highly  pri? e  this  simple  contrivance  for  using  water,  —  a 
means  which  every  family  possesses.     (Fig.  194.) 

The  water,  as  a  general  rule,  should  be  tepid,  ranging  from  72°  to 
90°,  and  may  be  prolonged  from  two  to  fifteen  minutes,  according  to 
the  strength  of  the  patient.  It  should  never  be  carried  to  the  extent 
of  producing  blueness  of  the  nails.  The  patient  should  be  dried  with 
towels,  or  the  dry  rubbing  sheet. 

This  bath  is  useful  in  the  treatment  of  eruptive  fevera,  bilious 
remittents,  the  hot  stage  of  intermittents,  and  in  hectic  and  typhoid 
fevera.  It  is  often  used  after  the  wet  sheet  pack,  in  chronic  affec- 
tions, and  may  then  have  a  little  cooler  temperature,  or  else  be  fol- 
lowed by  pouring  a  pad  of  cooler  water  over  the  shouldera  to  tone 
up  the  skin. 


^ 


752 


FUUUKUtiKS   UK   TUK   llYUKOl'ATUIO  XHKATMKNT. 


The  Affusion. 

The  patient  stands  in  a  wash-tub,  bathine-tub,  or  other  convenient 
place,  when,  by  means  of  a  pail,  pitcher,  or  basin,  the  ansiutant  pours 
water  upon  the  head,  neck,  etc.,  either  upon  the  whole  of  the  bo(])> 
or  only  upon  a  part.  The  water  is  used  in  quantity  and  tempenv- 
ture  according  to  the  necessities  of  the  case.  The  affusion  ii>  one  of 
the  best  of  hydropathic  modes. 

Fifty  years  ago  Dr.  Currie,  of  England,  performed  great  cures  in 
fever  by  the  affusion,  sometimes  tepid,  at  others  cold,  according  to 
the  strength  and  heat  of  the  patient.  li'  there  was  great  heat,  the 
water  was  used  cold ;  if  not,  the  reverse.  In  a  variety  of  febrile 
diseases,  such  as  typhus  fever,  scarlet  fever,  small-pox,  measles, 
tetanus,  convulsions,  etc.,  he  used  this  remedy  With  remarkable 
success. 

Towel  and  Spons:e  Bath. 

With  one  or  two  coarse  towels  and  a  quart  or  two  of  water  we 
may  take  a  very  good  bath  almost  anywhere,  even  in  a  carpeted  room, 
at  a  hotel,  or  wherever  we  may  be,  without  spilling  a  drop  of  the 
water.  After  a  person  becomes  accustomed  to  this  form  of  ablution, 
none  but  the  most  indolent  will  be  willing  to  do  without  it,  unless 
they  can  have  some  other  form  of  bath.  A  daily  towel  ablution, 
thoroughly  performed,  is  an  excellent  prevention  against  colds,  helps 
the  appetite  and  digestion,  and  is  a  good  means  of  preventing  con- 
stipation. 

Some  are  in  the  habit  of  sitting  in  a  half-bath  or  a  sitz-tub,  and 
with  a  large  sponge  making  the  water  pass  freely  upon  the  head, 
neck,  shoulders,  and  other  parts  of  the  body.  At  the  same  time  the 
bather  may  pour  water  from  a  cup,  basin  or  pitcher,  upon  the  head, 
neck,  etc.  This  is  a  mild  affusion,  and  stronger  in  effect  than  the 
towel-bath. 

Wash-Down. 

The  process  to  which  this  name  is  given  by  Dr.  Edward  Johnson 
is  practised  as  follows :  "  The  patient  stands  in  an  empty  sitting-  or 
wash-tub,  beside  which  stands  a  pail  of  cold  water  with  two  coarse 
towels  soaking  in  it.  The  bath  attendant,  taking  his  place  behind 
the  patient,  lifts  one  of  the  towels  all  loaded  with  water,  and  lays  it 
quickly  on  the  patient's  head.  The  patient  immediately  seizes  it, 
removes  it  from  his  head,  and  rubs  himself  rapidly  with  it, —  his  face, 
his  thioat,  shoulders,  arms,  chest,  stomach,  bowels,  thighf*  and  legs. 
having  gone  rapidly  over  the  whole  body  once,  he  droiw  his  towel 
into  the  pail  again,  which  the  bath-man  presses  down  to  the  bottom 
of  the  water,  then  lifts  it  out,  and  places  it  on  his  head  again.    As 


^^SSE^SSBSSSSS^^^SHMk 


Bonvenieni 
itant  pours 
'  the  boclj 
I  temperiv- 
n  is  one  uf 

it  cures  in 
oording  to 
b  heat,  thu 
■  of  febrile 
:,  measles, 
remarkable 


water  we 
letedroom, 
"op  of  the 
if  ablution, 
b  it,  unless 
1  ablution, 
iolds,  helps 
nting  con- 

bz-tub,  and 
the  head, 

8  time  the 

the  head, 

than  the 


Johnson 
sitting-  or 
two  coarse 
ace  behind 
nd  lays  it 
y  seizes  it, 
—  his  face, 

and  legs. 

his  towel 
le  bottom 
gain.    As 


PK00K88KH   OK  THE   HYDROl'ATHIO  TBRATMKNT. 


753 


before,  the  patient  seizes  it,  and  goes  all  over  the  same  ground  onoe 
more,  and  tiien  drops  it  into  the  water  again,  when  the  bath*man 
again  lifts  it  and  places  it  on  tho  head  to  be  a  third  time  removed  by 
the  patient,  and  applied  as  before,  rapidly,  actively  and  energetically, 
all  over  his  body  in  front.  The  bath-man  is  industriously  occupied 
all  the  time  l)elund  in  the  same  manner,  from  the  back  of  the  neck  to 
the  back  of  the  legs,  wetting  his  own  towel  as  often  as  he  wets  that 
used  by  the  patient,  viz.,  three  times.  This  is  called  a  wash-down  of 
three  towels.  The  patient  is  then  diied  in  a  dry  sheet.  It  is  a  more 
powerful  bath  than  the  common  towel-bath,  but  not  in  all  respeots  so 
coavenient  to  take. 

The  Cold  Foot-Bath. 

Oms  of  the  first  things  people  who  are  troubled  with  cold  feet  do 
is  to  plimge  them  into  cold  water.  Nor  is  the  assertion,  put  forth 
in  some  of  the  hydropathic  works,  that  the  cold  foot-bath  was  pre- 
scribed by  Priessnitz  for  the  same  purpose  that  the  faculty  order 
warm  ones,  correct.  When  the  feet  are  already  cold,  neither  Priess- 
nitz nor  any  one  in  his  sober  reason  would  prescribe  cold  water,  which 
can  only  make  the  parts  colder.  To  obtain  the  good  effect  of  the 
cold  foot-bath,  so  far  as  the  feet  are  concerned,  they  should  be  warm 
whenever  it  is  taken.  For  a  tendency  to  coldness  of  the  feet,  —  a 
very  common  symptom  in  these  days  of  so-called  luxury  and  refine- 
ment, and  one  that  indicates  a  state  of  things  in  the  system  incom- 
parably more  to  be  dreaded  than  the  mere  coldness  of  the  feet,  — 
this  is  the  remedy.  It  may  be  taken  at  any  convenient  time ;  just 
before  the  morning  walk  is  a  very  suitable  occasion,  the  parts  being 
usually  warm  early  in  the  day. 

At  other  times,  if  cold,  they  should,  if  at  all  praotioable,  be  warmed 
oy  exercise  and  friction  before  subjecting  them  to  the  action  of  cold 
water.  But  in  cases  of  old  age,  great  debility,  etc.,  the  warm  foot- 
bath and  other  warm  applications  may  be  resorted  to  before  the  cold. 
Thus  with  cold,  exercise  and  friction,  accustoming  the  feet  daily  and 
frequently  to  cold  water,  will  beget  in  them  a  habit  of  remaining  warm. 
In  a  great  variety  of  ailment^  such  as  toothache,  rush  of  blood  to  the 
head,  headache,  earache,  inflammation  of  the  eyes,  gout,  rheumatism, 
hemorrhage,  etc.,  the  cold  foot-bath  is  a  valuable  remedy.  It  is  or- 
dered deep  or  shallow,  and  of  duration  according  to  the  nature  of 
the  case. 

Wadins  Foot- Baths. 

I  HAVB  often  directed  patients  to  wade  in  water  in  some  conven- 
ient place  as  a  means  of  hardening  the  system  and  of  giving  tone  to 
the  nerves.  Delicate  ladies  who  were  not  able,  as  they  supposed,  to 
endure  cold  water  applied  to  the  feet,  have  by  degrees,  wetting  the 
feet  but  little  at  first,  become  so  accustomed  to  the  coldest  water  that 


i 


704 


rUOUEHHKS  or   TIIR   HYDKOPATHIC    TKRATMKNT. 


in  a  few  weeks  they  could  bear  ud  much  aa  any  one  would  dusiru. 
Caution  and  perseverance  should  be  the  mle. 

It  is  partly  by  Hyini)athy  and  partly  by  the  abe>traotion  of  heat,  that 
foot-lmths  and  wetting  the  feet  act  in  ho  beneficial  or  deleteriouH  a 
manner  as  we  know  them  to  do.  The  principle  of  Hympathy  is  an  old 
one  in  the  medical  art,  but  none  the  worse  for  that. 


The  Warm  Poot-Bath. 

I  AM  aware  that  some  who  consider  themselves  genuinely  hydro- 
pathic  object  to  the  use  of  this  remedy.  Having  truth  for  my  ubjecl, 
tiowever,  I  care  not  for  such  objections  so  far  as  I  myself  am  concerned, 
and  without  stopping  here  to  argue  the  question,  I  simply  remark 
that  warmth  under  some  oiroumstances  is  as  natural  an  applicutioti 
for  the  living  body  as  cold  under  other  circumstances.  I  have  already 
remarked,  under  the  head  of  the  cold  foot-bath,  that  putting  the  feot 
into  warm  water  is  often  a  good  preparatory  process  to  that  bath.  It 
is  good  also,  now  and  then,  for  soothing  divers  aches  and  pains,  and 
also  for  warming  the  feet  of  old  and  weakly  people,  who  cannot 
exercise  sufficiently.  Soaking  the  feet  in  hot  water  for  twenty  min- 
utes, and  taking  five  or  six  dro|«  of  spirits  of  Camphor  in  a  tea- 
spoonful  of  sugar  will  often  break  up  a  cold,  if  taken  in  season. 

The  Nose-Bath. 

Ik  a  variety  of  ntuKil  ailmentc,  catarrh,  colds  in  the  head,  inflam- 
mation and  ulceration  of  the  nasal  passages,  nose-bleed,  etc.,  the 
no^e-bath  is  a  salutary  rempdy.  The  water  is  used  either  tepid  or 
cold,  according  to  the  case.  It  should  be  drawn  back,  if  possible, 
so  that  it  is  ejected  by  the  mouth.  Those  who  have  injured  the 
nasal  cavities  by  much  snuff-taking  will  find  advantage  from  sniffing 
water  freely  into  the  nostrils.  If  one  is  determined  to  leave  off  snuff, 
as  every  one  addicted  to  it,  if  he  regards  either  health  or  bodily 
comf(M-t,  ought,  he  will  find  it  useful  oft«u  to  take  cold  water  in- 
stead of  the  abominable  weed. 


The  Eye  and  Ear  Bath. 

"^^  contrivances  may  be  brought  to  bear  in  applying  water 

^  a  and  ear.     Light,  ascending  douches   and    showers   are 

.  for  various  diseases  of  the  parts.     There  should  not  be  much 

oe  used  in  this  way.     Immersing  them  also  in  water  is  often  useful. 

The  water  should  not,  in  general,  be  very  cold,  tepid  or  warm  being 

often  the  best. 


iH* 


PKOCBHHKH  OK  THK   HYUKOPATHIU  TREATMENT. 


755 


mid  desire. 

f  heat,  that 
ileteriouH  u 
ly  U  an  old 


neli/  hydro- 
my  object, 
I  concerned, 
ply  remark 
application 
live  already 
iig  the  feot 
t  bath.  It 
paiiiH,  and 
rho  cannot 
iventy  min- 
r  in  a  te&- 
eason. 


Mouth,  or  Oral  Bath. 

For  inflammation  of  the  gumn,  mouth,  throat,  and  palate,  in  slimy 
seca'tioiiH  from  the  throat  and  utomach,  in  tootlmuhe,  cabirrh,  coUIh, 
and  uiironiu  hoarsenenH,  gargliugs  and  batlu  for  the  mouth  are  of 
great  Hervice.  Pauley,  a  merchant  of  Vienna,  has  been  thought 
HJnguhir  for  his  zeal  in  recommending  this  bath.  Clergymen  and 
otliers  wlio  suffer  hoareeueHS  bv  much  speaking  will  find  that  hold- 
ing very  cold  water  in  the  mo  ith  until  it  l)egin8  to  grow  warm,  and 
then  ejecting  it,  and  by  frequently  repeating  the  process,  much 
l)enefit  will  be  obtained.  Coughs  and  tightness  of  the  chest  may 
often  be  essentially  relieved  by  this  bath.  In  mucous  secretions 
from  the  throat  and  stomach,  by  ejecting  the  water  a  number  of 
times,  it  will  surprise  tho,se  who  have  not  v/itnessed  file  remedy  to 
see  the  amount  of  slimy  secretion  thrown  off. 


ad,  inilam- 
1,  etc.,  the 
sr  tepid  or 
if  possible, 
njured  the 
ora  sniffing 
e  off  snuff, 
I  or  bodily 
d  water  in- 


:    ^*    .P 


ying  water 
lowers  are 
jt  be  much 
ften  useful, 
yarm  being 


\h.\ 


DOMESTIC  MANAGEMENT  OP  THE  SICK 

EOOM. 


Choice  of  the  Sick-Room.  etc. 

Sleeping  Apartment. — In  every  case  of  disease,  however  slight 
its  nature,  the  sleeping  apartment  of  the  sick  should  be  airy  and  well 
ventilated;  but,  when  Providence  visits  any  member  of  a  family  with 
disease  of  a  serious  and  protracted  description,  all  other  considera- 
tions giving  way  to  the  necessity  of  the  case,  an  apartment  should  be 
chosen  and  arranged  in  a  special  manner  for  the  reception  of  the  in- 
valid. It  should  be  one  calculated  to  administer  to  his  temporary 
comfort,  as  well  as  to  aid  his  recovery.  It  is  not  time,  when  the 
alarm  is  sounded  and  the  danger  is  already  urgent,  to  think  of  such 
arrangements;  forethought  must  be  put  in  requisition;  every  want 
anticipated;  and  whatever  is  likely  to  be  required  should  not  only 
be  provif'^d,  but  so  armnged  that  it  can  be  instantly  found  when  it 
is  needed. 

The  sick-room  should  be  large,  lofty,  and,  if  possible,  with  a  north- 
em  aspect,  in  order  to  avoid  the  heat  of  the  mid-day,  or  the  after- 
noon sun;  the  windows  should  be  capable  of  being  opened  by 
drawing  down  the  uppermost  sash?  If  possible,  choose  a  room  with 
an  open  fireplace  or  a  ventilator  opening  into  the  chimney  in  the 
upper  part  of  the  room.  No  article  of  unnecessary  furniture  should 
be  permitted  to  remain  in  the  room;  and  that  which  is  left  in  it 
should  be  of  a  description  fitted  to  administer  to  the  convenience  of 
the  invalid. 

Two  tables  are  sufiScient.  One  of  them  may  be  small,  to  stand 
near  the  bed,  for  the  immediate  use  of  the  patient:  namely,  to  hold 
his  jug  of  barley-water,  or  toast-water,  or  other  beverage; --a  small 
tea-pot,  or  what  is  preferable,  a  half-covered  cup  with  a  spout,  to 
enable  fluids  to  be  administered  without  raising  the  sufferer  in  bed;— 
his  medicines  for  the  day; — and  any  other  thing  which  he  may  fre- 
quently require. 

The  other  table  should  be  large,  for  the  accommodation  of  medi- 
cines not  in  immediate  use,  and  also  for  spare  glasses,  jugs,  cups, 
spoons,  both  large  and  small,  and  other  necessary  articles.    This 

756 


' 


DOMESTIC  MANAGEMENT   OF  THE  BJCK-ROOM. 


767 


5  SICK 


ever  slight 
ry  and  well 
fomily  with 
considera- 
t  should  be 
1  of  the  in- 
temporary 
,  when  the 
nk  of  such 
every  want 
[d  not  only 
nd  when  it 

ith  a  noiiih- 
'  the  after- 
opened  by 
room  with 
iney  in  the 
ture  should 
)  left  in  it 
irenience  of 

1,  to  stand 
ily,  to  hold 
;  — ^  a  small 
i  spout,  to 
r  in  bed;— 
le  may  f  re- 

n  of  medi- 
jugs,  cups, 
;le8.    This 


table  should  have  one  drawer,  at  least,  which  ought  to  be  furnished 
with  the  following  articles:  broad  and  narrow  tape;  two  or  three 
half-worn  ribbons ;  a  bundle  of  old,  soft  linen  ;  a  sponge ;  a  few 
ounces  of  lint ;  scissors,  large  and  small ;  a  bone  spatula  for  spread- 
ing ointment;  a  couple  of  rolls  of  muslin,  and  the  same  quantity  of 
flannel  bandage  two  inches  broad ;  a  pin-cushion  well  supplied  with 
pins;  needles  and  thread;  and  about  half  a  yard  of  simple  adhesive 
plaster. 

A  Sofa  or  Reclining  Chair.  —  A  sofa,  if  the  apartment  be  suiB- 
ciently  large  to  admit  of  it,  is  a  very  important  piece  of  furniture  in 
the  sick-room;  the  erect  or  the  sitting  posture  being  injurious  in 
many  diseases ;  and,  when  the  sick-bed  requires  to  be  made,  a  sofa 
affords  the  means  of  removing  the  patient  from  the  bed  with  as  little 
inconvenience  to  him  as  possible. 

If  there  is  not  a  space  for  a  sofa,  there  should  be  an  invalid  or  re- 
clining chair;  and,  when  circumstances  will  permit,  it  should  be  of 
that  kind  which  is  susceptible  of  a  variety  of  changes,  so  as  to  vary, 
at  pleasure,  the  position  of  the  patient.  There  should  not  be  moi-e 
than  two  other  chairs  in  the  room.  If  there  is  a  looking-glass  in  the 
apartment,  in  a  situation  which  adm'.cs  of  the  patient  seeing  himself 
in  it  as  he  lies  in  bed,  its  place  should  be  changed,  or  it  should  be 
altogether  removed  from  the  room.  A  chest  of  drawers  is  essential ; 
but  none  of  the  drawers  should  be  appropriated  for  the  reception  of 
dirty  linen,  which  ought  never  to  be  allowed  to  remain  a  moment  in 
the  sick-room.  One  drawer  should  be  especially  allotted  for  towels, 
of  which  an  ample  supply  is,  in  every  case,  necessary.  The  washing- 
stand  will  require  two  additional  iMwins ;  an  additional  water-bottle 
and  a  tumbler;  and  a  large  water-pitcher,  under  the  table,  always 
full  of  water. 

No  Cookins  In  Sick-room.  —  There  should  be  no  kettle,  nor  any 
implement  of  cooking,  in  the  sick-room ;  even  in  winter,  and  when  a 
fire  is  required.  In  general,  a  fire  in  the  sick-room  is  only  necessary 
for  the  comfort  of  the  attendants.  The  lamp  termed  a  Night^urse, 
consisting  of  a  water-bath  placed  over  a  lamp  in  a  wire-worked  cylin- 
der; a  small  tin  kettle  which  enters  the  top  of  the  cylinder;  and  a 
covered  earthenware  vessel  which  fits  into  the  water-bath,  are  use- 
ful for  keeping  fluids  warin,  and  at  the  same  time  for  preserving  a 
light  in  the  room,  when  an  unshaded  lamp  or  a  candle  would  be 
hurtful. 

In  ro  itinued  fevers,  the  sense  of  hearing  is  often  so  morbidl;y  acute 
that  o/dinary  sounds  ^come  cau^^es  of  pain.  In  this  case,  if  the 
floor  of  the  sick-room  be  not  w?  jlly  carpeted,  every  precaution  to 
lessen  the  intensity  of  the  sound  should  be  taken.  One  of  the  most 
effectual  is  to  have  a  couple  or  more  pairs  of  :irge  list  shoes  outside 
the  door,  into  which  the  feet,  even  of  the  doctors,  may  be  advanta- 
geously thrust,  when  their  shoes  make  a  creaking  noise,  or  when  a 


758 


DOMESTIC   MANAGEMENT  OF  THE   SICK-ROOM. 


visitor  or  muse  treads  with  a  heavy  foot.  On  the  same  account, 
when  more  than  one  nurse  or  attendant  is  required  to  he  in  the  room 
at  the  same  lime,  no  conversation,  although  it  may  be  carried  on  in 
a  whisper,  should  be  permitted.  Whispering,  indeed,  is  apt  to  ex- 
cite delirium,  and  to  augment  it  when  it  is  already  present. 

Beds  and  Bedding. — Beds  without  curtains  are  those  best  adapted 
for  the  sick-room.  In  every  case  of  disease,  indeed,  especially  when 
it  is  attended  by  fever,  the  patient  should  be  kept  cool,  and  the  most 
perfect  freedom  be  given  to  the  breathing ;  the  hair  mattress  should 
be  used,  never  a  feather  bed,  and  the  pillows  be  firm  and  elastic. 
The  coverlets,  which  are  spread  upon  beds  during  the  day,  and  often 
retained  at  night,  are  heavy,  and  calculated  rather  to  increase  than  to 
subdue  fever ;  consequently  they  should  be  wholly  discarded  from 
the  sick-bed.  Indeed,  when  the  disease  is  fever,  and  when  it  is 
accompanied  with  great  restlessness,  owing  to  the  evening  exacerba- 
tion, if  the  bedroom  be  sufficiently  large,  two  beds  should  be  placed 
in  it;  or  if  two  adjoining  bedchambers  can  be  obtained,  a  bed  ought 
to  be  put  in  each,  so  that  the  patient  can  be  moved  from  one  bed  to 
the  other  every  morning  and  evening.  This  both  aids  sleep,  and  it 
also  tends  greatly  to  insure  the  personal  cleanliness  of  the  patient. 
The  Ijedclothes  of  the  bed  from  which  the  patient  is  moved,  should, 
on  his  removal,  be  immediately  turned  down  and  fully  exposed  to  the 
air ;  a  precaution  which  will  set  aside  the  necessity  of  so  frequent  a 
change  of  linen  as  would  be  otherwise  required.  When  there  is 
only  one  bed,  and  when  the  disease  is  fever  (unless  the  patient  is  too 
ill  to  permit  his  being  moved),  the  sheets  which  have  been  used  at 
night  should  be  replaced  by  others  in  the  morning,  and  hung  up  in 
the  free  air  during  the  day,  to  be  again  used  at  night.  But,  when  it 
can  conveniently  be  done,  in  every  case  of  continued  fever,  especially 
of  an  infectious  kind,  the  sheets  should  be  changed  once  in  twenty- 
four  hours ;  a  practice  which  is  likely  to  prevent  the  fumes  of  in- 
fection from  being  communicated  to  the  blankets,  or  to  any  of  the 
furniture  of  the  room. 

Ventilation  is  always  of  primary  importance ;  and  that  period, 
happily,  is  gone  by,  in  which  air  was  carefully  excluded  from  the 
chambers  of  the  sick,  even  when  they  were  suffering  under  febrile 
disease. 

Ventilation  is  particularly  demanded  in  those  fevers  in  which 
miliary  eruptions  display  themselves;  under  no  circumstances  is  it 
so  essential  as  in  febrile  diseases  of  an  infectious  kind.  It  may,  how- 
ever, be  consolatory  to  those  whose  duty  it  is  to  attend  such  cases,  to 
know  that  infection  communicated  through  the  air  rarely  extends 
above  a  few  feet  from  the  body  of  the  patient ;  and  even  in  the  most 
malignant  diseases,  with  the  exception  of  confluent  small-pox,  and 
malignant  scarlet  fever  of  the  woiBt  kind,  its  influence  does  not  ex- 
ceed a  few  yards,  if  the  room  be  well  ventilated.     On  the  contrary, 


iiiiiiiii 


DOMESTIC   MANAGEMENT  OP  THE   SICK-ROOM, 


769 


if  ventiliition  l)e  neglected,  the  power  of  infection  becomes  greatly 
augmented  from  its  concentration  in  coJifined  and  quiescent  air ;  it 
even  settles  upon  the  clothes  of  the  attendants,  and  on  the  furniture 
of  the  room ;  and  these  imbibe  it  most  readily  when  their  texture  is 
wool,  fur,  or  cotton,  or  any  loose  or  downy  substance  capable  of  re- 
ceiving and  readily  retaining  the  air.  Smooth  and  polished  surfaces 
do  not  easily  receive  or  retain  infectious  matter;  consequently  the 
nurses  and  attendants,  in  cases  of  infectious  diseases,  should  have 
glazed  gowns,  and  aprons  of  oiled  silk. 

In  no  infectious  diseases  are  these  rules  more  essentially  necessary 
than  in  small-pox  and  scarlet  fever.  It  is  well  known  that,  if  the 
bedclothes  of  a  patient  laboring  under  either  scarlet  fever  or  small-pox 
be  closely  folded  up,  they  will  letain  the  infectious  matter,  and  com- 
municate the  disease  at  a  great  distance  of  time ;  but  the  influence  of 
free  ventilation  is  so  great,  that  medical  practitioners  who  are  attend- 
r.g  small-pox  patients,  and  who  go  from  them  into  the  open  air,  do 
not  spread  the  disease.  Indeed,  all  infection  is  weakened  by  dilu- 
tion with  air.  The  danger  of  infection  is  augmented,  if,  along  with 
bad  ventilation,  the  atmosphere  of  the  room  be  moist  from  any  cause. 

It  is  further  consolatory  to  know  that  the  infectious  matter,  even 
of  the  most  virulent  description,  is  not  poisonous  to  everyone  who 
is  placed  within  the  sphere  of  its  influence.  A  predisposition  of  the 
body  to  receive  the  infection  must  exist  before  it  can  be  communi- 
cated; a  condition  which  is  augmented  by  fatigue  and  watching, 
defective  nourishment,  mental  depression,  or  anything  which  can 
lower  the  vital  powers.  The  necessity,  therefore,  of  maintaining 
these  powers  by  attention  to  rest,  a  sufficient  quantity  of  good  and 
generous  diet,  and  cheerfulness  of  mind,  need  not  be  insisted  upon. 

In  every  case  of  infectious  disease,  the  attendants,  even  in  the 
best  ventilated  rooms,  should  stand  on  the  windward,  or  on  that  side 
of  the  sick-bed  from  which  the  current  of  air  comes ;  as,  by  neglect 
of  this  rule,  and  by  standing  in  the  cunent  which  has  passed  over 
the  patient,  the  infectious  exhalations  are  blown  upon  them  in  a  direct 
stream  from  the  body  of  the  patient.  The  attendants  should  never 
lean  over  the  sick,  nor  should  they  receive  their  breath.  The  health 
also  of  the  nurses  should  always  be  supported  by  nutritious  and  gen- 
erous diet ;  but  not  by  brandy,  nor  any  other  ardent  spirit. 

The  term  infection,  in  its  most  extensive  signification,  implies  some 
deleterious  matter,  originating  from  any  source,  and  transmitted 
through  the  air,  which  is  capable  of  causing  diseases  in  the  human 
body.  When  this  matter  is  emanated  from  the  diseased  bodies  of 
men,  the  term  is  frequently  regarded  as  synonymous  with  contagion; 
but.  in  strictness  of  language,  the  latter  refers  only  to  the  communi- 
cation of  disease  by  contact.  Whatever  may  be  the  matter  of  infec- 
tion, it  may  enter  the  body  through  the  medium  of  the  lungs,  which 
is  the  most  ready  inlet,  or  by  the  saliva,  or  even  through  the  surface, 
if  the  skin  be  abraded,  or  if  any  ulceration  be  present.     The  iuflu- 


760 


DOMESTIC   MANAGEMENT   OF  THE   SIOK-ROOM. 


ence  of  infectious  matter  is  evidently  exerted  on  the  nervous  system, 
displaying  itself  by  debility,  inertness,  dislike  to  motion,  great  sus- 
ceptibility of  cold,  irritability  and  despondency  of  mind,  and  by  the 
production  of  a  disease  similar  to  that  of  the  person  from  whom  the 
infectious  matter  has  proceeded.  The  infection  may  be  supposed  to 
have  taken  effect,  and  to  have  produced  the  actual  disease,  when  the 
pei-son  who  has  been  exposed  to  its  influence  is  attacked  with  giddi- 
ness, pain  in  the  head,  irregular  heat  and  chills,  nausea,  and,  if  the 
infectious  disease  be  small-pox,  convulsions.  These  symptoms  are 
sufficient  to  denote  the  necessity  for  immediate  medical  advice. 

Temperature.  —  Next  to  ventilation  nothing  is  of  more  importance 
than  the  regulation  of  the  temperature  of  the  sick-room,  avoiding  both 
extremes  of  elevation  or  of  depression ;  but  much  depends  on  the 
nature  of  the  disease. 

The  best  general  temperature  of  a  sick-room  is  60°  (Fahr.)  ;  and 
it  is  preferable  to  regulate  this  rather  by  the  thermometer  than  by  the 
sensations  of  the  patients  or  the  attendants.  Under  some  circum- 
stances, however,  the  feelings  of  the  patient,  and  his  susceptibility  of 
impressions  upon  the  skin,  should  not  be  overlooked.  Thus  if  the 
temperature  be  a  little  above  that  of  summer,  and  the  patient,  never- 
theless, feel  chilly,  it  should  be  raised  five  or  six  degrees.  This  chil- 
liness is  very  apt  to  be  felt  in  a  dyspeptic  state  of  the  habit,  and 
more  especially  when  it  is  accompanied  with  hypochondriasis.  It  dif- 
fers from  that  more  severe  but  transient  coldness  which  accompanies 
intermittent  fevers,  and  some  other  periodical  affections ;  and  it 
requires  an  elevated  temperature  of  the  air  for  its  removal,  whilst  the 
cold  stage  of  intermittent  diseases  is  best  relieved  by  the  warm  bath, 
either  general  or  local. 

So  important  is  the  regulation  of  temperattire,  especially  in  fevers, 
that  it  often  does  more  good  than  any  other  remedial  measure.  I 
have  seen  patients  laboring  under  high  delirium  in  a  close,  ill-venti- 
lated room  become  rapidly  quite  collected  by  merely  lowering  the 
heat  of  the  apartment  twelve  or  fifteen  degrees. 

In  convalescence,  as  the  air  of  the  sick-chamber  should  be  fre- 
quently renewed,  the  temperature  in  spring  and  autumn  ought  to  be 
maintained  as  near  as  possible  at  55°  to  60°  (Fahr.)  ;  and  it  should 
be  very  gradually  lowered  as  the  invalid  acquires  strength,  so  as  to 
enable  him  to  bear  with  impunity  the  varying  temperature  of  these 
seasons  in  the  open  air.  Even  then,  if  the  previous  disease  has  been 
pulmonary,  the  air  admitted  to  the  lungs  should  be  tempered  by  the 
use  of  the  Respirator,  or  a  muslin  handkerchief  tied  around  the  mouth. 
When  the  invalid  first  ventures  out  of  doors,  nothing,  indee  is  so  • 
essential,  in  a  prophylactic  point  of  view,  as  avoiding  extremes  and 
sudden  transitions  of  temperature. 

Cleanliness.  —  Although  cleanline»a  in  the  sick-room  is  essential, 
yet  it  may  be  carried  so  far  as  to  become  an  annoyance  to  '>A'.k  invalid, 


DOMESTIC  MANAGEMKNT   OP  THE   8I0K-UOOM. 


761 


and  consequently  to  prove  injuTious.  It  is  not  requisite  to  sweep 
the  room  daily,  nor  to  dust  and  arrange  the  furniture  eveiy  morning, 
provided  order  be  preserved  in  the  room,  and  nothing  but  what  is 
immediately  necessary  for  the  comfort  and  convenience  of  the  invalid 
be  permitted  to  remain  in  it.  It  is  truly  distressing  to  observe  the 
confusion  which  prevails  in  some  sick-rooms ;  evervthing  being  out 
of  place,  and  to  be  searched  for  when  it  is  wanteu. 

The  period  chosen  for '  leaning  and  arranging  the  sick-room  should 
be  the  morning,  as  after  a  night's  rest  the  patient  is  mort  able  to 
bear  the  little  noise  and  bustle  which  it  always  more  or  less  occasions. 
The  carpet  should  be  sprinkled  with  moist  tea-leaves,  or  newspaper 
torn  in  small  pieces  and  wet,  and  lightly  swept. 

It  is  scarcely  requisite  to  insist  on  the  necessity  of  the  utmost 
attention  to  the  cleanliness  of  everything  in  the  sick-room.  The 
moment  after  any  vessel  or  implement  is  used  by  the  invalid,  it  should 
be  removed  from  the  apartment,  and  returned  as  soon  as  it  is  cleaned. 
Nothing  in  the  form  of  a  slop-basin  or  slop-pail  is  admissible  ;  they 
only  administer  to  the  laziness  of  nuiBes. 

The  necessity  of  cleanliness  in  the  vessels  used  for  the  food  of  in- 
valids is  strikingly  illustrated  in  the  bad  effects  arising  from  the 
neglect  of  it  when  an  infant  is  brought  up  by  hand.  In  such  a  case, 
if  the  feeding-bottle  which  is  employed  be  not  instantly  cleansed  after 
the  meal  has  been  given,  the  small  portion  of  the  pap  or  food  which 
remains  in  the  vessel  becomes  sour,  and  taints  the  whole  of  the  fresh 
food  mixed  with  it,  causing  colic  and  convulsions  in  the  infant.  The 
same  risk  of  injury  occui-s  in  the  sick-room,  if  the  vessels  used  for 
administering  food  to  the  invalid  be  not  instantly  and  well  cleansed 
after  every  time  they  are  used. 

It  is  too  common,  also,  to  use  one  glass  or  cup  for  administering 
medicines,  and  to  leave  it  unrinsed  from  time  to  time,  —  a  custom 
which  may  prove  as  deleterious  as  a  defect  of  cleanliness  in  vessels 
employed  for  food.  Some  medicines,  when  they  are  exposed  to  the 
air,  rapidly  undergo  changes  which  alter  their  properties ;  and  this 
alteration  having  been  undergone  by  the  small  portion  which  is  always 
left,  in  the  glass  or  cup,  communicates  the  disposition  to  be  decom- 
posed to  that  which  may  be  next  -loured  into  the  cup.  An  active 
medicine  maybe  thus  rendered  i..ort;  or  one  which  is  mild  in  its 
operation  may  be  so  changed  as  to  operate  with  hazardous  energy. 
The  same  precaution,  as  to  cleanliness,  is  also  requisite  as  to  the 
minim  measure,  when  medicines  are  directed  to  be  administered 
in  a  form  which  requires  its  employment. 

Darkening  the  Sick-room.  —  It  is  a  common  error  to  imagine  that 
a  sick-room  should  always  be  either  partially  or  wholly  darkened.  In 
some  diseases,  as,  for  example,  fevers,  when  the  eyes  are  acutely  sen- 
sible to  lipfht,  so  that  they  remain  half-closed,  and  the  eyebrows  are 
contracted,  the  greatest  relief  is  experienced  from  darkening  the 
room.     When  delirium  is  present,  a  certain  degree  of  darkening  is  in 


762 


DOMKUIIO  MANAI.KMKNT   OF  THE  BICK-UOOM. 


some  instances  serviceablo  ;  whilst  in  others,  especially  when  the  de- 
lirium is  accompanied  with  visual  illusions,  nothing  so  readily  dispels 
these,  and  consequently  abates  the  delirium,  as  the  admission  of  the 
full  daylight  into  the  sick-room.  Theie  is  much  difficulty,  however, 
in  determining  which  state  of  the  apartment  is  likely  to  l^e  must  ser- 
viceable in  any  particular  case.  Observation  of  the  effects  of  light 
and  darkness,  in  the  individual  case,  must  be  our  guide. 

These  illusions  of  the  sight  are  generally  the  result  of  former  im- 
pressions,' renewed  at  a  moment  when  the  brain  is  in  such  a  disturbed 
condition  as  to  set  aside  the  exercise  of  judgment.  In  this  condition 
of  the  brain,  the  renewed  conceptions  are  not  readily  corrected,  as  in 
health,  by  impressions  received  from  the  external  world;  hence,  they 
become  more  vivid  in  the  mind  of  the  invalid  when  the  sick-room  is 
darkened,  and  all  visible  objects  are  shut  out.  They  are  usually  dis- 
pelled by  new  impressions  on  the  organ  of  sense  chiefly  implicated ; 
on  which  account,  those  which  are  connected  with  sight  seldom  occur 
during  the  day,  when  real  objects  are  presented  to  the  eye,  unless  the 
brain  be  so  over-excited  as  to  bring  the  conceptive  faculty  into  in- 
tense exercise,  sufficient  to  awaken  those  false  perceptions  wliich 
create  a  belief  of  the  prbscnce  of  individuals  not  only  not  present, 
but  who  have  been  long  dead.  This  state  of  the  mental  organ  is 
similar  to  that  on  which  depend  the  spectral  illusions  of  the  insane, 
but  differing  from  it  in  its  transient  nature.  I  have  frequently  wit- 
nessed the  conversation  with  one  of  these  spectral  beings  instantly 
terminated,  and  the  whole  illusion  dispelled,  on  opening  the  window 
curtains  of  the  room ;  whilst  the  invalid  has  thus  expressed  himself : 

"  Bless  me  !  I  thought  I  was  talking  with  Mr. ,  just  now ;  I 

must  have  been  dreaming;  for  now  I  recollect  he  has  been  dead  many 
years."  A  twilight  obscurity  in  the  sick-room  is  often  more  produc- 
tive of  these  illusions  tiian  darkness. 

Fumigation. 

After  every  contagious  disease,  like  diphtheria,  scarlet  fever,  etc., 
the  room,  furniture,  bed,  etc.,  are  to  be  thoroughly  disinfected,  to  pre- 
vent the  development  and  spreading  of  the  germs. 

Sulphur  fumes  have  been  used  for  many  years  for  this  purpose, 
but  this  method  is  not  secure,  agreeable  nor  efficient.  It  no  doubt 
kills  many  germs  exposed  any  length  of  time  to  its  fumes,  but  never 
destroys  their  spores.  So  much  so-called  fumigation,  as  usually  prac- 
tised, is  useless,  that  it  might  as  well  not  have  been  doue,  as  it 
gives  a  false  impression  of  security.  Most  virulent  germs  are  capa- 
ble of  reproduction  and  dissemination  years  after  their  original  occu- 
pation of  a  house.  Old  bedding  and  clothing,  brought  out  months 
after  the  so-called  fumigation,  have  caused  the  death  of  many  a  little 
one,  and  the  dangerous  sickness  of  others. 

Sulphur  and  its  allies  have  been  found  to  be  so  altogether  uncer- 
tain and  untrustworthy  that  boards  of  health  are  no  longer  willing 
to  endorse  its  usefulness. 


■H^i 


DOMESTIC   MANAGEMENT   OF   THE   8ICK-K00M. 


763 


ion  tli(!  (le- 
lily  (li8i)els 
sion  of  the 
U  however, 
le  most  ser- 
ta  of  light 

former  im- 
a  disturbed 
s  condition 
acted,  a£i  in 
hence,  they 
ick-room  is 
usually  dis- 
Lmplicated ; 
Idom  occur 
),  unless  the 
ilty  into  in- 
lions  wliich 
lot  present, 
al  organ  is 
the  insane, 
uently  wit- 
^  instantly 
;he  window 
sd  himself: 
ist  now;  I 
dead  many 
ore  produc- 


b  fever,  etc., 
jted,  to  pre- 

lis  purpose, 
[t  no  doubt 
J,  but  never 
isually  prac- 
done,  as  it 
DS  are  capa- 
iginal  occu- 
out  months 
lany  a  little 

sther  uncer- 
iger  willing 


The  only  reliable,  practical  measure  against  the  life  of  contagious 
germs  is  the  same  as  now  used  in  ciujc  of  surgical  diseases.  Corro- 
sive  sublimate,  carbolic  acid,  boiling  water,  steaming,  and  baking  are 
sure  aud  safe  remedies. 

Of  this  xiwashev  corrosive  sublimate  is  easily  the  leader  in  efficiency. 
It  u  not  the  dangei'ous  drug  to  use  as  commonly  supposed,  since  the 
quantity  necessary  to  kill  cannot  be  collected  in  a  room  subjected  to 
ite  use.  Every  piece  of  furniture  and  all  woodwork,  even  the  paper 
of  the  wall,  can  be  safely  washed  in  a  solution  of  this  drug,  made  by 
dissolving  one  tablet  in  two  quarts  of  water,  and  fear  need  not  be 
enlertahied,  either,  of  its  efficacy  or  its  harmfulness.  Doors,  windows, 
and  other  woodwork  should  be  thoroughly  washed  with  it.  Carpets 
should  be  first  wet  with  it  from  a  sprinkler,  dried  and  beaten.  The 
piper  need  not  be  removed,  if  only  it  can  be  wiped  with  this  solution. 
Bedding  should  be  steamed,  bed-clothing  boiled,  and  all  articles  not 
readily  washed  may  be  likewise  steamed.  A  solution  of  carbolic  acid, 
1  pait  to  40  of  water,  is  likewise  efficient.  The  great  danger  of 
doing  poor  work  in  the  matter  of  fumigation  lies  in  the  practice  of 
carrying  things  out  of  the  room  during  the  illness,  before  fumigation 
has  been  commenced.  The  nurse  or  mother  travelling  from  one 
room  to  another  may  carry  in  her  clothing  germs  sufficient  to  infect 
a  whole  neighborhood.  The  attendants  of  such  a  case  should  wear 
some  tliin  linen,  cotton,  cambric,  or  other  washable  dress,  that  may 
now  and  then  be  put  into  the  boiler,  and  thus  thoroughly  cleansed. 

The  hair  of  patient  and  attendaint  should  be  thoroughly  washed  in 
the  corrosive  wash  on  leaving  the  room,  before  disinfection  of  same. 
Hands  are  to  be  scrubbed  in  soap  and  water,  and  then  washed  in 
corrosive  solution  on  leaving  the  room,  and  finally  the  room  is  to  be 
thoroughly  aired. 

K  the  work  is  done  well  and  care  has  been  exercised  not  to  have 
contaminated  other  portions  of  the  house  except  that  occupied  by 
the  patient,  all  will  be  well.  Frequently  during  the  illness  sheets 
wrung  out  of  the  corrosive  solution  are  hung  up  on  one  side  of  the 
door  to  filter  the  air  passing  out  of  the  room.  It  has-also  been  found 
that  the  evaporation  of  some  mild  antiseptic  in  the  room  during  the 
sickness  not  only  modifies  the  virulence  of  the  germ,  but  is  actually 
beneficial  in  the  treatment  of  these  diseases.  Of  these  drugs  the 
following  is  an  excellent  combination,  which  may  be  evaporated  in  a 
tin  dish-cover  placed  over  a  light,  a  stove,  or  other  heated  surface. 
It  should  be  burned  during  the  continuance  of  the  disease. 

Carbolic  Acid,        . 1  oz. 

Turpentine, 1  oz. 

Oil  of  Eucalyptus, 1  oz. 

Alcohol, 1  pint 

Let  the  rate  of  evapomtion  be  very  slow,  and,  if  much  carbolic  acid 
be  used  in  case  of  children,  see  that  the  drug  is  not  absorbed  into  the 
system  to  such  extent  a-s  to  cause  black  urine  or  a'backache. 


764 


DOMKSTIC   MANAGEMENT  OF   THE   SIOK-ROOM. 


m  Si 


Sulphur  Fumigation.  —  This  mode  of  fumigating  ohambera  after 
measles,  scarlet  fever,  and  diphtheria  is  perhaps  the  most  common, 
and,  while  not  an  ideal  method,  it  is  very  easy  of  application,  and 
quite  practical. 

Buy  two  sulphur  candles  for  every  room  to  be  fumigfated,  and, 
having  lit  them,  shut  up  all  windows  and  doors,  and  stuff  all  crevices 
in  the  doors  with  coi,tcn  batting.  Allow  the  fumes  to  penetrate 
every  closet  and  drawer  for  twenty-four  hours.  The  room  may  then 
be  occupic'l. 

Nitric  Aclfd  Fumigation. — Tho  efficiency  of  nitric  acid  in  the  form 
of  gas,  in  arresting  contagion,  and  in  cleansing  infected  rooms,  shiix, 
and  other  places,  is  well  established.  To  obtain  the  gaa,  pour  one 
ounce  of  sulphuric  acid  upon  two  ounces  of  nitrate  of  potash  in  a 
large  tea-cup, — the  cup  being  placed  in  a  basin  containing  hot  water. 
The  gas  or  vapor  will  be  immediately  disengaged. 

This  quantity  will  thoroughly  cleanse  a  small  apjirtment,  but  if 
used  in  a  sick-room,  should  be  placed  at  some  distance  from  the  pa- 
tient. In  a  large  room  two  cups  will  be  required ;  and  if  a  whole 
house  is  to  be  fumigated,  let  several  be  placed  in  various  apartments, 
and  the  doors  and  windows  be  closed  for  half  an  hour. 

Cliioride  of  Zinc.  —  A  solution  of  the  chloride  of  zinc  has  great 
power  in  arresting  contagion,  and  in  cleansing  infected  places.  A 
small  quantity  of  it  will,  in  a  few  minutes,  cleanse  the  most  offensive 
apartments. 

Chloride  of  Lime.  —  This  is  one  of  the  most  powerful  disinfecting 
or  cleansing  agents  known.  To  prepare  it  for  use,  add  four  gallons 
of  water  to  a  pound  of  the  chloride  of  lime ;  stir  the  mixture  well, 
and  after  allowing  it  to  settle  for  a  short  time,  pour  off  the  clear  solu- 
tion, and  keep  it  in  well-corked  bottles. 

Chloride  of  Soda.  —  This,  in  disinfecting  power,  is  about  equal  to 
the  chloride  of  lime.  In  order  that  it  may  retain  its  properties,  it 
must  be  kept  from  the  light,  in  a  well-stopped  glass  bottle.  When 
used,  it  must  be  mixed  in  the  proportion  of  one  ounce,  or  two  large 
spoonfuls,  to  the  pint  of  water.  It  is  excellent  for  cleansing  car- 
buncles, gangrenous  sores,  bad  ulcers,  ulcerated  soro  throat,  and  fetid 
discharges  of  every  kind.  A  weak  solution  should  be  frequently 
applied.  [ 

Uses  of  Chlorides  of  Lime  and  Soda. —  These  articles  almost  in- 
stantly destroy  every  bad  smell,  and  all  effluvia  arising  from  animal 
and  vegetable  decomposition,  and  entirely  prevent  their  bad  influ- 
ence. 

While  infectious  or  contagious  diseases  prevail  in  large  towns  or 
cities,  the  rooms  should  be  sprinkled,  morning  and  evening,  with 
some  of  one  of  these  solutions.  Some  of  it  should  be  placed  in  the 
different  rooms,  in  shallow  dishes, — the  small  bed-rooms  Jbeing  par- 
ticularly remembered. 


DOMESTIC   MANAUEMKNT  OF  THE   SICK-ROOM. 


765 


It  must  he  remembered  that  whatever  can  be  boiled,  like  linen 
sheets,  towels,  etc.,  and  whatever  can  be  subjected  to  prolonged 
steaming,  or  the  presence  of  boiling  water,  can  be  made  absolutely 
clean  and  germ-free.  No  fear  need  be  caused  after  such  a  disinfec- 
tion. 

In  houses  where  there  are  typhoid  and  putrid  fevers,  and  infectious 
complaints,  it  is  highly  proper  to  sprinkle  the  solution  about  the 
rooms,  and  occasionally  upon  the  bed-linen ;  and  the  air  of  the  room 
should  be  frequently  renewed.  A  wineglassful  added  to  the  cham- 
ber-vessel or  the  bed-pan  will  remove  all  smell.  The  most  frequently 
used  disinfectants  for  the  stools  of  typhoid  patients  is  carbolic  acid, 
in  the  strength  of  one  teaspoonful  to  the  p'lt  of  water;  of  this  use 
half  or  third  of  the  quantity  for  each  stool. 

Before  sending  the  bed  and  other  linen  to  the  wash,  let  it  be  im- 
mersed, live  or  six  minutes,  in  one  of  these  solutions,  diluted,  as  mere 
washing  will  not  always  remove  the  infection.  But  the  linen  should 
be  immediately  rinsed  in  pure  water  after  the  immersion ;  to  allow  it 
to  dry  without  such  rinsing  might  injure  it. 

By  pouring  a  quart  of  one  of  these  mixtures,  added  to  a  pailful  of 
watp*-,  into  drains,  sewers  or  cesspools,  and  repeating  the  application 
as  may  be  required,  wil.  destroy  all  their  offensive  effluvia. 

Meat  will  keep  for  some  time  without  any  taint,  and  without  the 
molestation  of  flies,  if  immersed  in  one  of  these  solutions  for  an  in- 
stant, and  hung  up ;  and  all  tainted  meat,  fish,  game,  etc.,  will  be 
rendered  sweet  by  a  little  sprinkling  of  the  same. 

To  purify  water  in  cisterns,  and  destroy  the  animalcules  in  it,  add 
to  every  one  hundred  gallons  about  a  pint  of  one  of  the  solutions. 

The  washing  of  bedsteads  with  one  of  the  solutions,  and  putting 
it  into  all  the  crevices,  will  destroy  bugs. 

A  room  just  painted  may  be  slept  in  safely,  if  one  of  the  mixtures 
be  sprinkled  about,  and  left  in  shallow  dishes. 

Stables,  slaughter-houses,  hog-sties,  privies,  and  all  places  from 
which  offensive  smells  arise,  may  be  thoroughly  purified  by  these 
mixtures ;  or,  still  better,  by  the  use  of  sulphur-naphtha,  "  oil  of 
milk,"  which  is  to  be  diluted  in  the  proportion  of  one  teaspoonful  to  a 
quart  of  water,  and  used  very  freely.  This  is  one  of  the  most  excel- 
lent wound  dressings  now  known,  but  should  be  used  in  one-half 
strength  solutions. 

Being  guardians  of  the  public  health  of  such  wide  application,  and 
of  so  great  utility,  it  is  surprising  that  they  are  not  more  used. 

Freezing  Mixtures. 

In  treating  wounds,  inflammation,  etc.,  it  is  often  quite  important 
to  have  ice,  where  it  is  not  to  be  obtained  without  manufacturing  it. 
Accordingly,  I«  give  here  a  few  directions  for  its  imaiediate  produc- 
tion. 


...'■rtfWi. 


ti  ^j^idSiSwi^i^*  • 


766 


<0ME8TI0  MAMAOEMKNT  OF  THE  BICK-ROOM. 


The  salta  U8«d  should  be  in  a  ciystallized  state,  with  as  much  water 
in  them  as  possible  without  being  damp.  They  should  be  coamely 
pulverized  at  the  time  of  using,  and  put  into  the  water  oontainvd  in 
a  basin,  or  other  suitable  vessel.  The  water  to  be  frozen  should  l)e 
inclosed  in  a  thin  vessel,  and  immersed  in  the  freezing  mixture.  To 
obtain  extreme  degrees  of  cold,  the  ingredients  and  the  vessel  should 
be  cooled  by  one  mixture  before  being  mixed  for  another. 

To  five  drams  of  pulverized  hydrochlorate  of  ammonia,  and  five 
drams  of  pulverized  nitrate  of  potash  (nitre),  add  two  ounces  of 
water,  in  a  tin,  stone-ware,  or  glass  vessel,  and  you  may  freeze 
water,  sea-water,  milk,  vinegar,  or  oil  of  turpentine.  It  will  cause 
the  thermometer  to  sink  from  60°  above  zero  to  10°  above ;  that  is, 
forty  degrees. 

A  mixture  of  five  drams  of  sulphate  of  soda,  and  four  drams  of 
diluted  sulphuric  acid,  will  sink  the  thermometer  seven  degrees  lower 
than  the  above,  namely,  down  to  8°  above  zero,  or  twenty-nine  degrees 
below  the  freezing  point. 

If  six  drams  of  sulphate  of  soda,  four  drams  of  hydrochlorate  of 
ammonia,  two  drams  of  nitrate  of  potash,  and  four  drams  of  diluted 
nitric  acid  be  put  together,  the  mixture  will  lower  the  thermometer 
60°  ;  that  is,  to  10°  below  zero,  or  42°  below  the  freezing  point. 

Besides  the  above  the  following  combination  may  be  used : 

Muriate  of  ammonia,  five  ounces ;  nitrate  of  potash,  five  ounces ; 
water,  sixteen  ounces.     Mix. 

Nitrate  of  ammonia,  four  ounces;  crystalized  carbonate  of  soda, 
four  ounces ;  water,  four  ounces.     Mix. 

Nitrate  of  ammonia  and  water,  equal  parts.     Mix. 

Nitrate  of  ammonia  and  nitrate  of  potash,  five  parts  each ;  sul- 
phate of  soda,  eight  parts ;  and  water,  sixteen  parts.     Mix. 

Phosphate  of  soda,  nine  parts ;  diluted  nitric  acid,  four  parte. 
Mix. 

Sulphate  of  soda,  eight  parts ;  muriatic  acid,  five  parts.     Mix. 

Sulphate  of  soda,  six  parts ;  nitrate  of  amiaonia,  five  parts ;  diluted 
nitric  acid,  four  parts.     Mix. 

Freezing  Mixtures  with  ice.  —  Snow  or  pounded  ice,  two  parts; 
salt,  one  part.  Mix.  This  will  sink  the  thermometer  to  5°  below 
zero. 

Snow  or  pounded  ice,  four  parts  ;  salt,  two  parts ;  muriate  of  am- 
monia, one  part.  In  this  mixture  the  thermometer  will  go  down  to 
12°  below  zero. 

Snow  or  pounded  ice,  twenty-four  parts ;  common  salt,  ten  parts ; 
muriate  of  ammonia,  five  parts  ;  nitrate  of  potassa,  five  parts.  Mix. 
Gives  18°  below  zero. 

Snow  or  pounded  ice,  twelve  parts;  common  salt,  five  parte; 
nitrate  of  ammonia,  five  parts.     Mix.     Gives  25°  below  zero. 

Snow,  eight  parts;  muriatic  acid,  five  parts.  Mix.  Gives  27° 
below  zero. 


niSKl  !*!'••»'»'■  11  vTJf»i 


^ 


DOMESTIC   MANAOBMKNT   OP  THE   SICK-UOOM. 


767 


1() 


of  soda, 


Snow,  sev  uii  parte ;  diluted  nitric  acid,  four  parte.  Mix.  Gives 
80°  below  zero. 

Snow,  four  parte ;  chloride  of  calcium,  five  parte.  Mix.  Gives 
40°  below  7A)ro, 

Snow,  three  parte ;  potassa,  four  parte.  .  Mix.  Gives  61  °  below 
zero,  or  88°  below  the  freezing  point. 

The  NuMe.  —  When  all  the  arrangemente  are  completed  in  the 
HJck-room,  little  l)enefit  can  1h!  anticipated  if  a  proper  nurse  be  not 
obtained  to  render  tlieni  available  to  the  invalid.  Every  female  who 
wishes  to  act  as  a  sick-nurse  should  1x3  obliged  to  serve  a  certain 
time  as  nn  assistjuit  nui'se  in  one  of  the  pulilic  hospitals,  and  to  re- 
ceive a  certificate  of  her  efKciency  before  she  leaves  the  establish- 
ment. The  advantages  which  tlie  public  derive  from  a  body  of  nurses 
ediK  ited  in  this  manner  must  be  obvious  to  every  one. 

in  hiring  a  sick-nurse,  the  qualifications  which  should  regulate  our 
choice  refer  to  a;  «,  strength,  healthy  temper,  disposition,  habits  and 
education. 

Age.  —  She  should  not  be  under  twenty-five,  nor  above  fifty-five 
years  of  age.  This  period  is  fixed  upon  on  account  both  of  the 
physical  powers  and  tlie  moral  conduct  of  the  individual.  Under 
twenty-five,  the  strength  of  a  woman  has  not  reached  ite  maturity, 
and  is  scarcely  adequate  for  lifting  patiente  in  and  out  of  Led,  and 
for  many  other  duties  which  require  strength,  connected  with  tlje 
office  of  a  nurse  ;  but  the  strength  and  the  muscular  power  in  females 
begin  to  fail  after  fifty-five,  when  the  natural  transition  from  maturity 
to  decay  takes  place. 

Strength.  —  The  foregoing  remarks  respecting  age  render  it  almost 
unnecessary  to  say  that  a  woman  of  a  naturally  delicate  frame  of 
body  is  unfit  for  a  sick-nurae ;  at  the  same  time,  a  coarse,  heavy, 
and  masculine  woman  is,  for  many  reasons,  objectionable.  Whilst 
strength  is  requisite,  the  fi-ame  should  be  such  as  to  indicate  activ- 
ity. 

Mealth.  —  None  of  the  qualifications  of  a  sick-nurse  are  of  more 
importance  than  health.  An  individual  who  herself  requires  atten- 
tion is  iil-calculated  to  attend  upon  others.  A  woman  who  is  asth- 
matic, or  has  any  difficulty  of  breathing,  or  a  habitual  cough  ;  who 
is  rheumatic  or  gouty,  or  has  any  sptismodic  affection ;  who  is  af- 
flicted with  palpitation  ;  or  suffers  from  periodical  headache,  vertigo, 
or  a  tendency  to  paralysis  ;  or  who  is  consumptive,  or  scrofulous ;  or 
has  defective  sight  or  hearing;  or  anything  which  causes  decrepitude, 
18  disqualified  for  a  sick-nurse.  It  is  important,  also,  to  ascertain  that 
there  is  no  hypochondriacal  or  hysterical  tendency,  nor  predisposition 
to  mental  depression. 

Temper  and  Disposition.  —  It  is  scarcely  r  [uisite  to  say  that  an 
attendant  upon  the  sick  should  possess  a  happy,  cheerful,  equal  flow 


768 


DOME8TI0  MAMAUKMKMT  OK  TUK  HIOK-KOOM. 


of  Bpirite ;  a  tuinper  not  easily  rufHed ;  and  kind  and  Hym|)ntlu>tic 
feelings ;  but,  tit  the  Hnine  time,  not  hucIi  as  to  intcrfeix)  witli  linn- 
nesB  of  oharucter.  The  expi-ession  of  the  countenanue  sliould  Iw 
open  and  winning,  so  as  to  attriict  the  good-will  and  confideneu  ut' 
the  invalid :  a  pleasing  and  gentle  manner  being  more  likely  to  },'iuii 
esteem,  and  insure  obedience  to  the  ordei-H  of  the  physician,  than  tliu 
most  persnasive  arguments  wiiiuh  can  be  addressed  to  the  under- 
stiinding  of  the  patieni. 

A  collected,  cheerful  expression  of  the  countenance,  in  the  attend- 
ant on  the  sick,  is  likely  to  inspire  hope,  and  to  aid  tlie  efforts  uf  the 
physicicji  for  the  recovery  of  his  patient. 

The  general  disposition  of  a  sick-nurse  should  be  obliging.  Every 
little  office,  which  the  invalid  may  require  to  be  done,  should  be  per- 
formed at  once,  and  without  the  smallest  apparent  reluctance,  even 
when  the  necessity  for  its  immediate  performance  is  not  absolute. 
There  is  also  an  earnestness  of  manner,  which  should,  if  possible,  l)e 
obtained  or  acquiesced  in  by  the  sick-nurse,  as  it  impresses  the  idea 
that  she  feels  deeply  interested  in  the  case ;  a  circumstance  whicli  is 
always  highly  appreciated  by  the  patient. 

Finally,  it  is  unnecessary  to  say  that  a  nurse  should  be  honest,  as 
no  description  of  servant  has  so  much  in  her  power.  But  the  hoiieHty 
of  the  nurse  is  not  to  be  measured  by  her  respect  for  property  ;  she 
must  be  above  imposing  on  the  physician,  with  respect  eitlier  to 
nitedicines  or  to  diet.  Iler  religion,  also,  should  be  sincere,  but  not 
Pharisaical ;  and  although  she  may  occiisionally  persuade  her  cliarge 
"  to  put  hia  trust  in  God,  the  fountain  of  hesilth,"  *  yet  she  must  rec- 
ollect that  preaching  is  not  her  province ;  and,  when  mistimed,  even 
the  best  advice  may  prove  not  only  profitless,  but  injurious;  and  this 
is  especially  likely  to  be  the  result  when  the  doctrines  she  professes 
are  of  a  controversial  kind. 

With  respect  to  gossiping,  it  is  a  detestable  habit  under  any  cir- 
cumstances; but  in  a  nurse  it  may  be  productive  of  the  greatest 
danger,  produce  family  feuds,  und  a  thousand  other  evils. 

In  her  Habits,  a  sick-nurse  should  be  sober,  active,  orderly,  and 
clean,  and  neat  in  her  person. 

The  first  of  these  habits  —  namely,  sobriety  —  is  so  essential  a 
qualification  in  every  attendant  in  the  sick-room,  that  it  requires  no 
comment.  Happily,  the  desire  for  ardent  spirits  is  now  less  frequent 
than  formerly,  when  women  were  seldom  employed  svs  nurses  until 
they  were  nearly  superannuated,  and  until  their  liabits,  good  or  bad, 
were  too  firmly  rooted  to  be  removed. 

The  Activity  essential  for  a  good  nurse  does  not  imply  a  bustling  or 
fidgety  manner,  but  a  quiet,  steady  method  of  proceeding  in  the  per- 
formance of  her  duties,  equally  devoid  of  fluster,  turbulence  or  noise. 
This  activity  is  generally  associated  with  orderly  habits ;  a  most  valua- 

♦PuUer. 


DCMRSTIO   MANAnRMKNT  or  TUB  8I0K-ROUM. 


76'J 


mpiithntic 
with  tiriii- 
hIiouUI  lit- 
fidt'iico  of 
Ay  to  },'iiiii 
I,  than  tin; 
;he  uiider- 

'Aie  attcnd- 
ort«  uf  the 

g.  Every 
iild  be  pur- 
ance,  even 
t  abBohite. 
)0H8ible,  Iw 
98  the  idea 
je  which  is 

honeHt,  as 
he  honesty 
perty ;  she 
t  either  to 
re,  but  not 
her  charge 
B  must  rec- 
imed,  even 
s;  and  this 

)  professes 

er  any  cir- 
le  greatest 

[•derly,  and 

Bssential  a 
equires  no 
)8  frequent 
ir8e8  until 
od  or  bad, 


justling  or 
in  the  per- 
e  or  noise, 
nost  valua- 


ble qualification,  and  without  which  the  Hick-room  IwcnmeH  a  scene  of 
confuHion  and  diHguat.  Kvery  medical  iniin  must  have  witneHHed  thJH 
Mtiite  of  disorder  with  regret,  when,  on  viHiting  his  patient,  he  Hnds  no 
ehair  to  Hit  U|  n  until  Home  article  of  bedding  or  of  clothing  he  re- 
moved from  i  and  the  Heat  duHted  with  the  apron  of  the  iiurHc;  and 
when  a  former  prencription,  dt  anything  else,  is  wanted,  he  niUHt 
wait  until  the  nurxe  rummagcH  out  half  a  dozen  of  drawero  in  search 
of  it. 

Another  quality,  UHUally  conjoined  with  activity  and  orderly  habitH 
in  a  nurse,  is  cleanliness  in  her  own  person  and  in  that  of  her  charge, 
as  well  as  that  of  the  Hick-room.  The  dress  of  a  nurse  should  be 
Himj)le  and  nea*^,  without  vrimmings.  Nothing  is  more  out  of  place 
tlian  a  fine  lady  attempting  to  |>erform  the  duties  of  a  nurse. 

Education.  —  It  niay  appear  a  refinement  to  talk  of,  the  education 
of  a  nurse;  but  there  is  not  a  greater  diffei-ence  between  noon-day 
and  midnight  than  Initween  an  educated  and  an  ignorant  nurse.  The 
former  is  often  an  aid  to  the  physician,  not  only  in  carrying  his  op^iers 
into  effect,  but  by  observing  and  informing  him  of  symptoms  of  great 
importance  which  h..ve  occurred  during  his  absence;  whereas  the  lat- 
ter is  a  source  of  constant  anxiety,  and  too  often  assumes  ohe  privi- 
lege of  acting  in  direct  contradiction  to  his  orders,  and  according  to 
her  own  opinion. 

Unhired  Attendants. 

The  selection  of  a  good  nurse,  however  eminently  qualified  she 
may  be  for  her  duties,  does  not  supersede  the  attendance  of  a  rela- 
tive or  friend  in  the  sick-room ;  on  the  contrary,  I  can  conceive  no 
condition  so  deplorable  as  that  of  an  invalid  left  altogether  to  the  care 
and  management  of  a  hireling.  It  is,  nevertheless,  too  true  that  few 
ladies,  even  those  who  are  wives  and  mothers,  have  any  acquaintance 
with  the  arrangements  of  the  sick-room,  and  the  management  of  the 
invalid ;  they  are,  consequently,  too  often  forced  to  be  guided  by,  and 
to  rely  for  instruction  on,  the  nurse,  instead  of  being  able  to  superin- 
tend her  conduct,  to  ascertain  that  she  performs  her  duty,  and  to 
correct  her  failings. 

The  degree  of  intelligence  which  is  demanded  in  a  nurse  is  very 
different  from  that  wliich  is  requisite  for  a  wife  or  a  relative  in  the  sick- 
••oom.  The  intelligence  of  the  nurse  is  directed  to  supply  the  wants 
of  tl.3  invalid,  to  administer  to  his  comforts,  and  to  obey  the  instruc- 
tions of  the  physician ;  that  of  the  friend  or  relative  involves  the 
power  of  discriminating  disposition  and  temper ;  of  watching  the 
progress  of  the  disease,  and  judging  of  the  propriety  of  not  pursuing 
I'ertiiin  measures,  which,  although  indicated  by  the  symptoms  at  the 
1  luie  of  prescribing,  yet  may  require  to  be  altered,  and  consequently 
detailed  to  the  physician,  whose  presence  maybe  retjuisite  before  his 
next  intended  visit.     It  is  of  the  utnjost  importance,  also,  that  rela- 


a 


770 


DOMESTIC   MANAGEMENT  OF  THE  SIOK-KOOM. 


tives  attending  in  the  sick-room  should  be  able  to  control  their  feel- 
ings in  the  presence  of  the  invalid. 

Nothing  is  more  essential,  in  the  domestic  management  of  diseases, 
than  a  knowledge  of  the  natural  disposition  and  temper  of  the  inva- 
lid. An  irritable  or  a  passionate  man  requires  a  very  different  man- 
agement from  that  which  is  proper  for  a  man  of  natui-ally  mild  and 
easy  disposition.  Disease  awakens,  in  an  augmented  degx  ee,  the  irri- 
tability of  the  former ;  he  becomes  impatient  of  contradiction  ;  and 
every  time  his  opinions  are  injudiciously  opposed,  the  turbulent  agi- 
tation of  the  nervous  s^-stem  Which  follows  either  increases  the  dis- 
ease or  weakens  the  influence  of  the  remedial  agents.  On  the  other 
hand,  a  mild  and  gentle  disposition  often  leads  to  extreme  sensitive- 
ness, when  disease  attacks  the  body ;  a  word,  a  look,  is  sufficient  to 
touch  some  sympathetic  cord:  to  unstring  the  whole  nervous  system; 
and  to  augment  the  morbid  susceptibility  already  present  in  the  habit 
to  a  degree  that  is  not  always  devoid  of  danger.  Much  discretion 
and  judgment,  therefore,  are  requisite  in  both  instances ;  in  the  one 
case,  to  present  ebullitions  of  temper;  in  the  other,  to  refrain  from 
anything  that  might  be  construed  by  the  invalid  into  harshness ;  and 
yet  at  the  same  time,  in  each  case,  to  maintain  that  influence  over 
the  patient  which  the  treatment  of  every  disease  demands  in  an  at- 
tendant on  the  sick. 

Prejudice  and  Antipathies.  —  In  those  who  are  imperfectly  or  erro- 
neously educated,  the  judgment  is  apt  to  be  biassed  by  prejudice  and 
antipathies  ;  and,  under  the  influence  of  these,  it  is  misdirected  in  a 
manner  of  which  the  individual  is  often  wholly  unconscious ;  thence 
the  necessity  of  freedom  from  prejudice  in  the  attendants  in  the  sick 
room,  and  the  farther  importance  of  the  friends  or  relatives  of  the 
sick  being  able  to  superintend  the  conduct  and  the  management  of 
hired  nurses.  On  the  other  hand,  the  judgment,  even  in  the  well- 
educated,  is  apt  to  be  misled  by  the  affections,  the  influence  of  which 
is  as  much  opposed  to  the  healthy  exercise  of  discrimination  as  the 
prejudices  of  the  ignorant.  Self-control,  therefore,  is  also  an  essen- 
tial qualification  of  the  sick-room. 

It  is  only  from  knowing  that  the  attendants  of  the  sick  are  pos- 
sessed of  intelligence  and  self-control,  that  a  physician  can  rely  upon 
having  his  orders  correctly  and  duly  executed  ;  when  those  qualities 
are  absent,  he  has  to  dread,  on  the  one  hand,  the  presumption  of 
ignorant  prejudice  ;  and  on  the  other,  the  improper  yielding  of  sensi- 
tive indulgence.  To  the  invalid,  also,  it  is  important  to  know  that 
the  directions  of  his  physician  are  filled  by  an  intelligent  person; 
for,  even  in  the  most  severe  diseases,  as  long  as  the  mental  faculties 
remain  unaffected,  a  sick  man  is  capable  of  detecting  ignorance,  or 
the  effects  of  prejudice,  in  his  attendants ;  and,  when  he  is  convinced 
of  the  existence  of  either,  all  the  influence  of  the  individual,  whether 
nurse,  or  friend,  or  relative,  is  at  an  end. 

Were  the  business  of  the  sick-room  findependent  of  the  wants  and 


DOMESTIC    MANAfiEMENT   OF   THE   SICK-ROOM. 


771 


>1  their  feel- 

i  of  diseases, 
of  the  inva- 
ffereut  man- 
ly mild  and 
fi  ee,  the  irri- 
liction ;  and 
irbulent  agi- 
Eises  the  dis- 
)n  the  other 
ne  sensitive- 
sufficient  to 
ous  system; 
in  the  habit 
h.  discretion 
;  \n  the  one 
refrain  from 
■shness ;  and 
fluence  over 
Is  in  an  afr 

sctly  or  erro- 
rejudice  and 
irected  in  a 
ous;  thence 
in  the  sick 
tives  of  the 
lagement  of 
in  the  well- 
ice  of  which 
lation  as  the 
30  an  essen- 

?ick  are  pos- 
m  rely  upon 
ose  qualities 
sumption  of 
ing  of  sensi- 
)  know  that 
:ent  person; 
tal  faculties 
gnorance,  or 
is  convinced 
ual,  whether 

le  wants  and 


(•(iniforts  of  the  invalid)  confined  to  the  mere  observation  and  collec- 
tion of  facts  —  namely,  the  noting  of  the  symptoms  of  disease  —  and 
reporting  them  to  the  physician,  it  would  be  superfluous  to  urge  the 
necessity  of  superior  intelligence  in  its  superintendent ;  but  many  of 
its  duties  require  not  only  a  well-regulated  understanding,  but  an 
equally  sound  condition  of  the  moral  feelings  and  the  benevolent 
affections,  with  a  recognition  of  the  authority  of  conscience  in  the 
whole  operations  of  life.  In  the  period  of  sickness,  under  the  direc- 
tion of  the  judicious  and  discreet,  an  invalid  may  be  led  to  the  in- 
vestigation of  his  moral  and  religious  condition,  and  to  review  his 
past  conduct,  with  the  determination  of  turning  the  result  to  his 
future  welfare,  should  he  happily  recover  and  re-enter  society.  Surely 
such  important  duties  as  these  cannot  be  intrusted  to  the  unqualified, 
or  the  ignorant,  or  the  hireling ;  nor  can  more  be  requir  ^o  demon- 
strate the  importance  of  adding  to  the  other  branches  at  female  edu- 
cation a  knowledge  of  the  various  important  duties  of  the  sick-room, 
which  females,  whether  as  mothers  or  daughters,  or  wives  or  friends, 
are  likely  to  be  called  upon  to  fulfil. 

Prognostics. 

In  every  disease  the  medical  attendant  is  naturally  called  upon  to 
deliver  his  opinion  of  the  degree  of  danger  which  hangs  over  the 
patient :  hence,  it  is  unnecessary  to  enter  into  any  minute  details  on 
the  subject  of  prognostics.  But,  as  in  many  diseases  changes  occur, 
in  the  absence  of  the  practitioner,  which  ought  instantly  to  be  ex- 
amined into,  in  order  that  the  danger  likely  to  accrue  from  them  may 
be  averted,  it  is  important  that  the  friends  and  ordinary  attendants 
of  the  sick  should  be  aware  of  their  presence,  so  as  to  obtain  the  im- 
mediate assistance  of  the  medical  attendant.  Were  this  information, 
also,  morft  generally  diffused,  many  unnecessary  visits  would  be  saved 
to  the  physician,  and  much  unfounded  suspicion  of  danger  prevented 
from  distressing  and  touturing  the  minds  of  the  friends  of  the  sick. 

In  Fevers  delirium  alone  should  excite  no  alarm,  unless  it  be  very 
high,  or  of  the  low,  muttering,  incoherent  kind.  In  jaundice,  and  in 
diseases  of  the  chest,  it  is  alarming ;  and  in  the  latter  stages  of  pul- 
monary consumption,  its  presence  always  indicates  the  approach  of 
death. 

Great  confusion  of  thought,  loss  of  recollection  of  the  most  recent 
occurrence,  a  restless,  wandering  eye,  and  a  correspondent  vacancy 
or  confusion  of  countenance,  are  always  to  be  dreaded  in  fevers  and 
in  diseases  of  the  brain.  An  expression  of  great  anxiety  is  equally 
alarming  in  all  acute  diseases ;  and  a  presentiment  of  death  is  still 
more  to  be  di-eaded. 

Hoarseness,  with  constant  spitting,  oocui'ring  at  an  early  period 
in  small-pox,  is  very  unfavorable. 


772 


DOMESTIC   MANAGEMENT  OF  THE   8I0K-R0OM. 


Squinting  in  affections  of  the  head  ought  to  be  particulaily  noticeu, 
and  mentioned  to  the  attending  practitioner;  and  the  same  remark 
applies  to  a  greatly  contracted^  or  a  dilated,  or  an  immovable  condition 
of  the  pupil  of  the  eye ;  or  the  turning  up  of  the  pupils  under  the 
upper  eyelids. 

Deafness  is  not  an  unfavorable  occurrence  in  continued  fever;  hut 
a  sudden  attack  of  headache  in  pulmonary  diseases  ought  instantly 
to  1)8  mentioned  to  the  physician. 

The  Sudden  Disappearance  of  Pain  in  inflammatory  affections  of 
the  bowels  is  always  to  be  dreaded ;  but  it  does  not  in  every  instance 
portend  the  existence  of  mortification. 

Cough,  depending  on  inflammation  of  the  bronchial  membrane, 
suddenly  supervening  on  a  suppressed  eruption,  is  always  to  be 
dreaded. 

In  Croup,  when  the  breathing  is  audible,  or  when  there  is  a  crow- 
ing sound  in  inspiration,  or  a  cooing  or  croaking  respiration,  danger 
is  present. 

In  Whooping-Cough,  when  the  paroxysms  suddenly  increase  in 
violence,  and  the  face  becomes  livid,  and  the  thumbs  are  drawn 
across  into  the  palms  of  the  hands,  the  appeamnce  of  convulsions 
may  be  anticipated :  hence  immediate  notice  of  these  symptoms 
should  be  communicated  to  the  medical  attendant. 

Rigors  invariably  excite  alarm ;  but  they  are  only  dangerous  in 
chronic  internal  diseases,  in  which  they  often  indicate  the  formation 
of  pus,  or  the  existence  of  suppuration. 

Pallidness  of  the  countenance,  with  a  slight  degree  of  lividity,wt 
sjonptoms  of  hazard  in  inflammation  of  the  lungs. 

The  Position  of  the  Patient  as  he  lies  in  bed,  especially  in  fevers, 
is  of  much  importance.  Constantly  lying  on  his  back,  with  a  ten- 
dency to  sink  to  the  bottom  of  the  bed;  a  propensity  to  keep  the 
arms  and  the  feet  out  of  bed,  and  to  uncover  the  trunk  ;  or  to  pick 
the  bed-clothes ;  tremors  ;  twitching  of  the  tendons ;  grindir.g  of  the 
teeth,  and  sleeping  with  the  eyelids  half  open,  fcud  the  white  of  the 
eyes  only  seen ;  are  all  justly  regarded  as  symptoms  of  great  danger. 

Fainting  (^Syncope )  is  to  be  considered  alarriing  in  diseases  of  the 
heart,  or  during  profuse  bleeding  from  the  nose,  or  from  any  other 
part:  deep  sighing,  also,  under  cuch  circumstances,  is  most  unfavora- 
ble, and  often  indicates  rapid  uis^OiUt'.on. 

Hiccup,  in  the  advanced  stages  oi  ''ther  acute  or  chronic  diseases, 
is  invariably  alarming. 

Difficulty  of  Swallowing,  also,  in  the  advanced  stages  of  fever, 
palsy,  and  affections  of  the  head,  always  indicates  extreme  danger; 


^iiMttiiiiii^^  '"^f  tiiiiijiiiiiiii 


mm 


wM 


DOMESTIC   MANAGEMENT  OF   THE  SICK-ROOM. 


773 


Illy  noticeu, 
Hue  remark 
le  condition 
1  under  the 

i  fever ;  but 
it  instantly 

iffections  of 
ery  instance 

membrane, 
ways  to  be 

•e  is  a  crow- 
ion,  danger 

increase  in 

are  drawn 

convulsions 

)  symptoms 


mgerous  in 
e  formation 


lividity,  are 

ly  in  fevers, 
with  a  ten- 
»  keep  the 
or  to  pick 
tding  of  the 
irbite  of  the 
:eat  danger. 

eases  of  the 
n  any  other 
jt  unfavora- 

lic  diseases, 

es  of  fever, 
ne  danger; 


vomitinff,  on  the  contrary,  is  not  unfavorable,  unless  it  be  very  severe 
and  protracted;  but,  if  the  ejected  matters  be  putrid,  or  feculent, 
then  the  vomiting  is  always  to  be  dreaded. 

Coma,  or  an  irresistible  propensity  to  sleep,  following  the  sudden 
suppression  of  gout,  or  the  cessation  of  periodical  bleeding  in  piles, 
or  the  healing  of  old  sores,  is  always  alarming,  and  requires  prompt 
medical  assistance. 

Convulsions  without  fever  or  any  affection  of  the  head  seldom 
prove  dangerous ;  but  they  are  never  free  from  danger  when  they 
are  accompanied  with  stupor  or  coma.  They  are  also  dangerous 
when  inflammatory  fever  is  present.  They  are  less  dangerous  in 
women  than  in  men,  in  the  young  than  in  advanced  age.  In  infancy, 
convulsions  aie  more  to  be  dreaded  in  the  robust  than  in  the  delicate 
and  irritable  child. 

Diarrhoea  is,  under  every  circumstance,  an  unfavorable  eventf 
when  it  occurs  either  in  fevers,  or  in  the  termination  of  chronic  dis- 
eases; and  the  passing  of  involuntary  stools,  when  scarcely  any 
diarrhoea  exists,  is  equally  to  be  dreaded. 

Retention  of  the  Urine,  as  well  as  its  involuntary  discharge,  is 
always  an  unfavorable  symptom. 

Purple  Spots  appearing  on  the  skin,  livid  lips  and  cheeks,  oozing 
of  blood,  svdden  flushings  followed  by  pallor,  are  unfavorable  symp- 
toms ;  and  the  appearance  of  oedematous  swellings  of  the  legs  and 
skin  in  the  last  stage  of  organic  diseases  always  indicate  approaching 
death.  When  purple  spots,  also,  appear  in  small-pox,  with  flattening 
of  the  pustules  on  the  trunk  of  the  body,  and  a  white,  pasty  aspect 
of  the  eruption  in  the  face ;  and  if,  at  the  same  time,  the  extremities 
'  become  cold,  any  hope  of  recovery  can  scarcely  be  entertained. 

Great  and  continued  or  progressing  emaciation  in  chronic  diseases, 
and  what  is  termed  the  fades  Hippocratiea,  are  to  be  dreaded. 

Excoriations  on  the  parts  on  which  the  body  rests,  — for  example, 
the  haunches,  or  the  lower  part  of  the  back,  —  especially  if  these 
become  livid  and  sloughy,  always  indicate  extreme  danger. 

Great  Difficulty  of  Breathing,  even  to  a  feeling  of  suffocation,  is 
not  necessarily  hazardous  in  asthma;  for  although  few  diseases  are 
so  little  under  control  by  the  interference  of  the  physician,  yet 
asthma  seldom  proves  fatal,  unless  it  tends  to  the  production  of 
other  diseases. 

In  Consumption,  partial  sweating,  as  of  the  head,  the  chest,  or  the 
limbs,  is  always  an  unfavorable  symptom. 

When  pregnancy  occurs  in  a  woman  laboring  under  consumption, 
the  disease  is  arrested  until  after  delivery,  as  if  Providence  threw  a 
shield  over  the  mother  for  the  safety  of  the  offspring. 


i 


774 


nOMESTIC-  MANAfiEMENT  OF   THE   SICK-HOOM. 


The  Sudden  Disappearance  of  Swellins:  of  the  Legs,  in  chronic 
organic  diseases,  is  indicative  of  ft,pproaching  death. 

When  a  child,  instead  of  rallying  after  any  acute  disease,  becomes 
emaciated,  and  the  belly  is  large  and  tympanitic,  there  is  always 
much  danger. 

Bed-Sores. 

The  danger  of  bed-sores  is  often  in  proportion  to  the  carelessness 
of  the  nurse,  although  the  condition  of  the  patient  has  much  to  do 
with  it.  They  attack  fii-st  the  skin  at  the  end  of  the  spine,  the  hip- 
joints,  knees,  elbows  and  heelp. 

Debility  from  continued  fever,  from  paralysis,  old  age,  continued 
pressure,  unclean  bedding,  and  the  untidy  habits  of  the  nurse,  are 
the  immediate  cause. 

The  first  appearance  of  a  bed-sore  is  to  be  noticed  in  redness  of 
the  skin  ;  soon  a  blister  forms,  the  skin  breaks  away,  leaving  the  sur- 
face raw  and  moist.  Decomposition  sets  in  very  qu'ckly  if  the 
symptoms  are  neglected,  and  the  blister  becomes  an  open  sore. 

The  outcome  of  the  disease  depends  upon  the  condition  of  the 
patient,  and  the  removal  or  non-removal  of  the  cause. 

Treatment.  —  If  there  is  much  debility,  tonics  should  be  given. 
The  various  places  of  the  body  which  are  likely  to  become  soie 
should  be  rubbed  four  times  a  day,  from  five  to  ten  minutes,  with  a 
stimulating  mixture  like  spirits  of  camphor  or  olive-oil  and  brandy ; 
a  good  liniment  is  alcohol  or  weak  bay  rum.  Be  careful  not  to  irri- 
tate the  skin,  — simply  cleanse  and  harden.  The  prominences  of  bone 
may  be  covered  with  surgeon-plaster  if  tliere  is  sweating  of  the  body. 
Unless  a  blister  forms,  the  part  should  be  relieved  of  pressure  by  air- 
cushions.     Collodion  should  be  applied,  and  the  parts  kept  dry. 

If  the  blister  turns  to  an  open  sore,  use  poultices  until  it  is  open 
and  the  matter  discharged,  then  use  stimulating  cleansing  washes  of 
borax-water  or  weak  carbolic-acid.  Peruvian  balsam  on  cotton- 
wool is  a  good  remedy. 

The  best  preventive  measures  are  careful  nursing,  dry,  smooth 
sheets,  air-cushions,  frequent  changes  of  position.  The  bedding  and 
night-x'obe  should  be  absolutely  clean,  dry  and  smooth  and  frequently 
changed. 

Ovarian  Disease. 

Or,  as  it  is  usually  termed,  ovarian  dropay^  has  hitherto,  proved 
incurable;  but  it  is  relieved  by  tapping;  and,  if  the  powers  of  life 
be  sustained  by  proper  food,  and  carriage  exercise  in  the  open  air ; 
and  if  all  medicines  be  let  alone,  except  such  as  are  required  to 
regulate  the  bowels,  life  may  be  sustained  for  many  years. 

All  diseases  not  involving  organic  changes  are,  with  a  few  ex- 
ceptions, more  or  less  under  the  control  of  medicines,  and  are  conse- 
quently curable.     But  some  diseases,  in  which  no  organic  changes 


^MrfM 


DOMESTIC   MANAGEMENT  OF  THE  SICK-ROOM. 


776 


have  been  discovered,  are  nevertheless  incurable.     This  is  the  case 
with  spasmodic  of  hma,  which  haa  rarely  been  cured. 

It  is  true  that  i  .ctional  disturbances  are  not  unfrequently  as'soci- 
ated  with  orgainc  diseases  ;  but,  under  such  circunistivnces,  it  is  tlie 
province  of  the  attending  physician  to  point  out  to  the  friends  of  the 
patient  the  greater  or  the  less  degree  of  danger  in  these  complica- 
tioiis. 

Diet,  etc.,  in  Disease  and  Convalescence. 

In  numerous  instances,  much  hazard  often  exists  after  disease  has 
disappeared,  and  when  the  patient  is  declared  convalescent ;  and  as 
this  period  in  the  removal  of  diseases  is  left  to  the  management  either 
of  the  patient  himself  or  of  his  friends,  some  general  remarks  re- 
specting it,  and  also  in  reference  to  particular  diseases,  are  requisite. 

In  every  recovery  from  sickness,  whether  external  or  internal,  be- 
fore the  salutary  advantages  obtained  from  the  treatment  be  confirmed, 
the  organ  or  part  which  has  suffered  must  be  either  left  at  rest  or  be 
used,  according  to  the  nature  of  the  case.  Thus,  if  any  part  have 
suffered  from  inflammation,  it  must  not  be  used  for  some  time  after 
the  inflammation  is  subdued.  If  the  eyes  have  suffered,  the  person 
must  neither  read  nor  write,  nor  expose  the  eyes  to  the  heat  of  the 
fire,  nor  to  a  strong  light,  until  some  days  after  every  trace  of  the 
disease  has  disappeared.  If  the  arm  has  been  affected  it  must  be 
kept  at  rest ;  and  if  the  leg,  not .  only  should  walking  be  refrained 
from,  but  the  limb  should  be  placed  mther  higher  than  the  trunk  of 
the  body.  If  the  previous  disease  has  affected  the  brain,  every  men- 
tal exertion  must  be  avoided ;  and  so  on,  whatever  may  be  the  ergan 
which  has  especially  suffered.  Even  when  the  exercise  of  the  organ 
is  resumed,  it  should  not  be  carried  to  fatigue,  nor,  on  any  account, 
should  it  be  such  as  to  produce  excitement.  At  the  same  time,  it 
must  not  be  forgotten  that,  in  the  treatment  of  external  injuries,  when 
it  has  been  necessary  to  keep  the  limb  long  in  a  sling,  in  one  position, 
—  as,  for  instance,  in  fractures,  —  the  muscles  which  bend  the  arm 
acquire  from  the  habit  a  contraction  which  cannot  be  overcome  by 
the  antagonist  muscles,  owing  to  the  length  of  time  they  have  been 
on  the  stretch,  weakening  their  contractile  power.  The  arm,  there- 
fore, should  be  frequently  taken  from  the  sling,  and,  being  rested  upon 
the  elbow,  a  moderate  weight  should  be  held  in  the  hand,  and  friction 
with  oil  employed  upon  the  contracted  muscles.  It  is  true  that  sur- 
geons usually  give  directions  for  this  operation,  before  they  quit  the 
management  of  the  case ;  but  surgeons,  as  well  as  physicians,  are 
sometimes  dismissed  b.foi'e  the  convalescence  is  complete ;  on  which 
account,  arms  and  limbs  have  remained  contracted  for  life,  from  a 
want  of  the  knowledge  necessaiy  to  counteract  the  evil  at  an  early 
stage.  I  say  nothing  respecting  the  continuance  of  remedies  during 
convalescence  from  many  diseases,  except  urging  the  necessity  of 
regulating  the  bowels. 


776 


DOMESTIC   MANAGEMENT  OF  THE   SICK-BOOM. 


The  most  important  part  of  the  management  of  convalescence  cer- 
tainly refers  to  air,  exercise,  and  diet.  The  erroi-s  daily  commitUMJ, 
in  all  these  matters,  exert  the  most  powerful  influence  in  retarding 
complete  restoration  to  health ;  and  often,  indeed,  induce  evils  of  a 
more  formidable  kind  than  the  diseases  from  which  the  patients  have 
just  emerged. 

1.  Air.  In  every  convalescence,  whatever  may  have  been  tlie 
nature  of  the  disease,  if  it  has  been  so  severe  as  to  wear  down  tlie 
strength  of  the  invalid,  countiy  air  is  essential.  The  benevolent 
Author  of  our  existence  has  made  medicinal  the  hills,  the  vales,  tlie 
groves,  and  all  the  harmonies  of  nature  ;  and  in  the  repose  of  these 
man  finds  a  balm,  not  only  for  a  wounded  spirit,  but  for  his  stricken 
body. 

In  selecting  a  country  residence  for  a  convalescent,  care  must  be 
taken  to  ascertain  whether  any  source  of  malaria  exists  in  the  neigli- 
borhood;  as,  in  that  case,  even  if  all  other  circumstances  be  favorable, 
the  place  is  exceptionable. 

2.  Exercise.  In  convalescence,  much  caution  is  requisite  in  apnor- 
tioning  the  exercise  to  the  degree  of  returning  strength.  When  the 
convalescent  is  still  too  feeble  to  take  sufficient  exercise  on  foot,  tlie 
best  substitute  for  it  is  riding  horseback;  but,  as  soon  as  walking 
can  be  borne,  it  should  be  preferred  to  either  horse  or  carriage  exer- 
cise. 

3.  Diet,  In  health,  diet  may  be  left,  in  a  great  degree,  to  the  in- 
clination or  the  taste,  as  far  as  regards  the  quality  of  the  food ;  and, 
although  diseases  occasionally  originate  from  repletion,  yet,  in  gen- 
eral, the  appetite  may  be  considered  as  the  best  regulator  of  quan- 
tity, when  the  food  is  simple,  and  the  appetite  is  not  pampered  by 
high  seasoning  and  rich  sauces.  In  disease,  however,  a  very  opi)o- 
site  rule  is  to  be  observed ;  the  regulation  of  both  the  quantity  and 
the  quality  of  the  food  is  of  the  utmost  importance.  The  taste  is 
often  so  perverted  as  to  desire  that  which  would  prove  injurious ; 
and  were  appetite  to  be  the  guide  of  quantity,  diseases  would  fre- 
quently not  only  be  increased  in  severity,  but  life  itself  would  be 
brought  into  .jeopardy. 

As  soon  as  solid  animal  food  can  be  taken  with  impunity,  that 
which  is  most  digestible  should  be  selected.  An  opinion  has  gener- 
ally prevailed  that  gelatinous  matters,  and  meats  which  readily  yield 
jelly, — such,  for  example,  as  veal  and  lamb,  —  are  the  most  easily 
digested,  and  at  the  same  time  are  also  the  mo;t  nutritive.  This  is 
a  mistake ;  for,  with  the  exception  of  poultry,  the  flesh  of  young  ani- 
mals is  stringy  and  of  a  lax  fibre,  and  is  even  less  easily  digested  than 
that  of  too  old  animals,  which  presents  great  density  of  texture. 
The  middle-aged  animals  afford  the  most  digestible  food. 

Nothing  tends  to  lessen  the  density  of  the  fibre  of  eveiy  kind  of 
animal  food  so  much  as  kee[)ing  it  for  a  certain  time  before  it  is 
cooked.     In  this  case  the  tenderness  is  the  result  of  incipient  decora- 


DOMESTIC   MANAGEMKNT   OF  THE   SICK-ROOM. 


777 


scence  cei- 

jommitted, 

retarding 

evils  of  a 

iients  have 

been  the 
•  down  tlie 
benevok-nt 
!  vales,  tlie 
je  of  these 
is  stricken 

re  must  be 

the  neigli- 

)  favorable, 

je  in  api)or- 
When  the 
m  foot,  the 
as  walking 
riage  exer- 

,  to  the  in- 
food;  and, 
et,  in  gen- 
)r  of  quan- 
mpered  by 
very  op»o 
lantity  and 
?he  taste  is 

injurious ; 
would  fre- 

would  be 

lunity,  that 
has  gener- 
adily  yield 
nost  easily 
J.  This  is 
young  ani- 
jested  than 
Df  texture. 

3iy  kind  of 
)efore  it  is 
ent  decom- 


position or  putrefaction  ;  but  the  utmost  caution  is  requisite  to  pre- 
vent this  from  advancing  so  far  as  to  present  the  slightest  trace  of 
taint  in  the  food  of  the  convalescent.  In  the  low  state  of  vitality  in 
convalescence,  the  change  which  commencing  decomposition  (putre- 
laction)  causes,  renders  animal  food  in  that  condition  a  source  likely 
to  occasion  either  a  relapse  into  the  disease  from  which  the  patient 
has  recovered,  or  to  form  a  new  disease. 

In  examining  the  relative  value  of  other  articles  of  diet  adapted 
for  the  sick  and  convalescent,  the  first  which  presents  itself  to  our 
notice  is 

Milk.  —  As  milk  is  the  food  of  almost  all  young  animals,  its  diges- 
tibility appears  at  once  evident ;  and  there  can  be  little  doubt  that  it 
is  very  digestible,  when  it  is  drunk  immediately  after  it  is  drawn 
from  the  udder  of  the  cow  or  the  goitt,  before  its  components  have 
time  to  separate.  When  this  separation  is  effected,  either  spon- 
tivneously  by  time,  or  by  means  of  rennet  or  other  agents,  its  prop- 
erties are  altered,  and  ita  digestibility  is  lessened. 

Cream,  when  intimately  united  with  the  other  components  of 
milk,  —  namely,  the  curd,  or  the  caseous  part,  and  the  whey,  —  is 
not  the  same  substance  as  after  its  separation.  In  the  milk,  it  is 
more  easily  digested,  and  is  the  most  nutritive  part  of  the  milk.  But 
in  its  separate  state  it  is  ill  adapted  either  for  the  sick  or  convales- 
cent except  in  the  form  of  butter,  which  is  not  unwholesome  unless  it 
be  eaten  in  excess  or  be  melted.  •  Although  cream  is  not  as  digesti- 
ble as  milk,  yet  it  is  much  less  liable  to  turn  acid  in  the  stomach  ;  it 
is  often  beneficial  to  dyspeptics,  either  alone  or  diluted  with  water. 
In  the  same  manner  the  separate  eurd  is  indigestible ;  and  whey 
itself,  although  highly  nutritive,  yet  is  flatulent ;  nevertheless,  it  is 
an  excellent  demulcent  in  many  cases  of  diseasfe.  But  none  of  the 
components  of  milk  are  equal  to  milk  itself.  It  is  often  necessary, 
in  convalescence,  to  dilute  it  with  water. 

Eggs.  —  It  is  not  uncommon  to  hear  that  the  yolk  of  a  raw  egg, 
beaten  up  with  water  and  sugar,  with  the  addition  of  a  small  quan- 
tity of  white  wine,  is  a  light  and  nutritive  aliment  in  convalescence, 
and  even  in  some  states  of  disease ;  but  eggs  aro  much  less  digestible 
in  this  form  than  when  they  are  lightly  boiled.  In  jaundice,  however, 
arising  from  viscid  mucus  obstructing  the  orifice  o^  the  common 
duct,  the  yolk  of  a  raw  egg  beaten  up  with  cold  water  is  serviceable. 

Fish,  at  least  the  white  kind,  stimulates  much  less  than  the  flesh 
of  land  animals;  hence  it  is  a  proper  food  for  those  laboring  under 
some  acute  diseases ;  and  also  for  convalescents,  when  a  sudden  re- 
turn to  more  stimulating  food  would  prove  hurtful.  But  it  is  not 
adapted  for  convalescents  when  the  object  is  to  bring  up  rapidly  the 
strength  of  debilitated  habits. 

Raw  oysters  have  been  erroneously  supposed  to  be  both  easy  of 
digestion  and  nutritive.     The  latter  opinion  is,  in  some  degree,  true; 


778 


DOMKSTIC    MANAOKMENT   OF   THE   SICK-ROOM. 


but  the  former  U  erroneous.  Raw  oyslurs  are  less  di^'csliMc!  than 
plainly-cooked  oysters.  Both  are  inij»rt)iHM'  for  the  sick  iiiid  for  eariy 
convalescents.  Lolwters,  crabs,  prawns,  cray-fisli,  scallops,  and  other 
shell-fish,  are  still  more  objectionable. 

If  fish  of  any  kind  be  admissible,  it  shouhl  be  simply  boiled;  fried 
fish  is  even  worse  for  invalids  than  the  outside  or  tlie  brown  of  roasted 
meat. 

Vegetables.  —  In  reference  to  vegetahle  diet,  it  is  only  the  mildest 
description  of  esculent  roots  that  are  fitted  for  the  use  of  the  sick. 
In  preparing  all  of  them  for  the  sick  room,  they  should  be  well  boiled 
in  two  distinct  waters,  until  they  are  soft  and  very  soluble,  and  in  a 
state  not  to  leave  undissolved  anything  which  could  act  as  a  mechani- 
cal irritant  on  the  intestinal  canal.  When  properly  cooked,  they  are 
moderately  nutritive,  and  free  from  any  stimulant  properties ;  and 
they  are  well  adapted  for  the  stomach  of  the  sick,  unless  in  cases  in 
which  the  torpor  of  the  organ  is  such  as  to  permit  them  to  run  into 
acetous  fermentation  and  to  prove  flatulent. 

Fruits.  —  With  respect  io  fruits,  they  produce  the  most  diversified 
effects ;  and,  consequently,  are  more  or  less  proper  for  invalids,  ac- 
cording to  circumstances,  either  connected  with  themselves  or  with 
the  condition  of  the  patient  at  the  time.  The  stone-fruits.,  with  the 
exception  of  the  ripe  peach,  or  the  nectarine,  are  to  be  rejected.  The 
apple  tribe,  except  very  soluble  pears,  are  still  less  admissible.  The 
apple,  however,  when  roasted,  and  when  the  seeds  and  the  hard  cen- 
tral parts,  as  well  as  the  skin,  are  removed,  is  less  objectionable  ;  and, 
as  it  possesses  laxative  properties,  the  roasted  apple  is  well  adapted 
for  the  sick,  when  food  is  at  all  allowable,  and  wiien  the  bowels  are 
torpid.  The  orange,  if  fully  ripe,  is  grateful  and  wholesome  to  all 
invalids,  and  is  only  equalled  in  these  qualities  by  the  grape ;  but  in 
using  the  orange,  the  pulp  should  be  rejected.  The  juice  of  the 
grape-fruit  is  good  and  refreshing,  but  care  should  be  taken  not  to 
use  any  of  the  pulp,  on  account  of  its  bitter  taste.  Care  also  should 
be  taken  not  to  swallow  either  the  skin  or  the  seeds  of  the  grape. 
Strawberries  are  a  little  stimulant,  of  easy  digestion,  and  more  cool- 
ing than  the  other  small  fruits ;  mulberries  are  also  unexception- 
able ;  but  currants  and  gooseberries,  and  even  raspberries,  are  not 
free  from  objection  for  invalids  laboring  under  acute  diseases. 

With  the  exception  of  oat  and  wheaten  hread,  especially  that 
made  from  Franklin  Mills  flour  (see  receipt),  all  the  varieties  of 
farinaceous  aliments  may  be  regarded  as  modiflcations  of  starch, 
containing  little  nutritive  matter,  and  therefore  well  adapted  for  the 
sick-room.  It  has  been  supposed  that  arrow-root,  sago,  tapioca,  and 
similar  substances,  are  very  nutritive,  because  they  form  mucilages 
with  boiling  water;  but  this  is  not  the  fact;  and  were  they  very 
nutritive,  they  would  be  ill  adapted  for  invalids.  Rice,  in  every  case 
where  the  stc  ^ach  is  in  an  acescent  state,  is  preferable  to  the  other 
farinacesB,  because  it  is  less  fermentable. 


^^^ 


nmtmatmtSA 


DOMESTIC   MANAQKMENT  OK   THE  8ICK-U00M. 


779 


The  farinaceous  food  which  is  ordered  in  the  convalescence  of 
children  from  acute  diseases,  is  often  made  of  bread  so  as  to  consti- 
tute pap.  No  description  of  food  has  a  greater  tendency  than  this 
to  become  sour;  a  ^^nantity  only  sufficient  for  a  single  meal,  there- 
fore, should  be  made  at  a  time ;  for  what  remains  is  always  sour 
before  the  next  meal ;  and  even  if  the  quantity  be  small,  and  it  be 
mixed  with  fresh  pap,  it  communicates  its  faculty  of  becoming  sour 
to  the  whole  mass. 

Fluid  Aliments. 

Water.  —  The  best  and  the  most  universal  beverage  for  the  sick 
is  water :  but  the  qualities  of  water  differ,  according  to  the  sources 
whence  it  is  procured.  The  fewer  foreign  ingredients  it  holds  in  so- 
lution the  greater  are  its  diluent  properties.  Distilled  water,  or  rain 
or  river  water  filtei-ed,  and  that  of  soft-water  springs  which  filtrate 
through  silicious  strata,  are  the  only  kinds  proper  for  the  use  of  the 
sick-room.  Hard  water,  under  whatever  name  it  is  found,  whether 
as  spring  water,  or  pump  water,  or  well  water,  should  be  excluded. 
The  impurities  of  river  and  min  water  are  merely  held  in  suspension ; 
consequently,  they  are  readily  removed  by  filtration. 

Water  itself  is  aliment ;  many  individuals  under  certain  circum- 
stances have  lived  for  a  considerable  time  upon  it  alone.  Those 
who  live  chiefly  on  animal  food  require  more  drink  than  those  who 
eat  much  vegetable  matter. 

The  influence  of  water  on  the  animal  economy  may  be  regarded  in 
two  points  of  view  : 

As  an  article  of  diet. 
As  a  medicinal  agent. 

As  an  article  of  diet,  in  health,  water  is  the  beverage  provided  by 
nature  for  all  animals,  man  not  excepted.  The  sensation  of  thirst  is 
the  natural  call  for  fluids,  either  to  assist  digestion,  or  to  allay  a  dry, 
hot  condition  of  the  mouth  and  the  gullet.  The  consequence  of  not 
satisfying  this  call  is  fever  of  a  nervous  kind;  and,  if  it  be  long  re- 
sisted, inflammation  of  the  air-passages.  On  the  other  hand,  too 
nmch  fluid  is  injurious  ;  for  although  the  vital  powers  of  the  stomach 
counteract  the  tendency  which  it  affords,  by  over-diluting  the  gastric 
fluid,  to  the  fermentation  of  the  aliment  in  the  stomach,  yet  when  it 
is  in  excess,  those  vital  powei"s  languish ;  hence  spontaneous  chemi- 
cal changes  in  the  contents  of  the  stomach  take  place,  and  induce 
dyspepsia.  For  all  the  purposes  of  dilution  in  health,  water  is  ade- 
quate, and  it  is  the  only  truly  wholesome  beverage. 

As  a  medicinal  agent,  water  is  demanded  in  every  disease  in  which 
a  dry  skin  and  an  elevation  of  the  natural  heat  of  the  surface,  con- 
stituting fever,  are  present.  In  this  case,  the  desire  is  for  cold  water 
or  cooling  fluids;  and  it  should  always  be  indulged.  The  degree  of 
temperature,  however,  must  be  regulated  by  the  condition  of  the  in- 
valid; but  the  best  medium  temperature  is  between  50°  and  60° 


mn 


tg0 


i 


780 


DOMESTIC   MANAOEMENT  OF  THE  BIOK-KOOM. 


Fahr.,  although  even  60°  is  too  low,  when  the  debility  ot  the  fiame 
is  Gonsidemhle. 

The  qualities  of  the  various  kinds  of  beverages  proper,  and  gene^ 
ally  employed  in  the  sick-room,  should  be  known. 

Toast-water,  when  properly  prepared,  which  it  seldom  is,  forms  a 
useful  beverage  in  the  sick-room.  It  is  slightly  nutritive,  owing  to 
its  containing  a  small  portion  of  gluten,  in  conjunction  with  fecula 
and  sug^r.  It  is  one  of  the  oldest  and  one  of  the  best  diluent  de- 
mulcents ;  diluting  at  the  same  time  that  it  softens  the  acridity  of 
the  secreted  juices  of  the  stomach,  in  febrile  diseases. 

Qruel,  whether  made  of  grroats  or  of  oatmeal,  is  less  mild  and  de- 
mulcent than  barley-water ;  and  it  is  more  likely  to  undergo  the  ace- 
tous fermentation  in  the  heat  of  the  stomach ;  a  circumstance  which 
is  greatly  favored  by  the  sugar  and  butter  which  is  sometimes  added 
to  it.  Unless  gruel  be  very  thin,  it  can  scarcely  be  regarded  as  dilu- 
ent ;  and  when  thick,  it  is  too  heating  an  aliment  for  patients  labor- 
ing under  febrile  symptoms. 

Tea,  in  the  form  in  which  it  is  usually  taken,  is  too  stimulant  and 
astringent  to  be  a  good  diluent :  and,  when  it  is  strong,  the  narcotic 
property  which  it  possesses  renders  it  improper  for  most  invalids, 
whatever  may  be  the  nature  of  their  diseases.  As  it  is,  nevertheless, 
agreeable  to  most  palates,  and  very  refreshing,  it  may  be  taken  in 
moderate  quantity,  provided  it  be  not  strong,  without  any  hazard. 

Sas^,  balm,  and  mint  teas,  are  often  substituted  for  common  tea. 
Each  of  them  undoubtedly  allays  the  irritability  of  the  stomach  in 
some  cases ;  but,  as  general  beverages  in  disease,  they  are  less  useful 
than  toast-water.  Raspberry  vinegar,  lemotiade,  tamarind  tea,  apple 
tea,  and  similar  compound  diluents,  should  never  be  administered 
without  the  consent  of  a  physician.  If  a  patient  be  taking  an  anti- 
monial,  they  will  excite  vomiting ;  if  a  mercurial,  gi  iping ;  and  they 
are  equally  incompatible  with  many  other  medicines,  and  with  many 
conditions  of  the  stomach  in  disease.  They  are  a  description  of 
beveragfe  greatly  recommerded  and  largely  distribn^  >d  by  the  Lady 
Bountifuls  in  the  country,  and  have  frequently  been  productive  of 
serious  mischief. 

Coffee  is  more  heating,  aud  connequently  less  ad"  issible  than  tea ; 
it  may,  however,  be  taken,  if  it  be  largely  combined  '  /ith  milk.  Cocoa 
and  chocolate  are  still  more  objectionable  than  eithrr  tea  or  coffee  in 
the  sick-room.     Shells  i're  good  and  nourishing. 

With  respect  to  the  Number  of  Meal?,  and  ihe  periods  best 
adapted  for  taking  them,  it  is  scarcely  requisite  x)  remark,  that, 
although  in  health  three  moderate  meals,  at  proj  ir  intervals,  are 
customary,  and  well  adapted  for  the  support  of  the  irame,  yet,  under 
the  changed  condition  of  the  system  in  disease,  it  would  be  improper 


DOMESTIC   MANAGEMENT   OF  TUB   8I0K-BOOM. 


781 


to  take  any  regular  number  of  meals,  or  to  observe  any  stated  periods 
for  takinnj  tl^em:  hence  no  general  rules  can  apply. 

As  a  general  rule,  in  the  decline  of  diseases,  and  on  the  approach 
of  convalescence,  when  the  desire  for  taking  food  rctuins,  the  test 
time  for  the  principal  meal,  dinner^  is  about  two  hours  after  noon. 
If  the  breakfast  be  taken  at  nine  o'clock,  and  the  evening  meal  at 
seven,  the  hour  of  two  is  the  middle  period  of  the  day  ;  so  that,  when 
dinner  ia  taken  at  that  time,  the  intervals  between  breakfast  and 
flinner,  and  between  dinner  and  suppei',  are  not  only  ecjual,  but 
neither  is  too  short  to  limit  the  complete  digestion  of  the  previous 
meal,  nor  too  long  to  injure  the  powers  of  the  weakened  stomach 
by  protracted  fasting. 

AH  acute  d'.^eases  require  more  or  less  abstinence,  especially  when 
the  object  of  'he  treatment  is  to  lower  the  system ;  and  in  some 
chronic  affections,  abstinence  is  almost  essential.  If  this  be  true,  the 
necessity  of  the  strictest  observance  of  the  directions  of  the  physician 
oil  this  subject  must  be  obvious.  It  is  one,  however,  which  is  not 
only  neglected,  but  is  often  combated  lx)th  by  nurses  and  friends; 
and  indulgences,  which  are  supposed  to  be  of  too  trivial  a  nature  to 
cause  any  injury  to  the  sick,  have  often  been  followed  by  fatal  effects. 

But,  although  abstinence  be  requisite  during  the  existence  of  an 
acute  disease,  yet  it  is  injurious  when  it  is  too  rigidly  maintained 
after  convalescence  is  actually  established :  it  often  induces  a  new 
train  of  symptoms,  not  very  nplike  those  for  which  it  was  properly 
prescribed  and  the  removal  of  which  it  has  aided ;  namely,  accelera- 
tion of  the  pulse,  increased  impetus  of  the  heart,  headache,  and  even 
delirium. 

General  Diseases. 

Happily,  in  febrile  affections,  the  appetite  of  the  invalid  is  not  in 
a  condition  to  desire  food ;  and  no  stronger  demonstration  can  be 
required  of  the  impropriety  of  forcing  it  upon  him  under  such  circum- 
stances. Simple  fluids,  such  as  diluents,  are  all  that  he  desires,  all 
that  the  stomach  can  bear  ;  and  such  alone  should  be  administered  in 
fever,  before  that  low  condition  of  the  system,  which  demands  the 
use  of  wine  or  other  stimulants,  supervenes.  In  these  cases,  when 
the  patient  desires  more  nourishment  than  is  usual,  animal  food 
ought  not  to  be  given,  unless  by  the  direct  recommendation  of  the 
physician.  Indeed,  in  general,  the  inclination  of  the  invalid  happily 
revolts  from  animal  food,  as  much  as  experience  condemns  its  ad- 
ministration. 

While  febrile  symptoms  are  present,  farinaceous  matters,  little 
nutritious,  such  as  barley-water,  gruel,  arrow-root  mucilage,  or  sago, 
acidulated  with  lemon-juice,  and  sweetened  to  the  taste  of  the  patient, 
are  most  suitable ;  but  even  these  should  be  given  in  small  quantity, 
and  at  considerable  intervals.  The  beverage  generally  most  agree- 
able, and  also  most  salutary,  to  those  suffering  under  fever,  is  cold 
water.  * 


78S 


DOMKHTIO   MANAdKMKNT   OV  THE   HICK-K(J(>M. 


In  the  decline  of  fevera,  even,  oh  I  have  alreiidy  remarked,  ftltlioiigli 
the  severity  ruH^Hiutiug  diet  Hhuiihl  be  relaxed,  yrt  much  diiiigei  may 
result  from  miHtnken  kindneHS  and  over-zeal,  in  urging  aiiinuil  uiul 
stimulant  food  at  too  early  a  period  of  the  uonvaltMcence.  Imlci'd, 
the  necessity  of  caution  at  IIiIm  time  is  greater  than  during  tli"  con- 
tinuance of  the  fever;  and  the  more  acute  tlie  disoaae  has  been,  tliu 
greater  must  be  the  caution  in  the  convah  Hcciice,  enpecially  if  the 
treatment  Iuvh  Imjoii  of  an  evacuant  and  lowering  description. 

The  first  change  of  di(it,  in  the  decline  of  fevers,  should  be  to  an- 
other article  of  the  same  kind  of  food  which  wiw  allowed  in  tlio  din- 
ease  ;  for  example,  from  simple  arrow-root  mncilaye  to  arrow-root  and 
milky  or  to  some  other  of  the  farinaceous  compounds ;  whilst,  at  the 
same  time,  agsee^  milk  may  l>e  given  in  small  quantity  in  the  morn- 
ing. Rice,  one  of  the  furinacete,  is  generally  supposed  to  be  aHtrin- 
gent,  but  this  is  a  mistake.  It  forms  an  excellent  diet  in  all  cases  of 
early  but  decided  convalescence.  It  should  be  well-boiled,  and  mixed 
either  with  bioth  and  beef-tea,  or  gravy  which  has  been  cooled,  and 
the  fat  taken  from  it.  In  the  transit  on  to  animal  food,  heef-tea, 
chicken-broth,  and  mutton-broth,  and  othtr  liquid  animal  decoctions, 
should  he  first  resorted  to;  then  ff/»7«jiv'«A,  simply  cooked ;  for,  al- 
though fish  is  more  digestible  than  animal  food,  yet  it  affords  nmcli 
less  stimulant  nourishment;  it  is  therefore  betti>r  iitted  for  the  early 
stage  of  convalescence.  When  convalescence  is  completed,  a  more 
generous  diet  is  admissible. 

With  respect  to  beverage,  water,  toast-water  or  lemon-peel^ater, 
is  sufficient,  until  the  medical  attendant  declares  that  a  little  wine  is 
requisite. 

In  convalescence  from /et>«r,  it  is  an  error  to  permit  the  patient  to 
get  up  too  soon.  He  should  not  leave  his  bed  until  his  strength  be 
considerably  advanced.  No  danger  can  result  from  too  strict  an 
observance  of  this  rule  ;  whereas  much  risk  may  be  incurred  by  its 
neglect. 

If  the  head  has  been  much  affected,  every  mental  exertion  should 
be  refrained  from  dunng  the  convalescence ;  and,  according  to  the 
degree  of  suffering  in  any  local  organ,  precautions  must  be  taken  to 
guard  that  part  of  tlie  frame  against  a  fresh  attack  of  disease. 

Eruptive  Fevers  require  more  i)recaution  in  convalescence  than 
general  fevers,  both  as  regards  diet  and  exposure  to  sudden  alterna- 
tions of  heat  and  cold.  This  is  more  especially  essential  after  measles 
and  scarlet  fever. 

Measles  are  often  followed  by  a  distressing  cough,  and  other  sjTnp- 
toms  of  piilmonary  inflammation ;  or  by  a  harassing  diarrhoea,  which 
wears  down  the  strength ;  or  by  inflamed  eyes,  catai'rh,  or  obstinate 
toothache.  In  infants,  canker  of  the  mouth  occasionally  makes  its 
attack,  and  pioves  fatal.  All  these  affections,  aftt^r  measles,  might 
generally  be  prevented  by  taking  care  not  to  allow  too  soon  a  return 


nOMKHTIO   MANAORMRNT   Off   THE   HICK-ROOM. 


788 


(1,  ivltliougli 
liiiigfi  nmy 
iiiiiiiiil  iind 
3.  Indeed, 
rig  tiut  coil- 
S   1)6011,  tlio 

ially  if  the 
on. 

(I   1)0  to  ftll- 

iii  tliu  dis- 
ow-root  ami 
lilst,  ut  the 

the  niorn- 
0  1)0  astrin- 
nil  cases  of 

and  mixed 
cooled,  and 
)(1,  heef-tea, 
decoctions, 
3(1 ;  for,  al- 
ords  much 
)!•  the  early 
ted,  a  more 

\rpeel^water, 
ttle  wine  is 

}  patient  to 
itrength  l)e 
o  strict  ai< 
rred  by  its 

bion  should 
ling  to  the 
be  taken  to 
sase. 

icence  than 
len  alternar 
ter  measles 


(tlier  syrap- 
;ioea,  which 
»r  obstinate 
makes  its 
sles,  might 
m  a  return 


to  the  use  of  animal  food,  or  too  early  an  cxpoHur«  to  cold  or  to  night- 
iiir.  Kvcn  in  summer,  flannel  should  Ih)  worn  next  the  ukin  for  some 
weeks  after  the  disease  has  disappeared. 

Scarlatina  is  frequently  followed  by  dro{>sical  symptoms  ;  which, 
however,  might  generally  ho  avoided  by  tht*  same  attention  to  diet 
and  regimen  as  after  measles. 

Small-Pox,  when  severe,  and  especially  when  confluent,  is  very  apt 
to  awaken  into  activity  the  dormant  seeds  of  sciofula,  if  any  lieredi- 
tary  taint  exists  in  the  constitution  ;  hence  al)sces8es,  ulcers,  and 
swelled  glands  make  their  appeamnce.  These  demand  the  aid  of 
the  physician  or  tlie  surgeon.  But  if  the  convalescent  be  properly 
dieted,  and  recourae  he  had  to  a  change  of  air  as  soon  as  his  strength 
will  permit,  tliese  evils  may  be  avoided. 

Erysipelas  not  unfrequently  attacks  convalescents  from  small-pox 
and  other  eruptive  fevers.  When  it  occurs,  independent  of  any  prior 
disease,  the  same  attention  to  diet  and  regimen  is  requisite  as  in  other 
eruptive  fevers. 

Convulsions,  it  is  well  known,  are  not  unfrequently  the  result  of 
errors  in  diet,  in  individuals  with  an  irritable  condition  of  the  stotn- 
ach  and  bowels.  Advice  should  always  be  demanded  respecting  the 
diet  of  those  who  are  liable  to,  and  who  suffer  from,  convulsions  ;  but 
it  must  not  be  supposed  that  when  they  occur  in  children  and  have 
l)een  subdued,  a  system  of  starvation  is  necessary  to  prevent  their 
recurrence.  As  far  as  regards  convalescence  in  such  cases,  it  will  be 
proper  to  bear  in  recollection  the  following  rules : 

1.  When  the  patient  is  of  a.  full  habit,  has  a  short  neck,  and  a  ten- 
dency to  diseases  of  the  head,  the  diet  should  be  spare.  The  use  of 
animal  food,  indeed,  in  BU(di  a  habit,  should  be  wholly  prohibited  in 
childhood,  and  very  sparingly  employed  by  adults  ;  whilst  vegetables, 
farinaceous  matters,  milk  and  weak  broths,  may  be  allowed. 

2.  When  the  habit  of  body  is  spare,  and  when  languor  and  chilli- 
ness are  present,  the  diet,  although  free  from  stimulus,  yet  should  be 
nourishing,  and  consist  of  the  lighter  kinds  of  animal  food ;  namely, 
poultry  and  fish,  with  a  moderate  share  of  vegetable  matters. 

3.  Under  all  circumstances,  and  at  every  period  of  life,  fermented 
liquora  and  wine  should  be  either  wholly  avoided,  or  very  sparingly 
used,  in  almost  all  convulsive  diseases  connected  with  affections  of 
the  head. 

In  convalescence  from  some  varieties  of  convulsive  diseases,  the 
nature  of  the  diet  must  depend  on  circumstances  which  cannot  be 
judged  of  by  the  attendants  of  the  sick-room;  hence  it  should  be 
referred  solely  to  the  medical  attendant.  In  St.  Vitus^a  Datice 
(chorea),  for  example,  although  a  tonic  plan  of  treatment  may  have 
l)een  successfully  pursued,  yet  the  diet  may  be  required  to  be  mild, 
and  wholly  free  from  stimulut}. 


^^P^-: 


mmm 


784 


DOMESTIC  MANAGEMENT  OF  Tl'E   SICK-BOOM. 


Attention  to  diet  in  Hysteria  is  most  important.  When  the  disease 
is  connected  with  indigestion,  the  meals  should  be  moderate :  and 
rest  in  the  horizontal  posture  should  be  indulged  for  an  hour  after- 
wards, and  then  moderate  exercise  taken.  Fluid  food,  such  as  broths 
and  gruel,  are  improper ;  yet  animal  food  should  be  eaten  only  once 
a  day.  Tea  and  coffee  should  be  very  sparingly  taken ;  and  the  sim- 
plest beverages,  even  water  and  toast-water,  should  be  taken  in  great 
moderation  after  a  meal,  and  should  not  be  drunk  during  dinner. 

In  convalescence  from  hysteria,  change  of  scene  and  air  are  abso- 
lutely requisite.  The  mind  should  be  directed  to  solid  studies,  and 
everything  which  can  cherish  morbid  sensibility  of  the  nervous  system 
avoided. 

Dropsy.  —  An  opinion  was  long  maintained  that  fluids  are  to  be 
withheld  from  dropsical  patients.  No  opinion  was  ever  founded  on 
more  erroneous  principles.  Dropsical  patients,  indeed,  should  be 
allowed  the  free  use  of  fluids.  With  respect  to  diet,  it  should,  gen- 
erally speaking,  be  light  and  unstimulating :  but  much  depends  on 
the  causes  of  dropsy.  There  is,  however,  less  n*-  ^essity  for  a  rigid 
adherence  to  low  diet  in  this  than  in  other  inflammatory  affections. 

In  Palsy,  abstinence  from  all  stimulating  food,  solid  or  fluid,  must 
be  rigidly  observed ;  and  the  restriction  should  not  be  discontinued 
in  convalescence.  At  the  same  time,  change  of  air  and  of  scene  is  al- 
ways of  decided  advantage.  In  every  instance,  an  easy  state  of  mind, 
and  freedom  from  every  source  of  irritation,  as  well  as  from  the  anxi- 
eties of  business,  are  indispensable. 

Qout  and  Rheumatism. — In  no  diseases  affecting  the  general 
habit  are  abstinence  and  repose  more  essential  during  the  attacks  than 
in  the  two  which  head  this  paragraph,  when  they  assume  an  acute 
form.  When  they  occur  in  weakened  or  in  biuken-down  habits,  it  is 
too  often  supposed  that  the  opposite  plan  of  diet  is  to  be  pursued, 
and  that  stimulating  food  and  a  liberdl  supply  of  wine  should  be  in- 
dulged; but  nothing  is  more  likely  to  prove  injurious. 

When  the  paroxysm  subsides,  it  is  too  customary  to  permit  the  in- 
valid to  glide  into  his  usual  habits  with  respect  to  diet  and  regimen ; 
consequently  the  plethora  which  originated  the  disease  gradually  re- 
turns ;  aad  the  same  plan  being  continued,  paroxysm  follows  after 
paroxysm,  at  shortening  intervals,  until  scarcely  any  interval  occura, 
and  life  is  sacrificed  on  the  altar  of  self-indulgence. 

For  some  weeks  after  the  paroxjram  of  gout  has  subsided,  in  a 
young  or  middle-aged  man,  animal  food  should  be  sparingly  taken, 
and  fermented  liquors  altogether  avoided. 

Chlorosis,  or  Qreen  Sic*'nes5,  in  a  state  of  the  habit  which  seems 
to  depend  on  an  i'npa.red  condition  of  the  blood  itself.  Its  treatment 
is  well  understood,  and  recourse  to  medical  advice  should  never  be 
neglected  j  otherwise  it  may  terminate  either  in  mental  demngement 


'^V'i^-\J^' 


DOMESTIC   MANAGEMENT  OF   THE  BICK-ROOM. 


785 


or  in  sudden  death.  In  convalescence  from  it,  the  diet  should  be 
mild  and  light,  but  nutritious ;  the  exercise  should  be  much  within 
the  limits  of  fatigue,  and  consist  of  both  walking  and  horse  exercise, 
dailv,  in  the  open  air ;  the  body,  more  especially  the  lower  extrem- 
ities", should  be  warmly  clothed ;  the  mind  ought  to  be  amused ;  all 
sedentary  occupations  thrown  aside;  and  confidence  placed  in  the 
honor  of  the  physician,  who  should  be  made  the  repository  of  any 
mental  anxiety,  especially  connected  with  the  tender  passion,  which 
may  be  preying  upon  the  vital  energy  of  the  body. 


Affections  of  the  Head. 

Whatever  may  be  the  cause  of  Apoplexy,  no  disease  requires  more 
prompt  and  energetic  treatment :  the  alarming  nature  of  the  symp- 
tf  03  is  always  sufficient  to  prevent  any  time  from  being  lost  by  at- 
tempts to  relieve  the  sufferer  without  medical  assistance.  Should 
the  attack  not  prove  fatal  at  the  time,  and  should  it  not  be  followed 
by  palsy,  still  the  utmost  caution  is  requisite  to  prevent  a  recurrence 
of  the  disease.  It  is  scarcely  necessary  to  insist  on  the  strictest  ad- 
herence to  temperance,  both  as  to  meat  and  to  drink ;  and  the  impor- 
tance of  daily  exercise,  when  the  attack  is  over,  and  indeed  for  the 
remainder  of  life.  Prolonged  study  and  intense  thinking  must  be 
given  up  ;  the  violent  and  exciting  passions  should  be  subdued ;  and 
even  the  pleasurable  moderated. 

Inflammation  of  the  brain  is  one  of  those  diseases  which  require,  as 
observed  respecting  apoplexy,  the  most  energetic  treatment.  When 
convalescence  has  fortunately  been  established,  the  attention  of  the 
physician  is  still  requisite,  during  several  weeks,  until  complete  re- 
covery be  fully  confirmed ;  for  the  brain,  after  suffering  from  inflam- 
mation, is  very  ap  to  relapse  into  the  same  stats,  from  the  excite- 
ment of  too  full  a  meal,  or  over-exercise,  or  even  slight  mental  exer- 
tions or  emotions.  On  this  account,  the  convalescent  must  be  kept 
perfectly  quiet,  and  completely  free  from  the  smallest  excitement, 
and  the  strictest  regimen  observed.  His  diet  should  not  only  be  mild 
and  unstiraulating,  but  small  in  quantity. 

Inflammation  of  the  eyes  requires  the  same  caution  when  convales- 
cence is  secured  as  other  inflammatory  affections ;  namely,  quiet, 
great  moderation  in  diet,  and  avoiding  exposure  either  to  much  light, 
heat  or  cold,  or  whatever  can  stimulate  the  still  highly  excitable 
organ. 

Affections  of  the  Chest. 

Inflammation  of  the  Lungs  (^Pneumonia).  —  In  convalescence 
from  this  disease,  the  temperature  of  the  room  in  which  the  patient 
sits  should  not  exceed  60°  F. ;  and  it  should  be  free  from  currents  of 
air ;  but  at  the  same  time  it  should  not  be  close.  The  necessity  for 
continuing  the  same  elevated  position  of  the  siuuildei-s  '^hen  in  bed, 


!PjilASBSiiMis:.mmj:^)!..:':^9rsiem 


immmtf- 


*  '■-. 


786 


DOMESTIC  MANAGEMENT  Or  THE   8I0K-R00M. 


which  18  demanded  during  the  existence  of  the  disease,  remains  even 
when  the  convalescence  is  advanced.  The  patient  should  be  pre- 
vented from  talking,  and  from  exerting  sChy  muscular  motion  that 
can  accelerate  the  circulation.  The  diet  should  be  of  that  descrip^ 
tion  which  will  support  the  strength  without  exciting  or  producing 
repletion.  As  the  convalescence  advances,  and  exercise  is  permitted 
by  the  medical  attendant,  it  should  be  regular,  but  not  hurried  nor 
violent ;  and  evening  air  should  be  sedulo'  sly  avoided. 

Pleurisy.  —  Inflammation  of  the  lining  membrane  of  the  chest  re- 
quires the  same  attention  to  diet  and  regimen  during  convalescence 
as  the  last-mentioned  disease,  except  that  a  greater  strictness  with 
regard  to  abstemiousness  in  food  is  requisite ;  the  least  deviation 
being  likely  to  bring  on  a  renewal  of  the  inflammation.  When  the 
disease  assumes  a  chronic  character,  and  when  the  object  is  to  remove 
fluid  effused  into  the  cavity  of.  the  chest,  and  pressing  upon  the  lungs 
so  as  to  circumscribe  their  action,  the  same  degree  of  strictness  with 
respect  to  diet  is  not  necessary ;  but,  as  in  this  condition  of  the  habit 
the  physician  must  continue  his  attendance,  the  regulation  of  the  diet 
devolves  upon  him. 

Angina.  —  In  that  condition  of  the  habit  which  is  connected  with 
a  predisposition  to  gout,  but  in  which,  instead  of  a  regular  paroxysm, 
the  heart  and  the  pulmonary  organs  become  affected,  and  the  disease 
assumes  that  form  which  has  been  denominated  diaphragmatic  gout 
(^Angina  pectoris^  the  regulation  of  diet  is  of  vital  importance ;  and 
it  should  be  of  as  low  a  standard  as  the  constitutional  powers  will 
admit.  It  should  not  be  of  a  description  either  to  nourish  much,  or 
to  augment  or  to  cause  fullness  of  habit ;  mild  animal  food,  in  mod- 
erate quantity,  may  be  allowed ;  but  the  staple  should  be  of  a  farina- 
ceous kind:  every  stimulant,  whether  solid  or  fluid,  should  be 
avoided ;  and  wine  and  malt  liquors  regarded  as  poisons.  The  in- 
valid himself  should  be  made  aware  that  whatever  tends  to  excite 
or  to  hurry  the  circulation  is  calculated  to  bring  on  a  paroxysm ; 
nor  is  it  sufficient  that  he  avoids  all  stimulating  viands  and  beve^ 
ages ;  he  should  also  be  instructed  that  the  same  deleterious  effects 
are  likely  to  follow  a  full  meal,  even  of  the  most  proper  and  mildest 
food. 

The  same  attention  to  diet,  both  as  regards  quantity  and  quality, 
is  essential  in  palpitations  depending  upon  organic  disease  of  the 
heart. 

Asthma.  —  In  no  affection  of  the  chest  is  attention  to  diet  so  im- 
portant as  in  asthma.  Sir  John  Floyer,  who  himself  suffered  from 
the  disease,  recommends  almost  a  degree  of  abstinence;  which  is 
correct  in  reference  to  quantity ;  but  the  diet,  although  of  a  light, 
yet  should  be  of  a  solid,  kind.  This  is  especially  necessary  when 
dyspepsia  is  present  to  aggravate  and  excite  the  disease  of  the  lungs. 


DOMESTIC  MANAGEMENT  OF  THE   SICK-ROOM. 


787 


jmams  even 
uld  be  pre- 
motion  that 
hat  descripi 
r  producing 
is  permitted 
hurried  nor 


ihe  chest  re- 
nvalescence 
ictness  with 
Jt  deviation 
When  the 
is  to  remove 
)a  the  lungs 
ictness  with 
of  the  habit 
n  of  the  diet 


nected  with 
r  paroxysm, 
[  the  disease 
Tmatic  gout 
rtance;  and 
powers  will 
jsh  much,  or 
>od,  in  mod- 
I  of  a  farina- 
,  should  be 
IS.  The  in- 
Is  to  excite 
,  paroxysm; 
i  and  bever- 
rious  effects 
and  mildest 

and  quality, 
lease  of  the 


3  diet  so  im- 
iffered  from 
e;  which  is 
I  of  a  light, 
lessary  when 
of  the  lungs. 


In  Whooping-cough,  the  diet,  whether  the  patient  be  an  adult  or  a 
child,  should  be  of  the  mildest  description ;  and  jjerhaps  no  nutri- 
ment is  so  well  adapted  to  support  the  tone  of  the  bod}',  v  ithout 
exciting  it,  as  milk.  In  infancy,  nothing  but  the  breast  sliould  be 
given ;  the  system  of  the  nurse,  at  the  same  time,  being  kept  as  cool 
as  possible  by  mild  diet,  and  her  mind  in  a  tranquil  state.  If  cou- 
vulsions  occur,  these  sometimes  depend  on  the  nature  of  the  milk : 
in  which  case  the  nurse  should  be  changed.  It  is  still  customary 
with  non-profe3sional  persons  to  consider  change  of  air  essential  in 
whooping-cough ;  but  it  is  only  after  the  malady  has  run  its  coui-se, 
and  convalescence  is  progressing,  when  the  cough  remains  as  a 
kabit,  that  change  of  air  is  really  beneficial.  It  is  unnecessary  to 
combat  the  absurd  opinion,  that  a  change  even  to  a  worse  air  is 
salutary. 

Affections  of  the  Stomach  and  Bowels. 

Although  acute  inflammation  of  the  stomach  rarely  occurs,  yet 
there  is  a  chronic  form  of  that  disease,  in  which,  during  its  actual 
existence,  and  also  in  convalescence  from  it,  much  of  the  safety  of  the 
invalid  depends  upon  domestic  management.  Every  source  of  excite- 
ment should  be  avoided ;  the  sick-room  should  be  airy,  and  its  tem- 
perature that  of  summer.  The  food  should  be  of  the  blandest  kind, 
given  cold,  or  iced,  and  in  small  quantity:  even  when  the 
convalescence  is  established  the  diet  should  consist  of  farinaceous 
matters,  mixed  with  small  quantities  of  beef-tea,  or  weak  broths ; 
and  this  severe  diet  should  be  pei-sisted  ija  for  a  considerable  time 
after  recovery. 

Enteritis.  —  When  inflammatory  action  extends  to,  or  exclusively 
exists  in,  the  mucous  lining  of  the  bowels,  constituting  this  disease, 
the  diet,  during  the  early  stage  of  it,  should  be  confined  to  cold 
water,  or  iced  almond-emulsion ;  after  which,  milk  and  barley-water, 
or  weak  chicken  or  veal-tea,  may  be  given  in  small  quantities;  namely, 
two  or  three  tablespoonfuls,  at  intervals  of  three  or  four  hours. 
Nothing  stronger  should  be  ventured  upon,  unless  expressly  ordered 
by  the  medical  attendant. 

Atonic  dyspepsia,  or  simple  indigestion.  —  During  the  attack,  ab- 
stinence, to  a  certain  degree,  is  necessary ;  but,  if  this  is  not  essen- 
tial, the  diet  should  be  somewhat  stimulant,  but  simple ;  namely,  a 
small  cup  of  moderately  strong  coffee,  with  little  sugar  or  milk ;  or 
beef-tea,  with  a  small  quantity  of  dry  toast ;  and,  as  the  stomach 
begins  to  regain  its  tone,  a  little  animal  food  of  easy  digestion,  such 
as  mutton  or  poultry. 

During  the  intervals  of  the  paroxysms  of  indigestion,  attention  to 
diet  is  of  the  first  importance.  As  a  general  rule,  the  patient  should 
be  confined  to  a  spare  animal  diet,  with  a  moderate  share  of  well- 
boiled  vegetables,  and  a  oonsiderable  restriction  with  respect  to  the 
use  of  fluids. 


■wawiiiiiiii 


788 


DOMESTIC   MANAGEMENT   OF   THE   SICK-ROOM. 


Dysentery,  which  impUes  inflammation,  acute  or  chronic,  of  tlic 
same  membrane  as  in  enteritis,  but  confined  to  the  larger  and  lower 
bowels,  requires  the  diet  to  consist  of  the  mildest  farinaceous  matters, 
strictly  avoiding  all  solid  animal  food.  It  should  be  given  in  small 
quantity  at  a  time,  and  the  whole  allowance  for  the  day  should  be 
moderate.  The  farinaceous  food  should  not  be  either  solid,  nor  yet 
altogether  fluid ;  the  former  may  prove  injurious  as  a  mechanical 
irritant ;  the  latter  is  liable  to  excite  griping,  from  the  extrication  of 
much  flatus. 

Diarrhoea.  —  Much  of  the  domestic,  as  well  as  the  medical  man- 
agement of  diarrhoea  depends  on  the  nature  of  the  attack,  and  its 
causes ;  but  too  much  attention  cannot  be  paid  to  the  regulation  of 
the  diet.  It  should  be  both  small  in  quantity,  and  mild  in  quality. 
In  the  early  stage,  and  the  acute  form  of  the  disease,  barley-water, 
arrow-root  made  with  water,  rice  or  grit-gruel,  and  light  broths,  are 
proper.  In  chronic  diarrhoea,  rice,  properly  boiled,  and  mixed  with 
a  small  quantity  of  beef-tea,  forms  an  excellent  diet,  as  it  nourishes 
moderately,  and  leaves  scarcely  any  feculent  matter  behind  it. 

In  Cholera,  convalescence  is  often  tedious ;  and  nothing  is  so  hkely 
to  cause  relapse  as  even  slight  irregularities  of  diet.  For  weeks  after 
the  feverish  symptoms  have  disappeared,  the  diet  should  consist  of  a 
very  moderate  quantity  of  vegetable  matter  only.  The  feet  should 
be  kept  especially  warm  and  the  whole  body  clothed  in  flannel,  to 
prevent  that  irregular  distribution  of  blood  which  so  strongly  charac- 
terizes the  disease. 

After  inflammation  of  the  lining  membrane  of  the  cavity  of  the 
belly  (peritonitis)  has  been  subdued,  the  invalid  should  still  observe 
the  strictest  diet  and  regimen.  He  should  return  very  gradually  to 
the  use  of  animal  food  and  wine.  The  bowels  should  be  moderately 
and  daily  opened,  the  feet  kept  warm,  and  the  skin  maintained  in  a 
healthy  condition  by  wearing  flannel  next  to  it,  for  a  very  considera- 
ble time  after  every  trace  of  the  disease  has  disappeared. 

Diseases  of  the  Liver.  —  In  all  cases  of  recovery  from  these  dis- 
eases, whether  inflammatory  or  otherwise,  every  precaution  should 
be  taken  to  guard  against  the  deleterious  influence  of  alternations  of 
temperature,  and  also  of  damp,  by  clothing  in  flannel  next  the  skin. 
Errors  in  diet  should  be  avoided  ;  and  fermented  liquors  and  stimu- 
lating '>everages  of  every  kind  refrained  from.  When  pains  of  the 
side  continue,  after  all  the  other  symptoms  of  the  disease  have  dis- 
appeared, the  introduction  of  a  seton,  if  prescribed,  should  not  he 
objected  to ;  as  the  greatest  benefit  has  often  followed  that  mode  of 
counter  irritation. 


■Mi 


nr  -mminssuammmB, 


onic,  of  tilt' 
r  and  lower 
0U8  matters, 
veil  in  small 
y  should  be 
alid,  nor  yet 
mechanical 
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ledical  man- 
ack,  and  its 
3gulation  of 
[  in  quality. 
)arley-water, 
.  broths,  are 
mixed  with 
it  nourishes 
nd  it. 

J  is  so  likely 
'  weeks  after 
consist  of  a 
feet  should 
a  flannel,  to 
ingly  charac- 

avity  of  the 
still  observe 
gradually  to 
!  moderately 
itained  in  a 
y  considera- 

m  these  dis- 
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ernations  of 
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and  stimu- 
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)uld  not  he 
txat  mode  of 


COOKEEY  FOR  THE  SICK-BOOM. 


It  was  said  by  the  distinguished  Dr.  Rush,  in  his  lectures  before 
his  class,  that  a  physician  ought  to  spend  six  months  in  a  kitchen  be- 
fore beginning  practice.  A  knowledge  of  dietetic  preparations  fitted 
for  the  sick,  and  for  those  recovering  from  disease,  however  ap- 
parently unimportant,  adds  much  to  a  physician's  power  over  his  pa- 
tient, and  to  his  popularity  and  usftfulness. 

In  giving  nourishment  to  the  sick,  who  are  suffering  from  low  dis- 
ease?, it  is  an  important  rule  which  should  never  be  forgotten,  to  give 
but  little  at  a  time,  and  to  repeat  that  often.  In  cases  of  great  proGtra- 
tion  from  disease,  life  may  at  times  bo  endangered  by  a  dela.y  in  giv- 
ing nourishment  of  even  a  few  minutes  beyond  the  proper  time. 

Barley-Water. 

Peakl  barley,  two  ounces ;  boiling  water,  two  quarts.  Boil  to 
one-half,  and  strain.  A  little  lemon-juice  and  sugar  may  be  added, 
if  desirable.     To  be  taken  freely  in  inflammatory  diseases. 

Rice- Water. 

Rice,  two  ounces ;  water,  two  quarts.  Boil  an  hour  and  a  half, 
and  add  sugar  and  nutmeg. 

Rice,  when  boiled  for  a  considerable  time,  becomes  a  kind  of  jelly, 
and,  mixed  with  milk,  is  a  very  excellent  diet  for  children.  It  has  in 
some  measure  a  constipating  property,  which  may  be  increased  by 
boiling  the  milk 

Decoction  of  Bran. 

New  wheat  bran,  one  pint ;  water,  three  quarts.  Boil  down  one- 
third,  strain  off  the  liquor,  and  add  sugar,  honey,  or  molasses,  accord- 
ing to  the  taste  of  the  patient.  A  bran  tea  may  be  made  by  using 
Iwiling  water,  and  suffering  the  mixture  to  stand  in  u  covered  vessel 
for  three  or  four  hours. 

7W 


ii|j(jB58«»isiia*!W»*5S~5^'^^'^'i*^^ 


.r,<B'i"Hi'<'J. 


790 


COOKKKY   FOR   THE   SICK-ROOM. 


Sage  Tea. 

Dried  leaves  of  sage,  half  -  an  ounce ;  boiling  water,  one  quart. 
Infuse  for  half  an  hour,  and  strain.  Add  sugar  and  lemon-juice  as 
required  by  the  patient.  Balm  and  other  teas  are  made  in  the  same 
manner. 

The  above  infusions  form  agreeable  and  useful  drinks  in  fevers,  and 
their  diaphoretic  powers  may  be  increased  by  adding  a  little  sweet 
spirits  of  nitre. 

Barley  Coffee. 

Roast  one  pint  of  common  barley  in  the  same  way  in  which  coffee 
is  roasted.  Add  two  large  spoonfuls  of  this  to  a  quart  of  boiling 
water;  boil  five  minutes.     Add  a  little  sugar. 

Lemon- Water. 

Put  two  slices  of  lemon,  thinly  pared,  into  a  ttrpot,  a  little  bit  of 
the  peel  and  a  bit  of  sugar.  Pour  in  a  pint  of  boiling  water,  and 
cover  it  close  two  hours. 

A  Refreshing  Drink  in  Fevers. 

Put  a  little  sage,  two  sprigs  of  balm,  and  a  little  sorrel  into  a  stone 
jug,  having  first  washed  and  dried  them.  Peel  thin  a  small  lemon, 
slice  it,  and  put  in  with  a  small  piece  of  the  peel ;  then  pour  in  three 
pints  of  boiling  water.     Sweeten,  and  cover  it  close. 

Anotlier. 

BoHi  an  ounce  and  a  half  of  tamarinds,  three  ounces  of  cranberries, 
and  two  ounces  of  stoned  raisins,  in  three  pints  of  water,  till  the 
water  is  reduced  to  two  pints.  Strain,  and  add  a  bit  of  lemon-peel, 
which  must  be  removed  in  an  hour,  as  it  gives  a  bitter  taste  if  left 
too  long. 

A  Very  Pleasant  Drink. 

Put  a  teacupful  of  cranberries  into  a  cup  of  water,  and  mash  them. 
In  the  meantime,  boil  two  quarts  of  water  with  one  large  spoonful  of 
corn  or  oatmeal  and  a  bit  of  lemon-peel ;  then  add  the  cranberries, 
as  much  fine  sugar  as  shall  leave  a  smart  flavor  of  the  fruit,  and  a 
wineglassful  of  sherry.  Boil  the  whole  gently  for  fifteen  minutes, 
and  strain. 

Crust  Coffee. 

Toast  slowly  one  or  two  slices  of  brown  or  white  bread,  pour  boil- 
ing water  over  it,  and  drink  hot  or  cold,  according  to  preference. 


:ai.V 


COOKEHY   FOR   THK   SICK-ROOM. 


791 


one  quart. 
on-juice  as 
n  the  same 

fevers,  and 
ittle  sweet 


hich  coffee 
of  boiling 


ittle  bit  of 
ivater,  and 


nto  a  stone 
all  lemon, 
ur  in  three 


ranberries, 
3r,  till  the 
emon-peel, 
ste  if  left 


lash  them, 
poonf  ul  of 
ranberries, 
:uit,  and  a 
I  minutes, 


pour  boil- 
irence. 


Infusion  of  Malt. 

To  one  pint  of  ground  malt  add  three  pints  of  scpldiiig  water,  that 
is,  water  not  quite  brought  to  the  boiling  point;  infuse  two  hours, 
and  strain.  Add  sugar  or  lemon  juice  as  desired.  An  excellent 
preparatiou  in  inflammatory  fevers. 

Lemonade. 

Fresh  lemon-juice,  lour  ounces ;  thin  peel  of  lemon,  half  an  ounce ; 
white  sugar,  four  ounces ;  boiling  wattir,  three  pints.  Let  them  stand 
until  cold,  and  strain.  When  used  in  fevers,  a  little  nitrate  of  potash 
or  sweet  spirits  of  nitre  may  be  added.  It  may  bfc  further  diluted  to 
the  tF,8te  of  the  patient. 

Water  Gruel. 

Oat  or  corn  meal,  two  tablespoonfuls ;  wat«r,  one  quart.  Boil  for 
ten  or  fifteen  minutes,  and  strain,  adding  salt,  and  sugar  if  desired  by 
the  patient. 

Milk  for  Infants. 

Cowe'  milk,  one  part ;  water,  two  parta  ;  sweeten  slightly  with  loaf 
sugar. 

It  is  necessary,  when  children  are  to  be  rained  by  hand,  to  di- 
lute the  milk.  The  above  proportions  may  be  altered  ap  the  child 
advances  in  age. 

Rice  Qruel. 

Grottxd  rice,  one  heaping  tablsspoonful ;  ground  cinnamon,  one 
teaspoonful;  water,  one  quart.  Boil  gently  for  twenty  minutes,  add- 
ing the  cinnamon  near  the  conclusion.  Strain  and  sweeten.  Wine 
may  be  ?^dded  in  some  cases. 

Panada. 

Whtte  ^read,  one  ounce;  ground  cinnamon,  one  teaspoonful; 
water,  one  pint.  Boil  them  until  well  mixed,  and  add  a  little  sugar 
and  aytmeg.     Wine  or  butter  may  also  be  added,  if  desirable. 

Compound  5alep  Powders. 

Sat^EP,,  tragacanth,  and  sago,  each  four  ounces ;  cochineal,  half  a 
dram  ;  prepared  oyster  shells,  one  ounce.  Mix,  and  divide  into  pow- 
ders of  one  dram  each.  Stir  one  of  these  powdei-s  into  a  pint  of  milk, 
and  boil  for  ten  or  fifteen  minutes.  To  be  drunk  freely  in  diarrhoea 
and  dysentery. 


792 


COOKKHY    FOR   THE    SICK-ROOM. 


Another. 

Gum  arable,  tragacanth,  maranta,  sago,  tapioca,  each  two  draiim. 
Mix  them  well  together,  and  boil  in  a  pint  of  milk,  flavored  with  nut- 
meg or  cinnamon.     To  be  used  as  a  diet  in  dysentery,  diarrhoia,  etc. 

Sag:o  Qruel. 

Sago,  two  tablespoonfuls ;  water,  one  pint.  Boil  gently  until  it 
thickens,  frequently  stirring.  Wine,  sugar,  and  nutmeg,  may  Iw 
added,  according  to  circumstances. 

Arrow- Root  Qruel. 

Arbow-ROOT,  one  tablespoonful ;  sweet  milk,  half  a  pint ;  boiling 
water,  half  a  pint.  To  be  sweetened  with  loaf  sugar.  Excellent 
aliment  for  children  when  the  bowels  are  irritable. 


Tapioca  Jelly. 

Tapioca,  two  tablespoonfuls ;  water,  one  pint.  Boil  gently  for 
an  hour,  or  until  it  assumes  a  jelly-like  appearance.  Add  sugar, 
wine,  and  nutmeg,  with  lemon-juice  to  suit  the  taste  of  the  patient, 
and  the  nature  of  the  case. 

Jelly  of  Irish  Moss. 

Irish  moss,  half  an  ounce ;  fresh  milk,  a  pint  and  a  half.  Boil 
down  to  a  pint.  Remove  any  sediment  by  straining,  and  add  the 
proper  quantity  of  sugar  and  lemon  juice,  or  peach-water,  to  give  it 
an  agreeable  flavor. 

Isinglass  Jelly. 

Isinglass,  one  roll.  Boil  in  one  pint  of  water  until  it  is  dissolved. 
Strain,  and  add  one  pint  of  sweet  milk.  Put  it  again  over  the  fire, 
and  let  it  just  boil  up.  Sweeten  with  loaf-sugar,  and  grate  nutmeg 
upon  it.     When  properly  made,  it  resembles  custard. 

This  forms  an  excellent  diet  for  persons  recovering  from,  sickness, 
and  is  well  adapted  to  the  bowel-complaints  of  children. 


Apple  Water. 

Cut  two  large  apples  in  slices,  and  pour  a  quart  of  boiling  water 
on  them.  Or,  pour  the  same  amount  of  water  on  roasted  apples.  In 
two  or  three  hours,  strain  and  sweeten  slightly. 


COOKKKV    KOK   THE   SICK-IIOOM. 


793 


two  drams. 
d  with  imt- 
irrhcea,  etc. 


tly  until  it 
3g,  may  Iw 


nt;  boiling 
Excellent 


gently  for 
!\.dd  sugar, 
the  patient, 


half.  Boil 
id  add  the 
r,  to  give  it 


8  dissolved, 
^er  the  fire, 
ate  nutmeg 

ra  sickness, 


iling  water 
apples.    In 


Milk-Porridge. 

\Vheat  flour,  cornmeal,  or  oatmeal,  two  tablespoonf uls ;  milk, 
one  pint;  water,  one  pint.  Mix  tho  flour  or  meal  with  cold  water, 
to  form  a  thin  paste ;  put  the  milk  and  water  over  the  fire,  and  when 
they  come  to  the  boiling  point,  add  the  paate,  carefully  stirring. 

French  Milk-Porridge. 

Stir  some  oatmeal  and  water  together ;  let  the  mixture  stand  to 
clear,  and  pour  off  the  water.  Then  put  more  water  to  the  meal, 
stir  it  well,  and  let  it  stand  till  the  next  day.  Strain  through  a  fine 
sieve,  and  boil  the  water,  adding  milk  while  so  doing.  The  propor- 
tion of  water  must  be  small.  With  toast,  this  is  a  good  preparation 
for  weak  pei-sons. 

Qround-Rice  Milk. 

Boil  one  spoonful  of  good  rice,  rubbed  down  smooth,  with  a  pint 
and  a  half  of  milk,  a  little  cinnamon,  lemon  peel,  and  nutmeg. 
Sweeten  when  nearly  done. 

Boiled  Flour. 

Tie  up  as  tight  as  possible,  in  a  linen  cloth,  one  pound  of  flour ; 
and,  after  frequently  dipping  it  in  cold  water,  dredge  the  outside 
Avith  flour  till  a  crust  is  formed  round  it,  which  will  prevent  the 
water  from  soaking  into  it  while  boiling.  Place  it  in  water  and  boil 
it  until  it  becomes  a  hard,  dry  mass. 

Two  or  three  spoonfuls  of  this  may  be  grated,  and  prepared  in  the 
same  manner  as  arrow-root  gruel,  for  which  it  is  an  excellent  substi- 
tute. 

Vegetable  Soup. 

Take  one  turnip,  one  potato,  and  one  onion,  let  them  be  sliced 
and  boiled  in  one  quart  of  water  for  an  hour.  Add  as  much  salt  as 
is  agreeable,  and  pour  the  whole  upon  a  piece  of  dry  toast. 

This  forms  an  agreeable  substitute  for  animal  food,  and  may  be 
given  when  the  latter  is  inadmissible. 

Beef-Tea. 

Lean  beef,  cut  into  shreds,  one  pound ;  water,  ohe  quart.  Boil 
for  twenty  minutes,  taking  off  the  scum  as  it  rises.  When  it  grows 
cold,  strain. 

Essence  of  Beef. 

Lean  beef  sliced.  Put  a  sufiicient  quantity  into  a  porter-bottle  to 
fill  up  its  body,  cork  it  loosely^  and  place  it  in  a  pot  of  cold  water. 


•mssmmm^i^y 


••Ij^tosfK'/i; 


794 


COOKERY   FOR   THE   8I0K-R00M. 


attaching  the  neck,  l)y  iiiuanH  of  a  string,  to  the  ha  lie  of  the  veHHul. 
Boil  this  for  an  hour  and  a  half  or  two  houre ;  t^en  pour  off  the 
liquor  and  skim  it. 

To  this  preparation  may  be  added  spices,  salt,  ,  tie,  brandy,  etc., 
acoording  t(>  the  taste  of  the  patient,  and  nature  of  '':e  disease. 

Calf  S'?eet  Jelly. 

Take  two  calf's  feet,  and  add  to  them  one  gall(<:.  of  waiter.  Boil 
down  to  one  quart.  Strain,  and  when  cold,  skim  !  the  fat.  Add 
to  this  the  white  of  six  or  eight  eggs  well  beaten,  a  pint  of  wine,  half 
a  pound  of  loaf  sugar,  and  the  juice  of  four  lemonB,  and  let  them  be 
well  mixed.  Boil  the  whole  for  a  few  minutes,  stirring  constantly, 
and  then  pass  it  through  a  flannel  strainer. 

This  forms  a  very  nutritious  article  of  diet  for  the  sick,  and  for 
those  recovering  from  disease.  The  wine  may  be  c»mitted  or  added 
according  to  choice. 

Chicken  Water. 

Take  half  a  chicken,  divested  of  all  fat,  and  break  the  boifes  ;  add 
to  this  half  a  gallon  of  water,  and  boil  for  half  an  hour.  Season 
with  salt. 

Suet  Ptisan. 

Sheep's  suet,  two  ounces ;  milk,  one  pint ;  starch,  half  an  ounce. 
Boil  slowly  for  half  an  hour.  This  may  be  used  aa  a  common  drink 
in  dysentery. 

Rennet  Whey. 

New  milk,  one  quart;  rennet,  a  large  spoonful.  Heat  the  milk, 
and  then  add  the  rennet.  Boil  until  the  curd  separates,  which  is  to 
be  taken  off.     To  many  persons,  this  forms  an  agreeable  nutriment. 

Vinegar  Whey. 

Milk,  one  pint;  vinegar,  one  tablespoonful.  Boil  for  a  few 
minutes,  and  separate  the  curd. 

Tartar  Whey.  ' 

Milk,  one  quart ;  cream  of  tartar,  one  dessert  spoonful. .  Boil, 
and  separate  the  curd. 

Mustard  Whey. 

Bruised  mustard^eed,  one  tablespoonful ;  milk,  one  pint.  Boil 
together  for  a  few  minutes,  and  separate  the  curd. 

This  has  been  found  a  useful  drink  in  dropsy.  A  teacupful  may 
be  taken  at  a  time. 


TsnsE-?Hrs^ 


v'W^'?**^ ' 


';-^-  V 


COOKERY   FOB   THE   8ICK-K00M. 


795 


i[ 


Alum  Whey. 

Alum,  one  teaspoonful ;  milk,  one  pint.  Boil  together,  and  strain, 
to  Heparata  the  curd. 

Orange  Whey. 

Milk,  one  pint ;  the  juice  of  an  orange  with  a  portion  of  the  peel. 
Hoil  the  milk  ;  then  put  the  orange  to  it,  and  let  it  r'  id  till  coagu- 
lation takes  place..     Strain. 

Sweet  Whey. 

Skimmed  milk,  two  quarts;  a  piece  of  prepared  calf's  rennet. 
Mix  and  put  in  a  warm  place  till  coagulation  takes  place ;  then 
strain. 

Whey  with  Tamarinds. 

Milk,  boiling,  one  pint ;  tamarinds,  two  ounces.  Boil  them  to- 
gether till  coagulation  takes  place. 

Wine  Whey. 

Milk,  two  thirds  of  a  pint ;  water,  one  third  of  a  pint ;  Madeira, 
or  other  wine,  one  gill ;  sugar,-  one  dessert  spoonful.  Place  the 
milk  and  water  together  in  a  deep  pan  on  the  fire,  and  at  the  moment 
when  it  begins  to  boil,  pour  in  the  wine  and  the  sugar,  stirring  assidu- 
ously whilst  it  boils,  for  twelve  or  fifteen  minutes.  Lastly,  strain 
through  a  sieve.  This  is  excellent  in  all  forms  of  fever,  given  in 
small  quantities.  It  may  be  drunk  either  cold  or  tepid,  a  wine- 
glassful  at  a  time. 

Milk  and  Soda  Water. 

Heat  nearly  to  boiling  a  teacupful  of  milk ;  dissolve  in  it  a  tea- 
spoonful  of  refined  sugar ;  put  this  into  a  large  tumbler  and  fill  with 
soda  water.  This  is  an  excellent  mode  of  taking  milk  when  the 
stomach  is  charged  with  acid,  and  is  oppressed  by  milk  alone. 

Sippets. 

On  an  extremely  hot  plate,  put  two  or  three  slices  of  bread,  and 
pour  over  them  some  of  the  juices  of  boiled  beef,  mutton,  or  veal. 
If  there  be  no  butter  in  the  dish,  sprinkle  over  them  a  little  salt. 

Restorative. 

Take  two  calf's  feet,  one  quart  of  water,  and  one  quart  of  new 
milk ;  place  all  in  a  close-covered  jar,  and  bake  three  hours  and  a 


796 


OOOKKRY    FOK   THE   8I0K-R00M. 


half.  When  cold,  remove  the  fat.  Any  deaired  flavor  may  lie  given, 
by  adding  lemon-peel,  cinnamon  or  maoe,  .while  baking.  Add  sugar 
afterwar«ls. 

Coffee-nilk. 

Boil  a  dessertHpoonful  of  ground  coffee  in  nearly  a  pint  of  milk, 
for  a  quarter  of  an  hour,  then  put  into  it  a  shaving  of  isingliws,  and 
clear  it.  Let  it  boil  a  few  minutes,  and  set  it  beside  the  fire  to 
clarify.     Sweeten  with  loafnsugar. 

Nutritive  Fluid. 

Tare  two  teaspoonfuls  of  lump  magnesia,  one  teaspoonful  of  sal- 
eratus,  one  tcaupoonful  of  salt,  two  teaspoonfuls  of  flour,  half  a  pint 
of  milk,  and  one  pint  of  water.  Put  the  milk  and  water,  united, 
over  the  fire,  and  rub  up  the  flour  with  a  little  cold  water  to  make  a 
thin  paste.  Just  when  iho  milk  and  water  begin  to  boil,  stir  in  the 
paste.  This  will  make  a  thin  porridge,  which  should  boil  about  five 
minutes.  At  the  end  of  this  time  remove  from  the  fire  and  pour 
into  a  pitcher.  Now  add  the  magnesia,  pulverized,  and  mixed  with 
the  salei-atus  and  salt.     Sweeten  to  suit  the  taste. 

This  may  be  drunk  freely,  several  times  a  day,  so  as  to  produce 
two  evacuations  of  the  bowels  in  twenty-four  hours,  in  those  cases  of 
dyspepsia  attended  by  acidity  of  the  stomach,  and  in  many  debilitated 
conditions  of  the  system  in  which  there  is  a  tendency  to  loss  of  flesh. 

This  is  one  of  the  leading  fluids  used  by  those  who  pursue  what  is 
called  the  "  Nutritive  Sy%tem "  of  treating  disease,  and  is  really  a 
valuable  preparation,  having  the  effect  often  to  increase  the  flesh,  even 
while  it  acts  as  a  cathartic. 

Franldin  Mills  Bread, 

OB   GERM-WHEAT   BREAD. 

One  quart  milk  or  water ;  one  quart  white  flour ;  one-half  yeast- 
cake  ;  one-half  cup  sugar  ;  one-half  teaspoon  salt ;  one  quart  Frank- 
lin flour. 

Put  the  white  flour  in  the  mixing-bowl,  then  add  the  milk  and 
yeast  gradually,  until  smooth.  Cover;  let  it  rise  in  the  bowl  all 
night.  In  the  morning,  if  light,  add  sugar,  salt  and  Franklin  flour, 
R  little  at  a  time ;  then  let  it  rise  again  until  light.  Fill  the  pans 
two-thirds  full,  and  rise.     Bake  one  hour. 


Indian-Meal  Qruel. 

Two  tablespoonfuls  of  commeal  to  one  quart  of  boiling  water; 
one  teaspoonful  of  salt.  Cook  about  thirty-five  minutes.  If  too 
thick,  thin  with  milk  or  cream. 


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COOKERY   FOn  THE   SICK-ROOM. 


797 


Oatmeal  Qruel. 

Take  one  quart  of  boiling  water,  three  tablespoonfuls  of  oatmeal, 
one-quarter  teaspoon  salt ;  cook  two  hours,  strain  and  add  milk  or 
cream. 

Floui  Qruel. 

Take  two  teaspoonfuls  of  white  flour,  one  cup  of  boiling  water, 
one-half  teaspoonful  of  salt.  Make  a  smooth  paste  of  the  flour  and 
salt  before  adding  to  boiling  water.  Strain  and  thin  with  milk  or 
cream. 

Mutton  Broth. 

Boil  one  pound  of  juicy  mutton  in  two  cups  of  cold  water.  Cook 
slowly  for  half  an  hour ;  strain,  and  after  it  is  cold,  remove  the  fat, 
and  serve  with  boiled  rice.  The  rice  should  be  boiled  separately  and 
added  to  the  broth  when  it  is  warming. 

Beef  Tea. 

Take  one  pound  of  round  steak,  remove  the  fat,  and  cut  fine,  and 
place  the  meat  in  a  self-sealing  jar  without  water  ;  cover  closely,  heat 
gradually  in  a  kettle  of  water,  one  hour,  or  until  there  is  no  color  in 
the  moat.  Press  with  a  spoon  all  the  juices  from  the  meat.  Serve 
with  salt. 

Broiled  Beef  Essence. 

Place  one  pound  of  round  of  steak  in  the  broiler  and  broil  until 
the  juice  begins  to  flow.  Cut  into  fine  pieces  and  squeeze  the  juice, 
using  a  lemon  squeezer.    .Salt  to  taste. 

Flaxseed  Lemonade 

Take  two  tablespoonfuls  of  whole  flaxseed,  and  pour  over  it  one 
pint  of  boiling  water.  Steep  one  hour  and  a  half ;  add  the  juice  of 
one  lemon  and  sweeten  to  taste.     Excellent  for  colds. 

Clam  Broth. 

^VA8H  the  clams ;  put  in  kettle  with  enough  water  to  cover;  boil 
antil  shells  open,  and  serve  hot. 

Egg-Nog. 

Take  one  tablespoonful  of  sugar  and  the  yolk  of  one  egg,  and 
b<iat  together ;  add  one-half  oup  of  milk ;  teat  the  white  separately, 
and  mix  in  lightly ;  add  brandy  or  wine.  A  little  nutmeg  is  used  to 
flavor. 


I  ;• 


DIETING  IN  REGARD  TO  HEAITH. 


I" 


How  to  Grow  Fat. 

It  is  often  as  annoying  to  many  to  be  thin  as  it  is  in  others  to  be 
fleshy.  Here  again  the  remedy  consists  in  overcoming  tlie  natural 
or  per  .liar  forces  at  work  predisposing  to  the  paucity  of  fat  accumu- 
lation, and  first  of  all  to  grow  fat  means  for  the  tliin  peraon  to  grow 
lazy  and  good-natured.  Worry,  cares,  much  work  and  short  hours 
for  sleep,  must  be  overcome.  Clean  skins,  clean  clothes,  clean  air 
and  plenty  of  sunshine  are  the  sine  qua  non  for  thin  people  to  observe. 

Little  work,  long  houits  of  sleep,  plenty  of  rich  food  well  digested, 
a  merry  disposition,  i-egular  hours  for  meals,  with  naps  between 
times  are  also  i-equisite  principles  to  observe  for  him  who  would  grow 
fat.  * 

Drink  plenty  of  water,  say  one  or  two  glasses  of  pure  water  on 
arising  and  again  on  retiring.  Do  not  overload  the  stomach  with 
water,  but  drink  all  it  will  comfortably  stand.  Ride  in  the  open  air 
often,  enjoy  the  sunshine  and  fresh  air,  and  bathe  in  cool  water, 
especially  sea-water  when  practicable. 

It  will  be  found  much  more  difficult  for  some  than  for  othei-s  to 
observe  all  these  principles,  and  again  much  more  difficult  for  some 
to  benefit  by  them  than  others;  yet  everybody  can  add  pounds  to 
their  present  weight  if  only  they  will  peraevere  in  all  these  instruc- 
tions. 

Of  the  food  necessary  to  avoid,  the  chief  articles  are  acids,  spices, 
and  condiments  generally. 

Of  those  most  productive  of  fat  are  the  cereals  and  starchy  food 
like  potatoes,  oatmeal,  bread,  puddings,  etc.  Again,  fatty  meats, 
cream,  butter,  and  milk,  chocolate,  oils,  etc.,  supply  fat  directly  to 
the  system.  Sweets  are  also  conducive  to  fat  formation,  like  sugar, 
beets,  custards,  etc.     Sweet  wines  and  porter  are  likewise  fattening. 

It  must  be  borne  in  mind,  however,  that  these  very  classes  of  food 
are  often  the  cause  of  indigestion,  which  makes  people  tliin,  hence  a 
gfjod  appetite  and  a  good  digestion  are  prerequisites  for  this  sort  of 
a  dietary.  It  is  often  a  benefit  for  those  with  weak  stomachs  to  eat 
a  little  six  times  a  day,  say  a  light  breakfast,  dinner,  and  supper,  and 
a  glass  of  milk  in  the  middle  of  the  forenoon  and  afternoon. 

798 


■■''■^'iniiih  iMlitf  iiii«i<iii»^ii 


''irl  lif-lT1lli«r>ririlll)VMl  liri'i  --|i 


ihers  to  be 
he  natural 
it  accumu- 
)n  to  grow 
liort  hours 
i,  clean  air 
to  observe. 
1  digested, 
i8  between 
rould  grow 

3  water  on 
mach  with 
16  open  air 
ool  water, 

othere  to 

for  some 

pounds  to 

SB  instruc- 

ids,  spices, 

archy  food 
;ty  meats, 
directly  to 
ike  sugar, 

fattening, 
jes  of  food 
n,  hence  a 

lis  sort  of 
ichs  to  eat 


upper, 


and 


1. 


DIETING   IN    KEGAKD   TO   HEALTH. 


To  Reduce  Flesh, 


1S)0 


CoiiPULKNCE  or  obesity  is  generally  more  annoying  (o  most 
people  than  the  opposite  extreme.  Ifc  is,  however,  as  natural  for 
some  people  to  be  fat  as  it  is  for  others  to  be  thin. 

To  reduce  flesh,  however,  is  legitimate  within  certain  limits.  The 
functions  of  the  body  should  not  be  interfered  with  nor  weakened  by 
any  sort  of  treatment  directed  to  the  reduction  of  flesh.  There  have 
alwcays  been  kept  on  the  market  for  sale  medicines  whose  sole  aim  is 
to  render  people  thinner,  but  most  of  them  are  neither  trustworthy 
nor  safe. 

Of  new  medicines  the  most  reliable  is  Phytolene.  The  thyroid 
gland  of  the  sheep,  taken  in  five-grain  doses  on  retiring,  has  quite 
recently  ^leen  extolled  as  a  reliable  and  harmless  medicine  against 
obesity.  This  medicine  has  been  on  the  market  for  only  a  short 
time,  but  it  is  known  to  be  perfectly  harmless. 


Corpulence. 

All  people  are  not  formed  in  the  same  mould,  some  ai'e  as  fat  as 
others  are  lean.  This  is  owing  to  a  number  of  causes,  namely : 
the  easy  digestion  and  absorption  of  food  stuffs ;  easy  dispositions 
coupled  with  easy  work  and  nourishing  food ;  the  preponderance  of 
fatty,  sweet  or  starchy  food  in  the  diet  list ;  a  certain  hereditary  pre- 
disposition, etc.,  etc.  The  style  of  one's  diet  (starchy),  and  the 
natural  tendency  in  some  to  put  on  fat,  have  probably  more  to  do 
with  corpulency  than  any  other  two  factors.  This  condition  ofteur 
times  is  so  distressing  as  to  amount  to  disease.  The  heart  walls  and 
sac  become  so  infiltrated  with  fat  as  to  impede  the  easy  action  of  the 
heart-muscle,  as  to  retard  slow,  deep  respirations  and  render  all  exer- 
tions a  labor.  One  may  die  quite  suddenly  of  fatty  heart.  The  con- 
dition at  all  events  often  calls  for  treatment. 


To  Reduce  Flesh. 

The  so-called  Banting  Treatment  consists  in  the  abptinence  from 
all  fats,  sweets,  and  starchy  food.  Banting  of  England,  after  having 
tried  all  other  procedures,  very  rationally  invented  this  treatment. 
Whatever  else  may  be  tried,  this  plan  of  dieting  stands  pre-eminently 
in  the  foreground,  and  must  be  persisted  in,  either  alone  or  as  an 
adjuvant  to  other  treatments. 

The  following  general  rules  will  serve  as  a  guide  in  the  selection 
of  proper  foods :  — 

Avoid  starchy  food,  sugar  and  fat,  milk,  coarse  cereals,  pork  or 
lard  in  all  its  forms. 


"^•""V^'T^W"^ 


^'1';  'ii'.iM''"'"- 


I     ■ 

I' 


V 


UOO 


DIKTING    IN   KBGAUD   TO    HEALTH. 


Can  eat :  — 

Of  So  tips  :  Mutton,  chicken  and  clam  broths,  beef-tea. 

Of  Fish  :  All  kinds  except  salt  or  fatty,  like  bluefish  and  mackerel. 

Of  Meats  :  The  lean  of  mutton,  beef  or  chicken  in  small  quantities. 

Of  Vegetables :  All  kinds  but  potatoes,  turnips  and  parsnips. 

Eggs,  bread,  cornmeal,  etc.     All  kinds  of  fruit  and  berries. 

Weak  coffee  with  little  sugar  or  milk,  light  wines,  and  the  various 
mineral  waters.  Poland,  Vichy,  Londonderry,  Hunyadi,  etc.,  can 
be  taken. 

Moderate  gentle  exercise  is  to  be  indulged  in.  The  bowels  are  to 
be  kept  loose  with  some  saline  aperient  each  day,  like  Carlsbad  salts. 

Recently  cases  have  been  reported  of  marked  success  in  the  use  of 
the  extract  of  thyroid  glands  in  tablet  form ;  one  each  night,  at  the 
same  time  using  Garfield  Tea.  Iodide  of  potash  in  ten-grain  doses 
taken  in  one-half  a  glass  of  water  three  times  daily,  has  been  for  a 
long  time  the  favorite  remedy  in  the  treatment  of  this  disease.  TliLs 
dose  should  be  increased  every  third  day  till  twenty  grains  are  taken 
as  a  dose.  If  the  mouth  tastes  very  badly  in  the  morning,  or  pimples 
on  the  face  or  back  appear  to  any  very  annoying  degree,  the  medicine 
may  be  discontinued  for  a  short  time,  although  these  symptoms  do 
no  harm. 


a*ita 


'    ' ' 


L  mackerel. 

quantities. 

nips. 

ies. 

;he  various 

,  etc.,  can 

vvels  are  to 
Isbad  salts. 
the  use  of 
ght,  at  the 
rrain  doses 
been  for  a 
ase.  This 
i  are  taken 
or  pimples 
^  medicine 
iptoma  do 


DIETING  IN  DISEASE. 


In  Dyspepsia,  great  care  should  be  taken  not  to  overload  the 
stomach.  It  is  better  to  eat  often,  and  take  smaller  quantities  at  a 
time,  and  at  regular  intervals.  Dyspepsia  assumes  so  many  different 
forms  that  experience  should  teach  each  patient  what  agrees  with 
him  best.  Regularity  is  of  importance,  and  in  no  case  should  a  meal 
be  eaten  in  a  hurry  or  when  the  mind  is  disturbed.  It  is  hjst  to 
avoid  pork  in  all  forms,  rich,  fatty  and  highly-seasoned  focds  or 
liquors.  Plain  foods  with  few  condiments  are  the  best.  A  little 
warm  water  or  milk  taken  with  the  food  is  hetU.r  than  tea  or  coffee. 
Vichy,  Apollinaris,  or  Poland  water  are  good  drinks. 

The  following  is  usually  a  safe  diet  in  ordinary  dyspepsias: 

Plain  soups  ;  oysters,  raw  or  roasted  ;  fish,  except  fatty  varieties  and 
blue-skinned  fish.  Fish  should  be  boiled  or  broiled.  Lobster,  blue- 
fish,  mackerel  and  salmon,  are  the  most  difficult  of  digestion. 
Meats :  mutton,  roast  or  broiled ;  chicken,  beef,  sweet-breads,  tripe. 
Eggs  can  generally  be  taken.  The  various  vegetables,  if  well 
cooked,  —with  the  exception  of  boiled  potatoes.  Only  stale  bread 
should  be  eaten.  That  made  from  the  Franklin  Mills  flour  is  the 
best.  The  various  coarse  cereals  are  good.  It  is  best  to  avoid  pud- 
dmgs  and  pies.  Fruits  of  different  kinds  are  good,  especially  apples 
and  grapes.  It  is  beneficial  in  some  cases  to  drink  hot  water  imme- 
diately on  rising,  and  in  others  cold  water,  —  experience  is  the  best 
teacher. 

Dyspepsia  accompanied  by  much  gas  and  belching  of  wind  is 
remedied  oftentimes  by  avoidance  of  starchy  food,  such  as  bread, 
potatoes,  etc.  Dyspepsia  of  the  small  bowel,  coming  on  one  or  two 
hours  after  meals,  means  less  starchy  food,  and  avoidance  of  heavy 
vegetables,  fruits,  cereals,  etc. ;  in  other  words,  the  patient  should 
live  on  an  animal  diet  of  meat,  eggs,  milk,  etc. 

For  Consumptives,  and  those  in  an  anaemic  state,  the  diet  should 
be  generous  and  and  easily  digested ;  food  should  be  taken  in  small 
quantities  and  often.  It  is  best  to  take  some  light  nourishment 
lietween  meals  and  before  retiring,  such  as  Mellin's  Food  and  milk, 
malted  milk  and  egg-nog.  In  consumption,  oils  and  fatty  foods  are 
beneficial  if  they  can  be  digested.     Various  preparations  of  cod-liver 

801 


f 


!  ,   >■ 


li^;  : 


n 

i: 


i^' 


M4 


802 


DIBTINO  IN  DI8EA8K. 


oil  are  excellent.     The  patient  should  avoid  pork  in  all  fornvs,  fried 
foods,  pies  and  pastry,  and  all  starchy  or  sweet  foods. 

Can  take  soups  and  broths,  oysters,  fish  and  eggs,  if  not  fried,  beef, 
jjoultry,  game  and  mutton,— , roasted  or  boiled;  fresh  vegetables; 
coarse  cereals  and  stale  bread.  Desserts :  baked  apples,  prunes,  sago,' 
tapioca  and  custards.  Best  to  avoid  strong  tea  or  coffee.  Vicliyi 
Poland  and  ozonized  waters,  milk.  Malted  milk  and  koumiss  are 
good  drinks. 

In  Albuminuria. —  Do  not  eat  to  excess,  or  overload  the  stomach 
in  any  way.  Eat  the  most  easily  digested  food,  such  as  plain  soups, 
codfish,  haddock,  clamj  and  oysters  raw.  Of  meats,  chicken  and 
game,  avoiding  those  that  have  most  blood  in  them.  Vegetables  of 
all  kinds,  especially  those  of  green  variety.  Laxatives,  coarse  cereals 
and  stale  bread. 

Do  not  take  of  pastry  or  rich  dishes  of  any  kind,  sweets,  coffee, 
tobacco  or  liquors.  Avoid  eggs  and  an  excess  of  meats.  Can  take 
tea,  milk,  koumiss  and  large  quantities  of  water,  Poland  if  possible. 

For  Qouty  and  Riieumatic  People  a  generous  diet  is  best.  Tbey 
should  avoid  all  foods  that  have  a  tendency  to  acidity  of  the  stomach, 
such  as  those  of  a  starchy  or  sweet  nature. 

Can  take  plain  soups,  broths,  beef-tea,  fish,  —  except  fatty  kinds,  — 
and  oysters  ;  meats,  with  the  exception  of  pork,  in  small  quantities ; 
fresh  vegetables,  —  onions,  cauliflower,  celery,  lettuce,  spinach,  peas 
and  baked  potatoes.     Also  various  coarse  foods  and  stale  bread. 

For  desserts  avoid  all  rich  puddings  and  pastry  and  sweets.  Can 
eat  baked  or  stewed  fruits,  lemons,  oranges  and  baked  apples. 

Should  drink  plenty  of  water  and  milk,  rather  than  tea  or  coffee. 
Vichy,  Poland  and  Lithia  water  are  the  best. 

For  Diabetes.  —  Take  easily-digested  food,  avoiding  as  much  as 
possible  sweet  and  starchy  varieties.  Avoid  the  use  of  sugar 
altogether,  and  substitute  saccharin,  both  in  the  preparation  of  foods 
and  for  tea  and  coffee.  Use  meats,  fats,  oils  and  butter,  cream  and 
water  especially,  say  one  pint  of  cream  daily.  Use  few  or  no  potatoes, 
and  those  baked.  Mai/  eat  all  kinds  of  soup,  and  various  shell-fish  ; 
fat  meats  and  fresh  vegetables  that  are  not  starchy.  Various  fruits, 
nuts,  gluten  bread,  etc.  Saja-bean  meal  contains  only  one  per  cent 
of  starch,  and  is  very  well  adapted  to  diabetes,  —  much  better  than  the 
ordinary  gluten  flour,  which,  after  all,  is  somewhat  starchy. 

For  beverages :  weak  tea  or  coffee  without  cream  or  sugar,  milk, 
koumiss,  ales  and  various  mineral  waters.  It  is  well  to  avoid  flours, 
coarse  cereals,  fruits  and  vegetables. 


'Kr 


orms,  fried 

fried,  beef, 
vegetables ; 
uiies,  sago, 
e.  Vichy, 
Dumiss  are 


le  stomach 
lain  soups, 
licken  and 
getables  of 
irse  cereals 

eta,  coffee, 
Can  take 
I  possible. 

est.  Tbey 
le  stomach, 

;y  kinds,  — 

quantities ; 

in.ach,  peas 

bread. 

eets.     Can 

lies. 

a,  or  coffee. 


s  much  as 
of  sugar 
)n  of  foods 
cream  and 
lo  potatoes, 
shell-fish ; 
ious  fruits, 
16  per  cent 
er  than  the 

• 

igar,  milk, 
roid  flours, 


BATHING, 


WITH  ESPECIAL  REFERENCE  TO  THE  TURKISH  AND  RUSSIAN  BATHS 
AND  THEIR  USE  AT  HOME. 


Bathing,  as  practised  both  for  pleasure  and  cleanliness,  has  been 
the  instinctive  custom  of  every  nation.  Records  date  to  the  bathing 
in  the  Nile  and  Ganges.  Jews,  Greeks,  Egyptians,  and  Assyrians 
were  all  lovers  of  the  bath. 

The  Romans  surpassed  all  others  in  the  variety  and  luxury  of  their 
baths,  but  to  an  excess  of  them  may  be  ascribed  much  of  the  final 
effeminacy  and  physical  degeneration  of  the  Roman  people. 

The  Roman  bather  first  entered  the  warm-air  room  or  "tepida- 
rium,"  where  he  sweated  with  his  clothes  on ;  here  he  was  anointed, 
after  which  he  passed  into  the  ".calidarium  "  or  hot  room,  in  one  end 
of  which  was  a  bath ;  here  he  sweated  more  freely,  and  afterwards 
had  plenty  of  cold  water  thrown  over  him  from  above  his  head :  first 
warm,  then  tepid,  and  after,  cold.  Succeeding  the  bath,  he  was 
scraped  and  rubbed  most  briskly  and  again  anointed.  The  popular- 
ity of  these  baths  caused  structures  to  be  erected  in  every  part  of  the 
city,  and  in  a  style  of  architecture  which  surpassed  all  other  art 
buildings.  The  immensity  of  these  buildings  may  be  imagined  from 
the  fact  that  ruins  of  the  baths  of  Titus  and  Caracalla  extend  one- 
fourth  mile  on  each  side,  while  one  room  of  the  bath  of  Diocletiuii 
has  been  "converted  into  a  church  of  imposing  proportions.  The 
baths  of  Diocletian  contained  3,200  seats  for  bathers.  To  such  a 
pitch  of  luxury  did  the  Romans  reach  in  their  bath-houses,  that  Sen- 
eca said  they  were  dissatisfied  unless  they  trod  on  gems  in  their 
bath.  These  structures  finally  were  also  equipped  for  all  literary 
pursuits,  for  sports  and  games. 

These  facts  show  how  a  simple  custom  of  bathing  became  a  national 
system  of  luxurious  living.  The  Roman  hour  for  bathing  was  one 
0  clock  (before  dinner),  as  it  was  supposed  to  promote  the  appetite, 
as  It  does.  But  these  baths  which  gave  such  invigoration  to  the 
body,  and  which  were  synonyms  of  the  highest  art  and  culture,  finally 
were  one  great  means  of  Roman  degeneracy. 

To  such  excess  did  they  carry  their  hot  baths,  that  the  nation 
finally  exchanged  its   manly  vigor  for   Eastern   effeminacy.     Un- 

808 


1' 


^11 


11 


1:: 


:=:i 


804 


TURKISH    AND   RUSSIAN    BATHS. 


bounded  license  in  social  evils  took  the  place  of  gynmattic  training 
and  philosoi)hical  study.  I  mention  these  facts  at  length  to  show 
how  Imthing  may  he  a  most  healthful  practice  and  a  most  injurious 
custom.  Modern  baths  are  more  or  less  the  outcome  of  the  old 
Roman  hath,  through  the  agency  of  the  Mahometans,  Turks,  Rus- 
sians, and  Crusadei-s.  The  Turkish  bath  is  a  modified  Roman  bath, 
while  the  Russian  bath,  so  far  as  its  vapor  is  concerned,  was  j)mcticed 
among  the  Indians. 

The  Russian  bath  is  essentially  a  vapor  bath.  In  the  centre  of 
tlie  building  is  an  open  space  where  one  undresses.  Around  this 
space  are  doors  opening  into  small  rooms  filled  with  vapor.  In  the 
centre  of  efoch  room  is  a  series  of  steps  leading  nearly  to  the  ceiling. 
The  bather  lies  on  the  lowest  one  of  these  steps  and  gradually  ascends 
to  higher  and  hotter  ones.  The  first  sensation  is  that  of  suffocation, 
the  breathing  is  difficult,  but  soon  perspiration  bursts  through  the 
pores  and  breathing  is  ea«y  -ind  agreeable.  These  steps  vary  in  heat 
from  96°  to  110°  F.,  and  in  olden  times  the  temperature  ranged  very 
much  higher  than  this.  Bath  attendants  then  flog  the  bather  with 
birchen  twigs  or  coarse  towels,  lather  well  with  soap,  and  rinsing  the 
latter  off,  the  bather  is  rubbed  down  and  put  under  a  shower  bath  of 
ice-cold  water.  The  shock  is  great,  but  the  sensation  is  pleasant 
after  a  few  moments.  In  olden  times  the  bather  was  made  to  rush 
out,  steaming  hot,  and  roll  in  the  snow.  Milder  customs,  of  coui-se, 
prevail  to-day,  yet  the  Russian  bath  is  not  to  be  indulged  in  by  all 
people  at  all  times  with  impunity.  When  tliere  is  any  tendency  to 
heart  disease,  palpitation,  vertigo,  or  fulness  of  the  head,  the  vapor 
bath  should  be  indulged  in  with  caution  or  not  at  all. 

The  Turkish  bath  differs  from  the  Russian  bath  in  that  the  atmos- 
phere is  dry.  The  Lather  first  enters  the  "frigidarium,"  or  cooling 
room,  where  he  undresses  and  passes  into  the  "  tepidarium,"  or  warm 
room,  the  temperature  of  which  ranges  from  110°tol40°F.  The 
object  of  this  room  is  to  bring  on  a  gentle  perspiration,  and  to  pre- 
pare the  system  for  exposure  to  a  still  higher  temperature.  This  is 
attained  in  the  "calidarium,"  the  temperatuie  of  which  varies  from 
140°  to  200°  F.  In  this  room  the  bather  undergoes  the  operation  of 
kneading  or  shampooing.  To  get  the  full  benefit  of  this  bath  this 
process  should  never  be  omitted ;  the  hands  alone  being  the  sole 
means  of  friction.  After  sweating,  shampooing,  and  soaping,  the 
bather  passes  into  the  "  lavatorium  "  or  wash  room.  In  this  room  he 
begins  with  a  warm  shower-bath,  which  is  gradually  changed  to  cool, 
and  then  to  cold.  This  not  only  washes  off  perspiration  and  soap, 
but  also  closes  the  pores  and  causes  a  vigorous  reaction. 

The  feeblest  people  react  readily.  The  bather  then  returns  to  the 
cooling-room,  where  he  lounges,  wrapped  in  a  sheet,  to  await  the 
secondary  perspiration. 

The  Turkish  bath  is  one  of  the  most  invigorating  and  refreshing 
institutions  we  have.     It  is  devoid  of  danger  almost  to  all,  if  used 


na 


"V^f, 


If! 


TURKISH   AND   RUSSIAK   BATHS. 


805 


ic  training 
h  to  hIiow 
t  injuriouN 
)f  the  old 
urks,  Rim- 
)man  biitli, 
8  practiced 

)  centre  of 
round  this 
r.  In  the 
-he  ceiling, 
lly  ascends 
uffocation, 
iroiigh  the 
iry  in  heat 
inged  very 
lather  with 
rinsing  the 
ver  bath  of 
is  pleasant 
ide  to  rush 
of  coui-se, 
d  in  by  all 
endency  to 
,  the  vapor 

the  atmos- 

or  cooling 

,"  or  warm 

°  F.     The 

ind  to  pre- 

i.     This  is 

aries  from 

peration  of 

bath  this 

y  the  sole 

aping,  the 

is  room  he 

ed  to  cool, 

and  soap, 

rns  to  the 
await  the 

refreshing 
il,  if  used 


in  moderation.  Veiy  hot^ir  rooms,  as  well  as  very  hot  baths,  are 
uiiiiucessary  and  dangerous  to  many,  as  the  heart  Ijegins  to  lul)or  and 
the  blood-vessels  rapidly  dilate. 

Fear  is  often  expressed  about  passing  from  the  hot-air  room  to  the 
cold-water  bath.  There  is  absolutely  no  danger  in  passing  into  cold 
water  while  in  a  state  of  profuse  perspiration.  Adverse  changes  are 
brought  about  through  the  nervous  system  of  the  skin ;  when  this  is 
elevated  above  the  normal  condition,  cold  water  causes  no  shock ; 
hut  when  the  power  of  the  nei'vous  system  is  depressed  by  being 
ciiilled,  weary,  or  by  disease,  then  it  is  that  ill  results  are  apt  to  ensue. 

Precautions  must  always  be  taken  in  indulging  in  any  bath.  Never 
take  a  bath  ou  a  hungry  stomach,  as  did  the  Romans,  nor  immediately 


Fio.  i»6.    Method  of  taking  a  VaporBath. 

after  meals ;  no  more  should  a  bath  be  taken  when  one  is  very  weary 
or  exhausted. 

Warm  baths  simply  relax  and  cleanse  ;  but  after  all  others,  whether 
hot  air,  vapor,  or  sea  bath,  a  good  glow  of  the  skin  should  follow. 

Elderly  people  should  use  tepid  baths  and  mild  Tuikish  baths; 
cold  bathing  chills  the  skin  and  depresses  the  nervous  system.  Cold 
sponge-bathing  is  a  useful  adjunct  to  other  health  measures  in  the 
young  and  middle-aged,  often  being  the  best  preventive  against 
catching  cold. 

The  duration  of  a  bath  may  last  from  fiftepn  minutes  to  two  hours. 
Too  much  bathing,  especially  with  soap,  deteriorates  the  skin  by  de- 
priving it  of  its  oily  matters.  The  continued  sweating  of  many 
water-cures  causes  bad  eruptions  and  boils,  which  are  difficult  of  cure. 
These  "  humors,"  so  called  by  many  hydropathists,  are  not  evidences 
that  bad  blood  thus  escapes  from  the  body,  but  that  the  system  .has 


•  , 


il. 


806 


TURKISH    AND    RU8BIAN    BATHS. 


been  much  debilitated  by  too  frecjiient  bitliing,  or  too  proloiigod 
sweating.  Part*  exposed  like  the  face  and  hands  niUHt  be  frequoiitly 
scmped  and  bathed,  while  the  rest  of  the  body  needs  soap  and  Iwith 
mueh  less  Ireciuently. 

Searbathing  should  not  be  indulged  iu  by  the  very  old  or  yoiuiL'; 
by  those  whose  circulation  is  languid;  by  {)ereon8  who  have  \mu[ 
disease,  chronic  lung  disorders,  brain  trouble  or  local  congestions. 

A  full  reaction  and  a  good  glow  must  ensue,  and  not  much  time 
spent  in  the  watar.  Don't  cool  off  before  plunging  in  the  water ;  all 
the  body  warrith  is  needed  for  a  full  reaction  ;  no  hesitancy  should 
be  harbored  alx)ut  plunging  in  at  once,  as  less  heat  is  thus  lost  from 
the  body,  and  the  consequent  shock  to  the  nervous  system  ib  thereby 
much  diminished. 

For  home  use  both  the  Turkish  and  Russian  bath  may  be  mucli 
simplified. 

The  vapor  for  the  Russian  Imth  may  be  improvised  as  follows: 
The  peraon  sits  on  an  open-work  chair,  preferably  a  stool  made  for 


Fio.  iw. 

the  purpose,  and  is  surrounded  by  a  water-proof  sheet  fitting  closely 
about  the  neck.  Hot  water  is  then  poured  over  heated  bricks  placed 
underneath  the  chair.  For  more  prolonged  steaming,  a  hose  may  be 
run  to  the  top  of  a  boiler,  on  the  stove,  from  whose  tin  cover  pro- 
jects a  tin  pipe,  to  which  the  hose  may  be  attached.     (Fig.  195.) 

The  shampooing  and  soaping  and  cold  douche  may  then  be  taken. 

For  Turkish  bath,  hot  air  may  be  obtained  by  burning  an  alcohol- 
lamp  under  the  chair  and  using  the  covering  mentioned  aibove,  or 
alcohol  may  be  mixed  with  salt  in  a  pan.     (Fig.  196.) 

The  shampooing  and  kneading  of  the  muscles  should  be  done  by 
an  assistant.  Rubber  tubing  attached  to  the  hot  and  cold-water 
faucets  of  the  bath-room  will  readily  furnish  the  requisite  shower-bath 
of  warm,  tepid,  and  cold  water,  as  one  or  both  of  the  lubber  tubings 
are  used.  The  essential  features  of  both  baths  may  thus  very  easily 
be  procured  by  almost  every  household. 


't- 


proloiigtMl 
frequoiitlv 
i)  atid  Iwth 

or  young; 
havf  liead 
eHtions. 
«uch  time 
water ;  all 
icy  Khould 
i  lost  from 
i'6  thereby 

y  l)e  much 

H  follows: 
made  for 


ng  closely 
iks  placed 
86  may  be 
lover  pro- 
195.) 
be  taken. 
II  alcohol- 
a.bove,  or 

B  done  by 
old-water 
3wer-bath 
r  tubings 
jry  easily 


PROOFS  OP  DEATH. 


The  universal  dread  of  l)eing  buried  alive  leads  us  to  give  an 
epitomized  account  of  the  various  signs  of  death. 

AMence  of  Circulation.  —  The  heart  cannot  be  heard  pulsating 
by  one  trained  to  the  proper  use  of  the  stethoscope.  If  a  band  be 
tied  around  a  toe  or  finger  no  change  results;  but  if  the  circulation 
still  exists,  after  a  few  minutes  a  livid  hue  will  be  noticed  at  the 
end  of  the  member. 

Absence  of  Respiration.  —  A  cold  miiTor  placed  against  or  close 
to  the  lipa  does  not  detect  the  presence  of  moisture.  A  flake  of 
fine  cotton  or  a  feather  similarly  placed  reveals  no  motion  imparted 
by  exhaled  air. 

Cooling  of  the  Body. — After  death  the  body  temperature  falls 
rapidly  to  that  of  the  surrounding  media.  As  a  rule  the  corpse 
becomes  cold  in  from, six  to  twelve  hours  after  death,  the  viscera, 
however,  requiring  much  longer  time. 

Rigor  Mortis.  —  Post-mortem  rigidity  is  one  of  the  most  ^ositive 
signs  of  death,  and  seldom  occurs  later  than  twenty-four  hours  after 
death. 

Putrefaction  is,  of  course,  absolute  proof  of  death,  but  it  does  not 
occur  early.  The  abdomen  becomes  green,  a  d  finally  the  whole 
body  assumes  this  livid  green  color,  with  a  sickish,  putrid  odor. 
These  are  the  chief  signs  of  death,  although  several  minor  ones 
might  be  mentioned.  It  may  be  said  in  general,  that  burial  almost 
never  takes  place  until  death  is  sure.  The  evidences  of  apparently 
suspended  animation,  of  the  body  turning  in  its  casket,  etc.,  may  be 
explained  otherwise. 

807  ■%'     ■•■■'■'■'.'  ■■'■■■'•,    '■ 


!■ 


MEDICINES  AND  THEIR  PREPARATIONS. 


Materia  Medica. 

That  department  of  medicine  which  treats  of  remedies,  their  doses, 
modes  of  using,  and  influence  upon  the  constitution,  is  called  materia 
medica.  The  agents  employed  in  the  treatment  of  disease  are  taken 
from  three  kingdoms  of  nature,  —  the  vegetable,  the  animal,  and  the 
mineral. 

The  largest  portion  of  medicinal  substances  are  taken  from  the 
vegetable  world.  They  consist  of  leaves,  flowers,  seeds,  barks,  and 
roots.  These  lose  much  or  all  of  their  medicinal  powers  unless 
gathered  at  the  right  seasons  of  the  year,  and  are  properly  cured. 
The  different  parts  of  a  plant  are  to  be  gathered  when  their  peculiar 
juices  are  most  abundant  in  them. 

The  Roots  of  Annual  Plants  are  best  supplied  with  their- juices 
before  they  are  in  flower ;  they  should  be  gathered  at  this  time. 

The  Roots  of  Biennial  Plants  should  be  gathei-ed  in  the  autumn, 
after  the  first  year's  growth. 

The  Roots  of  Perennial  Plants  should  be  gathered  in  the  spring, 
before  vegetation  has  begun. 

Before  they  are  dried,  the  solid  parts  of  these  roots  are  to  be  cut 
in  slices,  after  being  washed,  and  the  small  fibres,  unless  they  are  the 
parts  used,  are  to  be  thrown  away. 

Bulbous  Roots  are  to  be  gathered  at  the  time  their  leaves  decay. 
Their  outer  covering  being  rejected,  they  must  be  sliced,  strung  upon 
threads,  and  hung  in  a  warm,  airy  room  to  dry.  After  being  dried, 
roots  should  be  packed  in  barrels  or  boxes,  and  kept  as  free  as  possi- 
ble from  moisture. 

Barks,  whether  of  the  roots,  trunk,  or  branches,  must  be  gathered 
in  autumn,  or  early  in  the  spring,  when  they  peel  off  most  easily,  and, 
the  dead  outside  and  all  rotten  parts  being  separated,  they  must  be 
dried  in  the  same  manner  as  roots.  The  most  active  barks  are  gen- 
erally from  young  trees. 

Leaves  are  to  be  gathered  when  they  are  full  grown,  and  just  be- 
fore the  fading  of  the  flower. 

Those  of  biennial  plants  are  not  to  be  collected  until  the  second 
year.     For  drying,  they  should  be  thinly  spread  on  the  floor  of  a 

808 


1 


T 


.TI0N8. 


their  doses, 
led  materia 
e  are  taken 
lal,  and  the 

n  from  the 
barks,  and 
vers  unless 
erly  cured, 
eir  peculiar 

;heir- juices 
i  time. 

t»e  autumn, 

the  spring, 

•e  to  be  cut 
bey  are  the 

ives  decay, 
trung  upon 
leing  dried, 
ee  as  possi- 

)e  gathered 
easily,  and, 
jyniust  be 
ks  are  gen- 

nd  just  be- 

the  second 
floor  of  a 


MEDICINES   AND   TUEIK   PREPARATIONS. 


809 


room  through  which  a  current  of  air  passes.     For  preservation,  they 
should  be  packed  in  vessels,  and  kept  free  from  moisture  and  insects. 

Flowers  must  generally  be  collected  about  the  time  of  their  open- 
ing, —  either  a  little  before  or  just  after. 

They  should  be  dried  as  rapidly  as  possible,  but  not  in  the  sun,  and 
may  be  packed  away  in  the  same  manner  as  leaves. 

Fruits,  Berries,  etc.,  may  be  spread  thinly  upon  the  floor,  or  hung 
up  in  bunches  to  dry. 

Articles  to  Accompany  a  Medicine-Chest. 

It  is  advisable  for  families  who  prepare  their  own  medicines  to 
supply  themselves  with  scales  and  graduated  glasses,  as  the  medi- 
cines in  this  book  are  prescribed  in  this  way.  Still,  in  many  instances, 
meaauring  with  spoons  will  answer. 

The  following  articles  shouid  be  kept  in  the  medicine-chest :  — 

1.  A  spatula  for  mixing  ointments  and  pills,  and  for  spreading 
plasters. 

2.  A  piece  of  smooth  marble  on  which  the  above  articles  may  be 
mixed,  divided,  and  spread. 

3.  A  glass  funnel. 

4.  A  domestic  syringe  for  injection. 
6.  Adhesive  or  sticking  plaster. 

6.  Lint.  ' 

7.  Scales  and  weights.  - 

8.  A  glass  or  wedgewood  mortar  and  pestle. 

9.  A  graduated  wineglass  for  measuring  teaspoonfuls  and  table- 
spoonfuls  of  liquids.  ". 

10.  A  graduated  minim  measure. 

11.  A  two-ounce  graduated  measure. 

3  Dram.  Minims.  3  Ounce.  3  Dram.      ,.\ 


Fio.  196.   Minim  Heasurb. 


FlO.  198.    TWO-OCNCB  MBABURB. 


The  minim  measure  is  represented  by  Fig.  196,  and  contains  one 
fluid  dram,  or  sixty  minims,  which  is  divided  by  twelve  lines, —  each 
line  representing  five  minims.  A  minim  is  considered  about  equal 
to  one  and  a  half  drops. 

The  two-ounce  measure  is  represented  by  Pig.  196,  and  is  divided 
off  from  half  a  dram  upward. 


^Hiniii'ii  ■ ) 


-laiEsiesiiStifiWiE!, 


810  MEDICINES  AND  THEIR   PREPARATIONS. 


Doses,  Weights,  etc. 

Apotheoaby's  weights,  by  which  all  medicinal  preparations  ought 
to  be  weighed,  are  divided  into  pounds,  ounces,  scruples,  drams,  and 
grains. 

The  characters  marked  on  weights  and  graduated  measures  are 
explained  as  follows :  — 


§j    one  ounce, 
f  f  j  one  fluid  ounce. 
fss  half  an  ounce. 
3j    one  dram. 


f3j  one  fluid  dram. 
388  half  a  dram. 
9j    one  scruple. 
9s8  half  a  scruple. 


The  grain  weights  are  stamped  with  punch-marlcs. 

60  drops  make-one  fluid  dram. 
8  drams  make  one  fluid  ounce. 
13  ounces  make  one  pint. 


20  grains  make  one  scruple. 
3  scruples  make  one  dram. 
8  drains  make  one  ounce. 


By  apothecary's  weight:  — 

lb  The  pound  is  equal  to  12  ounces. 
§   The  ounce  is  equal  to  8  drams. 

By  apothecary's  measure :  — 


3  The  dram  is  equal  to  3  scruples. 
3  The  scruple  is  equal  to  20grain8. 


O 

3 


The  pint  is  equal  to  sixteen  ounces. 

The  dram  is  equal  to  ninety  drops,  or  sixty  minims. 


The  marks  and  words  used  by  physicians  and  apothecaries  may  be 
a  httle  more  fully  explained  by  the  following  table :  — 

B;  stands  for  recipe,  and  means  take. 
da  stand  for  ana,  and  mean  of  each. 
lb  stands  for  libra  vel  librce,  and  means  a  pound  or  pounds. 
I  stands  for  uncia  vel  vncim,  and  means  an  ounce  or  ounces. 
3  stands  for  drachma  vel  drachmce,  and  means  a  dram  or  drams. 
3  stands  for  scrupulus  vel  scrupuli,  and  means  a  scruple  or  scruples. 
O  stands  for  octarius  vel  octarii,  and  means  a  pint  or  pints. 
f|  stands  for  ftuiduncia  vel  Jluiduncioe,  and   means  a  fluid  ounce  or 
fluid  ounces. 

f3  stands  for  fluidrachma  vel  fluidrachmm,   and   means  a  fluid  dram 

or  fluid  drams, 
m  stands  for  minimum  vel  minima,  and  means  a  minim  or  minims. 
Chart,  stands  for  chartula  vel  chartulm,  and  means  a  small  paper  or 

papers.  ^  *^ 

Coch.  stands  for  cochlear  vel  cochlearia,  and  means  a  spoonful  or  spoon- 
fuls. '^ 
CoUyr.  stands  for  collyrium,  and  means  an  eye- water. 
Conflr.  stands  for  conguis  vel  conguii,  and  means  a  gallon  or  gallons. 
Decoct,  stands  for  decoctum,  and  means  a  decoction. 
Ft.  stands  tot  flat  and  means  make. 
Garg.  stands  for  gargarysma,  and  means  a  gargle. 
G^r.  stands  for  granum  vel  grana,  and  meanfi  a  grain  or  graiTiB. 
Gtt.  stands  for  gutta  i)el  giUtoe,  and  means  a  drop  or  drops. 


MKDICINE8  AND   THEIR   PREPAKATI0N8. 


811 


ions  ought 
irams,  and 

lasures  are 

ram. 

1. 

1^ 

pie. 


lid  dram, 
iiid  ounce, 
int. 


3  scruples, 
o  20  grains. 


Hauat.  stands  for  haustua,  and  means  a  draught. 

Infua.  stands  for  infuaum,  and  means  an  infusion. 

M.  stands  for  miace,  and  means  mix. 

Afass.  stands  for  maaaa,  and  means  a  mass. 

Mist,  stands  for  miatura,  and  means  a  mixture. 

Pil.  stands  for  pilula  vel  pilulce,  and  means  a  pill  or  pills. 

Pulv.  stands  for  pulvea  vel  pulverea,  and  means  a  powder  or  powders. 

Q.  S.  stands  for  quantum  aufficit,  and  means  a  Bufflcieut  quantity. 

S.  stands  for  aigna,  and  means  write. 

Sa.  stands  for  aemia,  and  means  a  half. 

Domestic,  or  Approximate  Measu>  .  —  A  tablespoon  contains 
about  four  drams ;  a  teaspoon,  one  dram ;  a  dessertspoon,  three 
drams ;  a  wineglass,  two  ounces.  Spoons  vary  so  much  in  size,  that 
they  should  not  be  used  as  measures  in  giving  powerful  medicines. 

Spoons  can  also  be  used  for  measuring  solid  substances,  but  are 
not  as  accurate,  as  the  solid  substances  vary  very  much  in  weight, 
so  that  I  would  not  advise  their  use  in  measuring  powerful  drugs. 

One  dram,  or  60  grains,  to  a  teaspoonful.  • 

Four  drams,  or  half  an  ounce,  to  a  tablespoonful. 

The  spoon  should  be  level  full  for  solids. 


IS. 

es  may  be 


ms. 
sruples. 

[  ounce  or 

luid  dram 

aims. 

i  paper  or 

or  spoon- 
iUons. 


The  Approximate  Value  of  French  Decimal 

Weights. 

One  centigramme  is  equal  to  J  grain. 

Two  centigrammes       "  |^  grain. 

One  demi-decigramme  "  1  grain. 

One  decigramme  "  2  grains. 

One  gramme  "  18  grains. 

One  gramme  and  three  decigrammes  is  equal  to  1  scruple. 

Two  grammes  "  |  dram. 

Four  grammes  "  1  dram. 

One  decagramme  is  equal  to  2  drams  and  36  grains.  ' 

Three  decagrammes  and  two  grammes  is  equal  to  1  ounce. 

Demi- kilogramme  "  1  pound. 

Kilogramme  ^  ,"  2  pounds. 

The  following  table  shows  the  relative  doses  for  young  people  of 
different  ages :  — 

The  dose  for  a  person  of  middle  age  being 
That  of  a  person  from  14  to  21  years  will  be 

"       7  to  14 

"       4  to    7 

"       4 

♦'       3 

"       2 

*♦       1 


t« 
u 
«i 
M 


(( 
it 
(( 
(( 
u 


u 


1  or  1  dram, 
f  or  2  scruples. 
I  or  I  dram. 
}  or  1  scruple. 
I  or  15  grains. 
^  or  10  grains. 
I  or   8  grains. 
^  or    5  grains. 


In  administering  medicines,  it  is  always  well  to  begin  with  the 


812 


MEDICINES   AND    THEIR   PKEPAKATI0N8. 


smallest  dose  mentioned  and  gradually  increase  until  the  desired  in- 
fluence is  produced. 

The  dose  given  should  not  only  vary  with  the  drug,  but  also  with 
the  condition,  age  and  sex  of  the  person. 

In  giving  medicine  to  children,  care  should  be  taken  as  to  the 
amount  administered.     (See  foregoing  table.) 

It  is  01  course  necessary  in  all  cases  that  the  strength  and  con- 
dition of  the  patient  should  be  taken  into  consideration.  Especially 
where  powerful  drugs  are  used,  it  will  be  better  to  give  smaller  doses 
than  mentioned  in  ti^e  table.  ^     ,  . 


Tinctures. 

Thk  preparations  called  tinctures  are  made  by  grinding  or  bruising 
the  roots,  leaves,  or  barks  used,  to  a  coarse  powder,  placing  it  in  the 
proper  amount  of  either  alcohol  or  diluted  alcohol,  letting  it  stand 
from  seven  to  fourteen  days, — shakiii  each  day, — and,  finally, 
filtering  through  paper.  A  large  proportion  of  tincture3  are  made 
by  taking  one  ounce  of  the  medicinal  substance  to  one  pint  of  the 
spirit ;  and  whenever  tinctures  are  spoken  of  in  this  Materia  Medica, 
and  the  quantities  are  not  named,  the  above  proportions  are  to  be 
presumed.  When  a  larger  proportion  of  the  medicine  is  to  be  used, 
I  shall  simply  indicate  the  proportions  in  the  fewest  words,  as  under 
Black  Cohosh,  —  "  this  tincture,  four  ounces  to  the  pint  of  alcohol," 
meaning  thereby,  that  the  tincture  is  made  by  using  four  ounces  of 
the  root  to  the  pint  of  alcohol.  Most  flui  '  extracts  have  the  same 
strength,  ounce  for  ounce,  with  the  roots,  bai  leaves,  etc.,  of  which 
they  are  made.  Tinctures  may  therefore  be  iuade  w^th  very  little 
trouble,  by  substituting,  in  each  case,  the  same  number  of  ounces  of 
their  fluid  extracts  to  the  pint  of  alcohol,  which  I  name  of  the  gross 
substance,  or,  when  no  quantity  is  named,  one  ounce  to  the  pint. " 

Infusions. 

These  doses  are  for  adults  :  — 

For  young  people  from  15  to  21,     give  |  of  dose. 
*'    children'  "       7  to  15,       "     i      »« 

"    infants,  i      " 

In  administering  medicines  of  all  kinds  the  strength  and  condition 
of  the  patient  should  be  taken  into  consideration. 

Infusions  are  solutions  of  vegetable  medicines,  generally  obtained 
by  pouring  boiling  water  upon  the  substance,  and  letting  it  stand  till 
it  cools.  When  a  more  prolonged  application  of  heat  is  desired,  the 
vessel  may  stand  for  a  while  by  the  fire,  but  must  not  be  permitted 
to  boil.     The  vessel  should  usually  be  covered. 

As  in  the  case  oi'  tinctures,  I  have  uniformly,  while  writing  this 
Materia  Medica,  briefly  named  the  quantity  to  be  used  to  the  pint, 
whenever  it  varies  from  one  ounce. 


MEDICINES   AMD   TUEIB   PKEFAKATIOMS. 


813 


desired  in- 

t  also  with 

as  to  the 

h  and  con- 
Especially 
aller  doses 


>r  bruising 
:  it  in  the 
g  it  stand 
d,  finally, 
are  made 
int  of  the 
ia  Medica, 
are  to  be 
o  be  used, 
,  as  under 
^  alcohol," 
ounces  of 
i  the  same 
,  of  which 
very  little 
ounces  of 
the  gross 
pint.  ■ 


condition 

'  obtained 
stand  till 
isired,  the 
permitted 

itiug  this 
the  pint, 


Acetic  Acid.  —  This  is  a  clear  liquid,  without  color,  and  has  a 
strong,  sour  taste,  and  an  agreeable  smell.  When  held  to  the  nose, 
its  fine,  pungent  odor  often  relieves  headache.  A  piece  of  cambric 
wetted  with  it  and  applied  to  the  skin,  excites  heat  and  redness,  and, 
very  soon,  a  blister,  —  for  which  this  acid  may  be  substituted  in  in- 
flammatory sore  throat,  and  other  cases  requiring  speedy  action. 
Applied  to  corns  and  warts,  with  a  camel's-hair  brush,  it  destroys 
them. 

Citric  Acid. — This  acid  is  extracted  from  lemon  or  lime  juice  ;  it 
is  also  present  in  the  cranberry,  currant,  strawberry,  raspberry,  tama- 
rind, and  is  very  abundant  in  the  red  elderberry.  It  is  refrigerant 
and  antiseptic,  and  is  chiefly  employed  as  a  substitute  for  lemonade. 
Nine  and  a  half  drams  of  the  crystals,  two  drops  of  oil  of  lemon, 
and  one  pint  of  water,  answers  a  good  purpose  in  place  of  lemon- 
juice. 

Diluted  Nitric  Acid.  —  This,  in  the  undiluted  state,  passes  under 
the  name  of  aqua-fortis.  It  is  tonic  and  antiseptic.  Largely  diluted 
with  water,  it  forms  a  good  drink  in  fevers,  especially  typhus.  Taken 
in  large  doses,  it  is  a  powerful  poison.  One-half  dram  of  this  prepai-a- 
tion,  thirteen  ounces  of  soft  water,  and  one  ounce  of  simple  syrup, 
make  a  good  drink  in  fevers,  of  which  half  a  wineglassful  is  a  dose. 
Excellent  in  cases  of  whooping-cough.     Use  with  care. 

Nitro-Muriatic  Acid*  — This  acid,  when  properly  diluted,  has  a 
tonic  and  stimulant  influence.  It  is  much  used  as  a  foot-bath  in 
affections  of  the  liver,  and  in  deficient  secretions  of  the  bile. 

Diluted  Hydrochloric  Acid.  —  This  is  known  by  the  name  of 
diluted  muriatic  acid.  It  is  tonic,  antiseptic,  and  diuretic,  and  is 
used  in  typhus,  eruptions  of  the  skin,  and  with  other  articles,  as  a 
gargle  in  inflammatory  and  putrid  sore  throats.  Dose,  from  five  to 
twenty  drops,  in  a  wineglassful  of  water.  It  is  given  in  scarlet  and 
typhoid  fevers,  about  ten  drops  being  put  into  a  bowl  of  barley- 
water  or  gruel. 

Diluted  Hydrocyanic  Acid This  is   commonly  known  by  the 

name  of  prussic  acid.  It  is  sedative  and  antispasmodic,  and  is  useful 
in  spasmodic  coughs,,  asthma,  whooping  cough,  nervous  affections, 
hiccough,  palpitation  of  the  heart,  initable  stomach,  and  dyspepsia. 
Dose,  from  two  to  five  drops,  in  a  glass  of  water  or  tea  of  Peruvian 
bark.  It  is  an  active  poison,  and  should  only  be  taken  when  pre- 
scribed by  a  physician. 

Diluted  Sulphuric  Acid.  —  This  acid,  known  by  the  name  of 
diluted  oil  of  vitriol,  is  tonic,  antiseptic,  refrigerant,  and  astringent. 
It  is  useful  in  dyspepsia,  diabetes,  nienorrhagia,  haemoptysis,  erup- 
tions of  the  skin,  hectic,  and  dianhcea.  It  is  often  given  Avith  some 
bitter  infusions,  as  rascarilla,  Colombo,  Peruvian  l)ark,  or  quassia. 
The  aromatic  sulphuric  acid  is  often  used  in  place  of  it,  being  some- 


(:i; 


814 


MEDICINES   AND   THEIR  PKEFABATIONH. 


V 


times  considered  more  grateful  to  the  taste.     Dose  of  each,  from  five 
to  ten  drops. 

Tannic  Acid.  —  This  is  an  astringent  preparation,  and  pasHes 
under  the  name  of  tannin.  It  is  prepared  from  galls.  It  is  used  in 
diarrhoea,  dysentery,  passive  hemorihagea,  and  diabetes.  Dose  of 
the  powder,  from  one  to  three  grains. 

Tartaric  Acid.  —  This  is  refrigerant  and  antiseptic,  and  ia  used  in 
inflammatory  affections,  fevers  and  scurvy.  It  is  much  need  in  pre- 
paring what  is  called  lemon  syrup,  and  forms  an  agreeable  and 
healthful  drink. 

Alcohol.  —  Alcohol  is  the  result  of  the  fermentation  of  the  juices 
of  many  vegetables.  It  is  the  intoxicating  constituent  in  whiskey, 
rum,  brandy,  gin,  wines,  porter,  ale,  beer,  and  cider.  Its  principal 
use  in  medicine  is  in  the  preparation  of  tinctures,  essences,  and 
extracts.  One  part  of  pure  alcohol  to  one  part  of  water  forms  the 
diluted  alcohol  of  the  shops. 

Almonds.  —  The  Amygdalus  communis,  or  almond  tree,  grows  in 
the  south  of  Europe  and  Asia,  and  yields  the  sweet  and  bitter  almond. 
The  oil  of  the  sweet  almond  is  used  as  a  demulcent,  in  coughs,  etc. 
A  dose  is  a  teaspoonful.  The  oil  of  the  bitter  almond  is  poisonous, 
and  is  occasionally  used  as  a  valuable  sedative.  Its  taste  is  like  that 
of  a  peach-kernel.  Dose,  one-quarter  of  a  drop.  It  owes  its  poison- 
ous properties  to  hydrocyanic  acid.  Cakes,  etc.,  are  sometimes 
flavored  with  an  essence  prepared  from  it.  Do  not  confound  the 
sweet  with  the  bitter. 

Aloes.  —  This  is  the  hardened  juice  of  the  leaves  of  several  species 
of  the  aloe-tree,  in  North  and  South  Africa,  in  the  south  of  Europe, 
and  in  the  island  of  Socotra.  Aloes  is  purgative,  acting  chiefly  upon 
the  rectum,  or  lower  bowel,  in  which  it  frequently  produces  irritation, 
and  is  apt  to  aggravate  and  induce  piles.  It  is  much  used  to  excite 
the  flow  of  the  menses,  and  should  never  be  given  to  women  during 
pregnancy.  It  produces  griping  of  the  bowels,  which  may  be  dimin- 
ished by  combining  it  with  carbonate  of  potash. 

Alum  (^Alumen^.  —  The  cheminal  name  of  this  is  sulphate  of  alu- 
mina and  potassa.  In  ordinary  doses,  alum  is  astringent  and  anti- 
spasmodic. In  large  doses,  it  is  purgative  and  emetic,  and  is  used 
both  externally  and  internally.  It  is  often  used  in  solution  as  a  gar- 
gle in  sore  throat,  and  falling  down  of  the  uvula,  and  as  an  injection 
in  leucorrhoea.  In  doses  of  twenty  or  thirty  grains,  it  acts  as  a  pur- 
gative, and  used  in  this  way  is  useful  in  painter's  colic.  When 
exposed  to  heat  in  a  vessel  till  it  ceases  to  boil,  it  becomes  dry,  and 
is  then  called  burnt  alum,  which,  when  pulverized,  is  applied  with 
advantage  to  canker  spots  in  the  mouth,  and  to  proud  flesh. 

American  Hellebore  (  Veratrum  Viride).  —  This  plant  grows  in 
many  parts  of  the  United  States,  usually  in  swamps,  wet  meadows, 


,  from  five 

nd   passes 

is  used  in 

Dose  of 

i«  used  in 
Bed.  in  pre- 
;eable  and 

the  juices 
1  whiskey, 
i  principal 
ences,  and 

forms  the 


3,  grows  in 
;er  almond, 
oughs,  etc. 
poisonous, 
is  like  that 
its  poison- 
sometimes 
ifound  the 

feral  species 
pi  Europe, 
biefly  upon 
I  irritation, 
d  to  excite 
aen  during 
f  be  dimin- 

late  of  alu- 
b  and  anti- 
md  is  used 
in  as  a  gar- 
n  injection 
6  as  a  pur- 
ic.  When 
>8  dry,  and 
plied  with 


grows  m 
meadows, 


MEDICINES   AMD   TIIEIK   PREPAKATIONS. 


815 


and  on  the  banks  of  mountain  streamlets.  The  root  is  the  part  used. 
It  is  sUghtly  acrid,  alterative  in  a  marked  degree,  very  decidedly 
and  actively  e:  ^ectorant  and  diaphoretic,  and  it  is  an  excellent 
nervine,  though  not  narcotic.  But  its  most  marked  and  valuable 
quality  —  that  in  which  it  has  no  rival  —  is  its  sedative  action  upon 
the  circulation.  In  suitable  doses,  it  can  be  relied  upon  to  bring  the 
pulse  down  from  a  hundred  and  fifty  beats  in  a  minutu  to  forty,  or 
even  to  thirty.  In  fevers,  therefore,  in  some  diseases  of  the  heart, 
in  acute  rheumatism,  and  in  many  other  conditions  which  involve 
an  excited  state  of  the  circulation,  it  is  an  article  of  exceedingly 
greau  value,  because  it  is  always  reliable.  Use  under  physician's 
directions  only. 

Preparatioii,%.  —  Veratum  is  used  chiefly  in  the  form  of  tincture, 
six  ounces  to  the  pint  of  diluted  alcohol,  or  of  fluid  extract.  The 
dose  of  each  of  these  preparations,  for  a  grown  person,  is  two  or 
three  drops  every  hour  or  two,  in  a  little  sweetened  water,  and  grad- 
ually increased,  if  necessary,  till  the  pulse  comes  down  to  sixty  or 
seventy.  If  taken  in  so  large  a  dose  as  to  produce  vomiting,  or  too 
much  depression,  a  dose  of  morphine  or  laudanum  in  a  little  brandy 
or  ginger,  is  a  co'iuplete  antidote. 

Veratrin,  the  t'ctive  principle  of  veratrum,  is  also  used,  iu  doses 
of  one-fourth  to  one-third  of  a  grain. 

American  Ipecacuanha  (^Euphorbia  Ipecac).  —  This  plant  is  per- 
ennial and  grows  in  sandy  soils  in  the  Middle  and  Southern  States. 
When  cut  or  broken  it  gives  out  a  milky  juice.  The  root  is  the 
medicinal  part.  It  is  emetic,  cathartic,  and  diaphoretic.  Dose,  as  a 
cathartic,  eight  or  ten  grains;  as  a  diaphoretic,  three  or  four  grains, 
every  three  or  four  hours. 

American  Ivy  (^Ampelopsis  QuinquefoUa).  —  This  vine  grows  in 
all  parts  of  the  United  States.  It  is  known  by  the  names  of  false 
grape  and  wild  woodbine.  It  is  alterative,  tonic,  astringent,  and  ex- 
pectorant.    Used  in  scrofula  a  id  syphilis. 

Water  of  Ammonia  (^Liquor  Ammonice). —  This  preparation,  called 
hartshorn,  or  spirits  of  hartshorn,  is  formed  by  the  union  of  water 
with  ammonia  gas.  It  has  a  powerful  ammoniacal  odor,  and  an  alka- 
line, caustic  taste.  Taken  internally  it  is  stimulant,  sudorific,  and 
antacid,  and  applied  externally,  it  is  rubefacient.  It  stimulates  par- 
ticularly the  heart  and  arteries,  without  very  much  exciting  the  brain. 
It  is  an  excellent  remedy  in  heartburn,  and  for  sick  headache  de- 
pendent on  sourness  of  the  stomach  A  dose  is  from  ten  to  twenty 
drops,  largely  diluted  with  water.  United  with  oils,  or  with  alcohol 
in  about  equal  proportions,  and  applied  externally,  it  reddens  the 
skin,  and,  if  the  cloth  wet  with  it  be  covered  with  oiled  silk  or  with 
flannel,  to  prevent  evaporation,  it  will  sometimes  quickly  raise  ablister. 
Ill  cases  of  fainting,  it  is  frequently  applied  to  the  nostrils,  to  excite 
the  brain,  and  rouse  the  system.  Aromatic  spirit  of  anjijonia  is  a 
better  preparation. 


^^ 


^ 


i-n\m 


mmtl^^  fv 


i^mjiumM  ri»irii   ifjUn  i  giaiwii  t,wtm  laMMhfci'Mi^Ht.iPi'w^iiiM. 


ai6 


MKUICINES   AND   TUKIH   PUKPAKATIONS. 


Carbonate  of  Ammonia.  — This  is  a  white,  moderately  hard,  crj> 
talline  salt,  having  a  pungent,  ammoniaoal  smell,  and  a  Kharp, 
penetrating  tatite.  When  exposed  to  the  air,  it  loses  some  of  its 
ammonia,  becomes  a  bicarbonate,  and  falls  to  powder.  It  is  stimu- 
lant, diaphoretic,  antispasmcJic,  powerfully  antacid,  and,  in  liirge 
doses,  emetic.  Internally,  it  is  more  often  used  than  water  of  ammo- 
nia, and  for  similar  purposes..  Coarsely  bruised,  and  scented  with 
oil  of  lavender,  it  constitutes  the  common  smelling  salts,  so  much 
used  in  fainting  and  hysterics.  For  internal  use,  the  dose  is  from 
five  to  ten  grains,  taken  in  the  form  of  pills,  every  two,  three  or  four 
houre. 

Muriate  of  Ammonia  (^Sal  Ammoniac.^  —  This,  also  called  hydro- 
chlorate  of  ammonia,  is  a  white,  translucent,  tough,  fibrous  salt,  in 
large  cakes,  about  two  inches  thick,  convex  on  one  side,  and  concave 
on  the  other. 

It  has  a  saline,  pungent  taste,  but  no  smell,  dissolves  in  one  part 
of  boiling  water,  and  three  parts  of  cold.  Taken  internally,  it  is 
stimulant  and  alterative.  It  is  a  valuable  remedy  in  chronic  bron- 
chitis, pleurisy,  and  inflammation  of  the  serous  and  mucous  mem- 
branes generally.  But  it  must  only  be  used  after  the  first  violence 
of  these  inflammations  has  abated.  Pulverized,  and  placed  over  a 
spirit  lamp  in  a  tin  cup,  the  fumes  which  arise  when  it  sublimes  may 
be  inhaled  five  or  ten  minutes,  once  or  twice  a  day,  with  great  ad- 
vantage in  chronic  bronchitis,  and  in  chronic  inflammations  generally 
of  the  air-passages.  A  solution  composed  of  one  ounce  of  the  salt 
dissolved  in  nine  fluid  ounces  of  water  and  one  of  alcohol,  may  be 
used  as  a  wash  for  bruises,  indolent  tumors,  and  ulcers. 

Solution  of  Acetate  of  Ammonia  (^Liquor  Ammonice  Acetatis).  — 
This  is  known  by  the  common  name  of  spirit  of  Mindererus.  The 
taste  is  saline,  and  is  like  that  of  a  mixture  of  nitre  and  sugar.  It  is 
a  valuable  diaphoretic,  and  is  much  employed,  alone  or  mixed  with 
sweet  spirit  of  nitie,  two  parts  to  one,  in  fevers  and  inflammations. 
It  is  a  valuable  external  application  iu  mumps,  applied  hot  upon  a 
piece  of  flannel.  One-half  ounce  mixed  with  seven  ounces  of  rose- 
water  and  two  drams  of  laudanum,  forms  a  valuable  wash  for  the 
eyes  in  chronic  ophthalmia.  The  dose  is  from  two  to  three  drams 
mixed  with  sweetened  water,  every  two  or  three  hours. 

Aromatic  Spirit  of  Ammonia  (^Spiritus  Ammonice  Aromaticus).-— 
Taken  internally,  this  answers  the  same  purpose  as  other  prepara- 
tions of  ammonia,  and  is  much  used  on  account  of  it  agreeable  taste 
and  smell.  It  is  valuable  as  an  antacid  in  sick  headache.  Dose, 
from  twenty  to  thirty  drops,  sufficiently  diluted  with  water. 

Anise  (^Pimpinella  Anisum).  —  This  is  a  perennial  plant,  and  grows 
in  Egypt.  Its  fruit  is  called  anise-seed.  It  is  aromatic  and  carmi- 
native. It  is  much  used  to  allay  nausea,  flatulency,  and  colic,  par- 
tioularly  in  children.     It  is  frequently  added  to  other  medicines  to 


hard,  crj> 
il  a  sharp, 
lome  of  itH 
.t  is  etimu- 
d,  in  large 
iT  of  ammo- 
iented  with 
ts,  so  much 
lose  is  from 
bree  or  four 

ailed  hydro- 
'ous  salt,  la 
and  concave 

iu  one  part 
irnally,  it  is 
lironic  hron- 
ucous  mem- 
rst  violence 
laced  over  a 
ublimes  may 
ith  great  ad- 
(ns  generally 
3  of  the  salt 
jhol,  may  be 

Acetatis).  — 
irerus.  The 
sugar.    It  ia 

mixed  with 
flammations. 

hot  upon  a 
ices  of  rose- 
vmh  for  the 

three  drams 

tmatictii)-  — 
ler  prepara- 
reeable  taste 
tche.  Dose, 
ter. 

it,  and  grows 
c  and  carmi- 
d  colic,  par- 
medicines  to 


■f 

'     ■tim 

m 

; 

I  J... 

i 

9Cmm  lu^^i.wUm* 


I  .1    .1  nwiwa)— ^WM^J^wmnbi 


MEDICINK8   AND   THEIR   PUEPAKATI0N8. 


817 


make  them  more  agreeable,  and  to  lessen  the  griping  effects  of  physio. 
The  oil  extracted  from  the  seeds,  diusolved  in  alcohol,  an  ounce  of 
thii  former  to  a  pint  of  the  latter,  forms  what  is  called  the  essence  of 
niilHe.  Dose  of  the  essence,  from  thirty  drops  to  a  dram  in  sweetened 
water.     Anise  forms  a  vry  valuable  siddition  to  cough  preparations. 

Arnica  (Arnica  Montana.) — This  is  a  perennial  plant,  growing  in 
moist,  shady  places  in  Silwria,  etc.  It  is  often  called  leopard's  bane. 
It  is  much  ..  jed  externally  as  a. stimulating  application  to  bruises,  local 
infliimmaticm,  etc. 

Preparations.  —  It  is  chiefly  used  in  the  form  of  tincture,  or  fluid 
extract.  Dose,  ten  to  thirty  droi»8.  Half  an  ounce  of  tincture,  five 
and  a  half  ounces  of  boiling  vinegar,  and  two  drams  of  carbonate  of 
ammonia,  used  warm,  make  in  some  cases  a  valuable  fomentation.  It 
is  one  of  the  leading  homoeopathic  remedies. 

Arrowroot.  —  This  is  prepared  from  the  Maranta  arundinaoea,  a 
plant  of  the  West  Indies.  It  is  chiefly  used  in  forming  dietetic  pre- 
parations, and  belongs  to  the  first  or  saccharine  group  of  food-articles. 

Assafoetida.  —  This  is  the  hardened  juice  from  the  root  of  a  Per- 
sian plant.  It  is  stimulant,  antispasmodic,  and  expectorant,  and  is 
much  used  in  nervous  complaints.  A  dose  of  the  powder  is  from 
five  to  ten  grains,  and  of  the  tincture,  made  by  macerating  two  ounces 
in  a  pint  of  diluted  alcohol,  from  thirty  to  sixty  drops. 

Balm  (Melissa  Officinalis').  —  This  is  a  perennial  plant,  growing  in 
Europe  and  this  country.  It  is  moderately  stimulant  and  diaphoretic. 
The  warm  infusion  causes  perspiration,  and  is  used  to  relieve  painful 
menstruation. 

Balm  of  Qilead  {Populus  Candicans').  —  This  is  a  tree  growing  in 
tlie  northern  parts  of  our  country.  A  tincture  made  from  the  buds, 
in  doses  of  from  one  to  four  fluid  dmras,  is  useful  in  affections  of  the 
kidneys,  in  scurvy,  and  rheumatism.  Steeped  in  lard  they  form  a 
useful  ointment  for  some  purposes. 

Balmony  (Chelone  Glabra).  —  This  is  a  perennial  plant,  common 
to  the  United  States.  It  is  tonic,  cathartic,  and  vermifuge.  It  is 
used  in  indigestion,  debility,  and  derangements  of  the  liver.  A  dose  of 
the  powdered  leaves  is  one  dram ;  of  the  tincture,  two  fluid  drams ; 
of  the  decoction,  one  or  two  fluid  ounces ;  of  the  active  principle 
called  chelonin,  one  or  two  grains.  A  decoction  of  balmony  com- 
bined with  tincture  of  assafoetida  foims  a  valuable  injection  for 
worms.  An  ointment  made  from  the  fresh  leaves  is  valuable  for 
piles,  inflamed  breasts,  tumors,  and  painful  ulcers. 

Balsam  Copaiba.  —  This  is  obtained  from  a  South  American  tree 
called  the  Copaifera  Officinalis.  It  is  a  clear  yellowish  fluid,  about 
the  consistency  of  honey.  It  is  a  stimulating  diuretic,  and  is  much 
used  in  chronic  gonorrhoea,  gleet,  irritable  conditions  of  the  bladder, 


'^ 


818 


MEDICINES  AND  THEIR   PREPARATIONS. 


and  ohrouio  bronchitis.     In  some  penonn  it  causes  an  eruption  ou  the 
skin,  with  itohing,  etc. 

In  large  doses,  it  acts  as  a  cathartic. 

Balsam  Tola.  —  This  is  the  juice  of  the  tree  Mymtpfrmim  Tolui- 
ferum,  growing  in  South  America.  It  is  soft,  U'lmtiiouH,  luul  of  ii 
piile  brown  cok)r;  and,  like  balHam  copaiba,  is  soluble  in  alcohol, 
ether,  and  volatile  oils.  It  haH  Iwun  used  in  asthma,  (;ough,  broii- 
cliitiH,  etc.     Dose,  from  ten  to  thirty  grains,  in  mucilage  or  syrup. 

Barberry  (^crAm«  Vulgarity). — This  shrub  gro^s  along  the  At- 
lantic coiist,  from  Canad.i  to  Virginia.  The  parts  used  are  the  Itark 
and  berricH.  It  is  tonic  and  laxative,  and,  in  doses  of  a  teaspoonful, 
powdered,  is  useful  in  jaundice,  chronic  diarrhoea,  and  chronic  dyHen- 
tery.  A  decoction  of  tlie  berries  forms  an  agreeable  acid  drink  in 
fevers,  cholera  infantum,  etc.,  and  as  a  gargle  it  is  useful  for  ulcers 
of  the  mouth,  etc.,  as  a  wash,  for  chronic  inflammation  of  the  eyes, 
and  as  an  injection  for  leucorrluva. 

Bay  berry  (^Myrica  Cerifera,  Fig  197). — This  is  found  in  danip 

places,  in  many  parts  of  the  United  States, 
and  is  very  abundant  in  New  Jersey.  The 
bark  of  the  root  is  the  part  used.  It  is  astrin- 
gent and  stimulant.  Pulverized,  and  com- 
bined with  powdered  blood-root,  it  forms  an 
excellent  application  to  indolent  ulcers.  In 
the  form  of  poultice,  combined  with  powdered 
slippery  elm,  it  is  a  useful  application  to 
scrofulous  tumoi-s  or  ulcers.  The  decoction 
is  a  good  wash  for  soie  mouth,  and  spongy, 
bleeding  gums.  It  is  chiefly  used  in  the  form 
of  tincture,  dose,  half  an  ounce  ;  fluid  extract, 
dose,  one  or  two  drams  ;  and  the  active  prin- 

Fio.  m    batbekrt.         ciple,  myricin,  dose,  two  to  ten  gmins. 

Bearberry  (  Uva  Urn,  Fig.  198). —  This  plant,  also  called  upland 
cranberry,  has  a  wide  range,  being  found  in  the  northern  parts  of  Asia, 
Europe  and  America.  It  flowers  from  June  to  Sep- 
tember, and  ripens  its  berries  in  the  winter.  The 
leaves  are  the  only  medicinal  parts.  It  is  astringent 
and  tonic,  and  acts  particularly  upon  the  urinary  or- 
gans, for  complaints  of  which  it  is  generally  used.  It 
is  specially  valued  as  an  antilithic  in  gravel,  and  as  a 
remedy  for  chronic  inflammation  of  the  kidneys,  ul- 
ceration of  the  bladder,  etc. 

Preparations.  —  Fluid  extract,  dose,  one-third  of  a 
dram  to  a  dram ;  solid  extract,  dose,  five  to  fifteen  j,,^  jgg 

grains;  tincture,  dose,  one  to  two  ounces.  beabberhy. 

Beef's  Qalls  {Fel  Bovinum).  —  This  being  dried  by  evaporation,  is 


l 


^ 


MEDI0INK8   AND   TIIRIK    HHKPAHATIONS. 


819 


laon  on  the 


lum  Tolui- 
,  and  of  a 
in  alcohol, 
ugh,  bron- 
r  Hyrup. 

rig  the  Atr 
L'  the  iMik 
iospoonful, 
Dnic  dyHen- 
id  drink  in 
for  ulcers 
E  the  eyes, 

d  in  damp 
ted  States, 
rsey.  The 
It  Ib  OHtrin- 
,  and  com- 
t  forms  an 
ulcere.  In 
h  powdered 
ilication  to 
e  decoction 
nd  spongy, 
in  the  form 
lid  extract, 
votive  prin- 
lins. 

led  upland 
[•te  of  Asia, 


)omtiou,  is 


fiomotimeH  u«e<1  as  a  tonio  and  laxative,  in  torywr  of  the  livor,  jaun- 
dice, indigestion,  uiid  coHtivonesH,  in  (Iohoh  of  from  one  to  ten  graiuH. 
Throe  drams  of  ox-gall,  one  dram  of  extract  of  oonium,  two  draiuH  of 
soda  soap,  and  one  ounce  of  sweet  oil,  make  a  valuable  preparation, 
which,  when  applied  externally,  has  a  Kurprisingly  rapid  etl'cci  in 
reducing  enlargement  and  hardening  of  the  breasts,  glandular  tumors, 
particularly  enlargement  of  the  tonsils,  and  is  useful  in  hypertrophioH 
generally.  For  application  to  the  tonsils,  the  gall  may  Ihj  rubbed  up 
with  water  to  the  consisteuce  of  an  ointment,  and  may  be  applied  with 
a  caniel's-hair  brush. 

Benzoin.  —  This  is  the  hardened  jnioe  of  a  tree  of  Sumatra  and 
lioriico.  It  is  very  brittle,  of  a  reddish  brown  color,  and  is  soluble  in 
alcohol  and  ether.  It  is  ('iefly  used  for  inhalation  in  chronic  laryn- 
gitis and  bronchitis.  Wh  n  used  for  this  purpose,  it  may  be  added 
to  l)oiling  water,  and  the  va^)or  iidialed;  or  it  may  be  burned  upon 
coals  or  a  hot  shovel,  the  fumes  being  inhaled. 

Benzoic  Acid.  —  This  is  nrepared  by  heating  benzoin,  and  causing 
it  to  sublime.  It  consists  of  b'.lky,  feathery  crystals,  which  are  white 
and  soft.  It  has  been  found  useful  in  the  phosphatic  vaiiety  of 
gnivfal.  A  convenient  way  of  giving  it  is  to  unite  one  part  of  it  with 
four  parts  of  phosphate  of  soda,  the  dose  of  which  is  from  ten  to 
twenty  grains. 

Betliroot  (Trillium  Pendulum).  —  A  perennial  plant,  growing  in 
rich  soils,  in  the  Middle  and  Western  States.  The  root  is  used,  and 
is  astringent,  tonic,  and  antist.ptic.  It  is  useful  in  bleeding  from  the 
lungs  and  kidneys ;  also  in  excessive  menstruation,  cough,  asthma, 
and  difficult  breathing.  Boiled  in  k.  .k,  it  is  used,  in  the  western 
country  in  diarrhoea  and  dysentery. 

Preparations.  —  Fluid  extract,  dose,  one  to  three  drams ;  trilliin, 
dose,  four  to  eight  grains  ;  infusion,  dose,  two  to  four  ounces  ;  decoc- 
tion used  as  a  local  application  to  ulcers  and  sore  mouth,  and  as  an 
injection  in  leucorrhoea  and  gleet.  A  poultice  made  from  the  root 
is  useful  for  carbuncles,  indolent  tumors,  buboes,  foul  ulcers,  and  for 
stings  of  insects. 

Bitter-root  (^Apocynum  Androscemifolium, 
Fig.  199).  —  An  indigenous  plant,  growing  in 
rich  soils  in  the  United  States  and  Canada.  The 
root  is  the  part  used,  and  is  laxative,  tonic, 
diaphoretic,  and  alterative.  It  is  employed  in 
chronic  affections  of  the  liver,  syphilis,  scrofula, 
interraittents,  and  the  low  stage  of  typhoid  fe- 
vera.  Forty  to  fifty  grains  will  cause  vomiting 
without  much  nausea. 

Preparations.  —  Fluid  extract,  dose,  as  a 
tonic,  '»n  to  twenty  drops ;  as  a  diaphoretic, 
fifteen  co  twenty-five  drops  j  as  an  emetic,  half     fio.  i9b.  bittkr-root. 


I   : 


'><<! 


^ 


820 


MEDICINES  AND   THEIR   FBEPARATI0N8. 


a  dram  to  «  dram.  Solid  extract,  dose,  two  to  eight  grains ;  apocy- 
nin,  the  active  principle  of  the  root,  dose,  half  a  grain  to  two  grains ; 
tincture,  dose,  two  to  three  drams ;  infusion,  dose  a  wine-glassful, 
three  times  a  day. 

Bismuth.  —  The  principal  preparation  of  this  metal  used  in  medi- 
cine,  is  the  trisnitrate  of  bui.mth,  also  called  nitrate,  aubnitrate,  and 
white  oxide  of  bismuth.  It  is  a  white  powder,  without  smell  or  taste. 
It  is  used  for  various  irritable  and  painful  affections  of  the  stomach, 
when  there  is  no  acute  inflammation.  It  is  particularly  useful  in 
chi'onic  diarrhoea,  more  especially  the  diarrhoea  of  the  latter  stages  of 
consumption,  over  which  it  has  more  control  than  any  other  known 
remedy.  To  show  its  best  effects  in  this  form  of  diarrhoea,  it  should 
be  given  in  large  doses,  not  less  than  fifteen  to  twenty  grains,  imme- 
diately afttjr  each  meal.  The  small  doses  usually  given  are  compara- 
tively useless.  Given  in  these  full  doses,  it  is  also  almost  a  specific 
in  heartburn  and  water-brash. 

Bittersvv^eet  (^Solanum  Dulcamara').  —  This  is  common  in  Europe 
and  North  America.  It  is  a  woody  vine,  the  roots  and  stalks  of 
which  are  used  in  medicine  It  is  slightly  narcotic,  and  has  altera- 
tive and  diaphoretic  properties.  It  is  used  in  scaly  and  syphilitic 
affections  of  the  skin.  It  is  said  to  have  antaphrodisiac  properties, 
and  is  serviceable  in  mania  connected  with  strong  venereal  propensi- 
ties. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram ;  solid 
extract,  daie,  three  to  eight  grains ;  infusion,  dose,  one  to  three 
ounces,  three  or  four  times  a  day. 

Black  Alder  (^Prinos  Verticillatus).  —  This  shrub  is  common  in 
the  United  States ,  its  bark  and  berries  are  used.  It  has  been  found 
useful  in  jaundice,  diarrhoea,  intermittent  fever  and  other  diseases 
connected  with  debility.  Applied  locally  in  the  form  of  a  wash  or 
poultice,  and  given  internally,  it  is  popular  in  chronic  eruptions  of 
the  skin,  and  in  flabby,  ill-conditioned  ulcers,  and  mortification. 

Preparations.  —  Fluid  extract,  do^e,  two  drams;  tincture,  dose, 
two  to  four  drams. 

Two  drams  of  the  fluid  extract  of  black  alder,  one  dram  of  the 
fluid  extract  of  golden  seal,  and  one  pint  of  water,  mixed,  and  taken 
in  doses  of  four  fluid  ounces,  three  or  four  times  a  day,  are  valuable 
in  dyspepsia. 

Blackberry  (Rvhus  Villosus). — There  are  many  species  of  this 
growing  in  the  United  States.  The  bark  of  the  root  is  the  part  used. 
It  is  tonic,  and  strongly  astringent,  and  is  a  valuable  remedy  in  diar- 
rhoea, dysent3ry,  cholera-infantum,  relaxed  condition  of  the  bowels 
of  children,  and  the  passive  discharge  of  blood  from  the  stomach, 
bowels,  and  womb. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram  ;  solid 
extract,  four  tp  six  grains ;  tincture,  dose,  two  to  four  d^ms ;  inf u- 


•wsrssMmwi^ 


n 


MEDICINES   AND   TH£IK    I'KEPARATIONS. 


821 


ms;  apocy- 
;wo  grains ; 
ne-glasst'ul, 

ed  in  medi- 
nitrate,  and 
bU  or  taste, 
le  stomach, 
y  useful  in 
sr  stages  of 
tJier  known 
a,  it  should 
ains,  imme- 
re  compara- 
)t  a  specific 

1  in  Europe 
d  stalks  of 

has  altera- 
i  syphilitic 

properties, 
il  propensi- 

Iram;  solid 
e  to   three 

ommon  in 
been  found 
er  diseases 
■  a  wash  or 
ruptions  of 
jation. 
iture,  dose, 

ram  of  the 

and  taken 

re  valuable 

ies  of  this 
part  used, 
jdy  in  diar- 
the  bowels 
e  stomach, 

ram ;  solid 
,ms;  iufu- 


rio.  900. 

Black  Cohosh. 


sion,  dose,  one  ounce.  This  last  preparation  i.s  also  useful  as  an  injec- 
tion in  gleet,  leucorrhoea,  and  prolapsus  of  the  rectum  and  womb. 
The  syrup  of  the  blackberry-root  is  also  a  valuable  preparation ;  so 
also  is  blackl)erry  brandy,  so  called,  which  is  the  juice  of  the  fruit 
mixed  with  brandy.     This  is  excellent  in  summer  complaints. 

Black  Cohosh  (  Cimicifuga  Racemo»a,  Fig.  200).  — This  grows  in 
rich  soils  throughout  the  United  State-s.  The 
root  is  the  part  used.  It  is  slightly  narcotic, 
sedative,  antispasmodic,  antiperiodic,  and  exerts 
a  marked  influence  over  the  nervous  system; 
being  useful  in  St.  V'tus's  dance,  epilepsy,  ner- 
vous excitability,  as  la,  delirium  tremens,  and 
many  spasmodic  affections.  It  has  an  especial 
affinity  for  the  uterus. 

It  reduces  the  arterial  action  very  materially, 
and  hence  is  useful  in  palpitation  of  the  heart. 
It  has  been  used  successfully  in  acute  rheuma- 
tism, but  more  particularly  in  chronic  rheuma- 
tism. 

Preparations.  —  Fluid   extract,    dose,   half   a 
di-am  to  two  drams ;  solid  extract,  dose,  four  to 
eight  grains ;  tincture,  four  ounces  to  the  pint  of 
alcohol ;  dose,  one  to  three  drams ;  cimicifugin,  the  active  principle, 
dose,  one  to  six  grains. 

Black  Willow  (Salix  Nigra). —  This  tree  is  found  in  the  Northern 
States,  along  the  banks  of  rivers,  especially  in  New  York  and  Penn- 
sylvania,  and  is  known  by  the  common  name  of  pussy-willow.  It  is 
a  bitter  tonic,  and  is  sometimes  used  in  fever  and  ague.  A  decoction 
made  from  the  buds  is  said  to  be  a  powerful  antaphrodisiac,  and  is 
accordingly  useful  in  the  treatment  spermatorrhea. 

Bloodroot  (^Saaguinaria  Canadensis.,  Fig.  201).  —  A  perennial 
plant,  growing  in  light,  ric'  soils,  in  most  parts  of 
the  United  States.  The  rv,jt  is  the  part  used.  It 
is  emetic,  narcotic,  expectorant,  alterative,  escha- 
rotic,  and  errhine.  It  is  used  in  typhoid  pneumonia, 
bronchitis,  rheumatism,  dyspepsia,  etc.  Three  to  five 
grains  stimulates  the  digestive  organs,  and  accele- 
rates the  pulse. 

Preparations.  —  Fluid  extract,  dose,  five  to  fifteen 
drops ;  solid  extract,  half  a  grain  to  a  grain  and  a 
half ;  tincture,  twenty  drops  to  a  dram ;  sanguina- 
ria,  the  alkaloid  principle,  from  one-twentieth  to  one- 
tenth  of  a  grain. 

Four-grain  pills,  made  of  sanguinarin,  twelve 
grail,  s,  caulophyllin,  twelve  grains,  solid  extract  of 
cimicifuga,  twelve  grains,  are  said  to  be  efficacious 
in  amenorrhoea,  dysmenorrhoea,  and  other  female  disorders. 


V  ;■' ;  ^-^ 


■i^^r 


'"  ».  iOl. 
rLoonBooT. 


II 


[^ 


822 


MEDICINES  AND   THEIR   PREPARATIONS. 


\'-' 


Blue  Cohosh  {Caulophyllum  Thalictroidea,  Fig.  202) A  peren- 
nial plant,  growing  in  low,  moist  grounds  in  most  parts  of  the  United 
States.  The  root  is  the  part  used.  It  is  antispasmodic,  diuretic, 
diaphoretic,  alterative,  emmeuagogue,  anthelmintic,  parturient,  and 
tonic.  It  is  used  in  rheumatism,  dropsy,  epilepsy,  hysterics,  cramps, 
amenhorrhoea,  dysmenoirhoea,  chorea,  leuconhoea,  hiccough,  to  hasten 
delivery,  and  to  relieve  after-pains. 

Preparations.  —  Fluid  extract,  dose,  fifteen  to  thirty  drops ;  sohd 
extract,  dose,  one  to  three  grains ;  tincture,  dose,  half  a  dram  to  a 
dram ;  infusion,  dose,  two  to  three  ounces ;  caulophyllin,  the  active 
principle  of  th*^  '-oot,  dose,  one-quarter  of  a  grain  to  a  grain. 

In  cases  of  protracted  labor,  occasioned  by  fatigue  or  debility,  the 
infusion  is  said  to  be  fully  equal  to  ergot  in  hastening  delivery.  A 
wash  made  by  combining  one  ftunce  of  fluid  extract  with  one  ounce 
of  the  fluid  extract  of  golden  seal,  and  eight  ounces  ui  water,  is  very 
excellent  for  apthous  sore  mouth. 


FiQ.  302.  Bluk  Cohosh. 


Fio.  203.    BLue  Flag. 


Blue  Flag  (Iris  Versicolor,  Fig.  203).  —  A  perennial  plant,  grow- 
ing in  damp  places,  in  most  parts  of  the  United  States.  The  root  is 
the  part  used  for  medicinal  purposes.  It  is  cathartic,  alterative,  sia- 
lagogue,  and  diuretic.  It  acts  particularly  on  the  glandular  system ; 
in  large  doses,  it  evacuates  and  exhausts  the  system,  acting  on  tlie 
liver,  and  fulfilling  the  purposes  of  mercury. 

Preparations.  —  Fluid  extract,  dose,  twenty  to  forty  drops ;  solid 
extract,  one  to  three  grains  ;  tincture,  one  to  two  drams.  Iridin,  tiie 
active  and  resinous  principle,  dose,  half  a  grain  to  three  grains. 
Equal  parts  of  blue  flag,  mandrake,  and  prickly-ash  bark,  mixed,  and 
given  in  five-  to  ten-grain  doses,  every  two  or  three  hours,  will  act  as 
a  powerful  alterative,  and  cause  free  salivation,  without  making  the 
breath  offensive  or  injuring  the  gums.  Three  grains  of  iridin,  five 
grains  of  leptandrin,  an.^l  twenty  grains  of  bitartrate  of  potassa,  form 
an  excellent  cathartic  in  dropsy,  producing  free  watery  stools. 


n 


MEDICINES  AND   THEIR   PKEPARATIONS. 


823 


—  A  peren- 
the  United 
3,  diuretic, 
urient,  and 
08,  cramps, 
1,  to  hasten 

rops;  solid 
dram  to  a 
,  the  active 
in. 

ebility,  the 

ilivery.    A 

one  ounce 

,ter,  is  very 


lant,  grow- 
The  root  is 
jrative,  sia- 
ar  system ; 
iug  on  tlie 


pops; 


solid 


Iridin,  the 
ree  grains, 
mixed,  and 
will  act  as 
ciaking  the 
iridin,  five 
tiissa,  fonn 
lols. 


Blue  PHI  (^Hydrargyri  Piluloe). —  This  mercurial  preparation, gen- 
erally known  by  the  common  name  of  blue  viaas,  or  blue  pill,  is  made 
by  rubbing  mercury,  confection  of  roses,  and  pulverized  liquorice-root 
together  until  all  the  mercurial  globules  disappear.  The  mass  is  di- 
vided into  pills  when  wanted.  It  is  the  mildest  of  all  the  mercurial 
preparations,  and  the  least  liable  to  produce  salivation  or  irritivtion 
of  the  system.  But  even  this  should  be  used  sparingly,  and  with 
caution,  and  I  do  not  recommend  its  use. 

The  blue  mass  is  alterative  and  cathartic,  and  is  considerably 
given  to  stimulate  the  action  of  the  liver,  and  to  produce  an  altera- 
tive effect  upon  the  digestive  organs.  The  leotandra  and  the  podo- 
phyllum have  become  its  rivals,  and  will,  1  si  ly  hope,  finally  take 
its  place. 

Boneset  (^Bupatorium  Perfoliatum,  Fig.  204).  —  An  indigenous 
plant  growing  in  most  parts  of  the  United  States.  The  tops  and 
leaves  are  medicinal.  It  is  tonic,  diaphoretic,  expectorant,  and,  in 
large  doses,  or  when  taken  as  a  warm  infusion,  emetic  and  aperient. 

Preparations^  —  Fluid  extract,  dose,  one  to  two  drams  ;  solid  ex- 
tract, dose,  five  to  fifteen  grains ;  tincture,  dose,  one  to  one  and  one- 
half  ounces ;  infusion,  dose,  one  to  two  ounces.  Eupatorin,  dose,  one 
to  three  grains. 

Two  soiuples  of  eupatorin,  cne  scruple  of  xanthoxylin,  and  one 
grain  of  strychnia,  mixed,  and  made  into  twenty  powdere,  is  excellent 
for  torpor  of  the  liver  or  kidneys,  and  for  rheumatism  ;  one  powder 
being  taken  three  or  four  times  a  day. 


I'lQ.  204.     BONKSKT. 


KlO.  a06.     BUCBU. 


Buchu  {Barosma  Crenata,  Fig.  206).  —  It  grows  at  the  Cape  of 
Good  Hope.  The  leaves  are  the  medicinal  portion ;  they  are  stim- 
ulant, diuretic,  antispasmodic  and  tonic.  Buchu  is  chiefly  given  in 
complaints  of  the  urinary  organs,  attended  with  increased  uric-acid 
gravel,  chronic  inflammation  or  morbid  irritation  of  the  bladder, 
urethra,  and  prostate,  and  retention  or  incontinence  of  urine. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  two  drams  ; 
tincture,  dose,  two  to  five  drams ;  infusion,  one  to  five  ounces.  A 
combination  of  fluid  extract  of  buchu  half  an  ounce,  acetate  of 


in 


IHM 


^ 


824 


MEDICINES   AND  THEIR   PREPARATIONS. 


potash  two  drams,  and  water  eight  ounces,  taken  in  doses  of  four 
ounces  three  or  four  times  a  day,  is  a  valuable  diuretio. 

This  combination,  however,  may  be  improved  by  the  addition  of  a 
little  sweet  spirits  of  nitre. 

Buckhorn  Brake  (^Oamunda  Regalia).  —  This  is  a  ferng^wing  in 
moist  grounds  in  most  parts  of  the  United  States.  The  root,  which 
is  the  medicinal  part,  should  be  gathered  in  the  latter  part  of  May, 
and  in  August,  and  very  carefully  dried,  to  prevent  moulding.  It 
is  mucilaginous  and  tonic,  and  is  used  in  coughs,  diarrhtjea  and 
dyBentery,  and  as  a  tonic  while  getting  up  from  exhausting  disease. 
One  root  infused  in  a  pint  of  hot  water  for  half  an  hour  will  convert 
it  into  a  thick  jelly.  This  mucilage  may  be  sweetened  with  sugar, 
and  freely  taken. 

Buckthorn  (Bhamnua  Catharticus).  —  This  plant  grows  in  Europe, 
where  it  is  much  esteemed  by  practitioners.  The  berries  and  juice 
are  actively  medicinal.  It  is  a  powerful  cathartic,  producing  large 
watery  discharges.  It  is  seldom  used  alone  on  account  of  the  severity 
of  its  action. 

Preparations.  —  Fluid  extract,  dose,  one  dram;  syrup  of  buck- 
thorn, made  by  uniting  four  ounces  of  fluid  extract  with  twelve 
ounces  of  simple  syrup,  dose,  two  drams. 

Bugle  weed  (^Lycopun  Virginicm).  —  This  grows  in  shady  and 
wet  places  throughout  a  greater  part  of  the  United  States.  The 
whole  herb  is  used.  It  is  a  mild  narcotic,  sedative,  sub-astringent, 
and  styptic.  It  is  a  valuable  remedy  in  bleeding  from  the  lungs, 
incipient  consumption  and  pneumonia.  It  quiets  irritation  and 
allays  cough  and  nervous  excitement. 

PreparatioTM. —¥\u\di  extract,  dose,  one  to  two  drams;  infusion, 
dose,  two  to  four  ounces. 

Burdock  (Lappa  Minor").  —  A  native  of  Europe,  and  growing  in 
the  United  States.  The  root  is  used,  which  is  useful  in  scurvy, 
syphilis,  scrofula,  gout,  leprosy,  and  disease  of  the  kidneys.  It  needs 
to  be  used  for  a  long  time.  It  is  said  io  be  useful  for  persons 
afflicted  with  boils,  stye,  etc.  An  ointment  prepared  from  it  is 
serviceable  in  some  diseases  of  the  skin,  and  obstinate  ulcers. 

Preparations.  —  Fluid  extract,  dose,  one  dram ;  solid  extract,  dose, 
five  to  fifteen  grains ;  tincture,  dose,  half  an  ounce  to  an  ounce. 

Burgundy  Pitch.  —  This  is  the  concrete  juice  of  the  Norway  pine, 
Abies  excelsa,  growing  in  Europe  and  Northern  Asia,  and  of  the  silver 
fir-tree  of  Europe,  Abies  picea.  It  gently  excites  the  skin,  and  is 
used  chiefly  in  the  form  of  plasters,  either  alone  or  mixed  with  other 
gums  and  resins. 

Butternut  (Juglans  Cinerea).  —  This  is  a  forest  tree,  growing  in 
various  parts  of  this  continent,  known  also  by  the  names  of  oilnut 


wes  of  four 
ddition  of  a 

i  growing  in 
root,  which 
irt  of  May, 
mlding.  It 
arrhcea  and 
ing  disease, 
ivill  convert 
with  sugar, 

8  in  Europe, 
BS  and  juice 
ucing  large 
the  severity 

p  of  buck- 
^rith  twelve 

shady  and 

bates.     The 

^astringent, 

the  lungs, 

itation  and 

3;  infusion, 


growing  in 
[  in  scurvy, 
1.  It  needs 
for  persons 
from  it  is 
ers. 

Ktract,  dose, 
ounce. 

orway  pine, 
}f  the  silver 
skin,  and  is 
;  with  other 


growing  in 
}s  of  oilnut 


wgm- 


,^u. 


MEDICINES   AND  TUEIK   PKEPAKATI0N8. 


825 


and  white  walnut.  The  inner  bark  of  the  root  is  used,  and  is  a  mihl 
cathartic,  being  useful  in  cases  of  constipation.  It  is  much  employed 
by  families  as  a  domestic  remedy,  in  intermittent  and  remittent 
fevers.     It  evacuates  the  bowels  without  debilitating  them. 

Preparations.  —  Fluid  extract,  dose,  one  to  two  drams;  solid  ex- 
tract, dose,  five  to  fifteen giains  ;  juglandin,  the  active  principle,  dose, 
one  to  three  grains.  A  very  good  pill  is  made  by  mixing  one  and  a 
quarter  drams  of  the  solid  extract  of  butternut,  three-quarters  of  a 
dram  of  the  solid  extract  of  jalap,  and  ten  grains  of  soap,  and  divid- 
ing the  whole  into  sixteen  pills.  Two  or  three  may  be  taken  for 
a  dose. 

Calcined  Deer's  Horn  (ComM  Cervince  Ustum).  —  The  horns  of 
the  deer  are  said  to  be  in  velvet  between  August  and  December,  and 
(luring  this  period  those  which  fall  are  collected,  coarsely  rasped,  and 
[ilaced  in  an  iron  vessel,  which  is  tightly  covered  and  placed  in  an 
oven,  or  elsewhere,  and  subjected  to  a  heat  of  200°  F.,  which  is  con- 
tinued until  the  rasped  horn  becomes  of  the  color  of  roasted  coffee. 
When  cooled,  it  is  reduced  to  powder  by  trituration,  and  preserved 
in  closely  stopped  vials.  It  is  a  powerful  styptic,  taken  in  teaspoonful 
doses  every  half-hour ;  or,  a  teaspoonful  added  to  a  gill  of  hot  water, 
and  a  tablespoonful  of  this  taken  every  five  or  ten  minutes.  It  has 
much  efficacy  in  floodings  from  the  womb,  and  in  excessive  menstru- 
ation. 

Calomel  {Hydrargyri  Chloridum  Mite).  —  This  is  prepared  from 
mercury,  sulphuric  acid  and  common  salt.  It  is  alterative,  antisyphi- 
litic,  and  anthelmintic,  and,  in  large  doses,  purgative.  It  is  much 
used  in  venereal  diseases  and  chronic  affections  of  the  liver,  combined 
with  opium ;  in  dropsies,  combined  with  squill,  foxglove  and  elate- 
rium;  and  in  rheumatism  and  leprosy,  combined  with  antimonials, 
guaiacum,  and  other  sudorifics.  In  the  beginning  of  fevers  and  other 
complaints,  it  is  often  combined  with  purgatives,  as  gamboge,  scam- 
mony,  jalap  and  rhubarb.  Given  in  small  doses,  not  large  enough  to 
purge,  it  gradually  excites  salivation.  Dose,  from  one  to  three 
grains. 

The  tendency  of  this  article  to  produce  salivation,  to  injure  the 
gums,  loosen  the  teeth,  etc.,  has  given  rise  to  much  prejudice  against 
it  in  the  public  mind  ;  and,  indeed,  it  must  be  confessed  that  it  has 
been  used  by  many,  from  time  immemorial,  with  great  indiscretion. 
In  the  hands  of  sensible  and  prudent  men,  it  is  very  serviceable  in 
some  cases;  but  the  podophyllum  and  leptandra  have  so  fine  an 
action  upon  the  liver,  that  they  are  fast  taking  the  place  of  calomel 
and  other  mercurials,  and  possibly  may  in  time  wholly  supersede 
them.  I  have  not  prescribed  it  in  this  book,  and  do  not  recommend 
its  use.  -<  : 


•tri 


826 


MEDICINES   AND   THEIU   PREPAUATI0N8. 


Fio.  S06.   Oamphob  Tree. 


Camphor  (Fig.  206).  This  is  obtained  from  an  evergreen  tree, 
growing  in  tho  EiiHt  Indies,  —  Launis  aim- 
phora.  It  is  a  white,  sliiny,  crystiUlino  sub- 
stance, extnicted  from  tlit-  wood  and  roots  of 
the  al)ove-nanied  tree  hy  boiling  them,  and  is 
subsequently  jjurified  by  sublimation.  It  lias 
a  j)enetniting,  peculiar  diffusible  odor,  and  a 
pungent,  cooling  taste.  It  is  moderately  stim- 
ulant, diaphoretic,  and  antaplirodisiac.  Dose, 
from  one  to  ten  grains. 

Canada  Balsam.  —  This  is  the  fluid  ob- 
tained from  the  fir-balsam,  Abies  balsamea,  of 
Canada,  Maine,  etc.  It  is  a  stimulating  diu- 
retic, and,  in  large  doses,  cathartic.  A  dose  is 
from  ten  to  fifteen  drops,  two  or  three  times 
a  day,  in  pills,  or  in  emulsion.  It  forms  a  part  of  several  ointments 
and  piasters.  It  is  used  to  mount  objects  in  microscopic  invesii- 
gfiitions. 

Canada  Fleabane  (Urigeron  Ccenadense).  —  An  annual  plant, grow- 
ing in  the  Northern  and  Middle  States.  It  is  diuretic,  tonic,  and 
astringent,  and  has  been  found  useful  in  droj)8ical  complaints  and 
diarrhoea.  The  dose  of  the  powder  is  from  thirty  grains  to  a  dram ; 
of  the  infusion,  from  two  to  four  fluid  ounces  ;  of  the  solid  extract, 
from  five  to  eight  grains ;  to  be  repeated,  in  each  case,  every  two  or 
three  hours. 

Canella  (Canella  Alba).  —  This  is  the  bark  of  a  South  American 
tree,  and  is  an  aromatic  stimulant  and  a  gentle  tonic,  and  useful  in 
debility  of  the  stomach. 

Caraway  (  Carum  Cami). —  This  biennial  plant  grows  in  Europe. 
The  seeds  are  the  part  used,  and  are  aromatic  and  carminative ;  tliey 
are  used  in  wind  colic,  and  to  improve  the  flavor  of  other  medicine. 
The  dose  is  from  t  i  to  sixty  grains.  The  dose  of  the  oil  of  caraway, 
extmcted  from  the  seeds,  is  from  one  to  five  drops. 

Cardamom  (Alpinia  Cardamomum) This  plant  grows   on  the 

mountains  of  Malabar.  The  seeds,  which  are  the  medicinal  parts, 
are  aromatic  and  carminative,  and  are  used  to  expel  wind,  and  to 
flavor  medicines.  Dose,  from  ten  grains  to  two  drams.  The  volatile 
oil  obtained  from  them  has  similar  properties. 

Cascarilla,  —  This  medicine  is  the  bark  of  the  West  India  shrub, 
Croton  eleuteria.  It  has  an  aromatic  odor,  and  a  warm,  spicy  taste. 
It  is  a  pleasant  aromatic  and  tonic,  and  is  used  in  dyspepsia,  chronic 
diarrhoea  and  dysentery,  wind  colic,  and  other  debilities  of  the  stom- 
ach and  bowels.  It  counteracts  the  tendency  of  cinchona  to  produce 
nausea. 

Preparations Fluid  extract,  dose,  twenty  to  twenty-five  drops  ; 


,iJii.j>iiUiijmu;. 


J. 


Tgreen  tree, 
Launis  mm- 
Htiillino  Kub- 
iml  rot  its  of 
-hem,  jiiid  is 
ion.  It  liiiB 
odor,  mid  a 
irately  stini- 
ttiuc.    DoHe, 

le  fluid  ob- 
balaamea,  of 
lulating  diu- 
.  A  dose  is 
three  times 
l1  ointments 
opic  investi- 

plant,grow- 
B,  tonic,  and 
iplaints  and 
i  to  a  dram ; 
)lid  extract, 
ivery  two  or 

|;h  Ameiican 
id  useful  in 

s  in  Europe, 
ative ;  tliev 
r  medicine, 
of  caraway, 

0W8  on  the 
cinal  pnrtfi, 
ind,  and  to 
The  volatile 

ndia  shrub, 
spicy  taste, 
sia,  chronic 
f  the  stom- 
to  produce 

•five  drops  ; 


MEDICINES   AKD   THEIR   PREPAKATIONS. 


827 


tincture,  dose,  one  dram ;  infusion,  dose,  one  to  two  drams.  An  alka- 
line infusion,  composed  of  fluid  extract,  three  ounces ;  carbonate  of 
potiissa,  two  drams;  and  water,  ten  ounces,  is  excellent  in  weak 
stomach,  with  acidity.     Dose,  one  dram.    . 

Castor  (Catitorevm').  —  A  peculiar  substance  obtained  fiom  the 
beaver.  It  is  antispasmodic  and  enuneiiagogue.  It  is  used  Id 
typhus,  hysterics,  epilepsy ,  retention  of  the  menses,  and  in  many 
other  nervous  diseases.  Dose,  from  ten  to  fifteen  grains.  A  medi- 
cine of  no  great  value. 

Castor  Oil  (  Oleum  Ricini).  —  This  is  obtained  by  expression  from 
the  seeds  of  the  castor-oil  bush,  Ridnus  communin.  When  exposed 
to  the  air,  it  becomes  rancid  and  spoils. 

As  a  mild  cathartic  this  oil  is  extensively  used,  but  may  be  ren- 
dered less  offensive  by  being  mixed  with  a  few  drops  of  oil  of  winter- 
green,  peppermint  oi  cinnamon ;  and  its  bad  taste  may  be  nearly 
destroyed  by  rubbing  it  up  to  a  thick  batter  with  carbonate  of  mag- 
nesia. Or,  if  boiled  a  few  minutes  with  a  little  sweet  milk,  sweet- 
ened with  loaf  sugar,  and  flavored  with  essence  of  cinnamon  or 
peppermint,  it  may  be  easily  taken.  Dose,  for  an  adult,  one  io  two 
tablespoonfuls  ;  for  a  child,  one,  two  or  three  teaspoonfuls,  according 
to  its  age. 

Catechu.  —  This  is  a  solid  extract,  made  from  the  wood  of  the 
Acacia  catechu^  a  tree  growing  ■  in  Asia.  It  is  in  dark,  brown,  and 
brittle  pieces,  and  is  soluble  in  alcohol.  It  is  a  powerful  astringent, 
and  is.  used  in  chronic  diarrhoea  and  chronic  dysentery.  .  It  makes  a 
useful  gargle  in  some  forms  of  sore  mouth,  in  elongated  uvula, 
spongy  gums  and  sore  nipples.  The  dose  of  the  powder  is  from  ten 
to  twenty  grains,  and  of  the  tincture,  from  one  to  two  teaspoonfuls. 

Catnip  {Nepeta  Cataria).  —  A  native  of  Europe,  and  widely  nat- 
uralized in  this  country.  The  tops  and  leaves  are  the  medicinal 
part,  and  are  carminative  and  diaphoretic  when  drunk  as  a  warm 
infusion.  It  is  useful  in  fevers,  in  wind  colic,  nervous  headache, 
hysterics,  and  nervous  irritability. 

Preparations.  —  Fluid  extract,  dose  two  to  three  drams  ;  infusion, 
dose  two  to  three  ounces.  Fluid  extract  of  catnip,  two  ounces  ;  and 
the  fluid  extract  of  saffron,  one  ounce  and  a  half,  united,  make  a 
popular  remedy  for  colds,  and  the  rashes  of  children.  In  nervous 
complaints,  a  combination  of  fluid  extract  of  catnip,  six  drams ;  fluid 
extract  of  valerian,  four  drams  ;  and  fluid  extract  of  scuUcap,  four 
dmiiis,  is  a  valuable  remedy.     Dose,  one  to  two  drams. 

Cayenne  Pepper  {Capsicum  Annuum,  Fig.  207).  —  This  plant 
grows  in  hot  climates,  and  is  known  by  the  common  name  of  red 
pepper.  The  berry,  which  is  the  part  used,  has  an  intensely  hot  and 
pungent  taste.  It  is  a  powerful,  diffusible  stimulant,  and  is  about  the 


tmd 


828 


MKDICINKH    AND   TIIRIK    PHKrAUATIONK. 


no.  W7.   Catkmnb  Pkffbr. 


only  stimulus  which  the  Htomach  will  bear  in  certain  formH  uf  dyg. 
peptiia.  It  is  useful  in  all  cases  uf  diminished  vital  action,  and  ih  fre- 
quently united  with  other  medicines,  either  to  promote  tluiir  action, 

or  to  lessen  the  severity  of  their  opemtioii.  It 
is  much  used  in  colds,  hoarsenesM,  etc.,  iw  it 
pn)nu)te8  a  free  discharge  of  nnumN  iiiui 
phlegm.  Taken  in  smal!  doses,  it  has  a  tine 
effect  upon  the  mucou.^  membrane  of  tliu 
stomach  and  bowels,  lessening  very  much  the 
severity  of  piles,  and  sometimes  curing  them. 
li  may  be  sprinkled  daily  upon  the  food,  or 
taken  in  the  form  of  cayenne  lozenges;  it  \» 
frequently  useful  as  a  gargle  in  sore  throatH, 
scarlet  fever,  etc.  Dose  of  the  powder  from 
one  to  eight  grains. 

Preparatiotis.  —  Fluid  extract,  dose,  five  to 
ten  drops ;  tincture,  dose,  half  a  dir.m  to  a 
dram,  used  in  low  forms  of  fever,  and  gastric 
insensibility;  infusion,  dose,  one  to  two  drams.  A  valuable  gargle 
in  R'^a'  lot  fever  may  be  made  by  combining  fluid  extract  of  cayenne 
one  ounce  ;  common  salt,  one  dram;  boiling  vinegar,  one  pint;  boil- 
ing water,  one  pint. 

Celandine  (^Chelidonium  Maju%).  —  This  plant  is  indigenous  to 
Europe,  and  is  extensively  naturalized  in  the  United  States.  It  is  a 
drastic  purge,  producing  watery  stools,  and  is  equal  to  gamboge ;  it  is 
useful  in  affections  of  the  liver,  and  particularly  in  those  of  the 
spleen.  In  the  form  of  a  poultice  it  is  effective  in  scrofula,  indolent 
ulcers,  skin  diseases,  and  piles. 

Preparations.  —  Fluid  extract,  dose,  ten  to  fifteen  drops  ;  solid  ex- 
tract, dose,  five  to  eight  grains  ;  tincture,  dose,  half  a  dram  to  a  dram ; 
infusion,  dose,  two  and  a  half  to  four  drams.  A  very  good  hydra- 
gogue  cathartic  is  made  by  compounding  two  and  a  half  drams  of 
fluid  extract  of  celandine  with  half  a  dram  of  fluid  extract  of  hen- 
bane, one  ounce  of  sulphate  of  potassa,  one  grain  of  tartar  emetic, 
six  ounces  of  elder-water,  and  ounce  of  syrup  of  squill. 

ChaFk. —  On  account  of  its  gpritty  particles,  it  is  unfit  for  medicinal 
use  intil  it  has  been  levigated,  after  which  it  is  cnlled  prepared  chalk. 
This  is  the  only  form  in  which  it  is  used  in  medicine.  It  is  an  ex- 
cellent antacid,  and  is  admirably  adapted  to  diarrluiea  accompanied 
with  acidity.  The  most  convenient  form  of  administering  chalk  is 
that  of  t'  chalk  mixture,  which  consists  of  prepared  chalk,  half  an 
ounce  ;  sugar  and  powdered  gum-arabic,  two  drams  each  ;  cinnamon- 
water  and  water,  four  fluid  ounces  each,  and  rubbed  together  in  a 
mortar  till  they  are  thoroughly  mixed.  Dose,  a  tablespoonful  fre- 
quently repeated. 


-r— T" 


ormH  of  (lyg. 
311,  and  ih  Ire. 

tluiir  action, 
npemtioii.  It 
JHtt,  etc.,  m  it 

n)ncu8  iind 
,  it  has  a  fine 
)rane  of  ihu 
ery  much  tliu 
curing  them. 

the  food,  or 
zenges;  it  in 
sore  throatH, 
powder  from 

dose,  five  to 
i  dir.m  to  a 
,  and  gastric 
uable  gaigle 
t  of  cayenne 
e  pint;  boil- 

idigenous  to 
ites.  It  is  a 
mboge ;  it  is 
hose  of  the 
ala,  indolent 

ps ;  solid  ex- 
n  to  a  dram ; 
good  hydra- 
alf  drams  of 
ract  of  hen- 
rtar  emetic, 

3r  medicinal 
pared  chalk. 
[t  is  an  ex- 
ocompanied 
ng  chalk  is 
alk,  half  an 
;  cinnamon- 
)gether  in  a 
joonful  fre- 


MEDIOINRH   AMI)   THKIK   PUKl'AUATIONB. 


829 


FlO.  908.    CHAMOIIILK. 


Ca4«la-Bud«.  —  This  spice  is  a  product  of  China.  It  consista  of 
the  calyx  surrounding  the  young  germ  of  one  or  more  species  of  cin- 
namon. CaHsia  buds  have  some  resemblance  to  cloves,  and  are  com- 
pared to  small  nails  with  round  heads.  They  may  be  used  for  the 
same  purposes  as  the  ciiinamon-bark. 

Chamomile  (Anthemis  Nobility  Fig.  208) — This  perennial  plant 
grows  in  Europe,  and  its  flowers,  the  white:;t  of  which  are  best,  are 
considerably  used  in  medicine.  They  are 
cfently  tonic,  and  are  generally  used  in  cold 
infusion,  in  cases  of  weak  stomach,  dyspej)- 
sia,  etc.  In  large  doses,  the  wai-m  infusion 
will  act  as  an  emetic. 

Preparation*.  —  Fluid,  extract,  dose,  half 
a  dram  to  a  dram ;  solid  extract,  dose,  four 
to  fifteen  grains;  infusion,  dose,  half  an 
ounce  to  an  ounce.  For  dyspepsia,  wind  in 
the  stomach,  etc.,  thirty  pills  may  be  made 
by  combining  one  dram  of  solid  extract  of 
chamomile  with  five  grains  of  the  solid  ex- 
tract of  rhubarb  and  ten  g^rains  of  assafoe- 
tida,  and  taken,  one  pill  at  a  time,  two  or 
three  times  a  day,  with  advantage. 

Charcoal  {Carbo  Ligni). —  Prepared  charcoal  is  antiseptic  and  ab- 
sorbent, and  is  employed  with  great  advantage  in  certain  forms  of 
dyspepsia,  attended  with  bad  breath  and  putrid  eructations ;  it  has  a 
good  effect  in  correcting  the  fetor  of  the  stools  in  dysentery :  it  is 
considerably  used,  and  with  much  advantage,  as  an  ingre(Uent  in 
poultices.  Dose,  when  taken  internally,  from  one  to  three  teiiepoon- 
fuls. 

Chloroform  (^Chloroformum). —  This  is  an  anasthetic,  used  to  pro- 
duce insensibility  during  surgical  operations.  A  t^aspoonful  or  more 
is  poured  upon  a  handkerchief,  which  is  held  tr  the  patient's  nose, 
but  not  so  closely  as  to  prevent  the  admission  ct  »ir.  The  numerous 
sudden  deaths  which  have  occurred  from  its  use  prove  it  to  be  an 
unsafe  agent,  and  it  is  now  seldom  employed  by  careful  surgeons. 
Taken  internally  it  is  sedative  and  narcotic  ;  applied  externally,  com- 
bined with  other  articles,  it  is  useful  in  painful  affections,  as  nervous 
headache,  rheumatism,  neuralgia,  etc.  The  dose  when  taken  inter- 
nally is  from  ten  to  twenty  drops,  in  flax-seed  tea. 

Cinnamon.  —  This  is  the  bark  of  trees  growing  in  Ceylon,  Mala- 
bar, and  Sumatra.  It  is  a  very  grateful  aromatic,  being  warm  and 
cordial  to  the  stomach ;  it  is  also  carminative  and  astringent. 

It  is  not  often  prescribed  alone,  but  is  chiefly  used  as  an  aid  to  less 
pleasant  medicines,  and  enters  into  a  great  number  of  pre'^arations. 
It  is  peculiarly  adapted  to  diarrhcea ;  and  in  treating  this  complaint 


■:1 


m: 


880 


MEDICINK8   AND  TIIRIK   PREPARATIONS. 


it  in  often  joined  with  chalk  and  iiHtringenUt.  DoHe  of  the  bark,  from 
ten  to  fifteen  grains.  The  oil  has  propertieH  Hiniilar  to  thoue  of  the 
bark. 

Cleavers  (Galium  Aparine).  —  An  annual  plant, common  to  thiH 
country  and  Euroi>e,  having  an  acid,  SHtringent  taste.  The  whole 
herb  i.s  UHed  in  infuHion,aH  a  cooling  diuretic,  in  Hcalding  of  the  uriiu;, 
inflammation  of  the  kidneys  and  bladder,  in  gravel,  suppression  of 
the  urine,  etc. 

It  is  hIho  used  in  fevers  and  all  acute  diseaseH.  The  infusion  is 
made  by  adding  two  ounces  of  the  herb  to  a  pint  and  a  half  of  warm 
water.  It  should  stand  three  or  four  bout's,  and  be  drunk  freely  when 
cold.  Equal  parts  of  elder-blows,  cleavers,  and  maidan-hair,  infused 
in  warm  water,  make  a  refreshing  drink  in  scailut  fever  and  other 
eruptive  diseases. 

Clove«  (^Caryophylluit  Aromatiem).  —  The  flowew  of  this  tree,  a 
native  of  tropical  climates,  collected  before  they  are  fully  developed, 
form  cloves.  They  are  highly  stimulant  and  aromatic,  and  are  used 
to  give  tone  to  the  digestive  organs,  particularly  when  flatulency 
exists,  and  to  relieve  nausea  and  vomiting.  They  are  more  generally 
employed  to  improve  the  taste  and  modify  the  tuition  of  other  medi- 
cines. The  dot.  in  powder  is  from  five  to  eight  grains.  The  oil  of 
cloves  has  similar  propei+'ei  ;  dose,  one  to  three  Irbps.  A  little  cot- 
ton moistened  with  the  oil,  and  pressed  into  a  decayed  tooth,  will 
frequently  relieve  the  toothache. 

Cochineal  (  Coccug  Cacti).  —  An  insect  found  in  Mexico,  inhabit- 
ing different  species  of  cactus.  They  are  gathered  for  use  by  detach- 
ing them  from  the  plant  with  a  blunt  knife,  and  dipping  them,  en- 
closed in  a  bag,  into  boiling  water.  Cochineal  is  anodyne,  and  has 
been  used  with  advantage  in  whooping-cough  and  neuralgia.  It  is 
much  used  for  coloring  tinctures  and  ointments,  and  the  color  called 
carmine  is  prepared  from  it.  A  tincture  is  prepared  by  macerating 
two  ounces  of  cochineal  in  one  pint  of  alcohol  for  seven  days,  and 
filtering  through  paper.  Dose,  from  twenty  to  twenty-five  drops, 
twice  a  day. 

Cod'LiverOII  {Oleum  Morrhuoe).  —  This  is  obtained  from  the 
livers  of  codfish,  and  is  nutritive  and  alterative.  It  is  a  popular  rem- 
.edy  in  consumption  and  scrofula,  and  in  those  complaints  genendly 
in  which  there  is  impaired  digestion,  assimilation,  and  nutrition. 
Dose,  a  tablespoonful  three  times  a  day. 

Inability  to  digest  this  oil,  to  eat  fat  meats,  or  to  take  fats  in  any 
form,  is  an  unfavorable  indication  in  consumption. 

Collodion.  —  This  is  gun-cotton  diF^solved  in  ether.  It  is  applied 
with  a  camel's-hair  brush,  to  cuts,  burns,  wounds,  leech-bites,  etc., 
over  which  it  forms  a  thin  pellicle  or  skin,  protecting  the  injured  part 
from  the  atmosphere.  It  should  be  kept  in  well  stopped  bottles,  to 
prevent  its  evapomting  and  becoming  iinfit  for  use. 


ria 


MEDICINKS   AKD  THKIR   PRKPAKATION8. 


831 


^  bark,  from 
those  of  the 

nmon  to  this 
The  wholo 
f  the  uriiit!, 
•pressioii  oi 

infusion  in 
lalf  of  wiirni 

reoly  when 
mir,  iiifuHed 

and  other 

tliis  tree,  a 
developed, 

nd  are  used 
flatulency 

le  generally 

other  medi- 
The  oil  of 

A.  little  cot- 
tooth,  will 

ico,  inhabit- 
by  detach- 
g  them,  en- 
ne,  and  has 
Jgia.  It  is 
color  called 
macerating 
I  days,  and 
■five  di'ops, 

from  the 
jpular  rem- 
I  generally 

nutrition. 

als  in  any 

is  applied 
bites,  etc., 
jured  part 
bottles,  to 


Colocynth  {^Cucumi»  Colocifnthin).  —  A  native  of  northern  Africa. 
The  part  used  in  medicine  is  the  fruit  deprived  of  itH  rind.  It  in  a 
powerful  drastic,  hydragoj^ue  cathartic ;  causing,  by  its  harsh  action, 
g.iping,  vomiting,  and  sometimes  bloody  discharges ;  from  the  severity 
of  its  operations,  it  is  mrely  used  alone.  Useful  in  dropsy,  derange- 
ments of  the  hmin,  and  for  overcoming  torpid  conditions  of  the  di- 
gestive and  biliary  organs. 

I'repamtionit.  —  Solid  extract,  dose,  two  to  twenty  gi'ains;  com- 
pound extract,  dose,  two  to  twenty  grains. 

Colombo  (CocouluH  Palmatuit).  —  A  perennial  climbing  plant, 
growing  in  East  Africa,  and  cultivated  in  the  Isle  of  France.  It  is  a 
pure,  bitter  tonic,  and  is  used  in  dyspepsia,  bilious  vomitings  which 
attend  pregnancy,  and  during  recovery  from  exhausting  diseases. 

Prepnrationtt.  —  Fluid  extract,  dose,  twenty  to  thirty  drops ;  solid 
extract,  dose,  four  to  eight  grains ;  tiiicture,  lose,  one  to  three  drams  ; 
infusion,  dose,  three  drams  to  an  ounce.  A  compound  infusion  made 
by  uniting  one  dram  of  fluid  extract,  four  dnuns  of  orange-peel,  and 
one  ounce  of  water,  is  useful  in  a  weakened  state  of  the  bowels, 
showing  itself  in  a  diarrhcea.  Dose,  two  drams  every  hour.  Fluid 
extract  of  Colombo,  one  ounc«\ ;  fluid  extract  of  ginger,  two  drams, 
and  water,  one  pint,  also  make  a  useful  compound  foithe  same  pur- 
pose. Fluid  extract  of  Colombo,  one  dram  ;  fluid  extract  of  rhubiirb, 
one  dram ;  fluid  extract  of  ginger,  half  a  dram  ;  water,  one  pint,  — 
this  is  useful  for  a  like  purpose.  The  following  is  also  a  very  good 
preparation  for  a  similar  use  ;  fluid  extract  of  Colombo,  half  an  ounce; 
fluid  extract  of  cascarilla,  two  drams ;  I'ucture  of  orange-peel,  two 
drams ;  syrup  of  cinnamon,  one  ounce ;  water,  six  ounces.  Dose,  one 
dram  every  hour. 

Coltsfoot  (^Tussilago  Farfara). —  A  native  of  Euro^jb, and  natural- 
ized in  this  country,  especially  in  the  Northern  States.  It  gprows  in 
wet  places  and  low  meadows.  The  leaves  are  principally  used. 
They  are  emollient,  dci.iulcent,  and  slightly  tonic ;  used  in  coughs, 
asthma,  and  whooping-cough ;  and  externally  in  the  form  of  poultice 
for  scrofulous  tumoi-s. 

Comfrey  {Symphytum  Officinale), — A  perennial  European  plant, 
cultivjited  in  'his  country.  The  root  is  the  part  used.  It  is  demul- 
cent, and  slightly  astringent,  and  is  serviceable  in  diseases  of  the 
mucous  tissues,  and  in  scrofulous  habits ;  also  in  diarrhoea,  dysen- 
tery, coughs,  bleeding  from  the  lungs,  whites,  etc.  It  may  be  taken 
as  an  infusion,  or  as  a  syrup,  one  ounce  to  a  pint  of  water ;  the  dose 
being  one  to  three  fluid  ounces,  three  to  four  times  a  day.  The  fresh 
root  bruised  forms  a  valuable  apjilication  to  ulcers,  bruises,  fresh 
wounds,  sore  breasts,  and  white  swellings- 
Common  Silk- Weed  {Asclepias  Syriaca).  —  This  is  a  perennial 
plant,  common  tliroughout  the  United  States.     It  gives  out  a  milky 


.Ji 


mOim 


832 


MEDICINES   AND   THEIR   PREPARATIONS. 


juice  upon  being  wounded,  and  hence  is  often  called  milk-weed. 
The  loot  is  diuretic,  alterative,  emmenagogue,  and  anodyne;  and  k 
sometimes  used  in  dropsy,  retention  of  urine,  suppressed  menstrua- 
tion, scrofula,  and  rl.  umatisra.  Dose  of  the  powder,  from  eight  to 
twenty  grains ;  of  the  decoction,  from  one  to  two  fluid  ounces. 

Copper  (C'ttjorwrn).  —  The  following  are  the  principal  salts  of  cop- 
per used  in  medicine  :  — 

Subacetate  of  Copper  (^Cupri  Subacetas),  —  This  is  known  by  the 
name  of  verdigris,  and  is  used  as  a  detergent  and  escharotic ;  it  is 
applied  to  warts  and  fungous  growths,  and  to  foul  ulcers  and  ring- 
worm. When  reduced  to  a  fine  powder,  by  trituration  in  a  porcelain 
mortar,  the  finer  parts  of  this  are  separated,  and  called  prepared  8ul> 
acetate  of  copper;  this  is  the  preparation  used  for  the  purposes  above 
named. 

Sulphate  of  Copper  (^Cupri  Sulphas).  —  In  small  doses,  the  sul- 
phate of  copper  is  astringent  and  tonic ;  in  large  ones  a  prompt 
emetic.  It  is  given  in  small  doses  in  hysterics,  epilepsy,  and  inter- 
mittent fevers ;  and  in  large  doses,  to  produce  speedy  vomiting  in 
croup,  and  to  eject  poisons  from  the  stomach.  A  weak  solution  is 
sometimes  usecl  for  syphilitic  ulcers,  and  as  an  injection  in  gleet. 
Dose,  as  a  tonic,  one-quarter  of  a  grain  to  one  grain  in  pill ;  as  a 
rapid  vomit,  from  two  to  five  grains,  in  two  ounces  of  water.  The 
medicines  which  are  incompatible  with  copper,  are  alkalies,  earths 
s»nd  their  carbonates,  borax,  salts  of  lead,  acetate  of  iron,  and  astrin- 
gent vegetable  infusions,  decoctions,  and  tinctures. 

Corrosive  Sublimate.  —  This,  in  chemical  language,  is  the  bichlo- 
ride of  mercuiy.  It  is  one  of  the  milder  mercuriar  preparations, 
although  when  taken  in  large  doses,  it  is  a  violent  poison,  and  oper- 
ates very  quickly  It  is  less  apt  to  salivate  than  any  other  mercurial, 
except  blue  pill.  It  is  much  used  as  a  remedy  in  syphilis,  particu- 
larly in  the  secondary  stage,  in  which,  in  many  cases,  it  does  much 
good.  It  is  also  popular  in  many  skin  diseases,  as  leprosy.  When 
employed  for  this  purpose,  it  is  generally  associated  with  alterative 
and  diaphoretic  medicines,  such  as  the  compound  decoction  or  syn  o 
of  sarsaparilla,  preparations  of  yellow  dock,  etc.  In  order  to  avoia 
its  irritating  effects,  it  is  often  united  with  opium,  or  extract  of  con- 
ium.  Dissolved  in  water,  it  is  valuable  as  a  wash  in  some  skin  dis- 
eases. It  is  an  ingredient  in  many  of  the  quack  nostrums  -which  are 
extensively  advei'tised.     It  is  the  most  powerful  antiseptic  known. 

Cotton  (^Q-os»ypium  Herbaceum).  —  Cotton  is  chiefly  employed  in 
cases  of  recent  burns  and  scalds, — an  application  of  it  which  sur- 
geons have  learned  from  popular  use.  It  diminishes  the  inflamma- 
tion, prevents  blistering,  and  hastens  the  cure.  It  is  applied  in  thin 
and  successive  layers.  The  absorbent  should  be  used.  The  inner 
bark  of  the  root  is  said  to  be  emmenagogue,  parturient,  and  abortive. 
It  is  excellent  in  chl'^rosis. 

Preparatian.  —  Fluid  extract,  dose,  three  drams. 


^m 


milk-weed. 
y»e;  ajui  iy 

d  menstrua- 
om  eight  to 
ances. 

salts  of  cop. 

lown  by  the 
rotic;  it  is 
and  ring. 

a  porcehain 
epai-ed  sul> 
loses  above 

les,  the  sul- 
8  a  prompt 

and  inter- 

omiting  in 

solution  is 

in  gleet. 

pill ;  as  a 
ater.  The 
ies,  earths 
and  astrin- 

the  bichlo- 
3parations, 
I  and  oper- 
mercurial, 
s»  particu- 
oes  much 
i-     When 
alterative 
I  or  syn  d 
to  avoiu 
it  of  con- 
skin  dis" 
^  hich  are 
£nown. 

loyed  in 
lich  sur- 
iflammfi- 
1  in  thin 
le  inner 
ibortive. 


MEDICINES   AND  THEIR   PREPAKATTONS. 


833 


KlO.  209.    CRAME8BILI.. 


Cranesbill  (^Geranium  Maculatum,  Fig.  209).  —  An   indigenous 
plant,  growing  in  all  parts  of  the  United  States,  in  the  open  woods. 
The  root  is  the  medicinal  part.     It  is  a  powerful  astringent,  similar 
to  kino  and  catechu,  and  a  valuable  substi- 
tute for  those  articles,  because  less  expensive. 
It  forms  an  excellent  gargle  in  sore  throat* 
and  uI(;erations  of  the  mouth,  and  is  valuable 
for  treating  those  discharges  arising  from  de- 
bility, after  the  exciting  causes  are  removed. 
It  has  no  unpleasant  taste,  and  is  therefore 
well  adapted  to  infants  and  persons  of  deli- 
cate stomachs.     As  an  injection,  it  is  used  in 
gleet  and  whites. 

Preparations.  —  Fluid  extract,  dose,  half  a 
dram  to  a  dram ;  solid  extract,  dose,  three  to 
ten  grains  ;  geraniin,  the  active  principle, 
dose,  one  to  three  grains  ;  tincture,  dose,  two 
and  a  half  to  three  drams  ;  infusion,  dose,  one 
to  two  ounces.  A  valuable  astringent  wash 
for  sore  mouth,  etc.,  and  as  an  injection  in  leucorrhoea,  etc.,  is  made 
by  uniting  fluid  extract  of  cranesbill,  half  an  ounce  ;  fluid  extract  of 
black  cohosh,  half  an  ounce ;  fluid  extract  of  golden  seal,  half  an 
ounce ;  fluid  extract  of  witch-hazel,  half  an  ounce ;  and  water,  one 
quart.  Geraniin,  dioscorein,  and  caulophyllin,  united  in  equal  pai-ts, 
and  given  to  an  adult  in  six-gmin  doses,  every  fifteen  or  twenty  min- 
utes, have  an  excellent  effect  in  diarrhoea  and  cholera-morbus,  when 
there  is  much  pain  and  rumbling  of  the  bowels. 

Crawley  (  Corallorhiza  Odontorhiza').  —  A  perennial  plant,  growing 
on  barren  hills  and  hard  clay  soils  in  New  York.  The  root  is  the 
part  used.  It  is  sedative  and  diaphoretic,  and  is  used  in  inflamma- 
tory diseases,  and  in  typhoid  fever;  also  in  flatulency,  cramps,  hectic 
fever  and  night-sweats.  When  the  liver  requires  to  be  acted  upon, 
it  should  be  combined  with  mandrake  or  Culver's  root.  The  pow- 
dered root  should  be  kept  in  well-stopped  vials;  its  dose  is  from 
twenty  to  twenty-five  grains,  in  warm  water,  every  hour  or  two. 

Creosote  (^Creosotum^.  —  This  is  obtained  by  the  distillation  of 
tar.  It  is  irritant,  narcotic,  styptic,  antiseptic,  and  moderately  escha- 
rotic.  It  has  been  given  in  diabetes,  epilepsy,  hysterics,  neuralgia, 
bleeding  from  the  lungs,  and  chronic  bronchitis.  It  is  an  excellent 
remedy  for  arresting  nausea  and  vomiting,  when  not  dependent  on 
inflammation.  The  dose,  when  given  internally,  is  one  or  two  drops. 
It  is  most  easily  taken  in  the  form  of  pill.  In  some  forms  of  bron- 
chitis, the  vapor  of  creosote  is  inhaled  with  advantage.  It  may  some- 
times be  applied  with  excellent  effect,  to  indolent  or  ill-conditioned 
ulcers,  in  which  case,  two,  four,  or  six  droj)s  may  be  dissolved  in  an 
ounce  of  distilled  water.     In  some  cases  the  solution  is  mixed  with 


^W.vrraOl^HP  ■* 


834 


MKUICINE8   AND  THEIR   PREPARATIONS. 


poultices.  One  or  two  drops  of  pure  creosote,  introduced  into  a  hol- 
low tooth  on  a  little  cotton,  is  generally  a  speedy  remedy  for  tooth- 
ache, but  great  care  must  be  taken  that  it  does  not  come  in  contact 
with  the  tongue  or  cheek. 

Croton  Oil  {Oleum  Tiglii).  —  This  is  obtained  from  the  seeds  of 
the  Croton  Tiglium,  a  plant  growing  in  the  East  Indies.  It  is  a 
powerful  cathartic  producing  watery  stools,  and  is  used  in  torpidity 
of  the  bowels,  dropsy,  apoplexy,  mania,  inflammation  of  the  brain, 
hydrocephalus,  coma,  and  wherever  a  powerful  revulsive  action  is 
needed  to  call  the  blood  away  from  the  brain.  A  drop  placed  on  the 
tongue  of  a  pei-son  in  the  comatose  state,  will  generally  operate.  Two 
to  six  drops,  rubbed  upon  the  skin,  produce  an  eruption  of  pimples 
in  twelve  houi-s.  In  this  way,  it  is  used  in  diseases  of  the  throat  and 
chest,  and  some  other  affections.  If  the  skin  is  very  sensitive,  let  it 
be  combined  with  an  equal  quantity  of  sweet  oil.  Use  only  under 
the  direction  of  a  physician. 

Cubebs  (Cubeboe). — A  climbing  perennial  plant,  growing  in  the 
East  Indies.  The  berries  are  the  medicinal  part.  They  are  stimu- 
lant, purgative,  and  diuretic,  acting  particularly  upon  the  urinary 
organs  and  arresting  discharges  from  the  water-pipe,  and  much  used 
in  the  treatment  of  gonorrhoea  and  gleet.  It  should  not  be  used  dur- 
ing active  inflammation.  Dose  of  powdered  cubebs,  from  thirty  to 
forty  grains. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram  and  a 
half ;  ethereal  fluid  extract,  dose,  one  to  two  drams ;  solid  extract, 
dose,  two  to  twenty  grains ;  tincture,  dose,  one  to  two  drams.  A 
compound,  made  of  fluid  extract  of  cubebs,  five  drams ;  fluid  extract 
of  ergot,  one  and  a  half  drams ;  cinnamon  water,  half  a  dram  ;  and 
powdered  loaf-sugar  one  dram,  may  be  taken  with  advantage  in 
gonorrhoea,  gleet,  and  leucorrhoea ;  dose,  one  dram. 

Culver's  Root  (^Leptandra  Virginica.)  —  A  perennial  plant  growing 
throughout  the  United  States  in  limestone  districts,  and  flowering  in 
July  and  August.  The  root  is  the  medicinal  part.  It  is  frequently 
called  black  root.  When  dried,  it  is  tonic,  cholagogue,  and  laxative, 
and  is  a  very  valuable  remedy  in  affections  of  the  liver,  as  it  acts 
upon  this  organ  with  energy,  without  puigation.  It  is  also  useful 
in  typhoid  fevers,  and  in  dyspepsia,  diarrhoea,  and  dysentery.  A 
powder  is  made  from  it,  containing  its  active  principle,  and  called 
leptandrin,  which  has  a  fine  effect  in  diarrhoea,  cholera  infantum,  ty- 
phoid fever,  some  forms  of  dyspepsia,  and  in  all  diseases  connected 
with  derangements  of  the  liver. 

Preparationx.  —  Fluid  extract,  dose,  one-third  of  a  dram  to  a  dram ; 
leptandrin,  the  active  principle,  dase,  in  acute  cases,  one-fourth  of  a 
grain  to  one  grain ;  in  chronic  cases,  one  to  two  grains  ;  tincture,  two 
ounces  to  a  pint  of  alcohol,  dose,  one  dram  to  one-half  ounce. 


'■■m'S'ii-xi.'ii 


:CA.3;.«^.>.sa..-i'^.W«riase^^ 


^■A 


MEDICINES  AND   THEIK   PREPARATIONS. 


835 


into  a  liol- 
for  tooth- 
Ill  contact 

e  seeds  of 
'•  It  is  a 
torpidity 
the  brain, 
5  action  is 
ced  on  the 
•ate.  Two 
>f  pimples 
throat  and 
tive,  let  it 
nly  under 

ng  in  the 
ire  stimu- 
e  urinary 
luch  used 
used  dur- 
thirty  to 

am  and  a 
extract, 
rams.  A 
id  extract 
ram  ;  and 
antage  in 

t  growing 
wering  in 
lequently 
laxative, 
IS  it  acts 
so  useful 
iteiy.  A 
ad  called 
ntum,  ty- 
onnected 

D  a  dram ; 
irtli  of  a 
ture,  two 

3. 


Dandelion  (^Taraxacum,  Dens  Leoms.)  —  This  perennial  her!)  is 
tliuretic,  aperient,  and  tonic,  It  is  generally  thought  to  act  especially 
upon  the  liver.  Used  in  dyspepsia,  diseases  of  the  liver  and  spleen, 
and  in  debilitated  and  irritable  conditions  of  the  stomach  and  bowels. 

Preparations.  —  Fluid  extract,  dose,  one  to  two  drams ;  compound 
fluid  extract,  dose,  one  to  two  drams ;  fluid  extract  of  dandelion  and 
senna,  dose,  one  to  two  drams  ;  solid  extract,  dose,  ten  to  fifteen 
grains;  infusion,  two  ounces  to  one  pint  of  water,  dose,  four  to  five 
ounces.  In  dropsical  affections,  the  following  compound  infusion 
will  be  found  useful :  fluid  extract  of  dandelion,  six  drams ;  fluid 
extract  of  rhubarb,  one  and  a  half  drams ;  fluid  extract  of  henbane, 
twenty-four  drops ;  bicarbonate  of  soda,  half  a  dram ;  tartrate  of 
potassa,  three  drams ;  water,  three  and  a  half  ounces  ;  take  one-third, 
three  times  a  day.  For  jaundice  and  diseases  of  the  liver  and  kid- 
neys, the  following  pills  have  much  elficacy :  Solid  extract  of  dande- 
lion, one  dram;  solid  extract  of  bloodrnnt,  one  dram;  leptandrin,  one 
scruple ;  podophyllin,  five  grains ;  oil  of  peppermint,  five  minims ;  to 
be  divided  into  fifty  pills,  and  one  or  two  taken  three  times  a  day. 

Deadly  Nightshade.  —  (Atropa  Belladonna,  Fig.  210).  —  A  per- 
ennial plant,  growing  in  Europe  and  this  country,  and  having  a  faint 
odor,  and  a  sweet,  nauseous  taste.  It  is  narcotic,  diaphoretic,  and 
diuretic ;  is  a  valuable  remedy  in  convulsions,  neuralgia,  whooping- 
cough,  rheumatism,  gout,  paralysis,  and  many  diseases  having  their 
seat  in  the  nervous  system.  "It  has  been  much  praised  as  a  preventive 
of  scarlet  fever,  though  its  powera  for  this  purpose  are  doubtful. 

Preparations.  —  Fluid  extract,  dose,  five  to  eight  drops ;  solid 
extract,  dose,  one  quarter  to  one  grain  ;  tincture,  two  ounces  to  a  pint 
of  diluted  alcohol;  dose,  from  thirteen  to  thirty  drops.  The  solid 
extract  is  used,  mixed  with  lard  or  with  other  ..  dwtances,  as  a  local 
application  for  relieving  pain,  dilating  the  pupil  of  the  eye,  for  re- 
moving stricture  of  the  urethra,  the  anus,  rigidity  of  the  mouth  of 
the  womb.  etc. 


Pio.  210.    Deadly  Nightshade. 


Fio.  211.   Dogwood. 


mi 


!i 


Dogwood  (ComM*  Florida,  Fig.  211).  —  This  is  a  small  tree 
growing  most  abundantly  in  the  Middle  States.  The  Kark  is  used 
as  a  medicine.    It  is  tonic,  astringent,  antiperiodic  and  stimulant.- 


BBsr 


886 


MEDICINES   AND   THEIK   PREPARATIONS. 


It  increases  the  frequency  of  the  pulse  and  elevates  the  teraperatuie 
of  the  body.  It  has  been  substitiited  for  Peruvian  bark  in  intei- 
mittent  feveis.  Dose  of  the  powdered  baik,  from  ten  to  sixty  grains. 
Preparadong.  —  Fluid  extmct,  dose,  half  a  dram  to  two  di'ams; 
solid  extract,  dose,  live  to  eight  grains ;  tincture,  four  ounces  to  a 
pint  of  alcohol,  dose,  one  to  three  di-ams ;  infusion,  two  ounces  to  a 
pint  of  wal  dose,  half  an  ounce  to  two  ounces;  comin,  the  active 
principle,  dose,  one  to  eight  grains. 

Dwarf  Elder  (Aralia  Hispida).  —  A  perennial  under-shrub,  grow- 
ing from  New  England  to  Virginia.  The  bark  of  the  root  is  diuretic 
and  alterative.  An  infusion  made  from  it  is  used  in  gravel,  suppres- 
sion of  the  urine,  and  dropsy;  to  be  taken  in  wineglassful  doses, 
three  or  four  times  a  day. 

Elder  (Sambucus  Canadensiti).  —  The  flowers,  berries  and  inner 
bark  of  the  elder  are  used  in  medicine.  A  warm  infusion  of  the 
flowei-s  is  diaphoretic,  and  gently  stimulant.  A  cold  infusion  is  diu- 
retic, alterative  and  cooling ;  used  in  ei-ysipelas,  liver  affections  of 
cliildren,  rheumatism,  scrofula,  and  some  syphilitic  diseases.  The 
bark,  pounded  with  lard,  forms  a  useful  ointment  for  burns  and 
scalds,  and  so»ne  diseases  of  the  skin. 

Elecampane  (Inula  Helenium). — This  perennial  plant  is  a  native 
of  Europe  and  Japan,  and  is  cultivated  in  this  country.  The  root  is 
stimulant,  tonic,  diuretic  and  expectorant,  and  is  used  in  chronic 
affections  of  the  lungs  and  air-passages.  It  is  said  a  decoction  from 
the  root  forms  a  good  application  for  the  itch  and  other  skin  diseases. 
Dose  of  the  powdered  root,  from  a  scruple  to  a  dr»m;  of  the  infusion, 
one  fluid  ounce 

Electro-Magnetism.  — Within  a  few  years,  electro-magnetism  has 
been  employed  extensively  as  a  remedial  agent,  particularly  in  the 
various  forms  of  nervous  disorders.  That  it  is  a  valuable  agent  in  the 
treatment  of  disease,  few  thinking  physicians  doubt ;  yet,  like  most 
other  new  things  in  medicine,  it  has  had  its  enthusiastic  admirers, 
who  have  claimed  for  it  remedial  powers  beyond  what  it  realty  has, 
and  who  have  applied  it  to  purposes  beyond  its  sphere  of  usciulness. 

Feverfew  (^Pyrethrum  Parthenium) .  —  In  warm  infusion,  this  herb 
is  valuable  in  i-ecent  colds,  flatulency,  worms,  irregular  menstruation, 
hysterics,  and  suppression  of  the  urine.  The  cold  infusion  is  a 
tonic.     A  poultice  made  of  the  leaves  soothes  and  alleviates,  pain. 

Figwort  (Scrophdaria  Nodosa).  —  The  leaves  and  root  are  diu- 
retic, alterative,  and  anodyne,  and  in  some  places  are  used  in  liver 
complaints,  scrofula,  dropsy,  and  diseases  of  the  skin.  Applied 
externally  in  the  form  of  ointment,  or  fomentation,  it  is  said  to  be 
useful  in  piles,  painful  tumors,  bruises,  ringworm,  and  inflammation 
of  the  breasts.  Dose  of  the  infusion,  from  two  to  three  fluid  ounces, 
three  times  a  day. 


temperature 
n'k  in  iiitei- 
iixty  grains, 
two  di-ams; 
Junces  to  a 
ounces  to  a 
,  the  active 

hrub,  grow- 
'tis  diuretic 
'el,  suppres- 
ssful  doses, 

i  and  inner 
ision  of  the 
Lsiou  is  diu- 
ffectious  of 
iases.  The 
burns  and 

'  is  a  native 
The  root  is 
in  chronic 
Dction  from 
in  diseases, 
le  infusion, 

;netism  has 
arly  in  the 
^ent  in  the 
,  like  most 
a  admirers, 
really  jjag, 
us^xulness. 

ti,  this  herb 
nstruation, 
fusion  is  a 
es  pain. 

)t  are  diu- 
d  in  liver 
Applied 
said  to  be 
lammation 
lid  ounces, 


SS" 


MEDICINES   AND  THEIR   PREPABATI0N8. 


837 


Fio.212.    Foxglove. 


Flax«eed  (Linum  Usitatissimum).  —  This  is  demulcent  and  nutri- 
tive, and  is  much  used  in  couglis,  bronchial  diseases,  intlammation  of 
the  urinary  organs,  bowels  and  lungs;  chiefly  taken  in  the  form  of 
flaxseed  tea.  The  infusion  is  sometimes  used  as  an  injection  in  dys- 
entery and  piles.     Linseed  oil  is  prepared  from  flaxseed. 

Foxglove  (^Digitalis  Purpurea,  Fig.  212). — A  biennial  plant,  grow- 
ing in  the  temperate  parts  of  Europe.  The  leaves, 
in  proper  doses,  are  sedative  and  diuretic,  reducing 
the  pulse,  and  increasing  the  flow  of  urine.  In 
large  doses,  they  are  a  narcotic  poison.  The  medi- 
cine has  been  much  used  in .  inflammatory  diseases, 
palpitation  of  the  heart,  and  in  dropsy  connected 
with  diseased  heart  or  kidneys.  When  taken  for 
some  time,  it  is  liable  to  accumulate  in  the  system, 
and  suddenly  to  manifest  poisorious  and  alarming 
symptoms,  as  if  a  large  dose  had  been  taken.  The 
American  hellebore  is  sometimes  used  in  its  place. 

Dose  of  the  powdered  leaves  of  foxglove,  from 
one  to  three  grains  ;  of  the  tincture,  from  eight 
to  ten  drops. 

Frost  weed  (^Helianthemum  Canadense). —  This 
herb,  also  known  by  the  name  of  rockrose,  is  tonic, 
astringent,  and  alterative,  and  has  been  considerably  used  in  scrofula; 
combined  with  turkey-corn  and  queen's-root,  itis  said  to  have  effected 
cures  in  secondary  syphilis.  A  decoction  forms  a  useful  gargle  in 
ulcerations  of  the  mouth  and  throat  in  scarlet  fever  and  other  dis- 
eases, and  as  a  wash  in  scrofulous  inflammation  of  the  eyes.  Dose  of 
the  fluid  extract,  one  to  two  drams,  three  or  four  times  a  day. 

Qalls.  —  These  are  the  unhealthy  excrescences  found  growing  on 
the  young  boughs  of  the  dyer's  oak,  QuercuB  infeotoria,  growing  in 
Asia.  They  are  powerfully  astringent.  In  the  form  of  infusion,  or 
decoction,  made  in  the  proportion  of  half  an  ounce  to  a  pint  of  water, 
they  are  useful  as  an  astringent  gargle,  wash,  or  injection ;  and  finely 
powdered  galls,  one  part  to  eight  parts  of  lard,  make  a  valuable  oint- 
ment for  bleeding  piles.  Dose  of  powdered  galls,  from  ten  to  fif- 
teen grains. 

Qamboge.  —  The  hardened  juice  of  trees  growing  in  Siam  and 
Cochin  China.  This  gum-resin  is  a  hydragogue  cathartic,  acting 
severely  and  harshly  upon  the  bowels,  and  hence  is  not  often  used 
alone.  On  account  of  the  severity  of  its  action,  it  is  improper  to  use 
it  during  inflammation  of  the  stomach  or  bowels,  piles,  pregnancy, 
diseased  womb,  or  excessive  menstruation.  Combined  with  cream  of 
tartar  and  jalap,  it  is  a  valuable  remedy  in  dropsy.  The  dose  is  one 
or  two  grains. 

Qarlic  (Allium  Sativum).  — The  bulb  is  the  part  used.     It  is  stim- 


"I 


I 


.^iftic 


f 


838 


MRDICINKH   AND   THEIK   PREPARATIONS. 


V 


ulant,  diuretic,  oxpoctorant,  and  mbcfacioiit ;  useful  in  couglis, 
hoarsenesH,  whooping-oough,  and  in  the  iiervuus  8pii.8iuudiu  couglhs  of 
cliildren.  Dose,  from  twenty  grains  to  tliree  drams ;  dose  of  the 
juice,  mixed  witli  sugar,  half  a  teaspoonful  to  a  teaspoonful. 

The  bruised  bulbs  are  sometimes  usefully  applied  as  a  poultice  to 
the  chests  of  young  children  having  inflammation  of  the  lungs,  and 
as  drafts  to  the  feet  in  inflammation  of  the  brain,  fevers,  etc. 

Qentian  ( Qentiana  Lutea).  —  It  grows  among  the  Alps,  Apennines, 
and  Pyrenees.  The  root  is  the  part  used,  and  is  brought  to  this 
countiy  from  Germany.  This  medicine  has  long  maintained  its  rejt- 
utation,  having,  it  is  said,  derived  its  name  from  Gentius,  king  of 
lUyria.  It  is  a  pure  and  simple  bitter,  exciting  the  appetite  and 
invigorating  the  digestive  powers.  It  may  be  used  in  all  cases 
dependent  on  pure  debility.  It  is  much  employed  in  dyspepsia,  and 
during  recovery  from  exhausting  diseases. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram  ;  com- 
pound fluid  extract,  dose,  half  a  dmra  to  a  dram ;  solid  extract,  dose, 
three  to  ten  grains ;  tincture,  four  ounces  to  one  pint  of  diluted 
alcohol,  dose,  two  to  three  drams.  A  valuable  preparation  is  made 
by  uniting  fluid  extract  of  rhubarb,  two  ounces ;  fluid  extract  of 
gentian,  half  an  ounce ;  diluted  alcohol,  two  pints ;  dose,  half  an 
ounce  to  an  ounce. 

Ginger  {Zingiber  Officinale').  —  This  is  a  native  of  Hindostan,  and 
is  cultivated  in  all  parts  of  India.  The  root  is  the  part  used.  It  is 
a  grateful  stimulant  and  carminative,  and  is  much  used  for  dyspep- 
sia, wind  in  the  stomach,  colic,  gout,  etc.  It  is  an  excellent  addition 
to  bitter  infusions,  and  is  much  used  to  disguise  the  taste  of  nauseous 
medicines.     Dose,  from  ten  to  twenty  grains. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram ;  tincture, 
four  ounces  to  one  pint  of  diluted  alcohol,  dose,  two  to  four  drams ; 
infusion,  dose,  one  to  two  ounces ;  syrup,  dose,  one  to  two  drams. 

Ginseng  (^Panax  Quinquefolium,  Fig.  213).  —  A  perennianl  plant, 
growing  in  the  Middle  and  Southern  States.  It  is 
a  mild  tonic  and  stimulant,  and  has  some  reputa- 
tion for  improving  impaired  appetite,  and  for  ner- 
vous debility,  weak  stomach,  etc.  Some  persons 
are  in  the  habit  of  chewing  it,  and  it  is  consid- 
erably used  in  this  way.  Dose  of  the  powdered 
rr  from  ten  to  forty  grains ;  of  the  infusion,  from 
J  to  three  fluid  ounces. 

Glycerin.  —  This  is  the  sweet  or  sugary  portion 
of  oils,  and  is  obtained  from  them  during  the  man- 
ufacture of  lead  plaster.     It  is  demulcent  and  an- 
Fio.  218.  GnrsBNo.     tiseptic,  and  has  been  recently  recommended  and 
used  to  some  extent  in  place  of  cod-liver  oil,  in 
It  has  been  still  more  used,  however,  as  a  soothing 


consumption. 


MEDICINES   AND   THEIR    PREPARATIONS. 


839 


in    couglis, 

ic  COUgllN  of 

dose  of  tlio 
ful. 

i  poultice  to 
)  lungs,  and 
etc. 

.  Apennines, 
lUght  to  this 
ined  its  reih 
ius,  king  of 
appetite  and 
in  all  cases 
spepsia,  and 

dram  ;  com- 
xtract,  dose, 
t  of  diluted 
ion  is  made 
:  extract  of 
ose,  half  an 

idostan,  and 
used.  It  is 
for  dyspep- 
3nt  addition 
of  nauseous 

n;  tincture, 
four  drams ; 
o  drams. 

nianl  plant, 
bates.  It  is 
ome  reputa- 
nd  for  ner- 
me  persons 
b  is  consid- 
3  powdered 
'usion,  from 

ary  portion 
ig  the  man- 
ent  and  an- 
lended  and 
iver  oil,  in 
a  sootking 


and  emollient  external  application  in  skin-diseases,  and  also  in  place 
of  lard  in  the  preparation  of  ointments. 

Qold. The  chief  salt  of  gold  used  in  medicine  is  the  chloride  or 

muriate  of  gold  and  soda.  It  is  diuretic  and  alterative.  It  ia  used 
in  scrofula,  skin  diseases,  goitre,  scirrhous  tumors,  ophthalmia,  dropsy 
and  8yi)hilis.  Also  in  the  Keeley  cure  for  inehriates.  It  will,  in 
many  cases,  take  away  the  craving  for  liquor,  hut  we  think  there  is 
great  danger  of  the  patient  becoming  insane  and  having  a  desire  to 
commit  suicide.  The  dose  is  from  one-thirtieth  to  one-twelfth  of  a 
grain,  and  is  given  dissolved  in  water,  or  made  into  pill  with  starch 
or  gum-arabic. 

Oolden  Seal  {Hydrastis  Canadensis,  Fig.  214).  — A  perennial  plant, 
growing  throughout  the  United  States,  par- 
ticularly in  the  West.  The  root  is  the  me- 
dicinal part.  It  is  a  tonic,  having  especial 
action  upon  diseased  mucous  tissues,  and  is 
particularly  beneficial  during  recdvery  from 
exhausting  diseases.  It  is  used  in  dyspepsia, 
chronic  affections  of  the  nervous  coats  of  the 
stomach,  erysipelas,  and  remittent,  intermit- 
tent and  typhoid  fevei-s.  United  with  gera- 
nium, it  has  u  tine  effect  in  chronic  diarrhoea 
and  dysentery. 

Preparations.  —  Fluid  extract,  dose,  half 
a  dram  to  two  drams ;  solid  extract,  dose, 
two  to  three  grains ;  hydrastin  (resinoid), 
dose,  one-half  to  three  grains ;  hydrastin 
(neutral),  dose,  two  to  five  grains;  hydras- 
tina  (alkaloid),  dose,  onfe  to  three  grains  ; 
tincture,  three  ounces  to  one  pint  of  dilut- 
ed alcohol,  dose,  from  half  an  ounce  to  an 
ounce.  For  varipus  forms  of  sore  mouth  and  ulcerated  sore  throat, 
the  following  is  a  useful  gargle :  fluid  extract  of  golden  seal,  half 
an  ounce ;  fluid  exti-act  of  blue  cohosh,  half  an  ounce ;  fluid  ex- 
tract of  witch-hazel,  half  an  ounce ;  pulverized  alum,  one  dram ; 
honey,  three  dmms  ;  water,  one  pint.  As  a  stimulant  for  a  sluggish 
liver,  and  as  a  tonic  in  enfeebled  mucous  membrane  in  epidemic  dys- 
entery, and  other  complaints,  the  following  powders  are  valuable : 
hydrastin,  twenty  grains ;  leptandrin,  twelve  grains ;  podophyllin, 
two  grains ;  pulverized  cayenne,  two  grains ;  sugar  of  milk,  or  pul-. 
verized  loaf-sugar,  one  dram ;  rub  together  thoroughly  in  a  mortar, 
and  divide  into  twenty  powders ;  give  one  every  two  hours. 

Ground  Ivy  (Nepeta  Gfhihoma).  —  A  perennial  herb,  common  to 
the  United  States  and  Europe  ;  in  some  places  known  as  gill-over-the 
ground.     The  leaves  are  the  part  used,  which  are  stimulant,  tonic, 


Flo.  814.     QOLDEM  SEAL. 


\im 


r;!? 


\}^ 


nut" 


840 


MKDICINES    AND   THEIU   PRKPAIIATIONH. 


mid  pectoral  ;  considered  useful  in  jaundice,  iiMthma,  and  diHeatitiH  of 
the  kidneys  and  lungs. 

Quaiacum.  —  This  medicine  is  the  simvings  or  chips  of  the  wnoil 
of  a  tree  growing  in  the  West  Indies,  also  resin  obtained  from  the 
same  tree.  It  is  stimulant  and  alterative,  and  is  used  in  chronio 
rheumatism,  diseases  of  the  skin,  scrofula,  and  venereal  complaints. 
The  tincture  of  the  resin  is  valuable  as  an  emmenagogue.  Dose  nf 
the  tincture,  from  one-half  to  two  teaspoonfuls,  to  be  taken  with 
milk.  The  wood  is  much  used  att  an  ingredient  in  alterative  prepar- 
ations of  sarsaparilla,  etc. 

Oum-Arabic.  —  This  is  the  hardened  sap  of  trees  growing  iii 
Egypt,  Arabia,  and  other  tropical  countries,  being  several  variotieH 
of  the  acacia.  It  is  demulcent,  and  a  combustive  nutritive,  and  '\n 
much  used  in  forming  mixtui-es  for  hoaraeness,  cough,  sore  throat, 
gonorrhceea,  inflammation  of  the  bladder,  strangury,  bronchitis,  and 
irritations  of  raucous  membranes  generally.  Mucilage  of  gum-arabic 
is  a  preparation  made  by  dissolving  four  ounces  of  powdered  gum  in 
a  pint  of  boiling  water. 

Qum,  Hemlock. — This  is  the  hardened  juice  of  the  hemlock,  Abies 
Canadensu,  a  tree  growing  in  Canada  and  Maine.  This  gum  is  a 
mild  rul)efacientv  and  like  burgundy  pitch,  chiefly  used  to  make  plas- 
ters, etc.,  for  which  purpose  it  is  very  valuable.  A  tincture  of  the 
gum  is  diuretic  and  stimulant.  The  oil  of  hemlock  is  valuable,  in 
combination  with  other  oils,  in  preparing  liniments.  The  bark  is 
astringent,  and  is  much  used  in  tanning  leather. 

Hcemastasis.  —  This  word  is  used  to  imply  the  retention  of  the 
venous  blood  in  the  limbs  by  ligatures.  A  cord  or  common  handker- 
chief is  tied  round  the  upper  part  of  the  arhis,  or  thighs,  and  a  piece 
of  wood  being  slipped  under  the  cord,  is  twisted  round  until  the  cord 
is  so  tightened  as  to  prevent  the  return  of  the  venous  blood,  but  not 
to  prevent  the  outward  passage  of  the  arterial  blood.  In  this  way, 
the  blood  passing  out  continually  in  the  arteries,  and  not  returning 
by  the  veins,  the  vessels  of  the  liml)8  become  filled  to  their  utmost 
capacity,  and  a  great  quantity,  for  the  time  being,  is  withdrawn  from 
tlie  trunk.  This  process  is  useful  in  bleedings  from  the  lungs,  stom- 
ach and  womb,  and  inflammation  of  the  brain,  lungs,  bowels,  etc., 
and  in  whatever  case  it  may  be  thought  desirable,  for  the  tipie  being, 
to  lessen  the  blood  in  the  head  or  trunk,  without  debilitating  the 
patient. 

Hair-cap  Moss  (Polytriehum  Juniperum).  —  An  evergreen  plant 
growing  on  poor,  sandy  soils  in  the  Northern  States.  A  strong  infu- 
sion of  it  is  powerfully  diuretic.  In  dropsical  cases,  two  fluid  ounces 
of  the  infusion  should  be  taken  every  half  hour.  It  is  useful  in 
fevers,  iiiflammations,  gravel,  etc.  * 


ite 


MKDICINKH   AND   TIIEIK    PUKI'AKATIONB. 


841 


MiseaHWH  of 

of  the  wo(Mi 
ed  from  tlie 
1  in  chroiiio 
coHiplaijitH. 
-'•  DoHe  of 
taken  with 
itive  prepur- 


growing  ill 
'•ill  varioticH 
itive,  and  m 
sore  throiit, 
iicliitis,  and 
gum-arabic 
3red  gum  in 

nlock,  Abies 
i«  gum  is  a 
»  make  plas- 
iture  of  the 
valualile,  in 
'lie  bark  is 

tion  of  the 
on  handker- 
and  a  j)iece 
til  the  cord 
od,  but  not 
1  this  way, 
t  retaining 
leir  utmost 
Imwn  from 
lings,  stom- 
owels,  etc., 
;iqie  being, 
itating  the 


reen  plant 

rong  infu- 

lid  ounces 

useful  in 


tiBrdflBCk  (Spint-a  Tomentom,  Fig.  21')).  —  Tliirt  is  a  iM-aiitifitl 
sliriib,  eoniniou  in  the  L'niUtd  StutuM.  ItM  leaves  are  of  a  dark  green 
color  above,  and  white  underneath.  It  is  tonic;  and  im- 
triagent,  and  is  muc.ii  used  in  chronic  diarrhuta,  eholera 
infantum,  etc.  It  agrees  well  with  the  stomach,  and  is 
deservedly  a  popular  remedy  in  summer  complaints  of 
children. 

A  fluid  extract  of  it  is  the  Ixsst  preparation ;  dose,  four 
to  twenty  drops.  It  is  much  used  in  the  form  of  infusion. 
The  green  herb  boiled  in  milk  forms  a  valuable  preparation 
in  clironic  diarrhcea,  when  attended  with  much  debility. 

Hardleaf  Qolden-Rod  (^Solidago  Riyida). —  A  {)eren- 
nial  plant,  growing  throughout  the  United  States,  espe- 
cially on  the  western  prairies.  It  is  tonic,  astringent  and 
styptic,  and  useful  to  arrest  bleeding  from  the  nose,  lungs, 
utomach,  and  bowels.  The  powder  and  infusion  are  used,  HAKDHAuk. 
both  externally  and  internally. 

Helonia«  {Helonias  Dioica). —  This  herb  is  common  in  the  United 
States,  and  is  known  by  the  name  of  faUe  unicorn  plant.  The  root, 
which  is  the  part  used,  is  tonic,  diuretic,  and  vermifuge.  In  large 
dose's  it  is  emetic,  and  when  used  fresh,  sialagogue.  In  five  or  seven 
grain  doses,  three  times  a  day,  it  relieves  dyspepsia,  restores  the  appe- 
tite, expels  worms,  and  relieves  colic.  It  is  a  valuable  womb-tonic, 
gradually  removing  debility  of  that  organ,  and  curing  whites,  pain- 
ful menstruation,  and  a  tendency  to  habitual  abortion.  Dose  of  the 
decoction,  from  two  to  four  fluid  ounces.  The  decoction  is  said  to 
kill  insects,  bugs,  etc. 

Preparations.  —  Fluid  extract,  dose,  one  to  three  drams  ;  helonin, 
the  ac'ive  principle,  dose,  one-fourth  to  one-half  a  grain. 

Hisnbane  (^Hyoscyamus  Niger,  Fig.  216).  —  This  plant  grows  abund- 
antly in  Great  Britain,  and  on  the  continent 
of  Europe,  and  is  rare  in  this  country.  All 
the  parts  are  active.  It  is  narcotic,  gently  ac- 
celerating the  circulation,  increasing  the  gen- 
eral warmth,  occasioning  a  sense  of  heat  in 
the  throat,  and  after  a  time  inducing  sleep. 
It  is  often  used  in  the  place  of  opium,  because 
it  does  not  bind  the  bowels.  Used  in  rheu- 
matism, gout,  bronchitis,  asthma,  consump- 
tion, whooping-cough,  hysterics,  and  spas- 
modic affections  generally. 

Preparations.  —  Fluid  extract,  dose,  ten  to 
fifteen  drops ;  solid  extract,  dose,  half  a  grain 
to  a  grain  ;  tincture,  two  ounces  to  one  pint 
of  diluted  alcohol,  dose,  half  a  dram  to  a  dram ;  hyoscyamin,  the  ac- 
tive principle,  dose,  one-eighth  to  half  a  grain.   In  neui-ulgia,  rheum- 


FIO.  !16.    HEKBAKE. 


'    i! 


MKni(;iNK8   ANI»   TUKIH   I'KKl'AKATIONS. 


843 


OIK)  ])int<)f  water,  domi,  Iwo  to  throo  ouiicus  ;  lupuliii,  dosu,  hIx  to  eiglit 
iM'iiiiiH;  tinutiirt)  of  liiiiuUn,  two  ouiicoh  to  one  pint  of  iilcohol,  doHt;, 
olio  to  two  (IniniH,  in  Hweeteiied  water ;  fifteen  to  twenty  fjriiiiis  of 
lii|)uliii,  well  rubbed  up  with  white  Huj^iir  in  ii  inortiv,  ia  very  efficii- 
fious  in  priiipisni,  ehonlee,  and  Hpennatorrho'a. 

Horscmint  (Monarda  Punctata^.  —  This  well-known  plant,  which 
is  common  to  the  United  States,  is  stiniidant,  carminative,  and  diu- 
retic. A  warm  infusion  maybe  used  .i  flatulence,  nausea,  and  vom- 
iting. If  the  Inxly  bo  kept  cool  while  takinjj  it,  it  will  act  lut  a  din- 
nitic.  The  oil  of  hoi-semint  is  used  for  similar  purposes  with  the 
plant.  Dose,  from  two  to  five  droj)s  on  suj^ar.  Dose  of  the  essence, 
from  ten  to  twenty  drops  in  sweetened  water.  The  oil  is  frequently 
used  as  an  ingredient  in  liniments.  > 

Horseradish  (^Coahlearia  Armoraoia).  —  The  fresh  root  of  this 
well  known  perennial  is  stimidant,  diuretic,  antiscorbutic,  and  rulx)- 
faciont.  It  is  useful  in  rheumatic,  paralytic,  scorbutic,  dropsical,  and 
dyspeptic  affections.  It  is  said  that  a  warm  infusion  of  the  fresh  root 
in  cider,  drunk  freely  every  night,  will  cause  perspiration  and  a  free 
flow  of  urine,  and  will  consequently  cure  dro{)8y.  The  fresh  root 
grated  in  vinegar,  and  eaten  with  meat  at  dinner,  strengthens  the 
stomach  and  promotes  digestion. 

houseleek  {Sempervivum  Trctorum).  —  The  bruihed  leaves  of  this 
perennial  form  a  cooling  application  to  burns,  stings  of  insects,  ery- 
sipelas, and  other  inflammations  ;  valuable  also  for  ringworm,  shin- 
gles, and  other  skin  diseases. 

Hydrangea  {Hydrangea  Arhoreseeng).  —  This  grows  abundantly 
in  the  Southern,  Middle,  and  Western  States.  Its  root  is  medicinal. 
It  is  diuretic,  and  has  been  much  praised  for  its  power  of  relieving 
the  excruciating  pain  caused  by  the  passage  of  stone  through  the 
urethra,  as  well  as  for  infallibly  removing  such  stones  from  the  blad- 
der, provided  they  are  not  already  too  large  for  passage  through  the 
water-pipe.  A  concentrated  decoction  or  the  fluid  extract  may  be 
taken  in  teaspoonf  ul  doses  several  times  a  day,  —  care  being  taken 
not  to  push  the  medicine  to  the  extent  of  dizziness  or  oppression  of 
the  chest. 

Hyssop  (Hyasopus  Officinalis.^  —  This  is  a  native  of  the  continent 
of  Europe,  and  is  cultivated  in  this  country.  The  tops  and  leaves 
are  the  parts  used.  They  are  stimulant,  aromatic,  carminative,  and 
tonic.  The  infusion  has  been  much  employed  in  chronic  bronchitis 
of  old  people,  and  those  of  debilitivted  habits.  It  makes  the  raising  of 
mucus  more  easy.  The  infusion  may  be  combined  with  sage  and 
alum,  and  sweetened  with  honey.  The  fresh  leaves  bruised,  and 
applied  externally,  relieve  the  pain  and  dispense  the  spots  and  marks 
caused  by  contusions. 


'r\: 


844 


MEDIOINKS   AND   THEIlt    FKKPAKATIONS. 


Iceland  floss  (^Cetraria  Islandica).  —  This  plant  is  found  in  the 
northern  latitudes,  both  of  the  old  and  new  world,  and  is  abundant 
or  the  mountains  and  in  the  sandy  plains  of  New  England.  It  re- 
ceived its  name  from  its  prevalence  in  Iceland,  in  which  country,  as 
well  as  in  Lapland,  it  serves,  in  consequence  of  the  gum  and  starch 
it  contains,  as  food  for  the  inhabitants.  It  is  demulcent,  tonic,  and 
nutritious,  and  is  well  fitted  to  relieve  affections  of  the  mucous  mem- 
branes of  the  lungs  and  bowels,  connected  with  debility  of  the  diges- 
tive organs;  it  is  given  therefore  in  Tihronic  bronchitis  and  other 
affections  of  the  chest,  attended  with  copious  expectoration,  especially 
when  the  matter  :' V'harged  is  purulent;  also  in  dyspepsia,  chronic 
dysentery,  and  r^.  n-h.^ea.  It  is  usually  employed  in  the  form  of  de- 
coction; and  \a  Mucii  used  in  the  common  article  of  diet  called 
blanc-mange.  ^ 

Ice'Plant  (^Mbnotropa  Unifiora).  —  This  perennial  plant,  found  in 
various  parts  of  the  country,  is  snow-white,  resembling  frozen  jelly, 
and  is  juicy  and  tender,  dissolving  in  the  hands  like  ice.  The  flowers 
are  in  shape  like  a  pipe;  hence  it  is  called  the  pipe-plant.  The  root 
V?  the  medicinal  part,  and  is  tonic,  nervine,  and  antispasmodic.  It 
'  as  also  been  considered  sedative  and  diaphoretic  ;  and  the  powder 
nas  been  sometimes  used  in  the  place  of  opium.  It  is  said  to  be 
valuable  in  epilepsy,  chorea,  and  other  spasmodic  affections.  Dose  of 
the  powdered  root,  from  thirty  to  sixty  grains,  two  to  three  times  a 
day.  » 

Indian  Hemp  {Avocynum  Cannabinum).  —  This  perennial  plant 
resembles  bitter-root,  and  grows  in  similar  situations.  The  root  is 
powerfully  emetic,  and  in  decoction,  diuretic  and  diaphoretic.  It 
diminishes  the  frequency  of  the  pulse,  and  produces  drowsiness.  It 
has  great  eflficacy  in  dropsy. 

Preparations.  —  Fluid  extract,  dose,  as  a  tonic,  five  to  ten  drops ; 
as  an  emetic,  twenty  to  twenty-five  drops ;  solid  extract,  dose,  one 
to  three  grains ;  tincture,  dose,  one  to  two  drams,  as  a  tonic,  half  an 
ounce  to  an  ounce,  as  an  emetic  ;  infusion,  half  an  ounce  to  a  pint  of 
water ;  dose,  half  an  ounce  to  an  ounce. 

Indian  Turnip  (^Arum  Triphyllum) This  is  a  perennial  plant, 

growing  in  damp  places  in  North  and  South  America,  and  known  by 
the  name  of  dragon-root.  The  root  when  chewed  is  excessively  acrid, 
producing  a  biting  sensation  which  may  be  somewhat  relieved  by 
milk.  The  fresh  root  is  acrid,  expectorant,  and  diaphoretic,  and  has 
been  used  in  asthma,  whooping-cough,  chronic  bronchitis,  chronic  rheu- 
matism, and  colic,  and  externally  in  scrofulous  tumors,  scald  head, 
and  other  skin  disorders.  Dose  of  the  gratsd  root,  in  syrup  or  muci- 
lage, ten  grains,  three  or  four  times  a  day. 

Iodine  {lodinurn).  —  This  is  prepared  from  the  ashes  of  kelp,  or 
sea-weed,  and  is  in  small  bluish-black,  shining  scales.     It  is  alterative, 


MEDICINES    AND   THEIR   I'REPARATIONS. 


845 


3und  in  the 
is  abundant 
and.     It  re- 
country,  as 
and  starch 
t,  tonic,  and 
1UC0U8  mem- 
of  the  diges- 
s  and  other 
n,  especially 
psia,  chronib 
form  of  de- 
diet  called 

mt,  found  in 
frozen  jelly, 
The  flowers 
t.  The  root 
lasmodic.  It 
I  the  powder 
is  said  to  be 
ins.  Dose  of 
ibree  times  a 

rennial  plant 

The  root  is 

phoretic.     It 

owsiness.     It 

to  ten  drops ; 
act,  dose,  one 
tonic,  half  an 
le  to  a  pint  of 

rennial  plant, 
md  known  by 
essively  acrid, 
,t  relieved  by 
iretic,  and  has 
,  chronic  rheu- 
8,  scald  head, 
lyrup  or  muci- 

les  of  kelp,  or 
t  is  alterative, 


tonic,  and  somewhat  diuretic.  It  has  been  chiefly  emjloyed  in  dis- 
eiises  of  the  absorbent  and  glandular  system,  particularly  scrofula, 
goitre,  and  glandular  tumors  generally.  Dose,  in  substance,  half  a 
grain,  two  or  three  times  a  day,  in  form  of  pill ;  in  form  of  tincture, 
thrbe  to  five  drops. 

Iodide  of  Potassium  (^Potmsii  lodiduni).  —  This  is  one  of  the  prep- 
arations of  iodine,  and  is  sometimes  improperly  called  hydriodate  of 
potasm.  It  is  formed  by  decomposing  the  iodide  of  iron  by  carbonate 
of  potassa.  It  is  used  for  the  same  purposes  as  iodine,  but  chiefly  as 
an  alterative  in  tertiary  syphilis,  for  which  it  is  a  specific ;  also  in 
some  forms  of  chronic  rheumatism,  and  in  leprosy.  Dose  of  the  salt, 
from  two  to  fifteen  grains.  It  is  much  combined  with  bitter  tinctures, 
and  particularly  with  the  compound  preparations  of  sarsaparilla,  yel- 
low dock,  and  queen's-root.  The  acids  and  metallic  salts  are  incom- 
patible with  it. 

Ipecacuanha.  —  This  is  a  small  perennial  plant,  growing  tr^  moist 
woods,  in  several  countries  of  South  America.  The  ^oct  is  the  part 
used.  It  is  a  very  valuable  emetic,  in  large  doses  j  in  smaller  doses, 
it  is  sudorific  and  expectorant.  Used  to  prr  iuce  vomiting  in  the 
commencement  of  fevers,  inflammatory  diseases,  swelled  testicles,  and 
before  the  paroxysms  of  ague ;  and  to  excite  nausea  in  dysentery, 
asthma,  whooping-cough,  various  hemorrhages,  and  inflammation  of 
the  lungs ;  and,  combined  wdtu  opium,  to  produce  diaphoresis  in 
rheumatism,  gout,  and  febrile  complaints.  Dose,  as  an  emetic,  from 
fifteen  to  thirty  grains ;  to  excite  nausea,  from  one  to  three  grains ; 
and  to  produce  diaphoresis,  two  to  six  gmins,  with  one  grain  of 
opium. 

Preparations.  —  Fluid  extract,  dose,  as  an  expectorant,  five  to  eight 
drops ;  as  an  emetic,  half  a  dram  to  a  dram  ;  tincture,  half  an  ounce 
to  an  ounce  ;  wine  of  ipecac,  three  ounces  to  one  pint  of  sherry  wine, 
dose,  a  quarter  to  half  a  di-am,  as  an  expectorant ;  two  and  a  half  to 
three  drams  as  an  emetic.  The  following  is  a  useful  expectorant  for 
young  children :  fluid  extract  of  ipecac,  two  drams ;  syrup  of  tolu, 
five  drams ;  mucilage  of  gum-arabic,  one  ounce  ;  sherry  wine,  three 
drams, —  mix.     Dose,  one  dram. 

Iron  (Ferrum).  —  As  this  is  the  most  abundant,  so  is  it  the  most 
useful  of  all  the  metals.  It  is  widely  diffused  through  the  mineral, 
the  vegetable,  and  the  animal  kingdoms.  It  is  an  essential  constitu- 
ent in  the  blood  of  man,  and  as  a  medicine  it  has  great  value,  being 
a  powerful  tonic.  In  most  cases  wh'^re  the  blond  is  thin  and  reduced, 
iron  is  our  best  remedy;  it  raises  the  pulse,  p.omotes  the  secretions, 
and  gives  color,  body,  and  nutritive  qualities  to  the  blood.  It  is 
much  used,  in  some  one  of  its  prepared  forms,  in  clironic  ana  nia,  chlor- 
osis, hysterics,  whites,  rickets,  chorea,  dyspepsia,  neuralgia,  and  par- 
ticularly consumption.  Care  should  be  taken  in  using  the  various 
preparations  of  iron,  not  to  let  the  remedy  touch  the  teeth.     It  is 


846 


MKDICINE^  AND   TH"IU   PREPAKATI0N8. 


V 


well  to  take  them,  when  not  in  pill  form,  through  a  gliws  tube.     The 
following  are  most  of  the  chemical  preparations  of  iron  used  in  medi- 


cine; 


Ammonia-Citrate  of  Iron  (^Ferri  Ammonio  Citras).  —  This  is  in 
the  form  of  thin  scales,  of  a  beautiful  garnet-red  color,  and  has  a 
slightly  acid  taste.  It  is  very  soluble  in  water.  Its  great  solubility 
gives  it  some  advantage  oyer  the  citrate.  The  dose  is  five  grams, 
three  times  a  day,  in  solution. 

Black  Oxide  of  Iron  (Ferri  Oxidum  Nigrum).  —  This  is  a  dark, 
grayish-black  powder,  unchangeable  in  the  air,  and  having  magnetic 
properties.  It  is  a  valuable  chalybeate,  and  may  be  given  in  five  to 
ten-grain  doses. 

Citrate  of  Iron  (Ferri  (7t«ra«).  —  This  is  a  valuable  preparation  of 
iron.  It  is  soluble  in  water.  Usually  given  in  the  form  of  pill,  in 
two  to  three-grain  doses,  three  times  a  day. 

Citrate  of  Iron  and  Quinia  (Ferri  et  Quinioe  Citras).  — In  the 
form  of  shining  scales,  garnet^jolored,  and  soluble  in  water.  Au  ex- 
cellent antiperiodic  and  tonic.  Given  in  intermittents,  when  the 
blood  is  low,  etc.  Dose,  five  to  eight  grains,  two  or  three  times  a 
day.    '  ,   , 

Citrate  of  Iron  and  Strychnia.  —  It  is  a  valuable  preparation,  and 
combines  the  properties  of  iron  and  strychnia,  and  has  proved  an 
efficacious  remedy  in  atonic  dyspepsia,  absence  of  the  menses,  St. 
Vitus's  dance,  green-sickness,  hysterics,  etc.  It  is  a  beautiful  salt, 
looking  like  citrate  of  iron,  except  that  it  is  a  little  darker.  Three 
grains  of  the  iron  are  combined  with  one-sixteenth  of  a  grain  of 
strychnia. 

Hydrated  Oxide  of  Iron  (Ferri  Oxidum  Hydratum').  —  This  is  in 
a  reddish-brown,  moist  mass,  not  much  used  in  medicine,  except  as 
an  antidote  to  the  poison  of  arsenic,  for  which  it  is  very  valuable.  It 
should  be  given  in  tablespoonful  doses,  often  repeated. 

Iodide  of  Iron  (^Ferri  lodidum,').  — The  iodide  of  iron  is  a  crystal- 
line substance,  of  a  greenish-black  color  and  styptic  taste.  It  has 
tonic,  alterative,  diuretic,  and  emmenagogue  properties.  It  is  em- 
ployed chiefly  in  scrofulous  complaints,  swelling  of  the  glands  of  the 
neck,  chlorosis,  absence  of  the  menses,  and  leucorrhoea.  In  obstinate 
syphilitic  ulcers,  and  in  secondary  syphilis,  occurring  in  scrofulous 
and  debilitated  subjects,  it  has  been  used  with  success.  Dose,  three 
grains,  gradually  increased  to  five.  It  should  never  be  given  in  the 
form  of  a  pill,  but  preferably  in  combination  with  simple  syrup  (see 
Syrup  of  Iodide  of  Iron). 

Lactate  of  Iron  (Ferri  Xac«a«).  —  This  has  the  general  medicinal 
properties  of  the  ferruginous  preparations.  It  increases  the  appetite 
m  a  marked  degree,  and  has  been  used  with  decided  benefit  in  clilo- 


MED1CINK8   AND   THEIR    PREPAKATI0N8. 


847 


58  tube.  The 
used  in  medi- 

—  This  is  in 
}r,  and  has  a 
reat  solubility 
,8  five  grains, 

'his  is  a  dark, 
fing  magnetic 
ven  in  five  to 

preparation  of 
jrm  of  pill,  in 

'as).  —  In  the 
'^ater.  An  ex- 
nts,  when  the 
three  times  a 

■eparation,  and 
las  proved  an 
le  menses,  St. 
beautiful  salt, 
iarker.  Three 
of   a  grain  of 

I.  —  This  is  in 
cine,  except  as 
:y  valuable.    It 

on  is  a  crystal- 
taste.  It  has 
ies.  It  is  eni- 
e  glands  of  the 
.  In  obstinate 
f  in  scrofulous 
J.  Dose,  three 
be  given  in  the 
aple  syrup  (see 

leral  medicinal 
ies  the  appetite 
benefit  in  clilo- 


rosis.  Dose,  one  to  two  grains,  three  times  a  day.  The  dose  may 
be  gradually  increased.  Given  in  the  form  of  solution,  pill,  or 
lozenge. 

Phosphate  of  Iron  (Ferri  Phosphas). — This  is  a  slate-colored 
powder,  insoluble  in  water.  It  is  a  valuable  remedy  in  consumption, 
cancer,  and  nervous  diseases,  accompanied  by  a  low  state  of  the  blood. 
Dose,  one  or  two  grains,  three  times  a  day. 

Persalt  of  Iron  {MoniseVs  Styptic').  — Thui  is  a  most  valuable 
styptic,  and  is  used  with  success  in  restraining  violent  bleedings.  It 
produces  no  irritant  effects  upon  the  tissues,  and  may  be  used  with 
safety  both  in  slight  and  extensive  surgical  operations.  Physicians 
should  have  it  by  them,  and  will  find  it  very  serviceable  in  sudden 
emergencies  of  bleeding.  It  is  prepared  in  solution  and  in  the  form 
of  diy  salt.  The  solution  is  the  most  convenient  and  eligible  form, 
and  may  be  applied  as  prepared. 

Powder  of  Iron  (^Ferri  Pulvis).  —  This  is  what  is  often  called  iron 
by  hydrogen,  or  Qu^venne's  iron.  It  is  an  impalpable  powder,  and 
of  an  iron-gray  color.  If  black,  it  is  worthless.  It  is  used  in  anaemia, 
and  in  all  those  conditions  characterized  by  deficiency  of  coloring- 
matter  in  the  blood.  The  best  metallic  iron  for  medicinal  use.  Dose, 
from  two  to  five  grains, several  times  a  day;  to  be  given  in  the  form 
of  pill. 

Precipitated  Carbonate  of  Iron  (Ferri  Subcarbonaa.)  -—  This  is  a 
reddish  powder,  insoluble  in  water.  It  is  tonic,  alterative,  and  em- 
menagogue,  and  is  used  in  neuralgia,  chorea,  chlorosis,  anaemia,  epi- 
lepsy, scrofula,  etc.  Dose,  five  to  twenty  grains,  three  times  a  day, 
to  be  taken  in  a  little  water. 

Protoxide  of  Iron  (Ferri  Protoxiduni).  —  This  is  of  a  dark-blue 
color,  and  has  a  tendency  to  absorb  oxygen  from  the  air,  which  con- 
verts it  into  the  sesquioxide.  It  is  a  valuable  preparation  of  iron. 
Dose,  from  two  to  five  grains,  tliree  times  a  day.  • 

Solution  of  Protoxide  of  Iron.  —  The  protoxide  of  iron  is  more 
readily  absorbed  and  assimilated,  and  agrees  better  with  the  stomach 
than  any  other  preparation  of  this  metal.  It  is  prepared  in  the  form 
of  a  syrup,  of  which  the  dose  is  from  one  to  two  teaspoonf uls ,  three 
times  a  day. 

Solution  Protoxide  Iron,  with  Rhubarb  and  Colombo.  —  This  is 
a  composition  of  protoxide  of  iron  with  vegetable  tonics.  As  a 
remedy  in  many  forms  of  dyspepsia,  it  must  prove  of  great  value. 

Solution  Protoxide  Iron,  with  Quinine.  —  This  has  become  a 
remedy  of  established  reputation.  Quinine  combined  with  iron,  par- 
ticularly with  the  protoxide,  must  have  great  advantages  as  a  chaly- 
beate tonic.     Each  tablespoonful  contains  half  a  grain  of  quinine. 


848 


MEDICINES   AND    THEIR   PREPABATIONS. 


V 


>. 


Solution  Protoxide  of  Iron,  witli  Iodide  of  Potassa. — In  this 

preparation  the  valuable  alterative  propeities  of  iodide  of  potassium 
are  connected  with  iron.  It  is  therefoi-e  alterative  and  tonic,  and 
may  be  used  in  scrofulous  and  other  weakened  conditions  of  the  sys- 
tem. It  is  a  remedy  of  decided  merit.  Three  grains  of  the  iodide 
of  potassium  are  contained  in  each  tablespoonful. 

Sulpliate  of  Iron  (^Ferri  Sulphas).  —  This  is  in  the  form  of  transpa- 
rent crystals,  of  a  pale,  bluish-green  color,  and  efflorescent  in  the  air. 
It  has  a  styptic  taste,  and  is  soluble  in  about  twice  its  weight  of 
cold  water,  but  insoluble  in  alcohol.  It  is  astringent  and  tonic.  In 
large  doses  it  produces  nausea  and  griping  of  the  bowels.  Useful 
in  scrofula  and  as  an  astringent  in  passive  hemorrhages,  sweats,  dia- 
betes, chronic  mucous  catarrh,  leucorrhcea  and  gleet.  As  a  tonic  it 
is  useful  in  dyspepsia. 

Syrup  of  Iodide  of  Iron  (^Syntpus  lodidi  Fern).  —  This  is  an 
elegant  preparation  of  iodine  and  iron,  and  is  given  in  all  debilitated 
conditions  of  the  system,  when  there  is  a  taint  of  scrofula.  Dose, 
from  twenty  to  sixty  drops,  well  diluted,  at  the  moment  of  taking, 
with  water. 

Syrup  of  iodide  Iron  and  flanganese.  —  This  is  of  a  light  straw- 
color,  prepared  from  protosulphate  of  iron,  protosulphate  of  man- 
ganese, and  iodide  of  potassium.  It  is  a  remedy  of  unsurpassed 
efficacy  in  anaemic,  scrofulous,  syphilitic,  and  cancerous  affections. 
It  is  considered  superior  to  the  syrup  of  iodide  of  iron.  Dose,  from 
ten  to  thirty  drops. 

Tartrate  of  Iron  and  Potassa  (Ferri  et  Potaasce  Tartras.  —  This 
is  in  the  form  of  beautiful  shining  scales,  of  a  dark  ruby  color,  of  a 
slightly  chalybeate  taste,  and  very  soluble  in  water.  It  is  one  of  the 
mildest  of  the  salts  of  iron,  and  is  considerably  used  in  scrofula,  weak- 
ness of  the  bowels,  general  debility,  etc.  It  is  much  used  as  a  remedy 
for  syphilis,  both  externally  and  internally.  The  dose  is  ten  to  twenty- 
five  grains  in  solution. 

Tincture  of  Muriate  of  Iron  (Tinctura  Ferri  Ghloridi').  —  This 
has  a  reddish-brown,  yellowish  color,  a  sour  and  very  styptic  taste, 
and  an  odor  like  muriatic  ether.  It  is  one  of  the  most  active  and 
certain  preparations  of  iron,  generally  agreeing  with  the  stomach,  and 
much  employed  for  purposes  for  which  iron  is  used.  It  is  useful  in 
scrofula,  gleet,  and  leucorrhcea ;  also  in  hemorrhages  from  the  womb, 
kidneys,  and  bladder,  of  a  passive  character.  Dose,  from  ten  to  twenty- 
five  drops,  gradually  increased  to  one  or  two  drams,  two  or  three 
times  a  day.     It  should  be  given  diluted  with  water. 

Valerianate  of  Iron.  —  This  salt  is  in  the  form  of  a  dark-red  pow- 
der, having  a  faint  odor,  and  a  taste  of  valerianic  acid.  It  is  soluble 
in  alcohol,  and  insoluble  in  water.  Given  in  hysterical  affections, 
complicated  with  chlorosis.     Dose,  one  grain,  several  times  a  day. 


a.  —  In  this 
'f  potassium 
i  tonic,  and 
s  of  the  sys- 
f  the  iodide 

a  of  transpa- 
it  in  the  air. 
is  weight  of 
i  tonic.  In 
!l8.  Useful 
sweats,  dia- 
k.8  a  tonic  it 

This  is  an 

debilitated 

ula.     Dose, 

of  taking, 

light  straw- 
te  of  man- 
msurpassed 
affections. 
Dose,  from 

•as.  —  This 
color,  of  a 
one  of  the 
f  ula,  weak- 
is  a  remedy 
to  twenty- 
mo.—This 
'ptic  taste, 
active  and 
)mach,  and 
8  useful  in 
the  womb, 
to  twenty- 
J  or  three 

k-red  pow- 
is  soluble 
affections, 
3  a  day. 


mr 


MEDICINES    AND   THEIR   PREPARATIONS. 


849 


Isinglass  (Ichthyocolla).  —  A  gelatinous  sul)8tance,  prepared  from 
the  bladder  of  fishes.  It  is  soluble  in  alkaline  solutions  and  diluted 
acids.  In  boiling  it  dissolves  and  forms  a  jelly  upon  cooling,  in  which 
form  it  is  chiefly  used  as  a  nutritive  diet  for  the  sick. 

Jalap  (Ipomcea  Jalapa).  —  This  is  a  Mexican  plant.  Its  root  is 
an  active  cathartic,  producing  liquid  stools,  more  or  less  griping. 
United  with  cream  of  tartar  it  becomes  a  hydragogue,  and  is  useful 
ill  dropsy.     The  dose  is  from  fifteen  to  twenty-five  grains. 

Preparations Fluid  extract,  dose,  a  quarter  to  one  dram  ;  solid 

extract,  dose,  three  to  five  grains ;  tincture,  two  ounces  to  the  pint  of 
diluted  alcohol,  dose,  one  to  two  drams  ;  jalapin,  the  active  principle, 
dose,  one  to  two  grains. 

Juniper  {Juniperu  Communin). —  This  evergreen  shrub  is  a  native 
of  Europe,  and  is  naturalized  in  some  parts  of  this  country.  The 
berries,  which  are  the  parts  used,  are  wrinkled,  of  a  dark-purple  color, 
about  the  size  of  a  pea.  They  are  gently  stimulant  and  diuretic,  and 
have  been  used  in  scurvy  and  inflammation  of  the  bladder,  chiefly  in 
connection  with  more  active  diuretics.  The  oil  of  juniper  obtained 
from  the  berries  is  used  for  similar  purposes.  Five  minims  of  the 
oil  mixed  with  one  fluid  dram  of  sweet  spirits  of  nitre,  and  given 
three  times  a  da}',  is  valuable  in  dropsy.  Dose  of  the  berries,  from 
one  to  two  drams ;  of  tlie  oil,  from  five  to  ten  drops. 

Kino.  —  This  is  the  hardened  juice  of  an  East  Indian  tree,  Ptero- 
carpus  Marmpium.  There  are  several  varieties  of  it.  It  is  a  power- 
ful and  valuable  astringent,  and  is  much  used  in  diarrlioea,  not 
attended  with  inflammation.  Opium  is  often  united  with  it,  and  it 
is  a  favorite  addition  to  chalk-mixture.  It  is  also  used  in  chronic 
dysentery,  leucorrhcea  and  diabetes.  It  may  be  used  in  the  form  of 
powder,  infusion,  or  tincture.  Dose  of  the  powder,  ten  to  twenty 
grains ;  of  the  tincture,  one  or  two  fluid  drams ;  the  infusion  is  use- 
ful as  an  injection  in  leucorrhcea  and  gonorrhoea.  The  powder  is 
sometimes  sprinkled  with  advantage  on  indolent  and  flabby  ulcers. 

Ladies'  Slipper  (^Cypripedium  ^ubescens.  Fig. 
218). —  The  fibrous  roots  are  the  parts  used  of  this 
plant.  It  is  tonic,  nervine,  and  anti-spasmodic,  and 
is  employed  in  nervous  headache,  and  other  ner- 
vous affections,  as  excitability,  hysterics,  neuralgia, 
etc. 

Preparations.  —  Fluid  extract,  dose,  half  a  di-am 
to  a  dram ;  solid  extract,  dose,  five  to  ten  grains  ; 
tincture,  two  ounces  to  a  pint  of  diluted  alcohol, 
dose,  half  an  ouuce;  cypripedin,  the  active  prin- 
ciple, dose,  two  to  three  grains.  The  following  is 
a  useful  preparation  for  producing  sleep,  in  wakeful 
and  excited  conditions :  fluid  extract  ladies'  slipper,  j.,q 

one  ounce;  fluid  extract  pleurisy  root,  one  ounce  ;      la»ii!,c'"slippek. 


m 


21ft. 


#r 


850 


MBD1CINE8   AND   THEIR   PRKPARATIONS. 


fluid  extract  skunk-cabbage,  one  ounce  ;   fluid  extract,  scuUcaj),  one 
ounce  ;  mix  ;  dose,  half  a  dmni  to  a  dram,  three  times  a  day. 

For  sick  and  nervous  headache,  dependent  on  an  acid  stomach, 
the  following  is  useful:  fluid  extract  ladies'  slipper,  half  an  ounce; 
fluid  extract  catnip,  half  an  ounce ;  fluid  extract  scullcap,  half  an 
ounce  ;  water,  one  pint ;  mix  ;  dose,  one  and  a  half  to  three  drams. 

Lead  {Plumbum).  —  Lead  acta  upon  the  system  as  a  sedative  and 
iwtringent.  Internally,  it  is  used  for  the  purpose  of  reducing  tlm 
force  of  the  circulation,  and  for  restraining  impioper  bleeding  and 
other  excessive  discharges.  Externally,  it  is  employed  to  sulKlne 
inflammation.  •  It  should  not  be  excessively  used,  for,  if  taken  in- 
ternally for  a  long  time,  it  injures  the  nervous  system,  and  brings  on 
apoplexy,  palsy,  and  particularly  lead  colic.  Nature  generally  gives 
notice  when  it  is  doing  mischief,  by  drawing  a  blue  line  around  the 
edge  of  the  gum».  The  preparation  of  lead  chiefly  used  in  medicine 
is  the  following :  — 

Acetate  of  Lead  {Plumbi  Acetas).  —  This  is  known  by  the  name 
of  mgar  of  lead  and  is  a  white  salt,  crystallized  in  brilliant  needles. 
It  has  first  a  sweetish,  and  then  an  astringent  taste.  In  medicinal 
doses,  it  is  a  powerful  sedative  and  astringent;  in  large  ones  an 
irritant  poison.  It  is  principally  used  internally  for  bleeding  from 
the  lungs,  bowels,  and  womb.  The  dose  is  generally  two  grains, 
united  with  half  a  grain  to  a  gnain  of  opium,  in  the  form  of  pill.  Ex- 
ternally, it  is  employed  in  form  of  solution  and  applied  to  inflamed 
surfaces  witli  cloths.  Four  grains  of  sugar  of  lead  and  four  of  pul- 
verized opium  to  the  pint  of  water,  make  a  good  lotion  for  various 
purposes. 

Lemon  (Citrus  Limonum).  —  This  is  a  well-known  tropical  fruit, 
the  juice  of  which  has  a  grateful  acid  taste,  and  is  much  used  in 
fevers  and  inflammatory  complaints,  forming  the  agreeable  drink 
called  lemonade.  The  oil  of  lemon,  obtained  from  the  fresh  rind  of 
the  fruit,  is  chiefly  used  in  perfumery,  and  to  render  the  taste  of 
medicines  more  agreeable. 

Lettuce  (Lactuca  Sativa).  —  The  medicinal  properties  of  this 
garden-plant  are  contained  in  the  milk.  It  is  given  when  opium 
disagrees  with  the  patient,  to  allay  cough  and  irritability.  It  is  one 
of  the  most  wholesome  vegetables  for  the  table. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  two  drams; 
solid  extract,  dose,  two  to  five  grains.  The  following  is  a  useful 
compotind  syrup :  fluid  extract  lettuce,  two  ounces ;  fluid  extract 
poppy,  four  ounces;  simple  syrup,  ten  ounces;  mix;  dose,  half  a 
dram  to  a  dram. 


Life- Root  (Seneeio  Aureus).  —  This  is  a  perennial  plant,  growing 
on  the  banks  of  mai-shy  creeks  in  the  Northern  and  Western  States, 
and  sometimes  called  ragwort.     Both  the  root  and  herb  are  diuretic, 


MEDICINKB   AND   THEIR   PREPARATIONS. 


851 


BcuUciiji,  one 
.  (lay. 

cid  stomach, 
If  an  ounce; 
leap,  half  an 
hree  drams. 

sedative  and 
reducing  ilm 
bleeding  and 
d  to  suhdne 
if  taken  in- 
nd  brings  on 
nerally  gives 
e  around  the 
I  in  medicine 

by  the  name 
iant  needles. 
In  medicinal 
irge  ones  an 
leeding  from 

two  grains, 
of  pill.     Ex- 

to  inflamed 

four  of  pul- 
i  for  various 

ropical  fruit, 
luch  used  in 
eeable  drink 
fresh  rind  of 
the  taste  of 

'ties  of  this 
wlien  opium 
y.     It  is  one 

two  drams; 
;  is  a  useful 
fluid  extract 
dose,  half  a 

mt,  growing 
stern  States, 
are  diuretic, 


pectoral,  diaphoretic,  and  tonic,  considerably  vabied  as  a  remedy  in 
gravel  and  other  urinary  affections,  particularly  strangury.  It  is 
useful  for  promoting  menstrual  discharges. 

PrepiiratioiiH.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram  ;  infu- 
sion, dose,  one  to  three  ounces;  senecin,  the  active  principle,  dose, 
three  to  five  grains.  For  chlorosis,  accompanied  by  absence  of  the 
menses,  the  following  is  a  useful  preparation :  senecin,  aletrin  and 
sulphate  of  iron,  four  grains  each.  Mix  and  divide  into  two-grain 
powdera.  Six  gmins  each  of  senecin  and  geraniin,  mixed  and  tivken 
in  doses?  of  two  to  four  grains,  has  a  good  effect  in  restraining  an 
immoderate  flow  of  the  menses.  In  painful  menstrua  'on,  the  follow- 
ing is  a  good  pill :  senecin,  two  grains ;  quinine,  six  grains ;  solid 
extract  belladonna,  three  grains ;  make  into  ten  pills,  and  take  one 
every  three  hours  till  the  pain  is  subdued. 

Lime  (^Calx).  —  This  is  one  of  the  alkaline  earths,  and  is  an  abun- 
dant natural  production.  It  is  used  in  several  forms  in  medicine,  of 
which  the  following  are  the  chief :  — 

Chloride  c'  t-ime  ( Calx  Chloirnata').  —  This  is  a  moist,  grayish- 
white  substsmce,  having  the  odor  of  chlorine,  and  possessing  powerful 
bleaching  properties.  Externally  used,  it  is  disinfectant,  and,  dis- 
solved in  water,  is  applied  with  advantage  to  ill-conditioned  ulcertf, 
burns,  chilblains  and  eruptions  of  the  skin  ;  also  as  a  gargle  in  putrid 
sore  throat,  and  as  a  wash  for  ulcerated  gums,  and  to  purify  the 
breath.  It  has  been  used  with  advantage  in  dysentery,  both  by  mouth 
and  injection,  to  correct  the  fetor  of  the  stools. 

Lime- Water  {Aqua  Calcis).  —  This  is  made  by  dissolving  four 
ounces  of  lime  in  a  gallon  of  water,  and  letting  the  solution  stand 
in  a  covered  vessel,  and  pouring  off  the  clear  liquor  when  it  is  wanted 
for  use.  It  is  antacid,  antilithic,  tonic,  and  astringent,  valuable  in 
all  complaints  attended  with  acidity  of  the  stomach.  United  with 
milk,  and  used  as  the  scile  diet,  it  is  sometimes  the  only  remedy  for 
chronic  diarrhoea  of  long  standing.  Dose  of  lime-water,  half  an 
ounce  to  an  ounce. 

Liquorice  (Glycm'rhiza  Q^labra').  —  This  grows  in  the  south  of 
Europe  and  Asia.  The  root  is  the  pari  used.  It  is  demulcent  and 
expectorant,  and  is  useful  in  cough,  chionic  bronchitis,  and  irritations 
of  the  mucous  surfaces  generally.  The  pulverized  root  "nited  with 
an  equal  amount  of  sulphur  and  a  little  molasses,  is  a  \iviaable  pre- 
paration for  coughs.  The  black  extract  may  be  used  for  the  same 
purposes  as  the  root. 

Liverwort  (^Bepatica  Americana). —  An  indigenous  plant,  growing 
in  woods,  upon  the  sides  of  hills  and  mountains.  The  leaves  with- 
stand the  cold  of  winter,  and  the  flowers  appear  early  in  the  spring. 
The  whole  plant  is  medicinal.     It  is  a  mild  demulcent  tonic  and 


Hf 


MBH 


852 


MEDICINES   AND   TIIRIK   PRKPARATIONS. 


FlO.  219.    LOBKLIA 


oHtringent,  and  has  been   used  in  fevei-H,  liver-complaints,  bleeding' 
from  the  lungn,  and  coiighH. 

Pri'parntioHK.  —  Fluid  extract, dose,  two  to  three  drams;  infuHion, 
four  ounces  to  the  pint  of  water,  to  be  taken  freely. 

Lobelia  {Lobelia  Infiata^  Fig.  219).  —  Thib  weed  grows  throughout 
the  United  States ;  both  its  seeds  and  leaves  are  used  in 
medicine.  The  plant  is  emetic,  expectorant,  sedative 
and  aiitispa^tmodic.  As  an  emetic  it  is  generally 
used  in  combination  with  other  articles  for  that  pur- 
pose. It  is  of  great  advantage  in  spasmodic  asthma, 
as  well  ivs  in  bronchitis,  croup,  whooping-cough,  and 
other  throat  and  chest  affections.  Whenever  relaxa- 
tion is  re(]uired  to  subdue  spasm,  or  for  other  pur- 
poses, lobelia  will  l)e  found  useful. 

Preparations.  —  Fluid  extmct,  dose,  as  an  ex- 
pectorant, ten  to  fifty  drops ;  as  an  emetic,  one-fourth 
of  a  dnvni  to  a  dram  ;  tincture,  two  ounces  to  a  pint 
of  diluted  alcohol,  dose,  as  an  expectorant,  one  to 
three  drams,  as  an  emetic,  half  an  ounce ;  infusion, 
dose,  an  ounce  every  half  hour  till  vomiting  ensues; 
lobelin,  the  active  principle,  dose,  half  a  grain  to  a  grain  and  a  half. 
The  following  mixture  will  be  found  excellent,  as  an  expectorant 
and  sudorific  in  spasmodic  croup,  whooping-cough  and  asthma,  and 
for  subduing  mucous  inflammation  about  the  throat  and  air-passages: 
tincture  of  lobelia,  half  an  ounce  ;  tincture  of  bloodroot,  two  ounces ; 
oil  of  spearmint,  half  a  diam ;  empyreumatic  syrup,  five  ounces ; 
dose,  half  a  dmm  every  two  hours.  A  poultice  made  of  lobelia,  elm- 
bark  and  weak  lye,  relieves  sprains,  bruises,  rheumatic  pains,  erysip- 
elatous inflammations  and  poison  from  ivy  or  dogwood. 

Logwood  (^Hcematoxylon  Oampechianum).  —  This  tree  is  a  native 
of  tropical  America.  The  wood  is  used  in  medicine.  It  is  tonic  and 
astringent,  and  is  used  with  advantage  in  diarrhoea,  dysentery,  and 
in  the  relaxed  state  of  the  bowels  after  cholera  infan^vni.  Used 
freely  with  other  treatment,  it  also  benefits  constitutions  broken  down 
by  disease  or  dissipation. 

Preparations.  —  Fluid  extract,  dose,  half  a  dmm  to  a  dram  ;  solid 
extract,  dose»  five  to  twenty  grains ;  infusion,  half  an  ounce  to  a  pint 
of  water,  dose,  four  drams  every  three  or  four  hours,  in  diarrhoea. 

Magnesia  (Magnesia  Ustd).  —  Calcined  magnesia  is  obtained  from 
carlxinate  of  magnesia,  by  exposure  to  a  strong  heat.  It  is  a  white, 
inodorous,  light  powder,  of  a  feeble  alkaline  taste.  It  is  antacid  and 
laxative,  and  is  much  used  in  dyspepsia,  sick  headache,  gout,  and  in 
other  complaints  attended  with  sour  stomach  and  costiveness ;  like- 
wise a  favorite  remedy  in  complaints  of  children.  Dose,  as  a  laxative, 
from  thirty  to  forty  grains ;  as  an  antacid  or  antilithic,  ten  to  twenty- 
five  grains,  once  or  twice  a  day. 


I 


} 


MKDICINES   ANP      HEIK    PRKPAKATIONS. 


853 


nts,  bleeding 
■ni8 ;  infiiHioii, 

vn  througliout 
/es  are  u.sed  in 
rant,  sedative 
is  gejiemily 
for  that  |)ur- 
lodic  aatluna, 
g-cough,  luid 
never  relaxa- 
or  other  pur- 

N  as  an  ex- 
ic,  one-fourth 
ices  to  a  pint 
Jraiit,  one  to 
ce;  infusion, 
iling  enwues; 
n  and  a  half, 
expectorant 
asthma,  and 
air-jjassages: 
,  two  ounces ; 
five  ounces ; 
■  lobelia,  elm- 
pains,  erjKip. 

i  is  a  native 
;  is  tonic  and 
sentery,  and 
it\au.  Used 
broken  down 

dram ;  solid 
ice  to  a  pint 
diarihoea. 

bteined  from 
t  is  a  white, 
antacid  and 
fout,  and  in 
eness;  like- 
8  a  laxative, 
I  to  twenty- 


Carbonate  of  Magnesia  (Mafln-'nice  Carhoruu).  —  This  is  prepared 
from  Hulpliiiti!  of  magnesia,  \)y  carbonate  of  soda.  It  is  antacid,  and 
when  it  meets  with  acid  in  the  stomach  and  bowels  it  is  laxativo. 

Sulphate  of  Magnesia  {Magnetia  Sulphas).  —  Obtained  from  sea- 
water.  This  is  the  well-known  EpLJm  salts  and  is  purgative  und 
diuietic.  Used  in  all  cases  which  require  purgatives.  It  generally 
operates  without  griping,  and,  when  united  with  an  acidulated  infu- 
sion of  roses,  will  remain  on  the  stomach  when  all  other  things  are 
rejected.  The  less  it  is  diluted  the  better  and  more  easily  it  oper- 
ates, provided  a  draught  of  warm  water  be  taken  an  hour  afteinvards. 
It  may  be  made  to  act  as  a  diuretic  by  keeping  the  skin  cool,  and 
walking  about  after  it  has  been  taken. 

Male  Fern  (^Anpidium  Filix  Mas).  —  This  perennial  plant  is  found 
in  both  Europe  and  America,  also  in  Asia  and  northern  Africa.  The 
root,  which  is  the  medicinal  part,  should  be  gathered  during  summer, 
as  thu  active  principle  is  more  abundant  at  that  season  than  any 
other.  It  is  also  said  to  deteriorate  by  age,  and  become  nearly  worth- 
less in  two  years.  It  is  slightly  tonic  and  astringent,  but  its  chief 
value  consists  in  its  power  to  destroy  and  expel  the  tapeworm. 

Preparations.  —  Solid  extract,  dose,  nine  to  twelve  grains.  The 
following  compound  pills  are  adapted  to  the  destruction  of  the  tape- 
worm :  solid  extract  male  fern,  two  scruples ;  gamboge,  fourteen 
grains ;  calomel,  fourteen  grains ;  scammony,  eighteen  grains.  Mix, 
and  divide  into  twenty  pills. '    Dose,  two  to  three  pills. 

Mandrake  (Podophyllum  Peltatum,  Fig.  220).  —  This  is  exclu- 
sively an  American  plant.     The  root  is  the     

medicinal  part.  It  is  cathartic,  alterative, 
anthelmintic,  hydragogue,  sialagogue,  and, 
in  large  doses,  emetic.  It  stimulates  and 
quickens  the  action  of  the  liver  and  kidneys, 
promotes  expectoration  and  determines  the 
blood  to  the  surface.  Combined  with  cream 
of  tartar,  it  produces  watery  stools  and  is  use- 
ful in  dropsy.  It  is  used  in  jaundice,  dysen- 
tery, diarrhoea,  bilious,  remittent,  and  inter- 
mittent fevers,  puerperal  fever,  typhoid  fever, 
and  all  glandular  enlargements.  But  it  has  a 
more  particular  action  upon  the  liver,  and  is  ^^°-  ^^O-  mandrake. 
especially  useful  in  derangements  of  that  organ. 

The  severity  of  its  action  seems  to  be  the  only  objection  to  its  very 
extensive  use.  Its  harshness,  however,  maybe  much  lessened  by  its 
combination  with  alkalies,  ginger,  or  caulophyllin. 

Preparations Fluid  extract,  dose,  half  a  dram  to  a  dram ;  com- 
pound fluid  extract,  dose,  one  to  two  dr.ais ;  solid  extract,  dose,  three 
to  twelve  grains ;  tincture,  three  and  a  half  ounces  to  one  pint  of  al- 
cohol, dose,  one  to  three  drams ;  podophyllin,  the  active  principle, 


i 


1 


864 


MEDICINEH    AND    I'HKIK   PKKf AUATIONH. 


dose,  iw  un  alterative,  ono-eighth  t4)  a  (juiirtui'  uf  a  grain  ;  uh  a  ciitli- 
artic,  one  to  two  gruins. 

Manna.  —  Tliis  is  the  concrete  juice  of  the  tree  called  OniuH 
Europcea,  growing  in  Sicily,  Calabria,  and  Aj.nlia,  as  well  as  of 
soveml  other  species  of  tree.  Manna  is  a  gentle  laxative,  operating 
mildly,  though  sonietinu's  producing  wind  and  pain.  It  is  consider- 
ably used  as  a  gentle  physic  for  children  and  women  in  the  family 
way.  The  usual  way  of  prescribing  it  is  in  connection  with  senna, 
rhubai'b,  magnesia,  or  the  neutral  salts.  Being  sweet,  it  conceals  the 
taste  of  these  remedies  in  some  measure,  while  it  adds  to  their  pur- 
gative effect.  Dose  of  manna,  for  a  grown  peition,  from  one  to  one 
and  a  half  ounces  ;  for  a  child,  from  one  to  four  drams,  according  to 
age. 

Marsh-Rosemary  (^Statice  Caroliniana).  —  This  plant  grows  on 
the  coast  from  Maine  to  Georgia.  The  root  of  it  is  the  medicinal 
part.  A  decoction  of  it  is  much  used  in  diarrhoea,  dysentery,  etc., 
also  ivs  a  gargle  in  ulcenited  sore  mouth  and  the  throat  affection  of 
scarlet  fever,  and  as  an  injection  in  gleet,  whites,  and  falling  of  the 
womb  and  bowel.  Dose  of  the  decoction,  one  or  two  tablespoonfuls 
every  hour  or  two. 

Marshmallow  (^Althcea  Offieinalis,  Fig.  221).  —  A  perennial  plant, 
growing  in  salt  marshes  and  other  moist  places  in 
Europe.  The  root  is  the  medicinal  part,  and  its 
properties  are  those  of  a  demulcent.  A  decoction 
of  it  is  used  in  irritations  and  inflammations  of 
mucous  membranes,  sis  in  inflammation  of  the 
lungs,  stomach,  bowels  and  bladder,  and  some 
affections  of  the  kidneys.  The  powdered  root, 
and  also  the  leaves  and  flowers,  are  sometimes 
employed  in  the  form  of  poultice. 

Mastic.  —  This  is  the  hardened  gum  or  resin 
which  flows  from  incisions  in  the  small  tree  or 
shrub  pistacia  lentiiscus,  growing  upon  the  borders 
of  the  Mediterranean.  It  is  not  much  used  in 
medicine,  but  is  chiefly  employed  in  manufactur- 
ing a  brilliant  varnish.  I  introdu(5e  it  here  principally  for  the  pur- 
pose of  recommending  the  following  use  of  it  in  carious  teeth,— 
particularly  in  those  new  parts  of  the  country  where  dentistry  is  not 
much  known.  Dissolve,  in  a  well-stopped  bottle,  four  parts  of 
mastic  in  one  part  of  sulphuric  ether.  Saturate  with  this  solution 
a  small  piece  of  cotton  of  the  size  of  the  cavity  in  the  tooth,  and  then, 
having  cleansed  and  dried  the  cavity,  gently  press  the  cotton  into  it. 
The  ether  will  soon  evaporate  and  leave  the  gum  to  attach  itsolf  to 
the  sides  of  the  tooth,  and  protect  its  inner  surfaces  from  the  action 
of  the  air  aud  food. 


FlO.  831. 
HAB8HUALLOW. 


mi ;  iiH  H  ciitli- 

called  Ormm 
lus  well  as  of 
live,  operiiiing 
It  is  coiiHider- 
in  the  fiiinily 
m  witli  seiiim, 
t  coiieealH  the 

to  their  pur- 
[)m  one  to  one 
I  according  to 

ant  grows  on 
the  medicinal 
ysentery,  etc., 
it  affection  of 
'ailing  of  the 
^blespoonfuls 

ronnial  plant 
loist  places  in 
part,  and  its 
A  decoction 
immations  of 
ation  of  the 
er,  and  some 
•wdered  root, 
fe  sometimes 


gum  or  resm 
small  tree  or 
n  the  borders 
inch  used  in 
manufactur- 
for  the  par- 
ous teeth, — 
atistry  is  not 
ur  parts  of 
this  solution 
th,  and  then, 
3tton  into  it. 
ich  ittsolf  to 
m  the  action 


i31b/mmttm»i^mmtm 


MEDICINES   AND   THEIR   PREPARATIONS. 


855 


Matico  (^Piper  Angustifolium).  —  The  leaves  of  this  plant  are 
styptic  and  somewhat  stimulant  and  tonic.  The  leaves  brought  in 
contact  with  a  bleeding  wound,  have  considerable  power  to  arrest 
the  flow  of  blood. 

Preparations. —  Fluid  extract,  dose,  half  a  dram  to  a  dram  ;  tinc- 
ture, four  ounces  to  a  pint  of  diluted  alcohol,  dose,  two  drams  to  one 
half  ounce ;  infusion,  half  ua  ounce  to  a  pint  of  water,  dose,  one  to 
one  and  a  half  ounces. 

Meadow-Saffron  (Colchicum  Autumnale,  Fig.  222).  —  This  is  a 
native  of  the  temperate  parts  of  Europe,  where  it 
grows  wild  in  moist  meadows.  The  roots  and  seeds 
are  used.  Colchicuin  is  justly  regarded  as  a  valuable 
remedy  in  gout  and  rheumatism,  in  which  it  is  much 
and  chiefly  used.  It  is  thought,  also,  to  act  upon  the 
nervous  system,  allaying  pain  and  producing  other 
sedative  effects.  When  not  carried  off  by  the  bow- 
els, it  {)roduces  sweating,  and  is  occasionally  diuretic 
and  expectorant.  Dose  of  the  dried  root,  from  two 
to  eight  grains. 

Preparations.  —  Fluid  extract  of  root,  dose,  three  fio.  222. 

to  ten  drops  ;  fluid  extract  of  seeds,  dose,  five  to  ten  meadow.saffbon. 
drojjs ;  tincture,  four  ounces  to  twelve  ounces  diluted  alcohol,  dose, 
ten  drops  to  half  a  dram ;  syrup,  two  ounces  to  fourteen  ounces  sim- 
ple syrup,  dose,  one  third  of  a  dram  to  a  dram;  wine,  three  ounces 
of  root  to  a  pint  of  sherry  wine,  dose,  twenty -five  to  thirty-five  drops. 

Monkshood  (^Aconite).  —  This  is  anodyne,  sedative  and  diapho- 
retic. The  leaves  and  roots  are  generally  used  separately.  It  is 
useful  in  inflammatory  diseases,  neuralgia,  epilepsy,  paralysis,  gout, 
and  particularly  in  fevers. 

Preparations.  —  Fluid  extract,  dose,  two  to  five  drops  ;  solid  ex- 
tract, dose,  one  quarter  of  a  grain  to  a  grain  ;  tincture,  eight  ounces 
of  the  root  to  a  pint  of  alcohol,  dose,  three  to  five  drops. 

A  preparation  composed  of  one  dram  of  the  tincture  of  aconite- 
root,  and  two  ounces  of  the  tincture  of  black  cohosh,  and  taken  in 
doses  of  one  teaspoonful  every  four  hours,  has  great  power  in  reliev- 
oig  the  various  forms  of  neuralgia,  and  also  chronic  rheumatic  pains, 
particularly  among  old  people. 

For  nervous  headache,  irritability,  restlessness  and  wakefulness, 
the  following  combination  of  aconite  is  useful :  — 

Solid  extract  of  aconite,  half  a  dram  ;  solid  extract  of  stramonium, 
four  grains  ;  valerianate  of  quinia,  one  scruple.  Mix  and  divide  into 
sixty  pills,  of  which  one  is  to  be  taken  every  two,  three,  or  four  hours, 
according  to  symptoms. 

Motherwort  (ieo«ttr««  Oardiaca). — This  perennial  plant  is  sup- 
posed to  be  a  native  of  Tartary,  and  introduced  into  this  country.  It 
IS  considerably  used  in  domestic  practice  for  nervous  complaints  and 


ill 


856 


MEDICINES   AND   THEIR   PREPARATIONS. 


many  chronic  disorders  attended  with  restlessness,  disturbed  sleep, 
pains  of  the  nerves,  and  affections  of  the  liver.  A  warm  infusion  of 
the  tops  and  leaves  is  useful  in  restoring  menstrual  suppression  from 
colds. 

Preparations.  —  Solid  extract,  dose,  three  to  five  grains.  Com- 
bined with  blue  cohosh  and  skunk-cabbage,  the  solid  extract  is  a 
nervine,  antispasmodic  and  emmenagogue. 

Mountain  Laurel  {Kalmia  LatifoUa,  Fig.  223).  —  The  laurel  is 

found  in  most  parts  of  the  United  States,  on  hills 

and  mountains,  flowering  in  June  and  July,  and  is 

very  ornamental.     It  is  sometimes  called  big  ivy,  or 

calico-bush.     The  narrow-leaf  laurel,  or  sheep-laurel, 

kalmia  angustifolia,  is  also  common,  and  similarly 

medicinal.     The  leaves  of  these  plants  are  used  in 

medicine,  and  produce,  when  taken  in  large  doses, 

vertigo,  dimness  of  sight,  etc.     In  medicinal  doses, 

they  are  sedative  and  astringent.     The   saturated 

no.  228.  tincture  is  the  best  form  of  administration,  which 

MoTOTAw  LAHBEL.    ^^^  j^  taken  in  ten  to  fifteen-drop  doses,  every 

two  or  three  hours,  in  syphilis,  active  hemorrhages,  hypertrophy  of 

the  heart  and  jaundice. 

Mullein  (^Verbascum  Thapsus'). —  The  leaves  and  flowers  of  this 
biennial  plant  are  antispasmodic,  diuretic  and  demulcent.  The  in- 
fusion is  frequently  used  in  domestic  practice,  and  is  useful  in  colds, 
coughs,  bronchitis,  etc. ;  and  may  be  drunk  freely.  The  leaves  are 
sometimes  boiled  in  milk,  sweetened,  and  taken  for  bowel  com- 
plaints. The  leaves  dipped  in  hot  vinegar  and  water  are  very  useful 
applied  as  a  fomentation  in  mumps,  acute  inflammation  of  the  tonsils 
and  malignant  sore  throat ;  a  handful  of  them  may  also  be  placed  '" 
a  teapot  with  hot  water,  and  the  steam  be  inhaled  tlu-ough  the  spo^c, 
in  the  same  complaints. 

Mustard.  —  The  seeds  of  the  white  mustard,  Sinapis  alba,  were  a 
few  years  ago  much  recommended  as  a  cure  for  constipation  of  the 
bowels ;  and,  swallowed  whole  in  teaspoonful,  or  even,  in  some  obsti 
nate  cases,  in  tablespoonful  doses,  they  afford  a  wholesome  stimulus 
to  the  bowels,  and  accomplish  some  good.  The  ground  mustftrd  is  a 
valuable  condiment  to  eat  in  small  quantities,  at  dinner,  in  dyspeptic 
cases.  It  finds  its  most  important  uses,  however,  as  a  prompt  and 
almost  instantaneous  emetic  in  cases  of  poisoning,  and  also  as  a  valu- 
able counter-irritant,  when  applied  extetn?l}y.  T'ne  ^'jlatile  oil  of 
mustard,  one  part,  and  ten  pails  of  sweet  oil,  nit;-  be  a^)plied  to  the 
skin  instead  of  the  mustard  poultice,  and  with  similar  results. 

Myrrh.  — The  tree  Balsamodendron  myrrha,  growing  in  Arabia, 
etc.,  yields  a  juice  which  hardens  into  a  gum-resin,  called  myrrh. 
This  pleasant,  aromatic  gum  is  stimulant,  tonic,  antiseptic,  emmena- 


MEDICINES   AND   THEIR   PREPARATIONS. 


857 


isturbed  sleep, 
rm  infusion  of 
ppression  from 

Efrains.  Coin- 
i  extract  is  a 

The  laurel  is 
itates,  on  hills 
I  July,  and  is 
led  big  ivy,  or 
r  sheep-laurel, 
and  similarly 
ts  are  used  in 
ti  large  doses, 
dicinal  doses, 
'he  saturated 
iration,  which 
doses,  every 
•pertrophy  of 

owers  of  this 
int.  The  in- 
ef  ul  in  colds, 
le  leaves  are 
bowel  com- 
e  very  useful 
of  the  tonsils 
be  placed  •" 
jh  the  spo^c, 

alba,  were  a 
tation  of  the 
I  some  obsti 
me  stimulus 
mustftrd  is  a 
in  dyspeptic 
prompt  and 
30  as  a  valu- 
tlatile  oil  of 
plied  to  the 

lUltB. 

X  in  Arabia, 
lied  myrrh, 
ic,  emmeua- 


ffogue  and  expectorant.  It  is  employed  in  chronic  bronchitis,  con- 
sumption, chlorosis,  absence  of  the  menses,  etc.  It  is  generally 
combined  with  iron  and  other  tonics,  and  in  amenorrhoea  it  is  fre- 
quently combined  with  aloes.  Locally,  it  is  considerably  used  as  a 
wash  to  improve  spongy  gums,  ulcers  of  the  mouth,  etc.  The  dose  is 
from  ten  to  twenty  grains,  to  be  given  in  pill  or  in  powder  suspended 
in  water.     The  tincture  uf  myrrh  is  a  useful  external  application. 

Naphtha.  —  This  belongs  to  the  class  of  native  inflammable  sub- 
stances, called  bitumens.  It  is  a  transparent,  yellowish  white,  very 
light  and  inflammable  liquid,  and  is  found  abundantly  in  Pereia. 
Said  to  have  been  used  with  advantage  in  Asiatic  cholera.  It  is 
composed  exclusively  of  carbon  and  hydrogen.  Dose,  from  ten  to 
twenty  drops,  given  in  half  a  glass  of  wine  or  mint-water.  During 
the  formation  of  coal-gas,  an  artificial  naphtha  is  obtained,  which, 
when  purified,  has  the  property  of  dissolving  India  rubber. 

Medicinally,  it  is  chiefly  used  for  purposes  of  inhalation  in  affec- 
tions of  the  chest. 

Naphthalin.  —  This  is  obtained  from  a  distillation  of  coal-tar.  Is 
is  soluble  in  ether,  alcohol,  naphtha  and  oils,  but  not  in  water.  It  it 
an  excellent  expectorant,  particularly  in  cases  of  impending  suffoca- 
tion of  old  persons  from  chronic  bronchitis ;  also  in  asthma  and  other 
pectoral  affections.  Being  stimulating,  it  is  improper  in  acute  bron- 
chitis, and  pulmonary  inflammation.  The  dose  is  from  ten  to  twenty- 
five  grains,  given  in  emulsion,  or  syrup,  every  fifteen  minutes,  until 
abundant  expectoration  takes  place.  A  scruple  of  naphthalin  mixed 
with  five  drams  of  lard,  makes  a  good  ointment  for  psoriasis,  dry 
tetter  and  leprosy. 

Nitrate  of  Silver  (^Argenti  Nitras).  —  Nitrate  of  silver  is  a  solu- 
tion of  silver  in  nitric  acid,  and  commonly  passes  under  the  name  of 
lunar  caustic.  It  is  both  in  the  form  of  small  cylindrical  rods  and 
of  crystals,  the  latter  being  more  pure  than  the  former. 

As  an  internal  remedy,  nitrate  of  silver  is  tonic  and  antispasmodic 
and  is  given  chiefly  in  nervous  diseases,  as  epilepsy,  St.  Vitus's  dance 
and  neuralgia  of  the  heart ;  also  in  some  forms  of  dyspepsia,  attended 
with  pain  in  the  stomach  and  vomiting.  The  dose  is  from  one-fourth 
to  half  a  grain  in  the  form  of  pill.  It  should  never  be  taken  regu- 
larly as  an  internal  remedy  more  than  two  months,  as  it  is  apt,  after 
long  use,  to  change  the  skin  to  an  indelible  slate-blue.  Use  only 
under  the  direction  of  a  physician. 

But  nitrate  of  silver  is  most  used  as  an  external  remedy  in  pharyn- 
gitis, laryngitis,  tracheitis  and  other  chronic  and  acute  inflammations 
of  mucous  membranes.  For  reducing  these  inflammations,  it  is  very 
nearly  a  specific ;  certainly,  it  is  altogether  the  best  remedy  we  have. 
It  fails  in  some  cases ;  but  when  skilfully  used  it  never  does  harm. 
The  solutions  to  be  applied  to  the  throat  require  to  have  a  strength 
of  from  fifteen  to  a  hundred  grains  to  the  ounce  of  soft  water.     A 


858 


MEDICINES   AND  THEIR  PREPARATIONS. 


solution  containing  one  to  four  or  more  grains  to  the  ounce  of  water 
is  often  used  in  inflammations  of  the  eye,  gonorrhoea,  etc. 

Nitre  (^Potassa;  Nitra%).  —  Nitre,  which  also  passes  under  the  name 
of  nitrate  of  potassa,  and  saltpetre,  is  both  a  natural  and  artificial  pro- 
duction. As  a  medicine,  it  is  refrigerant,  diuretic,  and  diaphoretic, 
and  is  much  used  in  inflammatory  diseases.  It  increases  the  secretion 
of  urine  and  sweat,  and  lessens  the  heat  of  the  body  and  the  frequency 
of  the  pulse.  United  with  tartar  emetic  and  calomel,  it  forms  the 
well-known  nitrous  powders,  which  promote  most  of  the  secretions, 
particularly  those  of  the  liver  and  skin.  One  of  these  powders,  con- 
stituting a  dose,  to  be  given  every  two  or  three  hours,  is  composed  of 
eight  grains  of  nitre,  one-eighth  of  a  grain  of  calomel,  and  one-eighth 
of  a  grain  of  tartar  emetic.     Use  with  care. 

Sweet  Spirit  of  Nitre  (Spiritus  jM:heris  Nitrici).  —  Sweet  spirit 
of  nitre  is  diuretic,  diaphoretic,  and  antispasmodic.  It  is  deservedly 
much  esteemed  as  a  medicine,  and  is  extensively  employed  in  febr-  ■ 
diseases,  either  alone  or  in  union  with  taitar  emetic,  or  with  spirit  of 
Mindererus.  It  is  often  a  grateful  stimulus  to  the  stomach,  relieving 
nausea  and  vomiting,  and  promoting  sleep.  It  acts  especially  upon 
the  kidneys,  augmenting  the  secretion  of  urine,  and  is  often  given  in 
conjunction  with  squills,  digitalis,  and  acetate  of  potassa.  The  dose 
is  a  teaspoonful,  given  in  water  every  two  or  three  hours. 

Nutmeg  (Myristica  Moschatd).  — The  nutmeg  is  from  a  tree  grow- 
ing in  the  Molucca  Islands.  It  is  stimulant  and  carminative,  and 
somewhat  used  to  remove  flatulency,  as  well  as  to  render  other  med- 
icines palatable ;  it  is  most  employed,  however,  to  flavor  drinks,  and 
articles  of  diet.  In  large  doses  it  is  poisonous,  producing  stupor  and 
delirium. 

Nux  Vomica  (Strychnog Niix  Vofnica,  Fig.  224).  —  The  tree  which 
produces  nux  vomica  grows  in  Bengal,  Malabar, 
on  the  coast  of  Coromandel,  and  in  other  re- 
gions.    The  seeds  are  the  medicinal  part. 

Nux  vomica  is  an  emphatic  excitant  of  the 
brain  and  spinal  cord,  and  in  large  doses  is  an 
active  poison ;  frequently  repeated  in  small 
doses,  it  is  tonic,  diuretic,  and  slightly  laxa- 
tive. 

Given  in  full  doses,  it  is  apt  to  produce  mus- 
cular contraction,  as  in  lockjaw,  together  witli 
frequent  starts  and  twitches,  as  if  from  electric 
shocks.  It  is  much  employed  in  treatment  of  paralysis,  and  is  more 
beneficial  in  general  than  in  partial  palsy. 

Preparations.  —  Fluid  extract,  dose,  two  to  seven  drops ;  solid 
extract,  dose,  half  a  grain  to  a  grain ;  tincture,  four  ounces  to  the  pint 
of  alcohol,  dose,  five  to  ten  drops  ;  strychnia,  commonly  called  strych- 
nin, the  active  principle,  dose,  one-sixteenth  to  one-eighth  of  a  grain. 


Fio.  824.  Nux  Vomica. 


aim 


MEDICINES  AND   THEIR   PKEPARATIONS. 


859 


unce  of  water 
Lc. 

ider  the  name 
artificial  pro- 
l  diaphoretic, 
I  the  secretion 
ihe  frequency 
it  forms  the 
le  secretions, 
powders,  con- 
1  composed  of 
lid  one-eighth 

Sweet  spirit 
is  deservedly 
l^ed  in  febr'; 
with  spirit  of 
ich,  relieving 
)ecially  upon 
ften  given  in 
a.  The  dose 
•8. 

I  a  tree  grow- 
ainative,  and 
!r  other  med- 
"  drinks,  and 
g  stupor  and 

le  tree  which 
gal,  Malabar, 
in  other  re- 
lal  part, 
itant  of  the 
3  doses  is  an 
sd  in  small 
lightly  laxa- 

)roduce  mus- 
Jgether  witli 
from  electric 
and  is  more 

Irops ;  solid 
>s  to  the  pint 
ailed  strych- 
h  of  a  grain. 


Oil  of  Cajuput  (  Oleum  \iuput%).  —  This  oil  is  obtained  from  the 
leaves  of  the  East  Indian  je  cajuputi.  It  is  diaphoretic  and  anti- 
spasmodic, and  a  powerful  diffusive  stimulant.  Given  in  cramps 
of  the  stomach  and  bowels,  colic,  flatulency,  hysterics,  and  chronic 
rheumatism.  It  is  considerably  used  as  an  ingredient  in  liniments, 
to  be  applied  externally  in  rheumatism  and  neuralgia.  Dose,  from 
one  to  three  drops,  on  sugar.  . 

Oil  of  Turpentine  (  Oleum  Terebinthince).  —  This  is  generally  called 
spirits  of  turpentine,  and  is  obtained  by  distilling  turpentine.  As  a 
medicine  it  is  stimulant,  cathartic,  diuretic,  anthelmintic,  and  astrin- 
gent. In  large  doses  it  causes  strangury  and  other  unpleasant  symp- 
toms. The  dose  is  from  five  to  twenty  drops,  repeated  every  two  or 
three  hours.  Fifteen  drops,  taken  every  fifteen  minutes  or  half  hour, 
powerfully  restrains  bleeding  from  the  lungs,  and  is,  perhaps,  the  best 
remedy  we  have  for  this  frightful  accident. 

It  is  also  very  efficacious  in  checking  other  hemorrhages.  Exter- 
nally, it  is  used  considerably  as  an  ingredient  in  liniments  and  rube- 
facients, in  rheumatism,  paralysis,  etc.  Combined  with  linseed  oil, 
it  is  much  used  for  burns  and  scalds. 

Olive  Oil  (  Oleum  Olivce).  —  This  oil,  often  called  meet  oil,  is  ex- 
pressed from  the  fruit  of  the  olive  tree,  Olea  Huropcea.  It  is  nutri- 
ent and  emollient,  and,  in  doses  of  one  to  two  fluid  ounces,  laxa- 
tive. It  is  much  employed  as  a  constituent  of  cerates,  liniments,  and 
plasters. 

Onion  (^Allium  Gepd).  —  The  medicinal  properties  of  the  onion  are 
much  like  those  of  garlic.  The  juice,  mixed  with  sugar,  is  used  to 
some  extent  as  a  remedy  for  the  coughs  and  colds  of  infants.  Roasted 
onions,  applied  as  a  poultice,  hasten  the  suppuration  of  boils,  tumors, 
etc.  They  are  also  useful,  in  some  cases,  applied  as  drafts  to  the 
feet. 

Opium.— This  is  the  hardened  juice  of  the  unripe  seed  of  the 
poppy,  Papaver  Somniferum.  It  is  a  stimulant  narcotic.  A  moder- 
ate dose  increases  the  fulness  and  frequency  of  the  pulse,  augments 
the  warmth  of  the  skin,  invigorates  the  muscular  system,  quickens 
the  senses,  animates  the  spirits,  and  gives  energy  to  the  mental  facul- 
ties. Its  operation  is  directed  with  special  force  to  the  brain,  which 
it  sometimes  excites  to  intoxication  and  delirium,  which  excitement 
subsides  in  a  short  time,  and  is  followed  by  a  delightful  calmness  and 
placidity  of  mind,  all  care  and  anxiety  being  banished,  and  the  thoughts 
yielded  to  the  control  of  pleasing  fancies.  At  the  end  of  an  hour  or 
more,  this  reverie  is  succeeded  by  sleep,  which,  at  the  end  of  eight 
or  ten  hours,  passes  off,  and  is  followed  by  headache,  nausea,  tremors, 
and  other  nervous  disturbances.  Large  doses  are  followed  by 
shorter  periods  of  exhilaration  and  excitement,  and  by  more  protracted 
sleep. 

Opium  is  used  in  medicine  to  produce  gentle  perspiration,  relieve 


860 


MEDICINES   AND  THEIR   PREPAKATIONS. 


V. 


pain,  and  lessen  nervous  excitability  in  all  febrile  and  inflammatory 
diseases ;  also  as  an  antispasmodic  in  hysterics,  colic,  convulHions, 
coughs,  etc.  It  should  not  be  used  in  cases  of  constipation  of  the 
bowels.  A  solution,  composed  of  two  grains  of  opium  to  one  ounce 
of  water,  is  sometimes  a  valuable  injection  in  gonorrhoea  and  spas- 
modic stricture.  Dose,  as  a  stimulant,  one-quarter  to  one-half  a 
grain  ;  as  a  narcotic,  one  to  two  grains ;  in  some  spasmodic  aflfections 
it  is  given  in  very  large  doses.  Use  only  under  the  direction  of  a 
physician. 

Morphia,  generally  called  morphine,  is  one  of  the  alkaloid  princi- 
ples of  opium.  It  is  used  under  the  various  forms  of  sulphate,  muri- 
ate, acetate,  and  valerianate  of  morphia,  —  all  having  the  general 
properties  of  opium,  and  are  given  for  similar  purposes,  in  doses  of 
one^ighth  to  one-quarter  of  a  grain.  One-sixth  of  a  grain  is  equal 
to  one  grain  of  opium. 

Strong  coffee  is  an  excellent  antidote  to  the  poisonous  effects 
both  of  opium  and  morphia.  A  solution  of  morphia  may  be  made  by 
adding  ten  grains  of  the  salt  to  one  fluid  ounce  and  a  half  of  distilled 
water,  and  half  an  ounce  of  diluted  alcohol,  and  then  adding  two 
drops  of  sulphuric  acid,  if  it  be  the  sulphate  of  morphia,  or  two  drops 
of  acetic  acid,  if  it  be  the  acetate  of  morphia,  or  two  drops  of  muri- 
atic acid,  if  it  be  the  muriate  of  morphia.  The  effects  of  morphia 
may  be  obtained  by  sprinkling  some  of  it  on  a  blistered  surface. 

Orange-Peel  (Aurantii  Cortex).  —  The  orange  is  the  fruit  of  a 
tree  belonging  to  the  tropical  climates.  Orange-juice  is  a  pleasant 
refrigerant,  useful  in  fevers,  and  particularly  in  scurvy.  Siok  per- 
sons sucking  the  juice  of  the  orange,  should  be  careful  not  to  swallow 
any  of  the  skinny  portion,  or  the  peel.  The  peel  of  the  orange  is 
chiefly  employed  to  give  a  pleasant  flavor  to  other  medicines,  and  to 
prevent  their  nauseating  properties.  It  is  a  mild  tonic,  carminative, 
and  stomachic,  and  improves  the  bitter  infusions  and  decoctions  of 
gentian,  quassia,  Colombo,  and  Peruvian  bark.  Orange-peel  should 
never  be  given  in  substance. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  two  drams ; 
tincture,  one  ounce  and  three-quarters  to  a  pint  of  diluted  alcohol, 
chiefly  used  as  an  addition  to  infusions,  etc. ;  syrup,  two  ounces  fluid 
extract  or  tincture  to  a  pint  of  simple  syrup,  used  with  water  as  an 
agreeable  drink. 

Origanum  (Origanum  Vulgare).  —  A  perennial  herb  growing  in 
Europe  and  this  country.  The  warm  infusion  of  it  causes  perspirar 
tion,  and  promotes  the  menstrual  discharge,  when  interrupted  by  a 
cold.  The  oil  of  origanum  is  a  very  useful  ingredient  in  several 
stimulant  and  rubefacient  liniments. 

Parsley  (Petroselinum  Sativum).  —  The  root  of  this  biennial  plant 
is  aperient  and  diuretic,  and  is  used  in  dropsy,  scarlet  fever,  and 
diseases  of  the  kidneys ;  also  in  retention  of  the  urine,  gonorrhoea. 


^ 


MEDICINES  AND   THEIK   PREPARATIONS. 


861 


inflammatory 
,  convulsions, 
pation  of  the 

to  one  ounce 
oea  and  spas- 
to  one- half  a 
>dic  affections 
direction  of  a 

kaloid  princi- 
ulphate^  muri- 
the  general 
,  in  doses  of 
fi-ain  is  equal 

)nous  effects 
y  be  made  by 
If  of  distilled 
adding  two 
or  two  drops 
ops  of  muri- 
I  of  morphia 
surface. 

le  fruit  of  a 
8  a  pleasant 
.  Sick  per- 
)t  to  swallow 
ihe  orange  is 
3ine8,  and  to 
carminative, 
ecoctions  of 
peel  should 

two  drams ; 
ted  alcohol, 
ounces  fluid 
ivater  as  an 


growing  m 

es  perspira- 

'upted  by  a 

in  several 


mnial  plant 

fever,  and 

gonorrhoea, 


and  strangury.    The  dose  of  the  infusion  is  from  two  to  three  fluid 
ounces,  two  or  three  times  a  day. 

The  bruised  leaves  are  applied  with  advantage  to  contusions, 
swelled  breasts,  and  enlarged  glands. 

Partridge  Berry  {Mitchella  Repem).  —  This  perennial  evergreen 
creeping  herb  grows  in  dry  woods  and  swampy  places  throughout 
the  United  States,  and  has  white,  fragrant  flowers  in  June  and  July. 
It  is  parturient,  diuretic  and  astringent,  and  is  used  in  dropsy,  sup- 
pression of  urine,  and  diarrhcea.  It  acts  as  a  tonic  upon  the  repro- 
ductive organs,  giving  tone  and  vigor  to  the.  womb,  and  making 
labor  less  tedious.  Dose  of  the  decoction,  from  two  to  tliree  fluid 
ounces,  two  or  three  times  a  day. 

Peach  (^Amygdalus  Persica). — The  leaves  of  the  peach  are  seda- 
tive and  slightly  laxative,  and  are  used  in  inflammations  of  the 
stomach  and  bowels ;  likewise  in  irritable  bladder,  whooping-cough, 
sickness  at  the  stomach,  and  dysentery.  They  are  used  in  the  form 
of  cold  infusion,  a  tablespoonful  being  a  dose,  to  be  taken  every  hour 
or  two.  A  good  tonic  is  made  by  adding  four  ounces  of  the  bruised 
kernels  to  a  quart  of  honey. 

Pennyroyal  (ffedeoma  Pulegioides,  Fig.  225).  —Pennyroyal  is  a 
gently  stimulant  aromatic ;  it  relieves  wind  colic 
and  sick  stomach,  and  qualifies  the  action  of  other 
medicines.  Like  most  aromatic  herbs,  it  has  the 
property,  when  given  as  a  warm  infusion,  of  pro- 
moting perspiration  and  of  exciting  the  menses 
when  the  system  is  already  disposed  to  the  effort. 
In  cases  of  recent  suppression,  it  may  be  given  at 
bedtime  as  a  warm  tea,  after  bathing  the  feet  in 
warm  water.  The  oil  of  pennyroyal  has  the  prop- 
erties of  the  herb. 

Peppermint  (^Mentha  Piperita). — The  pepper- 
mint is  a  native  of  England,  where  it  is  largely 
cultivated,  as  it  is  to  some  extent  in  this  country, 
for  the  sake  of  its  essential  oil.  It  is  a  valuable 
herb,  having  a  strong  aromatic  smell,  and  a  pun- 
gent, warming  taste.  It  may  be  used  in  the  form  of  tea,  which, 
when  largely  drunk,  imparts  warmth  to  the  system.  It  is  valuable 
in  colds,  flatulent  colic,  hysterics,  spasms,  cramps  in  the  stomach, 
nausea  and  vomiting,  and  to  disguise  unpleasant  medicines. 

The  peppermint  furnishes  an  essential  oil,  which,  dissolved  in  al- 
cohol, forms  the  essence  of  peppermint.  The  dose  of  this  is  fifteen  to 
twenty  drops,  on  a  lump  of  sugar,  or  in  sweetened  water,  warm  or  cold. 

Persimmon  (^Diospi/ros  Virginiand).  —  Tliis  is  a  tree  growing  in 
the  Southern  and  Middle  States.  The  bark  and  unripe  fruit  are  used 
in  medicine, — being  astringent  and  tonic.  Pei-sinimon  has  been 
found  useful    in  chronic  diarrhoea,  chronic  dysentery,  hemorrhage 


f/  \i!'.  'y )  -. 


Fio.  225. 
Pennvroval. 


862 


MEDICINES   AND   THEIR   PREPARATIONS. 


from  the  womb,  and  fever  and  ague.  It  is  used  in  the  form  of  infu- 
sion and  syrup,  in  doses  of  a  tablespoonful  every  two  or  three  horn's. 
The  infusion  is  also  used  as  a  wash  and  gtvrgle  in  sore  mouth  and 
thi'oai,  and  as  an  injection  in  whites. 

Peruvian  Bark  (^Cinchona,  Fig.  226).  —  This  valuable  bark  is 
derived  from  several  species  of  the  cinchona  tree,  on  the  western 
coast  of  South  America.  The  remedy  is  said  to  have  been  first  in- 
troduced into  Europe  in  1640,  by  the  Countess  of  Cinchon,  wife  of 
the  Viceroy  of  Peru,  on  her  return  to  Spain. 

There  are  three  varieties  of  this  bark :  the  pale,  the  red,  and  the 
yellow.  The  pale  bark  is  least  liable  to 
offend  the  stomach,  and  is  perhaps  the  best 
as  a  geneml  tonic ;  but  for  the  treatment 
of  fever  and  ague,  the  red  and  the  yellow 
are  both  preferable  to  the  pale,  and  the  red 
is  considered  better  than  the  yellow. 

Cinchona  is  tonic  and  antiperiodic,  and 
is  much  used,  and  with  great  success,  in 
all  periodical  diseases,  as  fever  and  ague, 
remittent  fever,  neuralgia  and  epidemic 
diseases  ;  also  in  chronic  diseases  attended 
with  debility,  as  scrofula,  dropsy,  and  affec- 
tions of  the  skin.  Dose  of  the  powdered 
bark  as  a  tonic,  from  ten  to  fifty  grains; 
as  an  antiperiodic,  from  twenty  to  seventy- 
five  grains. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram ;  com- 
pound fluid  extract,  dose,  half  a  dram  to  a  dram;  tincture,  four 
ounces  to  one  pint  diluted  alcohol,  dose,  one  to  four  drams  ;  infusion, 
dose,  one  to  one  and  a  half  ounces.  A  good  compound  infusion  of 
cinchona  is  made  by  combining  one  ounce  fluid  extract  with  half  an 
ounce  of  fluid  extract  of  snakeroot,  two  drams  of  fluid  extract  of 
orange-peel,  one  dram  of  fluid  extract  of  cloves,  one  dram  of  carbon- 
ate of  potassa  and  one  pint  of  water.  Dose,  one  to  one  and  a  half 
ounces.  The  following  is  a  good  nervine  and  tonic  for  persons  of 
nervous  temperaments :  fluid  extract  of  cinchona,  one  ounce  ;  fluid 
extract  of  valerian,  one  ounce ;  essence  of  cardamom,  two  drams ; 
dose,  one  dram  every  tlu-ee  hours. 

Cinchon ia  is  a  white  crystalline  substance  obtained  from  the  Peru- 
vian bark.  It  is  sometimes  used  as  a  substitute  for  quinia,  in  doses 
of  from  one  to  three  grains,  thi-ee  times  a  day. 

Sulphate  of  Quinia  is  snow  white,  and  in  satin-like  crystals, 
having  an  exceedingly  bitter  taste.  It  is  completely  soluble  in  water 
or  alcohol,  by  adding  a  few  drops  of  sulphuric  acid.  It  is  the  chief 
active  principle  of  cinchf  m,  and  has  similar  properties,  namely,  feb- 
rifuge, tonic  and  antipe;  iodic ;  it  is,  however,  less  apt  to  nauseate 


Fio.  226.   Peruvian  Babk. 


»  form  of  infu- 
or  three  liouw. 
»re  mouth  and 

luable  hark  is 
•n  the  western 
!  been  first  in- 
nchon,  wife  of 

i  red,  and  the 


RUVIAH  BaBK. 

I  dram ;  com- 
;incture,  four 
018 ;  infusion, 
i  infusion  of 

with  half  an 
id  extract  of 
ini  of  carbon- 
i  and  a  half 
)r  persons  of 
ounce ;  fluid 

two  drams; 

om  the  Peru- 
nia,  in  doses 

ke  crystals, 
ble  in  water 
;  is  the  chief 
namely,  feb- 
to  nauseate 


Peppermint. 


L- 


MKDIOINES   AND   THKIK   PKKrAKATIONS. 


863 


ami  oppress  tlie  stomach.  In  the  treatment  of  intermittent  fevei-8,  it 
liiis  ainioft  entirely  superseded  the  use  of  the  bark. 

Valerianate  of  Ou  In  la.  —  This  is  a  eomhiniition  of  quinia  and 
valerianic  acid.  It  is  tonic,  febrifuge  and  sedative.  It  is  used  for 
heailaciio  of  a  periodic  cJiaractci,  and  for  nervous  iiritahility,  wake- 
fulness, restlessness,  etc.     Dose,  from  half  a  grain  to  two  grains. 

Petroleum  or  Rock-Oil  is  a  dark  brown  or  greenish  liquid  found 
altnndiintly  in  the  upper  strata  of  the  earth  in  various  parts  of  the 
world.  Before  the  discovery  of  the  deep  deposits  of  the  oil  by  arte- 
sian wells,  the  Indians  of  New  York  used  to  collect  it  where  it 
oozed  from  the  ground,  and  sold  it  jus  a  family  medicine  niuler  the 
name  of  "Seneca  Oil."  It  has  been  used  externally  for  chilblains, 
chronic  rheumatism,  iiseases  of  tlie  joints,  and  skin  affections. 
Taken  internally,  it  is  stimulating,  anti-spasmodic,  and  sudorific,  and 
liiis  lieen  recomin.Muled  for  lung  troubles.  At  present  it  is  used  in 
various  rtiodified  forms. 

Phosphorus.  —  This  is  a  semi-tianaparent  solid,  is  flexible,  and 
lias  a  waxy  lustre.  It  is  extracted  from  bones  by  sulphuric  acid. 
As  a  medicine  in  small  doses,  it  acts  as  a  powerful  general  stimulant ; 
in  large  doses,  as  a  violent,  irritant  poison.  Wlien  taken  in  snl)- 
stance  it  causes  irritation  of  the  stomach,  and  should,  therefore, 
always  be  administered  in  solution  ;  and  even  in  this  form  it  is  ob- 
jectionable ;  it  is  better  to  resort  to  the  phosphates  and  the  hypo- 
])hosi)hites.  Phosphorus,  Ijcrng  an  element  in  the  composition  of  the 
brain,  has  l)een  given  with  advantage  in  the  various  forms  of  ner- 
vous debility,  as  consumption,  typhus  fever,  amaurosis,  paralysis,  and 
the  general  breakdown  of  the  vital  powers.  Phosphorus  b-.mis  when 
exposed  to  the  air,  and  should  therefore  be  kept  covered  with  water. 

Pink-Root  (Spiff elia  Marilandica,  Fig.  227).  —  This  perennial 
herb  grows  in  rich  soils  in  the  Middle  and  Southern 
States.  The  root  is  the  medicinal  part.  It  is  a 
powerful  anthelmintic,  and  is  but  little  used  except 
for  expelling  worms. 

Preparation)!.  —  PTuid  extract,  dose,  half  a  dram 
to  a  di-am  ;  compound  fluid  extract,  dose,  half  a 
dram  to  two  drams ;  fluid  extract  of  pink-root  aiid 
senna,  dose,  half  a  dram  to  a  dram ;  infusion,  half 
an  ounce  to  a  pint  of  water,  dose,  two  to  six 
ounces.  •  • 

P\ps,\ssaw a  (  Cldmaphila  Umhellata,  Fig.  228).  — 
This  is  a  small  evergreen  plant,  growing  in  the 
United  States,  and  in  Northern  Europe  and  Asia. 
It  is  known  by  the  name  of  princes  pine.  The 
whole  plant  is  Conic,  diuretic  and  astringent,  and 
has  proved  itself  useful  in  dropsy,  general  debility, 
rheuf    ..dm,  chronic  disorders  of  the  kidneys,  bladder,  urethra,  etc.  .■ 


Fio.227.  Pink-Root. 


864 


MKDIOINKH   AND   THKIK   PKKHAKATIONH. 


Preparatiov.».  —  Fluid  extract,  dose,  one  dram ;  solid  extract,  (lose, 
ten  to  fifteen  grains;  infusio.-j,  dose,  two  ouiiie*. 

Plantain  (PlatUago  M<y'or).  —  This  jicriju- 
nial  herb  grows  both  in  Europe  and  America. 
A  strong  decoction  of  the  tojw  and  the  roolH  Ih 
highly  spoken  of  for  syphilis  and  scrofula ;  the 
dose  [mug  from  two  to  four  fluid  ounces,  two 
or  three  times  a  day.  But  the  bruised  leaves 
are  most  useful  when  a]iplied  to  wounds,  ulcere, 
bites  of  ])oisonous  insects,  erysipelas,  etc. 

Pleuri«y-Root  (^Asclepian  Tuberosa,  Kijj. 
229). — This  perennial  plant  is  abundant  in 
the  Southern  States.  The  root,  which  is  the 
part  used,  is  carminative,  tonic,  and  diuretic ; 
used  in  pleurisy,  bronchitis,  inflamruation  of 
the  lungs,  acute  rheumatism  and  dysentery.  The  warm  infusion 
promotes  diaphoresis,  without  raising  the  tempeiature  of  the  body. 
United  with  the  warm  infusion  of  wild-yam  root,  "t  is  excellent  for 
flatulency  and  wind  colic. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  two  drams; 
tincture,  four  ounces  to  a  pint  of  diluted  alcohol,  dose,  three  to  five 
drams;  infusion,  dose,  one  to  four  ounces;  asclepidin,  dose,  one  to 
five  grains.  Ascelpidin  and  dioscorein,  united  in  equal  parts,  make 
a  valuable  preparation  for  flatulent  and  bilious  colic  ;  dose,  two  to 
three  grains. 


rio.  398.     PIPBIBBKWA. 


Fia.  339.    Pleurist-Boot. 


Fia.  iSO.  Poison  Hemlock. 


Poison  Hemiock  (Conium  Mamlatnm,  Fig.  230).  —  This  biennial 
plant  is  a  native  of  Europe  and  Asia,  and  is  naturalized  in  this  coun- 
try. The  leaves  and  the  seeds  are  used  in  medicine.  Conium  is 
narcotic,  anodyne,  antispasmciic  and  deobstruent;  used  in  neuralgia, 
asthma,  syphilis,  chronic  rheumatism,  and  various  other  affections. 

Preparation.  —  Fluid  extract,  Mose,  five  to  fifteen  drops  ;  solid 
extract,  dose,  half  a  grain  to  two  grains ;  tincture,  three  ounces  to  a 
pint  of  diluted  alcohol,  dose  thirty  drops  to  a  dram  ;  infusion,  half 


iii 


I    M     I  iiinnBilfti* 


MEDIOINRH   Am)   THEIR    PRKPAKATIONH. 


865 


i<l  extract,  dose, 
>st!,  two  ounces. 

—  'i'his  j)iTL'n. 
'•'  imd  iVnierica. 
mid  the  roots  \n 
1(1  Hcrofulii ;  the 
iiid  ounces,  two 

bruiHftd  leaves 
wounds,  ulcere. 
)ela8,  etc. 

Tuberosa,  Fip. 
is  abundant  in 
t,  which  JH  the 
,  and  diuretic ; 
iflanin^ation  of 
warm  infusion 
ve  of  the  body, 
is  excellent  for 

to  two  drams; 
le,  three  to  five 
1,  dose,  one  to 
lal  parts,  make 
;  dose,  two  to 


liniLooK. 

This  biennial 
in  this  coun- 
.  Conium  is 
I  in  neuralgia, 
r  affections, 
drops ;  solid 
e  ounces  to  a 
infusion,  half 


an  ounce  to  a  pint  of  water,  mainly  used  as  a  wash   for  malignant 
nlvrn,  etc.     Use  with  care. 

Poison  Oak  (^Rhu»  Tnricodendron). —  The  leaves  are  the  medicinal 
jiiirt  of  this  creeping  shrub,  which  is  common  in  this  country.  The 
lorni  of  using  this  mfulicine  is  that  of  a  saturated  tincture,  made 
from  the  fresh  leaves,  and  io  l)e  kejjt  in  well-corked  vials.  It  has 
Iwen  found  useful  in  paralysis  of  the  bladder  and  recituni,  in  diseases 
(»f  the  eyes  and  skin,  and  in  chronic  rheumatism.  Dose  of  the  tinc- 
ture, from  five  to  seven  drops,  three  times  a  day.  Large  doses  should 
Iw  avoided. 

Poke  {Phytolacca  Perandra,  Fig.  281).  —  A  perennial  plant, 
growing  in  nearly  all  parts  of  the  countiy,  and 
called  (target^  pigeon-berry  and  m'oke.  The  root 
i.s  the  part  used.  It  is  emetic,  cathartic,  alteia- 
live  and  sligiitly  narcotic.  It  excites  the  whole 
glandular  system,  and  is  used  in  8y[)hilis,  scrof- 
ula, rheumatism  and  affections  of  the  skin. 
The  root,  buried  in  hot  ashes  until  soft,  is 
then  mashed  and  api)lied  as  a  poultice  for 
felons  and  vaiious  tumors.  Dose  of  the  pow- 
dered root  as  an  emetic,  twelve  grains  to  half 
a  dram;   as  an  alterative,  from  two  to  five 


grams. 


Fio.  281.   Poke. 


Preparations.  —  Fluiw  extract,  dose,  ten  to 
twenty  drops ;  solid  extract,  dose,  one  to 
three  grains ;  tincture,  four  ounces  to  a  pint 
of  diluted  alcohol,  dose,  half  a  dram  to  a  dram  ;  syiup,  two  ounces  to 
fourteen  ounces  of  simple  syrup,  dose,  one  to  two  drams ;  phytolaccin, 
the  active  principle,  dose,  one  quarter  to  one  grain.  For  mercurial 
and  syphilitic  pains  in  the  bones  the  following  pill  is  useful:  solid 
extract  of  poke,  two  drams ;  solid  extract  of  stillingia,  one  dram ; 
solid  extract  of  stramonium,  eight  grains.  Mix,  and  divide  into  sixty 
pills,  of  which  one  pill  is  to  be  taken  every  two  or  three  houra. 

Potassa.  —  This  is  used  in  medicine  under  the  name  of  caustic 
liotiissa.  It  is  made  by  boiling  a  solution  of  potassa  in  a  clean  iron 
vessel  until  ebullition  ceases,  and  the  potassa  melts,  and  then  pouring 
it  into  cylindrical  moulds  ;  when  cold  it  is  to  be  kept  in  well-stopped 
bottles.  It  is  a  very  powerful  escharotic,  quickly  destroying  the  flesh 
which  it  touches,  and  extending  its  action  deep  under  the  surface.  It 
differs  in  this  respejt  from  nitrate  of  silver,  which  only  acts  upon  the 
surface,  and  is  not,  properly  speaking,  a  caustic. 

Caustic  potassa  is  used  for  forming  issues.  The  method  of  using 
it  for  this  purpose  is  to  cut  in  a  piece  of  adhesive  plaster  a  hole  as 
large  as  the  desired  issue,  and  then,  having  stuck  this  upon  the  skin, 
to  apply  the  end  of  the  caustic,  previously  moistened,  to  the  opening. 
This  application  is  to  be  continued  till  the  life  of  the  part  is  destroyed. 


866 


MEDICINKS   AND   THEIh   PllEPARATlON,?. 


when  the  caustic  must  be  neutralized  b}'  vinegar,  oj-  carefully  wiislied 
off  with  a  wet  sponge. 

The  following  preparations  of  potassa  are  used  in  medicine :  — 

Acetate  of  Potassa  (^Potassce  Acetas).  —  This  is  made  by  the  un  on 
of  acetic  acid  and  carbonate  of  potassa,  and  in  consequence  of  it« 
extreme  deliquescence  when  exposed  to  the  air  it  is  kept  in  ciosely- 
stopped  bottles.  It  is  diuretic,  deobstrueiit,  and  mildly  catlmrtic. 
It  is  used  in  febrile  diseases,  several  skin  disea^ses,  such  as  psnriiisis, 
eczema,  and  lej>ra,  and  particularly  in  dropsical  affections.  Dose,  iis 
a  diuretic,  from  ten  to  twenty  grains  ;  as  an  aperient  from  one  to  two 
drams. 

Bicarbonate  of  Potassa  {Potassce  Bicarbonas). —  This  is  a  solu- 
tion of  carbonate  of  potassa,  saturated  with  carbonic  acid.  This  acid  is 
diuretic,  antacid,  and  deobstruent;  used  in  dropsy,  acidity  of  tl.c 
stomach,  and  glandular  obstructions.  Dose,  ten  to  twenty  grains. 
Twenty  grains  dissolved  in  eight  fluid  ounces  of  water,  and  mixed 
with  four  fluid  drams  of  lemon-juice,  forms  a  good  effervescing 
draught. 

Bitartrate  of  Potassa  (Pota»»ce  Bitartras).  —  This  salt  is  better 
known  as  cream  of  tartar,  undi  nupertartrate  of  potaam.  It  is  formed 
from  the  matter  deposited  on  the  bottom  and  sides  of  casks,  during 
the  fermentation  of  sour  wines.  As  a  medicine  it  is  diuretic,  cathartic, 
and  refrigerent.  In  ^■mall  doses  it  acts  as  a  cooling  aperient,  gently 
opening  the  bowels  ;  in  large  ones  as  a  hydragogue  cathartic,  causing 
free,  wateiy  stools.  This  property,  as  well  as  its  power  of  acting  upon 
the  kidneys,  causes  it  to  be  much  used  in  dropsical  complaints.  Dis- 
solved in  boiling  water,  allowed  to  cool,  and  then  sweetened  with  loaf 
sugar,  it  forms  a  cooling,  pleasant,  acid  drink.  This  kind  of  solution, 
with  a  little  fresh  lemon-peel  added  to  it,  forms  the  drink  called  im- 
filial.  Combined  with  sulphur,  it  is  often  used  in  skin  diseases. 
Dose,  as  an  aperient,  a  dram  or  two ;  as  a  hydragogue  cathartic,  half 
an  ounce  to  an  ounce ;  as  a  diuretic  in  diopsical  complaints,  a  dram 
and  a  half  to  two  drams  several  times  a  day.  Cream  of  tartar,  pow- 
dered rhatany,  and  myrrh,  mixed  in  equal  propt)rtions,  form  a  good 
preparation  for  cleansing  the  teeth. 

Carbonate  of  Potassa  (Pota%»a>  Carho'nai<).  —  Carbonate  of  j)otii8sa 
is  purified  pearlanh,  and  is  frequently  called  mlt  of  tartar.  Carbonate 
of  potassa  has  the  same  medicinal  properties  with  the  bicarbonate,  and 
is  used  for  similai-  purposes.  • 

Chlorate  of  Potassa.  —  This  is  prepared  by  passing  an  excess  of 
chlorine  through  carbonate  of  potassa.  It  is  refrigerent  and  diuretic, 
and  is  given  in  scurvy,  scarlet  fever,  etc.,  and  as  a  wash  in  canker  in 
the  mouth,  and  varitnis  unnealthy  ulcers,  and  as  an  injection  in 
leucorrhcea  and  gleet. 


I)  ft  win  liW,  I  rill,- 


irefiilly  wiished 

neilicine :  — 

deby  theun  on 
equence  of  its 
kept  in  riosely- 
lildly  catliiirtic. 
jh  as  psnriiisis. 
ions.  Dose,  as 
rem  one  to  two 


'his  is  !i  solu- 
id.  This  acid  is 
acidity  of  tl;c 
twenty  grains, 
xjr,  and  mixed 
d  effervescing 

salt  is  better 
It  is  formed 

casks,  during 
•etic,  cathartic, 
)erient.  gently 
hartie,  causing 
of  acting  upon 
nplaints.  Dis- 
;ened  with  loaf 
nd  of  solution, 
•ink  called  im- 

skin  diseases, 
cathartic,  half 
laints,  a  dram 
>f  tartar,  pow- 

form  a  good 


late  of  potiissa 
ir.  Carbonate 
iarbonate,  and 


an  excess  of 
t  and  diuretic, 
ti  in  canker  in 

injection  in 


MEDICINES   AND   THEIR   PREPARATIONS. 


867 


Citrate  of  Potassa  {Potasscn  Citrus) .  —  A  grateful,  cooling  diapho- 
retic, long  and  much  used  in  fevere,  chiefly  in  the  forms  of  the  neutral 
mixture,  and  effervcscinff  draught. 

Solution  of  Citrate  of  Potassa  {Liquor  Fotassce  Gitratis).  —  This 
is  prepared  by  taking  half  a  pint  of  lemon-juice,  and  adding  bicarbonate 
of  potassa  gradually  to  it  until  it  is  saturated,  then  filtering.  This 
passes  under  the  name  of  neutral  mixture,  saline  mixture,  and  efferves- 
cing dratight.  It  is  a  valuable  refrigerent  diaphoretic,  well  adapted 
to  tlie  hot  stage  of  remittent  and  intermittent  fevers,  and  indeed  to 
almost  all  cases  of  fever,  with  a  dry,  hot  skin.  The  dose  is  a  table- 
spoonful,  or  half  a.  fluid  ounce,  which  should  be  well  diluted  when 
taken,  and  be  repeated  every  two  or  three  hours,  according  to  the 
necessities  of  the  case. 

Sol uti.  n  of  Potassa  (^Liquor  Po«a8«flB).^— This  is  a  transparent, 
caustic  fluid,  which  requires  to  be  kept  in  green  bottles,  tightly  corked. 
Jt  is  antacid,  antilithic,  and  diuretic.  It  is  used  in  some  affections  of 
the  skin,  and  scrofula,  but  more  particularly  for  scalding  of  the  ure- 
thra, in  gonorrhcea ;  in  this  case,  it  is  well  to  unite  a  few  drops  of 
laudanum  with  it.  The  dose  is  from  fifteen  to  twenty-five  drops,  two 
or  three  times  a  day,  in  half  a  tumblerful  of  water.  In  dyspeptic 
cases,  attended  with  acidity  of  the  stomach,  it  may  be  associated  with 
some  simple  bitters. 

Sulphate  of  Potassa  (Potassoe  Sulphas).  —  This  is  a  mild  purga- 
tive, operating  without  irritation  or  pain.  As  an  aperient,  it  should 
be  given  in  doses  of  from  a  scruple  to  a  dram.  Ten  grains  of  rhubarb 
and  one  dram  of  carbonate  of  potassa,  united,  and  divided  into*  six 
powdei-s,  is  an  excellent  alterative  cathartic  for  children  having  defec- 
tive digestion  and  nutrition,  and  a  tumid  state  of  the  abdomen.  One 
powder  may  be  given  at  a  time,  as  often  as  may  be  necessary  to  open 
the  bowels  gently. 

Tartrate  of  Potassa  (Potassce  Tartras).  — This  often  passes  under 
the  name  of  soluble  tartar.  It  is  a  mild,  cooling  purgative,  operating, 
as  most  of  the  neutral  salts  do,  without  much  pain,  and  producing 
watery  stools.  It  is  useful  in  fevers.  Combining  it  with  senna  destroys 
its  tendency  to  produce  griping  of  the  bowels.  The  dose  varies  from 
a  dram  to  an  ounce,  according  to  the  effect  desired. 

Potassium.  —  This  is  a  soft,  bluish- white  metal.  Its  union  with 
oxygen,  in  the  proportion  c  ■  one  equivalent  of  each,  forms  potassa  or 
potash.     The  following  preparations  of  it  are  used  in  medicine :  — 

Bromide  of  Potassium  (^li.  ssii  liromidum}.  —  This  is  a  perma- 
nent, colorless  salt,  having  a  pungent,  saline  taste,  a  little  more  acrid 
than  common  salt,  yet  similar  to  it.  As  a  medicine  it  is  alterative  and 
resolvent,  and  is  used  occasionally  for  secondary  syphilis,  scrofula,  and 
enlarged  spleen.  Dose,  from  three  to  five  grains,  three  times  a  day,  in 
pill  or  solution.     One  dram  of  the  bromide  of  pot£;88ium,  rub  »ed  up 


'yg^Xp'^iV^" 


J 


868 


MEDICINES    AND   THEIR   PREPARATIONS. 


with  an  ounce  of  lard,  luakcH  an  ointment  which  has  hevu  useil  witli 
some  good  effect  in  goitre  and  Hcrofulous  affections. 

Cyan u ret  of  Potassium  (Potassii  Cyanur,etum).  —  This  is  emi- 
nently poisonous,  acting  both  as  a  medicine  and  as  a  poison,  like 
hydrocyanic  acid.  It  has  therefore  been  recommended  as  a  substitute 
for  that  acid.  The  dose  is  one-eighth  of  a  grain,  dissolved  in  half  a 
fluid  ounce  of  water. 

Sulphuret  of  Potassium  {Pota%8ii Sulphuretum').—^T\\\&  is  called 
liver  of  sulyhur,  and  hepar,  being  composed  of  sulphur  and  potassium. 
It  has  been  used  in  chronic  bronchitis,  asthma,  whooping-cough,  and 
rheumatism.  Half  an  ounce  to  an  ounce  of  it,  dissolved  in  several 
gallons  of  warm  water,  makes  a  valuable  sulphur  bath  for  several 
skin  diseases,  as  itch,  prurigo,  etc. 

Prickly  Ash  (Xanthoxylum  Fraxineum).  —  This  shrub  grows  in 
various  parts  of  the  United  States.  The  leaves  and  capsules  have 
a  pleasant,  aromatic  smell.  Its  medicinal  properties 
are  in  the  bark  and  berries.  The  bark  is  stimulant, 
tonic,  alterative,  and  sialagogue.  It  is  used  to  rouse 
ar>d  excite  the  system,  when  in  a  languid  state,  and  for 
derangements  of  the  liver,  rheumatism,  and  chronic 
syphilis.  It  stimulates  and  strengthens  mucous  mem- 
branes, and  is  a  valuable  tonic  in  low  typhoid  fever. 
Applied  externally,  it  improves  indolent  and  malig- 
nant ulcere.  Dose  of  the  powdered  bark,  from  ten  to 
twenty  grains,  three  times  a  day. 

Preparations.  —  Fluid    extract,   dose,    fifteen   to 

twenty-five  drops ;  tincture,  four  ounces  to  a  pint  of 

diluted  alcohol,  dose,  half  a  dram  to  a  dram  ;  infusion, 

half  an  ounce  to  a  pint  of  water,  dose,  half  an  ounce 

to  two  ounces ;  xantioxylin,  the  active  principle,  dose, 

two  to  five  grains. 

For  chronic  rheumatism  the  following  is  a  good  preparation :  xan- 

thoxylin,  one  dram ;  cimicif ugin,  one  dram ;  apocynin,  one  dram ; 

diluted  alcohol,  one  pint ;  dose,  three  drams,  three  times  a  day. 

Prickly  Ash  Berries  are  carminative,  antispasmodic,  and  stimulant, 
and  have  a  special  direction  to  mucous  membranes.  The  tincture  is 
excellent  in  nervous  diseases,  spasms  of  the  bowels,  flatulency,  and 
diarrhoea ;  and,  combined  with  the  tincture  of  poke-berries,  is  very 
serviceable  in  chronic  rheumatism  and  sjrphilis.  It  is  said  to  have 
been  used  with  great  success,  in  the  West,  in  Asiatic  cholera.  Dose 
of  the  tincture,  from  ten  drops  to  a  fluid  dram,  in  sweetened  water. 
Dose  of  the  oil  of  prickly-ash  berries,  from  two  to  seven  drops,  on 
sugar. 

Prickly  Elder  (Aralia  Spinota). —  This  is  a  tree  which  grows  m 
the  Southern  and  Western  States,  and  is  called  Southern  prickly  ash, 
and  toothache  tree.     The  bark  is  stimulant,  alterative,  and  diaphoretic. 


FIO.  S82. 
Pricklt  Abh. 


I 


•|>iftirfi'flw,i. 


MEDICINES   AND   THEIK   PREPARATIONS. 


869 


t-'t'ii  used  will, 

This  is  enii- 
t  poison,  like 
as  a  substitute 
'Ived  in  half  a 

This  is  called 
nd  potassium, 
ig-cough,  and 
ed  in  several 
h  for  several 

rub  grows  in 

iapsules  have 

lal  properties 

is  stimulant, 

used  to  rouse 

state,  and  for 

and  chronic 

mucous  mem- 

yphoid  fever. 

Qt  and  malig- 

c,  from  ten  to 


,  fifteen  to 
3  to  a  pint  of 
•m;  infusion, 
lalf  an  ounce 
■inciple,  dose, 

iration :  xan- 
1  one  dram; 
3  a  day. 
d  stimulant, 
le  tincture  is 
tulency,  and 
Ties,  is  very 
aid  to  have 
ilera.  Dose 
tened  water, 
n  drops,  on 

ih  grows  m 
prickly  ash, 
diaphoretic. 


The  fresh  bark,  emetic  and  cathartic.  The  tincture  is  serviceable  in 
skin  diseases,  syphilis,  and  chronic  rheumatism.  The  bark  is  siala- 
gogue,  and  in  small  doses,  powdered,  is  said  to  relieve  the  dry  and 
parched  condition. of  the  throat,  in  many  diseases. 

Pumpkin-Seeds  —  The  infusion  of  pumpkin-seeds,  made  by  plac- 
ing them  in  water  without  bruising  them,  is  mucilaginous  and  diu- 
retic, and  is  used  in  inflammation  of  thei  stomach  and  bowels,  scald- 
ing of  the  urin§,  strangury,  etc.  But  this  infusion  is  more  particularly 
valuable  for  its  power  of  expelling  the  tape-worm.  It  may  be  drunk 
freely.  The  oil  of  pumpkin  .seeds,  obtained  by  expression,  has  similar 
properties,  and  may  be  taken  in  doses  of  six  to  ten  drops,  several  times 
a  day. 

Quassia  (^Picroena  ExceUa).  —  This  is  the  wood  of  a  tall  tree  grow- 
ing in  Surinam  and  some  of  the  West  India  Islands.  It  is  an  intensely 
bitter  tonic,  febrifuge,  and  anthelmintic,  possessing  in  the  highest  de- 
gree the  properties  of  the  simple  bitters.  It  invigorates  the  digestive 
organs,  without  producing  much  excitement  of  the  circulation.  It  is 
well  adapted  to  dyspepsia,  and  the  debility  of  the  stomach  which  suc- 
ceeds acute  disease,  and  indeed  all  complaints  where  simple  bitter  is 
required.  Its  generic  title  perpetuates  the  name  of  the  negro  Quassi, 
of  Surinam,  who  first  discovered  its  medicinal  virtues,  about  the  mid- 
dle of  the  last  century,  and  who  became  famous  for  treating  malig- 
nant fevers  with  it,  as  a  secret  remedy. 

Preparations,  —  Fluid  exrtract,  dose,  half  a  dram  to  a  dram  ;  solid 
extract,  dose,  three  to  five  grains ;  tincture,  dose,  four  to  eight  di-ams ; 
infusion,  two  drams  to  a  pint  of  water,  dose,  two  to  three  ounces. 

Queen  of  the  Meadow  (^Uupatorium  Purpureum) .  —  This  peren- 
nial herb  grows  in  low,  swampy  places,  in  many  parts  of  the  country. 
It  is  called  trumpet  weed,  and,  from  its  fine  medicinal  effects  in  com- 
plaints of  the  urinary  organs,  gravel-root.  It  is  an  excellent  diuretic, 
tonic,  and  stimulant.  Used  in  gout,  rheumatism,  hematuriu,  chronic 
diseases  of  the  urinary  organs,  strangury,  gravel,  and  dropsical  affec- 
tions. The  decoction  h  the  form  in  which  it  is  most  used ;  the  dose 
being  two  to  three  ounces,  two  or  three  times  a  day. 

A  preparation  called  eupurpurin  is  also  extracted  from  it,  which,  in 
three-grain  doses,  is  a  powerful  diuretic,  occasioning,  in  some  cases,  it 
is  said,  an  enormous  flow  of  urine. 

Queen's  Root  (^Stillingia  Sylvaticd).  —  This  perennial  herb  grows 
in  sandy  soils  in  the  Southern  States.  The  root  is  medicinal,  being, 
in  large  doses,  emetic  and  cathartic ;  in  small  doses,  an  alterative  of 
considerable  value  in  skin  diseases,  rlieumatism,  syphilis,  and  scrofula, 
and  in  such  other  complaints  as  require  alteratives. 

Preparations.  —  Fluid  extract,  dose,  five  to  ten  drops ;  compound 
fluid  extract,  dose,  half  a  dram  to  a  dram ;  tincture,  two  ounces  to  a 
pint  of  diluted  alcohol,  dose,  one  to  three  drams  ;  infusion,  dose,  one 
to  one  and  one-half  ounces.     In  clironic  bronchitis  and  similar  com- 


m 


MKDICINES    AND   THKIR    PREPARATIONS. 


plaints,  the  following  syrup  is  well  recommended :  fluid  extra<i  of 
stillingia,  two  ounces;  fluid  extract  of  blootlroot,  two  ounces;  Huid 
extract  of  cherry  biiik,  two  ounces;  balsam  of  tolu,  one  ounce  and  a 
half;  syrup,  two  and  a  half  pints.     Dose,  one  to  two  drams. 

Red  Chickweed  {Anagallu  Arveu»l%}.  —  An  annual  plant,  com- 
mon in  Europe  and  this  country.  It  has  small  scarlet  flowers  in  June 
and  July,  it  has  been  used  in  nervous  diseases,  as  mania,  delirium, 
epilepsy,  and  partieulaiiy  hydrophobia.  Old  and  ill-conditioned  ul- 
cers are  improved  by  its  use,  in  the  form  of  poultice. 

Red  Root  (  CeanothuH  Americanu»).  —  This  shrubby  plant  has  the 
names  of  New  Jersey  tea  and  wild  snowball,  and  is  found  in  all  parts 
of  the  United  States.  Tlie  bark  is  antispasmodic,  sedative,  astringent, 
and  expectorant,  and  tastes  and  smells  like  the  peach-leaf.  A  decoc- 
tion is  useful  in  dysentery,  diarrhoea,  whooping-cough,  and  chronic 
bronchitis,  in  doses  of  a  tablespoonful  three  times  a  day.  It  makes, 
likewise,  a  very  good  injection  in  leucorrhoea  and  gleet,  and  gargle 
for  ulcerations  of  the  mouth  and  thi'oat. 

Red  Clover  (^Trifolmm  Pratenxe).  —The  blossoms  of  this  very 
common  biennial  plant  are  medicinal,  and  are  highly  recommended 
in  deep,  ragged,  and  cancerous  ulcers,  as  well  as  in  badly  condi- 
tioned burns.  They  are  soothing  and  detergent,  and  promote  health- 
ful granulation.  Taken  in  large  doses  for  a  year  or  so,  it  is  said  to 
be  good  for  cancer. 

Preparation.  —  Solid  extract,  to  be  used  as  an  external  applica- 
tion, chiefly  in  tlie  form  of  ointment,  made  by  uniting  four  ounces  of 
it  with  half  a  pound  of  lard. 

Red  Rose  (^Rosa  Gallica).  —  The  petals  of  the  rose  are  slightly 
tonic  and  astringent,  and  are  considerably  employed  in  chronic  in- 
flammations of  the  eye.  Rose-water,  distilled  from  the  petals,  is 
used  for  similar  purposes. 

Red  5aunders  (^Pterocarpus  Santalinus).  —  This  is  a  large  tree 
growing  in  Ceylon,  the  wood  of  which  imparts  a  red  color  to  alcohol, 
ether,  and  alkaline  solutions,  but  not  to  water.  It  is  almost  solely 
used  for  imparting  color  to  tinctures,  etc.,  having  little  or  no  medi- 
cinal properties. 

Rosin. — This  is  the  solid  resinous  matter  which  remains  after 
the  distillation  of  turpentine.  It  is  much  used  as  an  ingredient  in 
ointments  and  plastei*,  but  is  never  taken  internally.  The  vapor 
which  arises  from  heating  it  upon  some  hot  surface  is  sometimes  in- 
haled with  great  advantage  in  chronic  bronchitis,  and  other  chronic- 
affections  of  the  air-tulies. 

Rhatany  (Krameria  Triandra).  —  This  is  a  native  of  Peru,  grow- 
ing in  dry,  sandy  places.  It  is  a  powerful  astringent,  and  a  gentle 
tonic.     It  is  given  with  advantage  in  excessive  menstruation,  vom- 


MKDICINE8    AND   THEIR    I'REPAHATIONS. 


871 


'iiid  extra<t,  of 
'  ounces ;  fluid 
ne  ounce  and  a 
drams. 

al  plant,  corn- 
flowers in  June 
lania,  delirium, 
jonditioned  ul- 

r  plant  has  the 
nd  in  all  {tarts 
ive,  astringent, 
eaf.  A  decoc- 
:h,  and  chronic 
ay.  It  makes. 
Jet,  and  gargle 

of  this  very 
recommended 

badly  condi- 
romote  health- 
o,  it  is  said  to 

ernal  applica- 
Four  ounces  of 

e  are  slightly 
in  chronic  in- 
the  petals,  is 

a  large  tree 
lor  to  alcohol, 
almost  solely 
e  or  no  medi- 

^mains  after 
ingredient  in 
The  vapor 
ometimes  in- 
ther  chronic 


w- 


:  Peru,  gro 
md  a  gentle 
uation,  vom- 


iting lit'  hlood,  chronic  diarrluua,  Uuicorrh(jea,  and  inability  to  retain 
the  urine ;  likewise,  as  a  local  Huplication  in  falling  of  the  l)owel. 
It  is  valuable  also  for  nosebleed,  and  bleeding  gums.  Dose  of  the 
powder,  for  internal  use,  from  ten  to  twenty-five  grains. 

Preparations.  — Fluid  extract,  dose,  half  a  dram  to  a  diam  ;  solid 
extract,  dose,  five  to  fifteen  grains ;  tincture,  three  ounces  to  a  pint 
of  diluted  alcohol,  dose,  three  to  five  drams  ;  infusion,  two  ounces  to 
a  pint  of  water,  dose,  half  an  ounce. 

Rhubarb  (Rheum  Palmatum).  —  This  root  is  derived  from  several 
species  of  rheum,  and  passes  under  the  various  names  of  European., 
Miissian,  Chinese,  Hast  India,  and  Turkey  rhubarb.  The  variety 
called  Russian  or  Turkey  rhubarb  (for  they  are  the  same)  is  consid- 
ered the  best.  Rhubarb  is  cathartic,  astringent,  and  tonic.  It  is 
much  used  in  mild  cases  of  diai-rhcea  and  cholera  inf an  tum  ;  likewise, 
as  a  stomachic  and  j^tntle  tonic  in  dyspepsia,  accompanied  with  a 
debilitated  state  of  the  digestive  organs.  It  is  a  valuable  remedy  in 
the  complaints  of  children,  and  is  deservedly  much  used  in  treating 
them.  It  acts  upon  the  muscular  coat  of  the  bowels,  producing  thick 
rather  than  watery  stools.  It  is  therefore  not  adapted  to  the  treatment 
of  dropsical  complaints.  Its  astringency  may  be  increased  by  roasting 
it,  or  diminished  by  combination  with  an  alkali. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram ;  aro- 
matic fluid  extract,  dose,  half  a  dram  to  a  dram ;  fluid  extract  of 
rhubarb  and  senna,  dose,  half  a  dram  to  a  dram  ;  solid  extract,  dose, 
two  to  eight  grains ;  tincture,  an  ounce  and  a  half  of  fluid  extract, 
and  half  an  ounce  of  essence  of  cardamom,  to  a  pint  of  diluted  alcohol, 
dose,  half  an  ounce  to  an  ounce  and  a  half ;  infusion,  one  ounce  fluid 
extract  and  two  ounces  spirit  of  cinnamon  to  a  pint  of  water,  dose, 
one  to  three  ounces ;  sjTup,  three  ounces  of  fluid  extract  to  fourteen 
of  syrup,  dose,  two  to  five  drams. 

Rosemary  (5o««mannM8  Officinalis).—  This  evergreen  shrub  grows 
on  the  borders  of  the  Mediterranean,  and  is  cultivated  in  Europe  and 
this  country.  It  is  stimulant,  antispasmodic,  and  emmenagogue.  It 
is  not  used  in  this  country,  however,  except  to  perfume  ointments, 
tinctures,  and  syrups. 

Round-Leaved  Pyrola  (^Pyrola  Rotundtfolia').  —  This  perennial 
shrub  grows  in  various  parts  of  our  country,  and  beans  white  flowers 
in  June.  It  is  called  canker-lettuce,  pear-leaf  wintergreen,  etc.  Its 
medicinal  properties  are  those  of  a  tonic,  astringent,  antispasmodic, 
and  diuretic.  Used  in  decoction  for  epilepsy  and  other  nervous  dis- 
order's ;  also  for  gravel,  and  other  diseases  of  the  bladder  and  kid- 
neys. The  decoction  may  be  used,  too,  as  a  wash  for  ulcerations  of 
the  mouth,  indolent  ulcers,  and  chronic  ophthalmia.  The  decoction 
may  likewise  be  used  in  making  poultices  for  painful  swellings,  boils, 
and  carbuncles.  It  may  be  taken  in  doses  of  from  one  to  four 
ounces. 


\ 


872 


MEDICINKS    AND   THEIR   PREPARATIONS. 


Rue  (Ruta  Oraveohnft).  —  Rue  luu*  the  medicinal  virtues  of  the 
Hiiti8pa»nic)(lic»,  authelininticb,  and  emmenagogucH.  In  large  dusts 
it  is  poisonous.  It  is  useful  in  wind-colic,  worms,  hysterics,  epile|i,s\, 
etc.  Dose  of  the  leaves,  from  ten  to  fifteen  grains ;  of  the  infusion, 
from  one  to  two  ounces.     Use  with  care. 

Saffron  (Crocus  iS'atiws).  —  This  is  a  native  of  Greece  and  Asia 
Minor;  it  is  also  cultivated  in  Fmnce,  England,  and  America,  as 
well  as  in  other  countries.  It  has  been  thought  to  be  stimulant  and 
antispasmodic  in  small  doses,  relieving  pain,  and  producing  sleep ;  in 
large  doses,  giving  rise  to  headache,  and  producing  stupor.  In  the 
general  judgment  of  the  profession  it  is  now  considered,  however,  as 
having  very  little  activity.  It  is  accordingly  not  much  used,  except 
in  domestic  practice,  where  it  has  some  reputation  among  nurses  for 
its  power  to  bring  out  measles,  and  other  eruptions.  It  is  also  thought 
to  be  beneficial  in  amenorrhcea,  dysmenorrhoea,  chlorosis,  and  hys- 
teria. It  is  chiefly  used  at  present  to  impart  flavor  and  color  to 
tinctures. 

Preparations.  —  Fluid  extract,  dose,  twenty  to  forty  drops  ;  tinc- 
ture, dose,  half  a  dram  to  a  dnim ;  infusion,  one  dram  to  a  pint  of 
water,  dose,  one  to  two  ounces. 

Sage  (^Salvia  Officinalis').  —  The  tops  and  leaves  of  this  well  known 
garden  plant  are  aromatic,  astringent,  diaphoretic,  and  slightly  tonic. 
The  infusion  is  useful  in  debilitated  conditions  of  the  stomach,  at- 
tended with  flatulence  ;  it  frequently  relieves  nausea ;  the  cold  infu- 
sion, checks  and  sometimes  entirely  removes  the  night-sweats  of 
hectic.  The  infusion  is  useful  as  a  gargle  in  inflammation  of  the 
tiiroat,  particularly  if  united  with  a  little  honey  and  alum.  Dose  of 
the  infusion,  from  one  to  three  fluid  ounces. 

Sarsaparilla  {Smilax  Officinalis').  —  Grows  in  swamps  and  hedges 
in  the  Middle  and  Southern  States.  The  root  has  long  been  held  in 
esteem  as  an  alterative,  diuretic,  and  demulcent,  being  used  in  scrof- 
ula, chronic  rheumatism,  and  affections  of  the  skin  ;  but  its  most  ex- 
tensive and  useful  application  has  been  found  to  be  in  the  treatment 
of  secondary  and  tertiaiy  syphilis ;  and  especially  in  the  broken  con- 
dition of  the  system  which  follows  the  use  of  mercury  in  these 
affections. 

Preparations.  —  Fluid  extract,  dose,  one  dram ;  fluid  extract  of  sar- 
saparilla and  dandelion,  dose,  one  dram ;  solid  extract,  dose,  five  to 
twenty  grains ;  infusion,  dose,  two  to  three  ounces. 

Sassafras  (Laurus  Sassafras). —  This  tree  is  common  in  theUnited 
States.  The  bark  of  the  root,  which  is  the  medicinal  part,  is  altera- 
tive diuretic,  diaphoretic,  and  a  warm  aromatic  stimulant.  It  is 
mainly  used  to  improve  the  flavor  of  other  medicines,  and  also  as  a 
constituent  ^f  those  compounds  which  are  recommended  in  chronic 


i 


MEDICINES   AND   THEIK   PKEI'ARATIONS. 


873 


virtues  of  tlic 
»i  large  ilosijs 
«ncH,  epile|),s;, 
the  infusioii, 

eece  and  Asia 
America,  as 
stimulant  and 
cing  sleep ;  in 
jpor.  In  the 
,  however,  as 
used,  except 
ng  nurses  foi- 
8  also  thought 
wis,  and  hys- 
and  color  to 

'  drops ;  tine- 
to  a  pint  of 

is  well  known 
Jlightly  tonic, 
stomach,  at- 
the  cold  infu- 
"ht-sweats  of 
lation  of  the 
im.     Dose  of 

8  and  hedges 
been  held  in 
ised  in  scrof- 

its  most  ex- 
he  treatment 

broken  eon- 
iry  in  these 

ctract  of  sar- 
iose,  five  to 


n  the  United 
%  is  alterji- 
iant.  It  is 
1  also  as  a 
in  chronic 


I'lieninatism,    syphiloid     affections,    eruptions     of     the    skin,    and 
scurvy. 

Preparations.  —  Fluid  extract,  dose,  one  to  two  drams  ;  tincture, 
six  ounces  to  a  pint  of  alcohol,  dose,  half  an  ounce  to  an  ounce ;  in- 
fusion, two  ounces  to  a  pint  of  water,  to  be  drunk  as  desired. 

Savin  (Jtmiperua  Sabina).  —  An  evergreen  shrub,  growing  in 
Europe  and  North  America.  The  tops  and  leaves  are  diuretic,  dia- 
phoretic, emmenagogue,  and  anthelmintic.  The  warm  infusion  pro- 
motes menstruation,  and  destroys  worms.  Care  should  be  taken  nevor 
to  administer  this  medicine  during  pregnancy,  its  effects  being  violent 
and  dangerous. 

Preparations.  —  Fluid  extract,  dose,  ten  to  twenty  drops;  solid 
extract,  dose,  one  to  three  grains ;  tincture,  four  ounces  to  a  pint  of 
diluted  alcohol,  dose,  half  a  dram  to  a  dram  and  a  half ;  infusion,  half 
an  ounce  to  a  pint  of  water,  dose,  half  an  ounce  to  an  ounce.  The 
following  mixture  is  useful  in  anienorrhcea :  fluid  extract  of  savin, 
iialf  a  dram ;  fluid  extract  of  ginger,  one  dram  ;  sulphate  of  potassa, 
two  drams.  Mix.  Dose,  half  a  dram  twice  a  day.  The  oil  of  savin 
has  properties  similar  to  those  of  the  leaves.  Dose,  from  two  to  five 
drops,  on  sugar. 

Scammony  (^Convolvulus  Scammonia) .  —  This  plant  is  a  native  of 
Syria  and  the  neighboring  countries.  The  medicinal  part  is  the  har- 
dened juice  of  the  fresh  root.  It  is  an  energetic  cathartic,  producing 
griping,  and  sometimes  operating  with  decided  harshness,  on  which 
account  it  is  generally  combined  with  other  medicines  which  lessen 
the  severity  of  its  action.     The  dose  is  from  five  to  fifteen  grains. 

Scullcap  (Scutellaria  Lateriflora,  Fig.  233). — An  indigenous  plant, 
flowering  in  July  and  August.  The  whole  herb  is  used.  It  is  a  valuable 

nervine,  tonic,  and  antispasmodic;  while  it 
gives  support  to  the  nerves,  it  imparts  both 
quietness  and  strength  to  the  whole  system, 
and  does  not,  like  other  nervines,  leave  the 
patient  excited  and  irritable.  It  finds  its  use 
in  the  treatment  of  neuralgia,  chorea,  con- 
vulsions, lockjaw,  and  most  other  diseases  of 
the  nervous  system. 

.  Preparations.  —  Fluid  extract,  dose,  half  a 
dram  to  a  dram  ;  compound  fluid  extract,  dose, 
half  a  dram  to  a  dram  ;  tincture,  four  ounces  to 
a  pint  of  diluted  alcohol,  dose,  one  to  two 
drams;  infusion,  dose,  a  wineglassful  three 
times  a  day ;  scutellarin,  the  active  principle, 
dose,  two  to  five  grains. 

Seneka  (Polygala  Senega^ An    indigenous   plant,  commonly 

called  snakeroot,  the  root  of  which  is  used  in  medicine.     It  is  a  stim- 


Fia.288.    SCDLLCAF. 


874 


MRPICINKS    AND   TIIEIU    I'HEI'AKATTONS. 


r.lating  di'v  retic  and  exiMU'toiant,  anil  in  large  doses  an  emetic  ami 
(■atlmrtic.  It  excites  all  tlu;  sucretions.  it  is  useful  in  ciinniii' 
bi'onchitis,  and  in  other  chronic  affections  of  the  hreathing-tuln's. 

PreparatioriH.  —  Fluid  extract,  dose,  twenty- to  twenty-five  drops; 
infusion,  dose,  one  ounce  to  an  ounce  and  a  half;  syrup,  four  ounces 
of  fluid  extract  to  twelve  ounces  simple  syrup,  dose,  half  a  dram  to 
a  dram.  The  following  is  a  very  good  expectorant  cougli  prepara- 
tion :  fluid  extract  of  seneka,  three  drams ;  fluid  extract  of  squill, 
half  a  dram  ;  syrup  of  tolu,  two  drams  ;  paregoric,  two  drams  ;  car- 
bonate of  ammonia,  twenty  grains ;  water,  four  and  a  half  ounces. 
Mix.     Dose,  one  dram. 

Senna  (  Cassia  Acutifolia.^.  —  Grows  abundantly  in  Upper  Egypt. 
The  leaves  are  the  medicinal  part.  It  is  a  mild,  active,  and  certain 
cathartic,  and  is  much  used  in  combination  with  other  medicines, 
jiarticularly  epsom  salts.  The  addition  of  cloves,  ginger,  cinnamon, 
and  oth^T  aromatics,  removes  all  its  tendency  to  griping,  and  makes 
it  a  safe  and  gentle  yet  active  purgative,  calling  for  an  evacuation 
of  the  bowels. 

Preparations.  —  Fluid  extract,  dose,  one  to  two  drams ;  fluid  extract 
of  senna  and  jalap,  dose,  half  a  dram  t,o  a  dram ;  solid  extract,  dose, 
three  to  five  grains ;  tincture,  three  ounces  to  thirteen  ounces  of 
diluted  alcohol,  dose,  half  an  ounce  to  an  ounce  ;  infusion,  two  ounces 
to  a  pint  of  water,  dose,  half  an  ounce  to  an  ounce. 

Shrubby  Trefoil  (Ptelea  Tr\foliata).  —  This  shrub,  which  grows 
in  the  West,  is  called  wafer-ash  and  wmg»eed.  Its  bark  and  root 
have  tonic  properties,  and  are  used  in  intermittent  and  remittent 
fevers,  and  wherever  nature  needs  a  lift  in  getting  up  from  exhaust- 
ing complaints.  The  medicine,  like  other  tonics,  improves  the  ap- 
petite and  digestion.  Dose  of  the  solid  extract,  from  three  to  five 
grains,  three  or  four  times  a  day ;  of  the  cold  infusion,  a  tablespoon- 
ful  every  two  or  three  hours. 

The  oleo-resinous  principle  of  the  crude  bark  is  called  ptelein,  and 
is  a  powerful  tonic.  Dose,  one  or  two  grains  three  or  four  times  a 
day. 

Skunk-Cabbage  {Symplocarpm  Fcetidus,  Fig.  284).  —  A  peren- 
nial plant,  growing  in  moist  places  thi-oughout  the  United  States ; 
sometimes  called  meadow-cahbage.  The  root  is  stimulant,  expectorant, 
antispasmodic,  and  slightly  narcotic.  It  is  given  for  pulmonary  and 
bronchial  affections,  epilepsy,  hysterics,  asthma,  whooping-cough, 
and  irritable  nerves. 

Preparations.  —  Fluid  extract,  dose,  twenty  to  fifty  drops ;  tinc- 
ture, three  ounces  to  a  pint  of  alcohol,  dose,  half  a  dram  to  a  dram ; 
infusion,  dose,  one  to  one  and  a  half  ounces ;  syrup,  two  ounces  of 
fluid  extract  to  eight  ounces  of  simple  syrup,  dose,  two  to  three  drams. 
For  asthma  and  cough,  and  to  promote  expectoration  and  remove 


MED1CINK8   ANlJ    TIIKIK    PUErARATIONS 


875 


"1  eiiictic  iiiid 
f»l    in   cliioiii,. 

thing-tulH'H. 

Biity-five  (Irups; 

lip,  four  ounces 
mif  a  (iriuii  to 

cougli  prepai-a- 

tract  of  squill, 

vo  drains;  cnr. 

a  half  ouuces. 

Upper  Egypt. 
ve,  and  certiiiu 
;her  medicines, 
ger,  cinnamon, 
ng,  and  makes 
an  evacuation 

i;  fluid  extract 

extract,  dose, 

Ben  ounces  of 

on,  two  ounces 

which  grows 
3ai-Jc  and  root 
and  remittent 
from  exhaust- 
iroves  the  ap- 
tliree  to  five 
a  tablespoon- 

d  ptelein,  and 
four  times  a 

•  —  A  peren- 
rnited  States ; 
■,  expectorant, 
ulmonary  and 
)oping-cough, 

drops ;  tinc- 
tn  to  a  dram  ; 
vo  ounces  of 
'  three  drams. 

and  remove 


tigliinesH  across  tlie  chest,  the  following  is  a  very  good  compound 
preparation:  one  ounce  each  of  the  fluid  extract  of  skunk-cabbage, 
l()l)elia,  bloodroot,  pleurisy-root,  and  ginger,  one  pint  of  water,  anil 
tliiee  pints  of  alcohol.     Dose,  two  to  three  drams. 


KIO.  234.     SKCNK-CabBAOE. 


KlO.  ,05.     Sl-IPPKKY   KLM. 


Slippery  Elm  (^Ulmun  Fulva,  Fig  236).  —  The  inner  bark  of 
tiiis  well-known  tree  is  nutritive,  demulcent,  emollient,  and  slightly 
expectorant  and  diuretic.  It  is  valuable  as  a  demulcent  drink  in  in- 
flammations of  the  lungs,  stomach,  bowels,  bladder,  and  kidneys ; 
also  for  coughs,  strangury,  dysentery,  and  the  summer  complaints  of 
infants.     It  makes  a  valuable  poultice  for  various  purposes. 

Small  5plkenard  (Aralia  NudicauHs).  —  This  plant  grows 
tlnoughout  the  United  States,  from  Canada  to  the  ('arolinas,  in 
rocky  woods.  It  is  called  false  sarsaparilla  and  wild  sarsaparilla. 
The  root  is  a  gentle  stimulant,  diaphoretic  and  alterative.  It  is  used 
in  domestic  practice,  and  by  some  physicians,  in  rheumatism,  syph- 
ilis, and  cutaneous  diseases.  The  American  spikenard,  Aralia  raoe- 
mom,  resembles  the  small  spikenard  in  medicinal  jjroperties.  Either 
of  these  roots  is  valuable  in  chronic  affections  of  the  lungs  and  air- 
tubes. 

Soap  (Sapo).  —  Soap  is  laxative,  antacid,  and  antilithic,  and  is 
much  used  in  combination  with  cathartics,  to  lessen  the  severity  of 
their  action.  In  mesenteric  fever,  advantage  is  derived  from  rubbing 
the  tumid  belly  of  children  with  a  strong  lather  of  soap,  morning  and 
evening ;  and  few  things  are  more  effectual  in  removing  hardened 
feces  from  the  rectum  in  cases  of  obstinate  costiveness  than  an  injec- 
tion of  soapsuds.  Soap  is  now  made  out  of  so  many  kinds  of  fat 
that  care  should  be  taken  to  use  as  medicine  only  the  best  Castile. 

Sodium.  —  This  is  a  soft  white  mebil.  .United  with  oxygen  in 
the  proportion  of  one  efjuivalent  each,  it  forms  the  alkali,  ioua.  The 
loUowing  are  the  principal  preparations  of  soda  usei^.  iu  medicine:  — 


t 


876 


MBDIOINES   AN!)   THEIR   PRKPAKATIONS. 


Bicarbonate  of  Soda  {Sodce  £icarhonan). —  This  in  a  wliito,  inodor- 
ous powder,  sometimes  called  super  carbonate  of  soda.  Il  is  arit<u;icl, 
antilithic,  and  slightly  diuretic.  It  is  chiefly  used  in  preparing  what 
are  called  soda-powders,  and  in  various  preparations  of  medicine,  when 
an  antacid  is  required.  It  is  also  taken  simply  dissolved  in  water, 
for  acidity  of  the  stomach. 

Borate  of  Soda  (Sodcp  Boras).  —  This  is  everywhere  known  l)y  Iho 
name  of  borax.  It  exists  naturally  formed  in  various  parts  of  the 
world,  and  is  likewise  manufactured.  It  is  a  mild  refrigerent  and 
diuretic  ;  also  emmenagogue,  promoting  menstniation,  facilitating  par- 
turition, and  favoring  the  expulsion  of  the  after-birth  liy  its  specific 
influence  upon  the  womb.  It  has  considerable  reputation  in  the  treat- 
ment of  urinary  diseases,  particularly  those  connected  with  an  excess 
of  uric  acid.  The  dose  is  from  twenty  to  twenty-five  grains  in  solu- 
tion. Combined  with  rose-water,  honey,  and  various  other  thingiS, 
according  to  circumstances,  borax  makes  a  valuable  wash  for  inflam- 
matory affections  of  the  mouth  and  throat,  skin-diseases,  etc. 

Chloride  of  Sodium  (^Sodii  Chloridurn). — This  is  the  chemical 
name  of  muriate  of  soda  or  common  salt.  In  small  doses,  it  is  tonic, 
alterative  and  anthelmintic.  It  checks  bleeding  from  the  lungs,  when 
taken  in  teaspoonful  doses.  The  dose  as  an  alterative  is  from  ten  to 
sixty  grains.  As  moderately  used  in  food  by  most  civilized  people, 
it  promotes  digestion  and  improves  the  general  health. 

Sulphate  of  Soda  (^Sodce  Sulphas').  —  This  has  a  very  pretty 
name,  but  it  will  not  sound  half  as  well  to  thousands  of  young  per- 
sons, when  they  are  told  that  it  is  the  well-known  Glauber's  salts. 
From  half  an  ounce  to  an  ounce  of  it  dissolved  in  half  a  tumblerful 
of  water  acts  as  a  cathartic ;  a  smaller  dose,  as  a  laxative  and  diu- 
retic. Its  nauseous  and  bitter  taste  may  be  somewhat  concealed  by 
a  little  cream  of  tartar  or  lemon-juice. 

Sulphite  of  Soda  (aS'oc?^?  Sulphis'^.  —  This  preparation  is  in  the 
form  of  transparent  crystals,  and  is  very  soluble  in  water.  In  doses 
of  sixty  grains,  this  is  said  to  have  been  used  with  success  in  frothy 
vomitings ;  it  is  also  well  spoken  of  as  a  remedy  in  acute  rheuma- 
tisir,  and  as  a  wash  in  thrush  and  some  diseases  of  the  skin. 

Tartrate  of  Potassa  and  Soda  (Sodce  et  Potasses  Tartras).  —  This 
is  one  of  the  mildest  and  most  cooling  purgatives  among  the  salts. 
It  is  known  as  Rochelle  salt,  and  generally  agrees  well  with  irritable 
and  delicat*  stomachs.  Dose,  from  four  drams  to  two  ounces,  in  a 
tumblerful  of  water.  The  gentle  physic  called  Seidlitz  powders  is 
composed  of  two  drams  of  rochelle  salt  and  two  scruples  of  bicarbon- 
ate of  soda  in  a  blue  paper,  and  thirty-five  grains  of  tartaric  acid  in  a 
white  paper.  The  contents  of  each  paper  is  dissolved  in  half  a  tum- 
bler of  water  by  itself ;  one  solution  is  then  poured  into  the  other, 
and  the  whole  is  drunk  during  the  effervescence. 


MEDIOINKH   AND   THKIU    PKKI'ARATIONH. 


877 


H  wliito,  iiiodor- 
h  is  antacid, 
>i  t'lJiiritig  wlmt 
inutJiciiie,wht'ii 
olved  in  wutt-r, 

V  'cnown  iiy  the 
18  parts  of  the 
•efrigerent  and 
"acilitating  par- 

'•y  its  specific 
ion  in  the  treat- 
with  an  excess 
grains  in  solu- 

other  thing.s, 
ash  for  inflam- 
38,  etc. 

the  chemical 

ses,  it  is  tonic, 

he  lungs,  when 

is  from  ten  to 

vilized  people, 

very  pretty 
of  young  per- 
rlauber's  salts. 
f  a  tumblerful 
itive  and  diu- 
concealed  by 

ion  is  in  the 
ter.  In  doses 
Jess  in  frothy 
cute  rheuma- 
skin. 

tras).  —  This 
ng  the  salts. 
with  irritable 
ounces,  in  a 
te  powders  is 
i  of  bicarbon- 
aric  acid  in  a 
n  half  a  turn- 
to  the  other, 


5olomon's  Seal  (^Convalaria  MuUifiora).  —  This  is  one  of  our  own 

TK-rennial  plant**,  and  is  found  in  various  parts  of  the  country.  The 
root  is  tonic,  mucilaginous  and  HMtringeut.  It  acts  especially  upon 
mucous  tissues,  and  has  therefore  found  its  use  in  chronic  dysentery 
and  piles,  and  in  chronic  inflammation  of  the  stomach  and  bowels. 
Dose  of  the  decoction,  or  infusion,  from  one  to  four  fluid  ounces, 
three  or  four  times  a  day.  Large  doses  purge  and  vomit.  The  de- 
coction applied  locally,  relieves  the  inflammation  caused  by  the  p^^'son 
ivy. 

Solution  of  Arsenlte  of  Potassa  (^Liquor  Potasscp  Arsenitis). — 
This  is  known  under  the  names  of  arsenical  solution  and  Fowler's 
solution.  It  is  a  tran8{)arent  liquid,  having  the  color,  taate  and 
smell  of  spirits  of  lavender.  It  has  the  general  action  upon  the 
human  body  of  the  arsenical  preparations.  It  is  the  preparation 
generally  resorted  to  where  araenic  is  given  internally,  and  is  used 
with  considerable  success  in  intermittent  fever,  leprosy  and  several 
other  skin  diseases,  St.  Vitus's  dance,  periodical  headache,  and  some 
other  complaints.  The  dose  is  from  three  to  five  drops,  three  times 
a  day,  given  in  water ;  generally,  it  is  better  not  to  go  beyond  five 
drops.  Sometimes  it  disturbs  the  stomach  and  binds  the  bowels, 
producing  headache,  dizziness  and  confusion  of  mind.  When  such 
effects  follow  its  use,  it  must  be  laid  aside  and  a  purgative  given. 
After  an  interval  of  two  weeks,  it  may  be  resumed  in  smaller  doses. 
It  often  requires  to  be  used  for  several  months. 

Spanish  Flies  (^Gantharis  Vesicatoria^.  —  These  insects  are  of  a 
beautiful,  shining,  golden-green  color.  They  attach  themselves  to 
such  trees,  in  Franco,  Spain  and  Italy,  as  the  white  poplar,  elder, 
privet  and  lilac,  upon  the  leaves  of  which  they  feed.  They  make 
their  appearance  in  swarms  upon  these  trees  in  May  ar>d  June,  and 
are  shaken  off  in  the  morning  while  torpid  with  the  cold.  Internally 
administered,  they  are  a  powerful  stimulant,  exercising  a  peculiar 
influence  over  the  urinary  and  genital  organs.  In  large  doses,  they 
excite  violent  inflammation  of  the  alimentary  canal  and  urinary  or- 
gans, strangury,  irritation  of  the  sexual  organs,  headache,  delirium, 
and  convulsions ;  also  painful  priapism,  vomiting,  bloody  stools,  sali- 
vation, fetid  breath,  hurried  breathing,  and  difficulty  of  swallowing. 
They  are  given  internally  for  chronic  gonorrhoea,  leucorrhoea,  seminal 
weakness,  and  paralysis  of  the  bladder.  Dose  of  the  powder,  from 
half  a  grain  to  a  grain ;  of  the  tincture,  from  twenty  to  fifty  drops. 
Solution  of  potassa  given  every  hour,  in  thirty-drop  doses,  is  a 
remedy  for  strangury  produced  by  cantharides.  Spanish  flies  are 
used  externally,  in  the  form  of  blistering  plaster ;  also  in  the  form  of 
tincture,  mixed  with  various  solutions,  to  produce  irritation  and  red- 
ness of  the  skin. 

Spearmint  (Mentha   Vtridis') This  has   carminative,  diuretic 

and  antispasmodic  virtues.     The  warm  infusion  of  it  is  much  em- 


i 
1 


878 


MKDIOINKS   AND   THBIR    PKBPARATIUNB. 


ployed  in  domestic,  pmctice  to  produce  perspinitioii  after  takinjr  col,], 
Hud  while  sufforiiiif  from  feverish  symptoiiiH  from  various  cauHi'n. 
The  oil  of  spearmint  hiw  similar  properties  with  the  herh,  and  nmy 
be  taken  in  five-  to  eight-drop  doses,  on  sugar.  One  ounee  of  the  oil 
of  spearmint  dissolved  in  a  pint  of  alcohol,  constitutes  the  essence  uf 
spearmint. 

Spermaceti  {Cetaceum').  —  This  is  a  white  crystalline  sulistaiice 
obttiined  froni  the  head  of  the  spermaceti  whale.  In  househeld  prac- 
tice, it  is  considerably  used  for  the  coughs  'ind  'iolds  of  children, 
\mng  generally  simmered  with  molasses  or  wUte  sugar.  It  forms  a 
part  of  several  cerates  and  ointments. 

Spider's  Web  (^Tela  Aranecp).  —  The  web  of  the  black  or  brown 
spider,  gathered  in  barns,  cellars,  etc.,  is  sometimes  given  in  fivi-  or 
six-grain  doses,  in  pill  form,  and  it  is  said  with  good  effect,  in  peri- 
odical headache,  hysterics,  St.  Vitue's  dance,  asthma,  and  fever  and 
ague.  It  is  likewise  applied  externally  to  check  bleeding.  Care 
shouh'  ''«  taken  to  have  it  clean  and  free  from  dust. 

Spirit  of  Nitric  Ether  (^Spirittia  j^Etheris  Nitrici).  —  The  general 
reader  will  know  this  article  better  under  the  name  of  sweet  spirttn  of 
nitre.  It  is  diuretic,  diaphoretic,  antispasmodic  and  stimulant,  and 
in  large  doses,  a  narcotic  poison.  It  is  much  used  in  diseases  of  the 
urinary  organs,  either  alone  or  combined  with  sedatives,  and  other 
diuretics.  Dose,  from  twenty  to  thirty  drops,  to  be  taken  in  water, 
three  or  four  times  a  day. 

Sponge  (^Spongia).  —  When  burned,  this  is  used  as  an  alterative  in 
scrofula,  scrofulous  tumors,  goitre,  and  obstinate  diseases  of  the  skin. 
It  is  much  employed  by  homoeopathic  physicians,  though  it  has  much 
less  remedial  power  than  iodine.  Dose,  one  to  two  drams,  mixed 
with  honey  or  syrup. 

Spurred  Rye  (Secale  Gomutum).  —  This  is  a  diseased  product  of 
rye,  known  by  the  name  of  ergot.  This  article  has  a  peculiar  effect  upon 
the  womb,  causing  it  to  contract  with  great  energy,  when  given  in  full 
doses.  It  should  never  be  given,  however,  continuously,  for  a  great 
length  of  time,  as  it  has  been  known,  when  so  used,  to  produce  dry 
gangrene,  typhus  fever,  and  nervous  disorders  connected  with  con- 
vulsions. Such  were  its  effects  in  certain  provinces  of  P^rance,  in 
consequence  of  the  use  of  rye  bread  contaminated  with  it.  It  is  use- 
ful in  excessive  uterine  hemorrhage,  which  it  arrests  by  causing  the 
womb  to  contract,  and  thus  to  condense  its  tissue  and  close  up  its 
bleeding  vessels.  It  has  also  been  successful  in  bleeding  from  the 
lungs. 

PreparatioiiH.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram;  tinc- 
ture, four  ounces  to  a  pint  of  diluted  alcohol,  dose,  two  and  a  half  to 
five  dmms  j  infusion,  dose,  one  to  two  ounces ;  wine,  five  ounces  of 


mm 


^.T       ^WiiZ^lM-.i 


IMAGE  EVALUATION 
TEST  TARGET  (MT-3) 


1.0 


I.I 


Ett   1^     12.? 

^  Hi    ™^ 

lAo    Hill  2.0 

1.8 


n 


Photographic 

Sciences 
Corporation 


m  iiiu  11.6 


«' 


23  WE^T  MAIN  STREET 

WEBSTER,  N.Y.  14S80 

(716)  872-4503 


CIHM/ICMH 

Microfiche 

Series. 


,  srt 


CIHM/ICMH 
Collection  de 
microfiches. 


Canadian  Institute  for  Historical  MIcroreproductions  /  Instltut  canadJen  de  mJcroreproductlons  historlques 


L„,...^:i_, 


MEDICINES   AND   THEIK   PREPARATIONS. 


879 


fluid  e3:tract  to  a  pint  of  sherry  wine,  dose,  two  to  thi-ee  drams,  in 
cases  of  labor ;  for  other  purposes,  one  to  two  drams. 

Squill  {Seilla  Maritima),  —  A  perennial  plant  growing  in  coun- 
tries on  the  Mediterranean.  In  large  doses  it  is  emetic  and  purga- 
tive ;  i:,!  small  doses  expectorant  and  diuretic.  It  is  used  in  pulmonary 
affections  to  increase  expectoration,  and  in  dropsical  complaints  to 
augment  the  secretions  of  the  kidneys.  Dose  of  the  dried  root,  one  to 
five  grains,  generally  to  be  united  with  nitre  or  ipecac. 

Preparations.  —  Fluid  extract,  dose,  as  an  expectorant  and  diuretic, 
two  to  six  drops  ;  as  an  emetic,  twelve  to  twenty  drops;  compound 
fluid  uxtl^ct,  dose,  ten  to  twenty  drops ;  tincture,  two  ounces  to  a 
pint  of  diluted  alcohol,  dose,  twenty  to  thirty  drops ;  syrup,  dose, 
a  quarter  to  half  a  dram. 

StarsQrass  (^Aletri»  Farinom,  Fig.  236).  —  This  plant  is  found  in 
dry  soils  throughout  most  parts  of  the  United 
•States,  and  called  uniconirroot^  ague-root,  and 
crow-corn.  The  root  is  an  intensely  bitter  tonic, 
and  is  used  to  improve  the  tone  of  the  stonnch, 
and  for  flatulent  colic  and  hysterics.  It  is  said 
also  to  give  tone  to  the  female  generative  organs, 
affording  a  protection  against  miscarriage.  Tlie 
Eclectics  call  it  one  of  their  best  agents  in  chlo- 
rosis, suppressed  menstruation,  engorgement  and 
falling  of  the  womb,  and  painful  menstruation. 
Dose  of  the  powdered  root,  from  five  to  ten 
grains,  three  times  a  day. 

Preparations.  —  Fluid    extract,   dose,  ten  to 
twenty  drops  ;  tincture,  two  ounces  to  a  pint  of    ^'°-  ^^-  stah-gkabb. 
diluted  alcohol,  dose,  half  a  dram  to  a  dram ;  infusion,  two  drams  to 
a  pint  of  water,  dose,  one  or  two  ounces ;  syrup,  dose,  one  to  two 
drams ;  aletiidin,  the  active  principle,  dose,  one  to  three  grains. 

St.  Ignalius'  Bean  (^Faba  3ancH  IgnatW). —  The  seeds  are  the 
part  used,  and  are  the  product  of  the  Ignatia  Amara,  —  a  tree  of 
middle  size,  growing  in  the  Philippine  Islands,  and  is  a  species  of  the 
istrychnoa.  These  seeds  possess  a  large  amount  of  strychnine,  and 
consequently,  in  medicinal  doses,  are  a  pov/erful  nervine  tonic,  and 
are  used  for  improving  the  digestive  functions,  and  for  rousing  and 
strengthening  the  whole  system  when  prostrated  by  nervous  com- 
plaints. 

Preparations.  —  Fluid  extract,  dose,  five  to  ten  drops ;  solid  ex- 
tract, dose,  half  a  grain  to  a  grain  and  a  half. 

Storax  (^Styrax  Officinale).  —  This  is  the  hardened  juice  of  the 
storax,  a  native  of  the  countries  along  the  Mediterranean.  It  is  a 
stimulant  and  expectorant,  and  is  used  for  chronic  bronchitis,  laryn- 
gitis, and  cough.     The  liquid  storax  is  sometimes  employed  instead 


fii, 


'■'  > 


I        ,\  «,l^*MI|ilJ|i| f 


8M  MEDICINES   AND  THEIR   PREPARATIONS. 

of  copaiba  in  gonorrhoea  and  gleet.     The  dose  is  from  ten  to  Pfteen 
grains.     Storax  is  a  constituent  in  the  compound  tincture  of  benzoin. 

Stramonium  (Datura  Stramonium,  Fig.  287).—  This  annual 
plant  is  most  known  in  this  country  by  the 
name  of  Jamestown  iveed  ;  in  England  by  that 
of  thomapple.  The  leaves  and  seeds  are  med- 
icinal. Stramonium  is  a  powerful  narcotic  ;  it 
is  also  antispasmodic,  anodyne,  and  sedative. 
It  is  used  in  various  nervous  affections,  as 
chorea,  epilepsy,  palsy,  tetanus,  and  mania. 
It  is  much  used  for  relieving  acute  ^ains,  etc. 
Taken  in  large  doses,  it  is  a  powerful  poison. 
Preparations.  —  Fluid  extract,  dose,  five  to 
Fio.  237.  8TBAM0NIUM.  fif^gn  drops  ;  solid  extract,  dose,  half  a  grain 
to  a  grain ;  tincture,  two  ounces  to  a  pint  of  alcohol,  dose,  half  a 
dram  to  a  dram,  and  to  be  gradually  increased.     Use  w  ith  care. 

Sulphur.  —  This  is  considerably  used  in  medicine,  being  laxative, 
diaphoretic,  and  resolvent.  It  is  chiefly  used  for  piles,  chronic  rheu- 
matism, gout,  asthma,  and  those  affections  of  the  breathing  organs 
not  attended  with  acute  inflammation.  Externally  and  internally, 
it  is  much  employed  in  skin-diseases,  particularly  for  itch,  for  which 
it  is  a  specific.  In  these  affections,  it  is  frequently  applied  in  the 
form  of  sulphur  baths.  The  dose  of  sulphur  is  from  one  to  three 
drams,  mixed  with  syrup,  molasses,  or  milk.  When  sublimed, 
this  article  is  called  flowers  of  sulphur,  which  is  the  form  in  which 
it  is  chiefly  used  in  medicine. 

Sumach  (^Bhus  Glabrum}.  —  Found  in  almost  all  parts  of  the 
United  States  in  old,  neglected  fields,  and  by  the  side  of  fences.  The 
bark  and  berries  are  astringent,  tonic,  antiseptic,  and  diuretic,  and 
are  used  in  diarrhoea,  dysentery,  gonorrhoea,  whites,  hectic  fever, 
and  scrofula.  The  berries  make  a  valuable  gargle  in  quinsy  and 
ulcerations  of  the  mouth  and  throat,  and  also  a  useful  wash  for 
ringworm,  tetter,  and  ulcers.  The  excrescences'  which  grow  upon 
the  leaves  have  nearly  as  much  astringency  as  galls,  and  when  pul- 
verized and  mixed  with  lard,  have  a  similarly  soothing  effect  upon 
piles. 

Preparations — Fluid  extract,  dose,  one  to  two  drams;  tincture, 
four  ounces  to  thirteen  ounces  of  diluted  alcohol,  dose,  half  an  ounce 
to  an  ounce. 

Sunflower  (ffelianthus  Annuus) The  seeds  and  leaves  of  this 

plant  are   expectorant  and   diuretic,   and   are   useful    in    several 
pulmonary  affections.     The  seeds  yield  a  fixed  oil,  in  which  their 
\^  '  medicinal  virtues  are  chi(jfl3'  found.     In  doses  of  t.n  or  fifteen  drops, 

this  oil  acts  favorably  upon  inflamed  mucous  surfaces,  and  in  doses 
twice  as  large  it  greetly  augments  the  flow  of  uriae. 


\: 


MEDICINES  AND   THEIR   PREPARATIONS. 


sai 


: 


ten  to  Pfteen 
ire  of  benzoin. 

This  annual 
juntry  by  the 
gland  by  that 
leeds  are  med- 
il  narcotic ;  it 

and  sedative. 

affections,  a.s 
3,  and  mania, 
ute  ^ains,  etc. 
.^erful  poison. 
I,  dose,  five  to 
},  half  a  grain 
,  dose,  half  a 
ith  care. 

•eing  laxative, 
chronic  rheu- 
ithing  organs 
ad  internally, 
tx;h,  for  which 
pplied  in  the 
I  one  to  three 
len  sublimed, 
oTva  in  which 

parts  of  the 
f  fences.  The 
diuretic,  and 
hectic  fever, 
1  quinsy  and 
ful  wash  for 
sh  grow  upon 
nd  when  pul- 
r  effect  upon 

ms;  tincture, 
half  an  ounce 


eaves  of  this 

in    several 

n  which  their 

fifteen  drops, 

and  in  doses 


Swamp  Dogwood  (^Gornvs  Sericea).  —  This  is  found  in  damp 
places,  and  along  the  banks  of  rivers,  in  various  parts  of  our  cotintry, 
and  is  known  as  red  osier,,  red  willow  and  rose  willow.  The  bark  is 
tonic,  stimulant  and  astringent,  and  has  been  used  for  similar  pur- 
poses with  dogwood-bark  ;  it  is  well  spoken  of,  also,  for  dyspepsia, 
diarrhoea,  malignant  fevers,  and  as  an  external  application  to  foul 
and  ill-conditioned  ulcers.  Dose  of  the  powdered  bark,  from 
twenty  to  fifty  grains;  of  the  infusion,  from  two  to  three  fluid 
ounces. 

Swamp  Milkweed  (Asclepias  Incamata).  —  This  is  a  native  of 
the  United  States,  and  bears  red  flowers  from  June  to  August.  It 
has  the  name  of  white  Indian  hemp.  The  root  is  emetic,  cathartic, 
and  diuretic,  and  is  useful  in  asthma,  bronchitis,  rheumatism,  syphilis, 
and  worms. 

Preparations.  —  Fluid  extract,  dose,  twenty  to  thirty  drops ; 
solid  extract,  dose,  three  to  five  grains ;  tincture,  two  ounces  to  a 
pint  of  diluted  alcohol,  dose,  one  and  a  half  to  three  drams ;  infu- 
sion, dose,  three  to  five  drams ;  syrup,  four  ounces  fluid  extract  to 
twelve  ounces  simple  syrup,  dose,  half  a  dram  to  a  dram. 

Sweet  Fern  (Comptonia  Asplenifolia^.  —  This  shrub,  growing  in 
stony  pastures  in  New  England  and  Virginia,  is  tonic,  astringent, 
alterative  and  aromatic,  and  is  used  in  diarrhoea,  dysentery,  cholera- 
infantum,  rheumatism,  and  debility  after  fevers.  Dose  of  the  decoc- 
tion, from  one  to  three  fluid  ounces,  three  or  four  times  a  day. 

Sweet  Flag  {Acorus  Calamus).  —  Found  in  damp  places,  in  most 
parts  of  the  world.  The  root  is  stimulant,  tonic,  and  aromatic; 
useful  in  wind  colic,  weakened  conditions  of  the  stoibach,  and  dys- 
pepsia. Dose  of  the  root,  from  twenty  to  sixty  grains  ;  of  the  infu- 
sion, from  two  to  three  fluid  ounces. 

Sweet  Gum  {Liquidamher  Styraciflua').  —  This  tree  grows  in  the 
Middle  and  Southern  States.  Being  wounded,  it  yields  a  yellowish- 
white,  honey-like  balsam,  which  hardens  into  a  gum.  This,  melted 
with  equal  parts  of  lard  or  tallow,  forms  an  ointment  which  is  used 
in  some  parts  of  the  country  for  piles,  ringworm  of  the  scalp,  fever- 
sores,  and  other  complaints.  Used  internally,  it  has  very  neany 
the  same  effects  as  storax. 

Tag  Alder  (Alnus  Rubra).  —  This  shrub  grows  in  swamps  and 
other  damp  places,  in  northern  United  States.  The  bark  is  altera- 
tive, emetic,  and  astringent.  It  is  used  in  scrofula,  secondary 
syphilis,  herpes,  impetigo,  and  other  skin-diseases. 

Preparations.  —  Fluid  extract,  dose,  one  to  two  drams  ; '  infusion, 
two  ounces  to  a  pint  of  water,  dose,  one  to  one  and  a  half  ounces  ; 
alnuin,  the  active  principle,  dose,  one  to  two  grains. 

Tansy  (^Tanacetum  Vvlgare) —  Tansy  is  a  perennial  herb,  having 
tonic,  emmenagogue,  and  diaphoretic  properties ;  the  cold  infusion 


I 


i 


882 


MEDICINES    AND   THEIR   PREPARATIONS. 


■       :.'^ 


being  tonic,  and  useful  in  dyspepsia,  wind  in  the  stomach,  jaundice, 
and  worms ;  the  warm  infusion,  diaphoretic  and  emmenagogue. 
Dose  of  the  infusion,  from  one  to  three  fluid  ounces,  two  or  three 
times  a  day. 

Tar  (Pix  Liquida).  —  The  medicincil  qualities  of  tar  are  like  those 
of  turpentine,  and  it  is  sometimes  used  in  old  chronic  coughs  and 
bronchitis.  The  vapor  of  boiling  tar  was  once  thought  to  be  very 
serviceable  in  bronchial  diseases,  when  inhaled.  Doubtless  it  is 
useful  in  some  cases,  but  its  virtues  have  been  extolled  above  their 
merits.  In  the  form  of  ointment  it  has  real  efficacy  in  scald  head 
and  tetter. 

Thimbleweed  (JRudbeckia  Laciniata).  —  The  whole  of  ohis  herb 
is  balsamic,  diuretic,  and  tonic,  and  in  the  form  of  decoction,  used 
freely,  is  said  to  have  been  found  useful  in  some  urinary  complaints, 
as  Bright's  disease,  strangury,  etc. 

Tobacco  {Nicotiana  Tahaoum).  —  The  leaves  of  tobacco  are  acrid, 
narcotic,  and  poisonous,  and  are  chiefly  used  in  the  form  of  oint- 
ment, in  skin  diseases,  etc.  Its  poisonous  qualities,  however,  render 
it  dangerous  when  much  used,  even  externally.  Nervous  people 
should  not  smoke.  Chewing  is  not  only  an  unhealthy,  but  a  dis- 
gusting habit. 

Trailing  Arbutus  (Upigicea  Repens).  —  This  grows  in  sandy 
woods  and  rocky  soils,  its  flowers  appearing  in  early  spring,  and  ex- 
haling a  spicy  fragrance.  The  leaves  are  diuretic  and  astringent, 
and  are  very  useful  in  gravel,  and  most  diseases  of  the  urinary 
organs,  being  regarded  in  some  cases  superior  to  uva-ursi  and  buchu. 

Preparations —  Fluid  extract,  dose,  one  to  two  drams ;  infusion, 
dose,  two  to  three  ounces. 

Tapioca  (Janipha  Manihot,  Fig.  238).  —  This  plant  grows  in  the 
West  Indies  and  Brazil.  It  is  cultivated 
chiefly  on  account  of  the  root,  which  is  large- 
ly used  as  an  article  of  food,  particularly  for 
the  sick,  or  rather  for  those  recovering  from 
sickness.  The  starch  which  it  contains  is 
separated  by  washing,  scraping,  grating,  and 
grinding,  and  is  in  the  form  of  hard,  white, 
rough  grains.  It  is  prepared  for  use  by  boil- 
ing; ?,nd,  in  debility  and  low  forms  of  disease, 
may  have  tte  addition  of  wine,  nutmeg,  or 
other  aromatics. 


Fio.  888.    TAPIOCA. 


Tulip  Tree  (Liriodendron  Tulipifera) . — 
This  is  a  large  and  elegant  tree  growing  in 
many  parts  of  the  country,  and  called  poplar  and  white  poplar. 
The  bark  of  the  root  is  aromatic,  stimulant,  and  tonic,  and  in  warm 
infusion,  diaphoretic.     It  is  used  in  fever  and  agra,  chronic  rheuma,- 


MEDICINES   AND   THEIR    PREPARATIONS. 


883 


lach,  jaundice, 

iinmeuagogue. 

two  or  three 

•  are  like  those 
ic  coughs  and 
ht  to  be  veiy 
}ubtless  it  is 
jd  above  their 
in  scald  head 

B  of  chis  herb 
ecoction,  used 
ry  complaints, 

acco  are  acrid, 
form  of  oint- 
Dwever,  render 
3rvou8  people 
hy,  but  a  dis- 

)W8  in  sandy 
pring,  and  ex- 
id  astringent, 
:  the  urinary 
•si  and  buchu. 
kins ;  infusion, 


grows  in  the 
is  cultivated 
vhich  is  large- 
articularly  for 
overing  from 
contains  is 
,  grating,  and 
f  hard,  white, 
)r  use  by  boil- 
:ms  of  disease, 
le,  nutmeg,  or 


t 


'hilipifera).  — 
e  growing  in 
white  poplar. 
and  in  warm 
ronic  rheuma- 


tism, and  chronic  diseases  of  the  stomach  and  bowels.  Dose  of  the 
powdered  bark,  from  a  scruple  to  two  drams ;  of  the  infusion,  from 
one  to  two  fluid  ounces. 

Turkey  Corn  {Corydalis  Formosa).  —  This  perennial  plant  is 
called  wild-turkey  pea  and  »tagger^weed,  and  grows  in  rich  soils  in 
the  Southern  arul  Western  States.  The  tuber,  which  is  the  medicinal 
part,  should  only  be  collected  when  the  plant  is  in  flower.  It  is  tonic, 
diuretic,  and  alterative.  It  is  much  valued  do  «  remedy  in  syphilis 
and  scrofula. 

Preparations.  —  Fluid  extract,  dose,  ten  to  thirty  drops  ;  tincture, 
three  ounces  to  a  pint  of  diluted  alcohol,  dose,  half  a  dram  to  two 
drams ;  corydalin,  the  active  piinciple,  dose,  half  a  grain  to  a  grain. 
A  valuable  alterative  for  syphilis  is  made  by  uniting  eight  grains  of 
corydalin  with  ten  grains  of  hydi-astin,  and  dividing  into  twelve 
powders.     Dose,  one  powder  three  or  four  times  a  day. 

Turmeric  (CwrcMwa  Longa").  —  This  is  a  native  of  the  East  Indies 
and  Cochin  China.  The  root  is  a  stimulant  aromatic  and  tonic, 
somewhat  like  ginger,  employed  in  debilitated  states  of  the  stom- 
ach, etc. 

Preparations.  —  Fluid  extract,  dose,  two  or  three  drams ;  tincture, 
two  ounces  to  twelve  ounces  of  diluted  alcohol,  dosf  one  and  a  half 
to  two  ounces  ;  infusion,  dose,  two  to  four  ounces. 

Valerian  ( FaZer«a«rt  Officinalis). — This  is  a  European  plant, 
flowering  in  June  or  July.  The  root  is  tonic,  nervine,  and  antispas- 
modic, and  is  much  used  in  cases  of  iiregular  nervous  action,  partic- 
ularly morbid  nervous  vigilance,  or  hypochondria,  epilepsy,  lowness 
of  spirits,  and  nervous  headache. 

Preparations Fluid  extract,  dose,  half  a  dram  to  a  dram  ;  solid 

extract,  dose,  three  to  eight  grains ;  tincture,  four  ounces  to  a  pint 
of  diluted  alcohol,  dose,  two  to  tlu-ee  drams  ;  infusion,  half  an  ounce 
to  a  pint  of  water,  dose,  two  to  three  ounces  ;  syrup,  four  ounces  of 
fluid  extract  to  \  pint  of  simple  syrup,  dose,  two  to  three  drams. 

Vervain  (^Verbena  ffastata}.  —  A  perennial  plant,  common  in  the 
United  States.  The  root  is  tonic,  emetic,  expectorant,  and  sudorific. 
It  is  used  in  intermittent  fevers,  colds,  and  obstructed  menstruation, 
in  the  form  of  warm  infusion.  The  cold  infusion  is  a  good  tonic  in 
loss  of  appetite,  debility,  etc.  Dose  of  the  powdered  root,  one  or  two 
scruples ;  of  the  infusion,  from  two  to  three  ounces,  three  or  four 
times  a  day. 

Vinegar  (Aeetum) This  is  refrigerant,  diuretic,  astringent,  and 

tonic ;  used  in  fevera  and  inflammatory  complaints,  likewise  in  8cui"vy 
and  typhus,  as  an  antiseptic.  It  has  been  found  useful  in  dysentery 
and  scarlet  fever,  saturated  with  common  salt.  Externally,  it  is  ap- 
plied to  bruises,  inflammations,  sprains,  and  swellings.  It  sometimes 
hfis  a  good  effect  as  a  gargle  in  putrid  sore  throat,  etc.,  and  as  a 
cooling  wash  in  headache  during  fevers. 


884 


MKUIOINES   AND   THKIK    I'KKI'AltATIONS. 


Virsinia  Snake-root  (^Arittolochia  Serpentaria^  Fig.  289).  — Tliis 
is  a  perennial  lierb  of  the  Middle  and  Southern  States.  The  root  is 
stimulant,  tonic,  and  diaphoretic.  It  is  used  in  typhoid  fevers,  when 
the  system  needs  support,  but  cannot  bear  active  stimulation.  Com- 
bined with  Peruvian  bark,  it  is  also  used  in  intermittent  fevers.  The 
cold  infusion  is  employed  in  some  forms  of  dyspepsia ;  likewise  as  a 
gargle  in  malignant  sore  throat. 

Preparations.  —  Fluid  extmct,  dose,  one-quarter  to  half  a  dram ; 
tincture,  thiae  ounces  to  i  pint  of  diluted  alcohol,  dose,  one  to  two 
drams ;  infusion,  half  an  ounce  to  a  pint  of  water,  dose,  one  to  two 
ounces,  in  low  forms  of  fever.  The  following  is  a  good  compound 
tincture  :  half  an  ounce  each  of  fluid  extract  of  snake-root,  fluid  ex- 
tract of  ipecac,  fluid  extract  of  saffron,  fluid  extract  of  ladies'  slipper, 
together  with  half  an  ounce  of  camphor,  and  one  and  a  half  pints  of 
diluted  alcohol ;  dose,  a  dram  to  a  dram  and  a  half. 


VM.  239.     VlKGIMIA  SNAKK  KOOT. 


FlO.  240.    Watbh-Hobehounu. 


Water-Horehound  (Fig.  240).  —  This  article  has  been  described 
under  Bugle-Weed  (Lycopus  Virginicus).     See  Bugle-Weed. 

Water-Pepper  (^Polggonum  Punctaturn).  —  This  annual  plant  is 
called  smartr^eed,  and  grows  throughout  our  country,  in  low  grounds, 
and  along  ditches  and  brooks.  It  has  a  pungent,  biting  taste,  and  is 
stimulant,  diuretic,  emmenagogue,  antiseptic,  and  vesicant.  It  is 
used  in  coughs,  colds,  gravel,  and  womb-complaints. 

Preparations.  —  Fluid  extract,  dose,  ten  to  forty  drops ;  solid 
extract,  dose,  two  to  three  grains  ;  tincture,  four  ounces  to  a  pint  of 
diluted  alcohol,  dose,  half  a  dram  to  two  drams ;  infusion,  half  an 
ounce  to  a  pint  of  water,  dose,  half  an  ounce  to  an  ounce. 

Wahoo  (Muonymu^  Atropurpureus).  —  A  small  shrub  growing 
in  woods  in  many  parts  of  the  United  States.  The  bark  of  the  root 
is  a  bitter  tonic,  laxative,  alterative,  diuretic,  and  expectorant,  and  is 
advantageously  used  in  pulmonary  affections,  dropsy,  constipation, 
torpidity  of  the  liver,  dyspepsia,  and  intermittent  fevers. 


MKTITClTnilfl   AND   THKIR   PRRPAKATI0N8. 


88r. 


r.  239).— This 
1.  The  root  is 
id  fevers,  when 
Illation.  Com- 
nt  fevers.  The 
;  likewise  as  a 

I  half  a  dram; 
se,  one  to  two 
se,  one  to  two 
ood  compound 
i-root,  fluid  ex- 
'  ladies'  slipper, 
a  half  pints  of 


BB-HOBEHOUND. 

been  described 
-Weed. 

nnual  plant  is 
in  low  grounds, 
ng  taste,  and  is 
/^esicant.     It  is 

J  drops ;  solid 
ces  to  a  pint  of 
'usion,  half  an 
ince. 

shrub  growing 
ark  of  the  root 
lectorant,  and  is 
J,  constipation, 
srs. 


Preparationa.  —  Fluid  extract,  dose,  one  to  two  drams ;  tinctuns 
four  ounces  to  twelve  ounces  of  diluted  alcohol,  dose,  half  an  ounce 
to  an  ounce. 

Wax.  —  The  yellow  and  white  wax  are  chietly  used  as  ingredients 
of  plastera  and  ointments. 

White  Hellebore  {Veratru,ii  Album).  —  This  is  a  European 
perennial  plant,  the  root  of  which  ia  a  violent  emetic  and  purgiitive, 
and  in  large  doses  is  poisonous ;  not  often  used,  except  externally, 
in  the  fonn  of  ointment  or  decoction,  for  the  cure  of  itch  and  some 
other  skin-diseases. 

White  Oak  (Quercus  Alba').  —  The  inner  hark  of  the  white  oak 
is  astringent,  tonic,  and  antiseptic,  and  has  been  used  in  intermit- 
tent fever,  chronic  diarrhoea,  chronic  mucous  discharges,  and  passive 
hemorrhages.  As  a  wash  aj)plied  externally  it  sometimes  arrests 
night-sweats,  and  as  an  astringent  gargle  and  injection  its  use  is  com- 
mon for  relaxed  palate,  spongy  gums,  leui.*  rrhauv  falling  of  the 
bowel,  etc. 

Preparations.  —  Fluid  extract,  dose  half  a  dram  to  a  dram  ;  solid 
extract,  dose,  ten  to  fifteen  grains;  tincture,  two  ounces  to  a  pint  of 
diluted  alcohol,  dose,  half  an  ounce  to  an  ounce. 

White  Pond-Lily  (iV//mpA(Bof  Odoratd). —  This  grows  in  ponds 
and  marshes  in  many  parts  of  our  country.  The  root  is  demulcent, 
anodyne,  astringent,  and  alterative ;  used  in  dysentery,  diarrhcea, 
gonorrhoea,  whites,  and  scrofula.  An  infusion  is  sometimes  used  as 
a  gargle  in  ulcei"s  of  the  mouth  and  throat,  and  as  an  injection  in 
leucorrhoea.     Dose  of  the  infusion,  from  two  to  three  fluid  ounces. 

Wild  Cherry  (Prunus  Virginiana).  —  This  tree  grows  extensively 
in  the  American  forests,  flourishing  wheie  tlie  soil  is  fertile  and  the 
climate  temperate.  The  inner  bark  is  tonic  and  stimulant  to  the 
digestive  organs,  and -sedative  to  the  nerves  and  the  circulation.  It 
is  much  used  in  consumption,  scrofula,  and  dyspepsia. 

Preparations.  —  Fluid  extract,  dose,  two  to  three  drams,  compound 
fluid  extract,  dose,  half  a  dram  to  a  dram ;  infusion,  half  an  ounce 
to  a  pint  of  water,  dose,  one  ounce  ;  syrup,  three  ounces  of  fluid 
extract  to  thirteen  ounces  of  simple  syrup,  dose,  two  drams  to  an 
ounce. 

Wild  Cucumber  (^MomordicnMaterium).  —  This,  sometimes  called 
squirting  cucumber^  is  a  native  of  the  south  of  Europe,  and  is  culti- 
vated in  Great  Britain.  It  is  a  powerful  hydragogue  cathartic,  and 
in  large  doses  causes  nausea  and  vomiting.  On  account  of  the 
watery  stools  it  produces  it  is  much  used  in  dropsical  complaints, 
though  the  severity  of  its  action  foibids  its  being  used  alone.  Dose, 
a  quarter  to  half  a  grain,  repeated  every  hour  till  it  operates  ;  of 
elaterin,  from  a  sixteenth  to  a  twentieth  of  a  grain,  given  in  solution. 


88fi 


MEDICINEH    AND   THEIR    PHEPAUAT10N8. 


'■^^N     ' 


Wild  Qinger  (^Amruiii  (^anadeiMP)  —  This  JH  known  by  tho  iiivineM 
of  roUitfoot  and  Cunaitii  xnake-roof,  nml  is  common  in  all  parts  of  tlif 
country.  The  root  is  tonic,  stimulant,  aromatic,  expectorant,  and 
dia|)horotic.  It  is  used  in  pains  of  the  stomach,  colic,  etc.  Dose  of 
the  powder,  half  a  dram ;  of  the;  tincture,  half  a  dram  to  two  drams. 

Wild  Indigo  (^Bapiuia  Tinctnriu,  Fig.  241).  —  This  perennial 
sliriil)  is  found  in  most  j)art«  of  the  country. 
The  hark  of  the  root  is  purf>;ative,  emetic,  stimu- 
lant, astrinjvent,  and  antiseptic.  It  is  chiefly 
used  for  its  antiseptic  [jroperties.  For  external 
ust^  it  is  viilnahle  as  a  wtush  oi'  gargle  for  vaiious 
uhjcrs,  nien^vuial  sore  mouth,  and  scrofulous 
and  syph'litic  ophthalmia. 

PrvparatlonH. —  Fluid  extract,  dose,  a  quarter 
to  half  .'•  dram  ;  tincture,  two  ounces  to  a  pint  of 
diluted  alcohol,  dose,  two  to  four  drams ;  infu- 
sion, (lose,  half  an  ounce;  baptisin,  the  active 
Fio.  241.  WILD  iNwdo.      p,.i„eiple,  a  quarter  to  half  a  grain  ;  gargle,  four 
ounces  of  fluid  extract  tt)  "twelve  ounces  of  water,  to  be  used  as 
occasion  requires.  .   . 

Wild  Yam  {Dioxcorea  ViUom). — A  perennial  vine,  Ton nd  mostly 
at  the  South.  The  root  is  antispasmodic,  and  is  successfully  used  in 
bilious  colic.  It  is  said  to  bring  relief  in  the  most  violent  Ciiscs  of 
this  complaint.  It  allays  nausea  and  spasms  during  pregnancy.  It 
is  given  in  the  form  of  decoction,  two  or  three  fluid  ounces  every 
thirty  or  forty  minutes.  Dose  of  the  tincture,  from  a  quarter  of  a 
dram  to  a  dram ;  of  dioscorein,  the  active  princi[)le,  one  to  three 
grains. 

Willow  {iSalLr  Alba).  —  The  willow  is  common  in  Europe  and 
America.  Its  bai-k  is  tonic  and  astringent,  and  is  used,  occasionally, 
as  rt  substitute  for  Peruvian  bark  in  intermittent  fever.  It  is  also 
(Mnployed  in  the  treatment  of  chronic  diarrhoea  and  dysentery. 
Uose  of  the  powdered  bark,  one  dram ;  of  the  decoction,  one  to  two 
fluid  ounces.  Salicin,  the  active  prino'.ple,  is  given,  sometimes,  in 
place  of  quinine  ;  dose,  from  two  to  eijht  grains. 

WIntergreen  (OauUheria  Prommhenti).  —  This  evergreen  grows 
in  mountsiinous,  barren  regions,  throughout  our  country.  The  leaves 
are  an  agreeable  stimulan,,  aromatic  and  astringent.  Used  for 
chronic  diarrhn;a,  and  as  an  emraenapogue.  The  oil  and  essence  are 
useful  in  flatulent  colic ;  dose  of  the  oil,  from  five  to  eight  drops,  on 
sugar ;  of  the  essence,  twenty  to  thirty  drops.  Much  used  to  flavor 
other  medicines. 

Witch-Hazel  (^HamamellH  Virginica,  Fig.  242).  —  This  derives  its 
name  from  its  having  fruit  and  flowers  together  on  the  same  tree. 
It  is  found  in  most  parts  of  our  country.     The  bark  and  leaves  are 


by  tlui  iiiunoK 
1  partH  of  the 
3ct()i-iint,  iiiiii 
)tc.  Doso  ol 
o  two  drams. 

lis  peronnial 
the  cou'iitry. 

iinctic.  Htimu- 

It  iw  chiefly 

For  extoriial 

le  for  various 

1(1  Hcrofulous 

ose,  a  quarter 
es  tt)  a  pint  of 
drams ;  infu- 
in,  the  active 
;  gargle,  four 
«  be  used  iis 

found  mostly 
sfuUy  used  in 
lent  Ciist'8  of 
•egnancy.  It 
ounces  every 
(juarter  of  ii 
one  to  three 

Europe  and 
occasionally. 
It  is  also 
dysentery. 
1,  one  to  two 
ometimes,  in 

rgreen  grows 

The  leaves 

Used  for 

I  essence  are 

ht  drops,  on 

ised  to  flavor 


iLs  derives  its 
same  tree, 
id  leaves  are 


c 


MEDIOINES    AND   THKIR    PRKPAUATI0N8. 


887 


tonir,  aHtringent  and  .sedative.    It  is  used  in  bleeding  from  the  lungs 
iinil  stomach,  and   in  diarrlxpa,  dyst-ntcry, 
iiMil   excessive   mucous  discihargos.      it    is 
also  used  in  incipient  consumption,   and 
for  Hore  mouth,  e*';. 

PreparntionH.  —  Fluid  extract,  dose,  one 
to  two  dmms  ;  infusion,  dose,  three  drams  ; 
svi'Up.  four  ounces  of  lluid  extract  to  twelve 
ounces  bf  simple  syrup,  dose,  one  to  two 
drains. 

Wolfsbane  (Aeonitum  Na/tflliix,  Fig. 
243).  —  This  haa  already  been  deseiibed 
under  its  other  common  nuiiie,  whieli  is 
monkshood.  See  "  Monkshood "  for  its 
description. 

Wormseed    (Ohenopodium  AntheJmintunivi) This  perennial  is 

CA\\tidiJeruHalemoak,a.i\(x  is  found  in  waste  places  all  over  the  United 
States.  An  oil  is  extracted  from  the  seeds,  whi?b.  in  doses  of  from 
three  to  five  drops,  morning  and  evening,  for  a  child,  destroys  worms. 
A  strong  infusion  of  the  tops  has  a  similar  effect.  The  remedy 
should  be  used  four  or  five  days,  and  be  followed  by  a  purge. 


FIO.  242.    WITCH-HazKL. 


Fro.  248.     WULFSBANB. 


Flo.  244.    Wormwood. 


Wormwood  {Artemisia  Absinthium^  Fig.  244).  —  The  tops  and 
leaves  of  this  perennial  are  tonic  and  anthelmintic ;  used  in  inter- 
mittent fever,  jaundice,  and  worms.  It  restores  the  appetite  in  a 
weakened  state  of  the  digestive  organ?,  and  is  also  useful  in  amen- 
orrhcea.  It  is  excellent  applied  as  a  tincture,  or  in  the  form  of  fo- 
mentation, to biuises,  sprains,  and  local  inflammations. 

Preparations.  —  Fluid  extract,  dose,  one-third  to  two-thirds  of  a 
dram ;  solid  extract,  dose,  three  to  five  grains ;  tincture,  two  ounces 
to  fourteen  ounces  of  diluted  alcohol,  dose,  two  to  three  drams; 


1"*^ 


888 


MEDICINES   AND   THEIR   PKEPARATIONS. 


syrup,  two  ounces  fluid  extract  to  six  ounces  of  simple  syrap,  dose, 
one  to  two  drains. 

Yarrow  (^Achillea  Millefolium).  —  A  perennial  herb,  common  to 
the  Old  World  and  New,  and  growing  in  old  fields  and  along  fences. 
It  is  tonic,  astringent,  and  alterative,  and  has  been  used  in  intermit- 
tent fever,  bleeding  from  the  lungs,  excessive  menstruation,  wind 
colic,  and  chronic  dysentery.  Dose  of  the  infusion,  a  wineglassful 
three  or  four  times  a  day. 

Yeast  (  Cerevisice  Fermentum).  —  Yeast  is  slightly  tonic  and  stim- 
ulating, and  has  been  used  with  advantage  in  typhoid  fever ;  also  in 
scarlet  fever,  and  in  all  diseases  where  there  is  a  disposition  to 
putridity.  The  dose  is  from  one  to  two  fluid  ounces  ewery  two  or 
three  hours.  It  makes  an  excellent  antiseptic  poultice  for  imhealthy 
and  fetid  ulcers,  especially  if  combined  with  powdered  slippery  ^lm 
bark  and  charcoal.  ' 

Yellow  Dock  {Rumex  Crisjms,  Fig.  246). — The  root  of  this 
perennial  plant  is  alterative,  tonic,  diuretic,  and  deter- 
gent, and  is  regarded  as  very  valuable  in  the  treat- 
ment of  scrofula,  syphilis,  leprosy,  scurvy,  and  other 
skin  diseases. 

Preparations.  —  Fluid  exti-act,  dose,  one  to  two 
drams ;  solid  extract,  dose,  four  to  five  grains ;  syi'up, 
four  ounces  of  fluid  extract  to  twelve  ounces  of  simple 
sjrrup,  dose,  half  an  ounce  to  an  ounce ;  rumin,  the 
active  principle,  dose,  two  to  three  grains. 

Yellow  Jessamine  ( Qelseminum  Sempervirens). — 
This  abounds  in  the  Southern  States,  where  it  is  cul- 
tivated as  an  ornamental  vine.  The  root  is  a  power- 
ful febrifuge,  narcotic  and  relaxant,  conti-oliing  and 
subduing  fever,  quieting  nervous  irritability  and  ex- 
citement, equalizing  the  circulation,  promoting  perspiiution,  and.  recti- 
fying the  secretions.  It  is  much  used  by  the  Eclectics  of  the  West- 
ern States,  but  the  general  judgment  of  the  profession  is  that  it  is 
too  powerful  a  remedy  to  be  safe.  My  own  opinion  is,  that  the 
American  hellebore  is  equally  effective  with  the  yellow  jessamine, 
and  that  its  general  use  involves  far  less  danger. 

Preparations.  —  Fluid  extract,  dose,  two  to  ten  drops ;  tincture, 
four  ounces  to  a  pint  of  alcohol,  dose,  fifteen  to  thirty  drops,  and  in- 
crease ;  gelseminin,  the  active  principle,  dose,  half  a  grain  to  a  grain 
and  a  half. 

* 

Yellow  Ladies'  Slipper  (  Cypripedium  Pubescens'). — This  perennial 
plant  is  called  American  valerian,  nerve-root,  etc.  The  fibrous  roots 
are  tonic,  nervine,  antispasmodic  and  diaphoretic,  and  are  used  in 
nervous  headache,  nervous  excitability,  hysterics,  neuralgia,  and  St. 
Vitus's  dance.    Dose  of  the  powder,  from  ten  to  twenty  grains. 


Fio.  S45. 
Yellow  Dock. 


V 


MEDICINES   AND  THEIR  PREPARATIONS. 


889 


syrup,  dose, 


),  common  to 
[  along  fences, 
i  in  intermit- 
ruation,  wind 
I  wineglassful 


)nic  and  stim- 
fever ;  also  in 
disposition  to 
every-  two  or 
for  unhealthy 
slippery  ^lm 

root   of   this 
tic,  and  deter- 
in  the  treat- 
vy,  and  other 

one  to  two 
'rains ;  syiup, 
ices  of  simple 
;    rumin,  the 

18. 

ipermrens). — 
here  it  is  cul- 
5t  is  a  power- 
jntrolimg  and 
.bility  and  ex- 
tion,  andrecti- 
of  the  West- 
m  is  that  it  is 
.  is,  that  the 
ow  jessamine, 

)p8;  tincture, 
irops,  and  in- 
ain  to  a  grain 

rhis  perennial 
fibrous  roots 
are  used  in 

algia,  and  St. 

jr  grains. 


Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram ;  solid 
extract,  dose,  five  to  ten  grains ;  tincture,  two  ounces  to  a  pint  of 
diluted  alcohol,  dose,  half  an  ounce  to  an  ounce ;  syrup,  four  ounces 
of  fluid  extract  to  fourteen  ounces  of  simple  syrup,  dose,  two  to  three 
di-ams ;  cypripedin,  the  active  principle,  dose,  two  to  three  grains. 

Yellow  Parilla  (^Menispermum  Canadenae).  —  This  is  a  perennial 
plant,  grov  ing  in  woods  and  near  streams,  throughout  the  country. 
The  root  has  the  properties  of  a  tonic,  laxative,  alterative,  and  diu- 
retic. It  is  valued  in  the  treatment  of  scrofula,  syphilis,  skin  dis- 
eases, gout,  rheumatism,  dyspepsia,  general  debility  and  chronic 
inflammation  of  the  stomach  and  bowels.  Dose  of  the  decoction, 
from  two  to  three  fluid  ounces,  three  times  a  day ;  of  the  solid  ex- 
tract, from  two  to  three  grains. 

Zinc.  —  Several  preparations  of  this  metal  are  used  in  medicine, 
as  follows: — 


Acetate  of  Zinc  (^Zinei  Acetas).  —  This  is  used  as  an  external 
remedy  only,  generally  as  an  astringent  wash  for  inflammations  of  the 
eye,  and  as  an  injection  in  gonorrhoea,  but  only  after  the  acute  stage 
of  these  diseases  has  past.  The  strength  of  these  solutions  gen- 
erally should  be  one  or  two  grains  to  a  fluid  ounce  of  soft  water. 

Chloride  of  Zinc  (Zinci  Chloridum).  —  This  is  a  powerful  escharo- 
tic,  and  is  epiployed  as  an  external  application  to  cancera  and  obsti- 
nate ulcers.  A  weak  solution  of  it  is  occasionally  employed  in  old 
chronic  gleet,  also  in  whites  and  purulent  discharge  from  the  neck 
of  the  womb. 

Iodide  of  Zinc  (^Zinci  lodidum).  —  This  is  in  the  form  of  white 
needles,  and  is  tonic  and  astringent.  It  is  not  much  used,  except 
externally,  being  applied  in  a  solution  of  twenty  grains  to  a  fluid 
ounce  of  water,  to  enlarged  tonsils,  by  means  of  a  camel's-hair  pencil 
or  a  piece  of  sponge  tied  to  the  end  of  a  stick. 

Oxide  of  Zinc  (^Zinci  Oxidurn).  —  This  is  an  inodorous  white 
powder,  insoluble  in  water  and  alcol  il.  It  is  tonic  and  anti- 
spasmodic, and  is  given  in  chorea,  epilepsy,  whooping-cough,  and 
other  similar  diseases  ;  but  it  is  more  especially  employed  to  arrest 
the  night-sweats  of  consumption,  for  which  purpose  we  have  at 
present  no  other  article  of  equal  efficacy.  It  is  sprinkled  externally 
upon  excoriated  surfaces,  and  is  used  in  ointmentM.  Dose,  from  two 
to  five  grains,  in  the  form  of  pill. 

Precipitated  Carbonate  of  Zinc  (^Zinci  Carbonas  Prcecipitas.')  — 
This  is  employed  for  the  same  purpose  as  prepared  calamine,  being 
adapted  only  to  external  use. 

Prepared  Calamine  (Calamina  Prmparata). —  This  is  in  the 
form  of  a  pinkish  or  flesh-colored  powder,  of  an  earthy  appearance. 
It  is  employed  only  as  an  external  application,  being  dusted  on  ez- 


illii^" 


890 


MEDICINES    AND   THEIK   PKEPAKATI0N8. 


conations  and  superficial  ulcerations,  as  a  mild  astringent.     It  should 
be  a  very  fine  powder. 

Sulphate  of  Zinc  {Zinei  Sulphas).  This  is  a  colorless,  transpar- 
ent salt,  crystallizing  usually  in  small  four-sided  prisms.  It  is  tonic 
and  astringent,  and  ui  large  doses,  a  prompt  emetic.  Used  as  a  tonic 
in  cases  of  debility  attended  with  irritation.  In  obstinate  intermix 
tents,  it  is  sometimes  conjoined  with  sulphate  of  quinia ;  it  is  chiefly 
employed,  however,  in  such  spasmodic  diseases  as  epilepsy,  chorea 
and  whooping-cough.  As  an  astringent,  it  is  used  externally,  being 
applied  in  solution  to  bleeding  surfaces,  as  a  wash  in  ophthalmia, 
and  as  an  injection  in  whites  and  chronic  gonorrhoea. 

Valerianate  of  Zinc  (Zinei  Valerianas).  —  This  is  in  white, 
pearly  scales,  with  a  faint  odor  of  valerianic  acid.  It  is  tonic  and 
antispasmodic,  and  is  used  in  the  various  nervous  affections  which 
accompany  chlorosis.  Dose,  one  or  two  grains,  several  times  a  day, 
in  the  form  of  a  pill. 

Vaseline  {Petrolatum).  —  This  is  a  transparent,  fat-like  substance, 
obtained  in  the  distillation  of  crude  petroleum.  It  is  very  exten- 
sively used  in  the  domestic  materia  medica,  in  the  treatment  of  colds 
and  many  other  ailments.  Its  eflScacy  has  been,  however,  much 
overrated,  its  chief  utility  being  that  of  a  neutral,  simple  unguent, 
and  as  a  vehicle  for  the  application  of  more  active  remedies,  for 
which  purpose  it  is  preferable  to  the  animal  fats  generally  employed. 


. 


ie~-^ 


.uiut^' 


t.     It  should 


ess,  transpar- 
It  is  toniu 
led  as  a  tonic 
late  intermits 
;  it  is  chiefly 
lepsy,  chorea 
srnally,  being 
ophthalmia, 

is  in   white, 

is  tonic  and 

ictions  which 

times  a  day, 

ke  substance, 
3  very  exten- 
nent  of  colds 
ivever,  much 
pie  unguent, 
•emedies,  for 
ly  employed. 


PEEPAKATIONS.  -  PHARMACY. 


The  preparation  of  medicines  for  use  constitutes  the  art  of  phar- 
macy. It  is  the  peculiar  business  of  the  apothecary.  It  will  not  be 
necessary  in  these  pages  to  describe  liis  art,  in  all  particulai-s,  but 
merely  as  many  of  the  preparations  wliich  it  is  his  duty  to  prepare 
as  are  really  needed  in  the  treatment  of  disease.  In  doing  this,  I 
shall  classify  the  preparations  alphabetically,  and  begin  with 

Cerates. 

These  substances  have  a  degree  of  hardness  midway  between 
ointmeiitB  and  plasters.  They  may  be  spread  iii)C)ii  leather  or  linen, 
without  the  use  of  heat,  and  they  do  not  melt  and  run  when  applied 
to  the  skin.  They  are  made  of  wax,  or  spermaceti,  combined  with 
lard  or  oil.  The  articles  are  melted  together  by  a  very  gentle  heat, 
and  during  the  process  of  cooling  the  whole  should  be  well  stirred. 

Calamine  Cerate.  —  Prepared  calamine  and  yellow  wax,  each 
three  ounces;  lard,  one  pound.  Melt  the  lard  and  wax  together. 
When  the  mixture  begins  to  thicken,  on  cooling,  gradually  stir  in  the 
calamine. 

This  is  called  Turner' 8  CeraU,  and  is  useful  for  burns,  excoriations, 
superficial  ulcers,  and  sores. 

Qoulard's  Cerate.  —  Take  of  solution  of  subacetate  of  lead,  two 
fluid  ounces  and  a  half ;  white  wax,  four  ounces ;  olive  oil,  nine  fluid 
ounces;  camphor,  half  a  dram.  Mix  the  wax,  previously  melted, 
with  eight  fluid  ounces  of  the  oil ;  remove  from  the  tire,  and  when 
the  mixture  begins  to  thicken,  gradually  pour  in  the  solution  of 
subacetate  of  lead,  stirring  constantly,  with  a  wooden  spatula,  till  it 
becomes  cool.  Then  add  the  camphor,  dissolved  in  the  remainder  of 
the  oil. 

This  is  the  cerate  of  subacetate  of  lead,  and  is  used  for  excoriations, 
inflamed  burns,  scalds  and  chilblains,  and  for  eruptions  of  the  skin. 
Excellent  for  blistered  surfaces,  indisposed  to  heal. 

Half  an  ounce  of  this  preparation  united  with  half  an  ounce  of 
simple  cerate,  and  one  dram  each  of  calomel  and  powdered  opium, 
makes  a  very  valuable  remedy  for  various  eruptions  of  the  skin,  of  a 
local  nature. 


■■',  I 


fl 


'<M;i'  s 


r 


892 


MKDICINES   AND   THEIR   PRKPARATIONS. 


Resin  Cerate.  —  Take  of  resin,  five  ounces ;  lard,  eight  ounces ; 
yellow  wax,  two  ounces.  Melt  together  with  a  gentle  heat,  and  stir 
till  cool. 

This  is  known  as  hcmlicon  ointment,  and  is  used  as  a  gentle  stimu- 
lant to  blistered  surfaces,  indolent  ulcers,  burns,  scalds  ftnd  chilblains. 

Compound  Resin  Cerate.  —  Take  of  resin,  suet,  and  yellow  wax, 
each  a  pound ;  turpentine,  half  a  pound  ;  flax-seed  oil,  half  a  pint. 
Melt  together,  strain  through  linen,  and  stir  till  cool. 

•  This,  under  the  name  of  Deshler^s  salve,  is  popularly  used  for  sim- 
ilar purposes  with  the  resin  cerate. 

Savin  Cerate.  —  Take  powdered  savin,  two  ounces ;  resin  ce- 
rate, a  pound.  Mix  the  savin  with  the  cerate,  previously  softened. 
Used  as  a  dressing  for  perpetual  blisters. 

Simple  Cerate.  —  Lard,  eight  ounces  ;  white  wax,  four  ounces. 
Melt  together  and  stir  till  cool. 

Used  for  dressing  blisters,  wounds,  etc.,  where  it  is  desirable  sim- 
ply to  preserve  the  moisture  of  the  part,  and  to  exclude  the  air. 

Spanish  Flies  Cerate,  known  as  blistering  plaster.  Take  finely 
powdered  Spanish  flies,  a  pound ;  yellow  wax  and  resin,  each  seven 
ounces ;  lard,  ten  oimces.  To  the  wax,  resin  and  lard,  previously 
melted  together  and  strained,  add  the  Spanish  flies,  and,  by  means 
of  the  most  gentle  heat,  keep  the  mixture  in  a  fluid  state  for  half  an 
hour,  stirring  occasionally,  then  remove  the  heat  and  stir  till  cool. 

This  can  be  easily  spread  without  the  aid  of  heat,  and  is  used  for 
the  purpose  of  drawing  blisters.  It  is  now,  however,  supeiseded  in 
a  great  degree  by  various  preparations,  composed  for  the  most  part 
of  cantharidin,  either  dissolved  in  oil,  and  applied  to  the  skin  by 
means  of  a  piece  of  paper  saturated  with  it,  or  incorporated  with  wax 
and  spread  in  a  very  thin  layer  upon  fine  waxed  cloth,  silk,  or  paper, 
constituting  the  blistering  cloth,  blistering  paper,  etc. 

Confections,  Conserves  and  Electuaries. 

These  are  soft  solids,  in  which  medicinal  articles  are  incorporated 
with  sugar,  syrup,  honey,  or  some  other  saccharine  matter,  for  the 
pui-pose  both  of  preserving  the  mass,  and  of  rendering  the  medicine 
more  palatable  and  convenient  for  use. 

Aromatic  Confection.  —  Take  of  aromatic  powder,  fivp  and  a  half 
ounces ;  powdered  saffron,  half  an  ounce ;  syrup  of  orange-peel,  six 
ounces ;  clarified  honey,  two  ounces.  Rub  the  aromatic  powder  with 
the  saffron ;  then  add  the  syrup  and  honey,  and  beat  the  whole  to- 
gether in  a  mortar  till  they  are  thoroughly  mixed. 

Given  in  debilitated  states  of  the  stomach,  as  a  vehi  le  for  other 
medicines.     Dose,  ten  grains. 


sight  ounces ; 
heat,  and  stir 

gentle  stimu- 
\nd  chilblains. 

i  yellow  wax, 
,  half  a  pint. 

used  for  sim- 


ses ;   resin  ce- 
asly  softened. 

four  ounces. 

iesirable  sim- 
3  the  air. 

Take  finely 
n,  each  seven 
d,  previously 
-nd,  by  means 
te  for  half  an 
;ir  till  cool, 
id  is  used  for 
superseded  in 
he  most  part 
I  the  skin  by 
ted  with  wax 
iilk,  or  paper, 


ries. 

incorporated 
atter,  for  the 
the  medicine 


v^  and  a  half 

mge-peel,  six 

powder  with 

the  whole  to- 


n; 


le  for  other 


MEDICINES   AND    THEIR   PREPARATIONS. 


893 


Compound  Confection  of  Catechu.  —  Take  of  compound  powder 
of  catechu,  five  ounces ;  simple  syrup,  five  fluid  ounces.  Add  the 
syrup  gradually  to  the  powder,  and  mix  them  well. 

To  be  given  in  diarrhoea  and  chronic  dysentery,  in  the  dose  of  half 
a  dram  to  a  dram. 

Confection  of  Senna,  otherwise  called  lenitive  electuary.  Take  of 
senna,  eight  ounces;  coriander  seeds,  four  ounces;  bruised  liquorice- 
root,  three  ounces;  figs, a  pound;  pulp  of  prunes,  pulp  of  tamarinds, 
pulp  of  purging  cassia,  each,  half  a  pound ;  refined  sugar,  two  pounds 
and  a  half ;  water,  four  pints.  Rub  the  senna  and  coriander  together 
and  separate  ten  ounces  of  the  powder  with  a  sieve.  Boil  the  residue 
with  the  liquorice-root  and  figs,  in  the  water,  to  one  half ;  then  press 
out  the  liquor  and  strain.  Evaporate  the  strained  liquor,  by  the 
most  gentle  heat,  to  a  pint  and  a  half ;  then  add  the  sugar  and  form 
a  syrup.  Lastly,  rub  the  pulps  with  the  syrup,  added  gradually,  and, 
having  thrown  in  the  sifted  powder,  beat  all  together  till  well  mixed. 

This  is  a  pleasant  and  admirable  laxative,  being  well  adapted  to 
the  habitual  costiveness  of  pregnant  women,  and  those  affected  with 
piles  ;  for  this  latter  purpose,  it  is  still  better  combined  with  cream 
of  tartar  and  sulphur,  as  described  in  No.  6  of  the  prescriptions. 

Decoctions. 

These  are  solutions  of  vegetable  medicines,  obtained  by  boiling 
them  in  water.  They  differ  from  infusions,  in  being  subjected  to  a 
greater  degree  of  heat,  the  water  during  their  preparation  being  kept 
up  to  the  boiling  point.  The  process  should  bb  conducted  in  a 
covered  vessel,  and  the  boiling  must  not  be  continued  for  a  very  long 
time.  ^Medicines  whose  active  principle  is  volatile  are  not  proper 
for  decoctions,  the  active  principle  being  driven  off  by  heat  and  lost. 

The  usual  proportion  of  vegetable  substances  used  in  making  de- 
coctions is  one  ounce  to  a  pint  of  water,  and  the  dose  of  the  decoction, 
from  one  to  three  ounces. 

Essences. 

These  are  generally  prepared  by  dissolving  one  ounce  of  the 
essential  oils  of  plants  in  one  pint  of  alcohol.  The  oils  of  lemon, 
peppermint,  sassafras,  etc.,  are  made  in  this  way,  and  their  properties, 
of  course,  are  similar  to  the  oils  from  which  they  are  prepared.  They 
are  generally  taken  in  a  little  sweetened  water,  in  doses  of  ten  drops 
to  a  teaspoonful. 

Extracts. 

These  are  soft  solids,  obtained  by  evaporating  the  tinctures,  or 
solutions,  of  vegetable  substances.  The  active  principles  of  dried 
vegetables  can  only  be  extracted  by  some  liquid ;  this,  for  prepariii;^ 


t 


n 


804 


MSDICINES   AND   THEIK   PUEPAKATIONS. 


extracts,  is  either  water  or  alcohol,  or  a  mixture  of  the  two.  Those 
obtained  by  the  use  of  water  are  called  aqueouy  or  watery  extracfs  ; 
those  by  means  of  alcohol,  alcoholic  extracts ;  and  those  by  both 
alcohol  and  water,  hydro-alcohol     extracts.        .  '^ 

Fluid  Extracts. 

These  are  concentrations,  into  a  small  bulk,Jn  liquid  form,  of 
the  active  principles  of  medicinal  substances.  They  are  a  valuable 
class  of  remedies,  being  in  some  wuses  preferable  to  tinctures,  having 
less  alcohol :  and  better  than  extracts  or  decoctions,  because  not  ho 
often  injured  by  heat  in  their  preparation,  and  not  requiring  to  be 
taken  in  large  doses.  Great  skill  is  required  in  their  preparation, 
and  they  should  always  be  obtained  from  those  who  have  the  repu- 
tation of  making  reliable  articles. 

•         :     r  Fomentations. 

Fomentation  is  a  sort  of  partial  or  local  hot  bath,  and  consists 
either  in  the  application  of  cloths  dipped  in  hot  water,  or  some  hot 
medicated  decoction,  and  applied  to  the  affected  oart,  or  of  bitter  or 
anodyne  herbs  steeped  in  vinegar  or  water,  and  tnen,  while  hot,  en- 
closed in  a  muslin  bag,  and  laid  upon  the  diseased  place.  In  either 
case,  whether  the  cloths  wet  in  a  decoction  of  the  herbs,  or  the  herbs 
themselves,  slightly  steeped,  be  applied  in  a  bag,  the  application 
should  be  as  hot  as  can  be  borne,  and  not  so  moist  as  to  wet  the  bed 
or  clothes  of  the  patient. 

Fomentations  act  by  their  warmth  and  moisture  chiefly:  and 
8lightl3%  in  some  cases,  by  their  medicinal  virtues.  Their  object  is 
to  lessen  pain  and  inflammation,  by  relaxing  the  parts,  and  relieving 
tension  and  spasm.  They  may  be  prepared  from  equal  parts  of  hops, 
tansy,  and  wormwood,  or  from  equal  parts  of  hops,  lobelia,  and  stra- 
monium, etc.,  etc. 

,  Infusions. 

Those  made  of  one  article  only  are  sufficiently  referred  to  in  pre- 
vious pages.  It  will  only  be  necessary  here  to  insert  such  compound 
infusions  as  are  deemed  important. 

Compound  Infusion  of  Catechu.  —  Take  of  powdered  catechu 
half  an  ounce,  bruised  cinnamon  a  dram;  boiling  water  a  pint;  mace- 
rate for  an  hour  in  a  covered  vessel,  and  strain.  An  elegant  mode 
of  administering  catechu.  Dose,  from  one  to  two  fluid  ounces  three 
or  four  times  a  day. 

Compound  Infusion  of  Qentian.  —  Take  of  bruised  gentian  half 
an  ounce  ;  dried  oninge-peel  and  coriander-seeds,  bruised,  each  a  dram ; 
diluted  alcohol,  four  fluid  ounces ;  cold  water,  twelve  fluid  ounces. 


MEDICINES  AND   THEIR   PREPARATIONS. 


895 


e  two.  Those 
itery  extractx ; 
hose  by  both 


iqaid  form,  of 
ire  a  valuable 
ictures,  having 
•ecause  not  so 
squiring  to  l)e 
r  i)reparation, 
lave  the  repu- 


i,  and  consists 
',  or  some  hot 
or  of  bitter  or 
while  hot,  en- 
ice.  In  either 
»,  or  the  herbs 
he  application 
to  wet  the  bed 

chiefly :  and 

!'heir  object  is 

and  relieving 

parts  of  hops, 

lelia,  and  stra- 


rred  to  in  pre- 
iich  compound 

iered  catechu 
ri  pint;  mace- 
elegant  mode 
i  ounces  three 

i  gentian  half 
I,  each  a  dram ; 
fluid  ounces. 


First  pour  on  the  diluted  alcohol,  then,  three  hours  afterward,  the 
water.  Let  the  whole  stiind  twelve  houre,  and  strain.  An  excel- 
lent foi-m  for  using  gentian.  Dose,  one  fluid  ounce  three  or  four 
times  a  day. 

Compound  l.ifusion  of  Qeranium.  —  Take  of  geranium  root, 
sweet  bugle-leaves,  golden-seal  root,  witch-hazel  bark,  each,  in  coarse 
powder,  one  ounce  ;  boiling  water,  four  pints.  Mix,  and  allow  all 
to  stand  in  a  covered  vessel  two  hours,  applying  a  gentle  heat; 
then  strain.     Two  drams  of  alum  may  or  may  not  be  added. 

Used  in  chronic  diarrhoea  and  dysentery,  in  one  or  two  tablespoon- 
ful  doses,  every  two  or  three  houra ;  also  as  an  injection  in  gleet, 
whites,  falling  of  the  bowel,  etc. ;  and  as  a  gargle  in  ulcerations  of 
the  mouth  and  throat. 

Compound  Infusion  of  Parsley.  —  Take  of  parsley  roots  and 
seeds  and  subcarbonate  of  iron,  each  two  ounces ;  horseradish-root, 
one  ounce ;  squill,  juniper-l>erries,  white  mustard-seed,  mandrake 
root,  and  queen  of  the  meadow  root,  each  half  an  ounce ;  coaraely 
bruise  these  articles,  and  place  them  in  boiling  cider,  and  expose 
them  for  twenty-four  hours  to  a  very  gentle  heat,  in  a  covered  earthen 
vessel.  The  cider  should  be  sparkling  and  tart.  Let  the  articles 
stand  in  the  cider. 

Useful  in  dropsy.  Dose,  one  or  two  fluid  ounces  three  or  four 
times  a  day. 

Compound  Infusion  of  5enna.  —  Take  of  senna  and  manna,  each 
one  ounce ;  jalap,  <jream  of  tartar,  and  caraway  seeds,  bruised, 
each  two  drams ;  boiling  water,  one  pint.  Add  all  the  ingredients 
to  the  water,  in  a  covered  vessel,  and  let  them  stand  twelve  hours. 
Then  add  four  ounces  of  elixir  salutis. 

This  is  a  valuable,  and  not  disagreeable,  gentle  jthysic  for  various 
purposes.     Dose,  from  one  to  three  ounces. 

Compound  Infusion  of  Trailing:  Arbutus.  —  Take  of  queen  of 
the  meadow  root,  dwarf-elder  bark,  marshmallow  root,  and  trailing 
arbutus,  each,  coarsely  bruised,  half  an  ounce ;  add  to  them  one  pint 
of  boiling  water  and  one  pint  of  Holland  gin,  and  steep  by  the  fire 
four  hours,  in  a  closely  covered  vessel.  Strain,  and  sweeten  with 
honey. 

Excellent  for  gi-avel,  suppression  of  urine,  scalding  of  urine,  and 
various  other  disorders  of  the  uiinary  organs.  Dose,  from  an  ounce 
to  a  winegliissful,  with  more  or  less  frequency,  according  to  the  ur- 
gency of  the  case. 

Injections.  —  Chjsters. 

These  are  preparations  to  be  introduced  into  the  lower  bowel  by 
means  of  a  syringe.  A  sufficient  number  of  them  are  given  among 
the  recipes.     It  is  not  necessary  to  repeat  them  here. 


896  MBDIOINKti   AND   THEIR   PREPARATIONS. 

Liniments. 

T7r»*?E  are  liquid  preparations,  generally  a  little  thicker  than  water, 
and  thinner  than  oils,  intended  only  to  be  applied  to  inflamed,  piiin- 
ful,  01-  swelled  parts.  They  are  designed  to  soothe,  or  quiet,  or 
stimulate,  or  make  red  the  part  to  which  they  are  applied ;  and  are 
rubbed  on  with  the  hand,  or  a  piece  of  flannel  or  cotton,  and  fre- 
quently in  connection  with  heat,  by  sitting  or  standing  before  a 
fire. 

A  large  number  of  liniments  are  given  under  the  head  of  recipes. 
To  those  I  add  a  few  valuable  ones  here. 

Camphor  Liniment.  —  Take  six  drams  of  camphor,  and  dissolve  it 
in  one  fluid  ounce  of  chloroform,  and  add  to  this  one  fluid  ounce  of 
olive  oil. 

For  Bpiains,  neuralgia,  rheumatism,  etc. 

Compound  Camphor  Liniment. — Take  two  ounces  and  a  half 
of  camphor,  a  fluid  dram  of  oil  of  lavender,  seventeen  fluid  ounces 
of  alcohol,  and  three  fluid  ounces  of  strong  solution  of  ammonia, 
dissolve  the  camphor  and  oil  in  the  alcohol ;  then  add  the  ammonia, 
and  shake  till  they  are  mixed. 

To  be  used  as  a  rubefacient  and  anodyne  for  local  pains,  particu- 
larly rheumatism. 

Compound  Liniment  of  Ammonia.  —  Take  five  fluid  ounces  of 
strong  water  of  ammonia,  two  fluid  ounces  of  tincture  of  camphor, 
and  one  fluid  ounce  of  spirit  of  rosemary.     Mix  them  well  together. 

This  is  used  as  a  prompt  and  powerful  rubefacient,  or  even  vesi- 
catory, in  neuralgia,  rheumatism,  gout,  spasms,  and  inflammations. 

Croton  Oil  Liniment.  —  Take  one  fluid  ounce  of  croton  oil  and 
seven  fluid  ounces  of  oil  of  turpentine.  Mix,  and  shake  them  well 
together. 

A  good  rubefacient  and  pustulating  preparation  to  apply  to  the 
chest  and  other  parts. 

Liniment  of  Opium.  —  Take  six  ounces  of  Castile  soap,  an  ounce 
and  a  half  of  opium,  three  ounces  of  camphor,  six  fluid  drams  of  oil 
of  rosemary,  and  two  pints  of  alcohol.  Macerate  the  soap  and  opium 
in  the  spirit  for  three  days ;  then  filter,  and  add  the  oil  and  camphor, 
and  shake  briskly. 

This  is  a  useful  anodyne  and  rubefacient  liniment  for  bruises, 
sprains  and  pains  of  a  rheumatic  and  gouty  nature. 

Liniment  of  Spanish  Flies.  —  Take  an  ounce  of  powdered  Span- 
ish flies,  and  half  a  pint  of  oil  of  turpentine.  Mix,  and  apply  gentle 
heat  to  them,  in  a  covered  vessel,  for  three  hours.     Then  strain. 

Employed  with  advantage  externally  in  the  sinking  stage  of  ty- 
phoid fevers.  If  so  powerful  as  to  cause  blistering,  it  may  be  weak- 
ened by  adding  flax-seed  or  olive  oil. 


.-:T>i-»r<  ?i^<Vf  ^■•^"v«*»w»«*»"-y^  Xl^Kl^lGCA 


MUDICINKB  AMD   THKIU   PREPARATIONS. 


897 


jker  than  water, 
inflamed,  paiii- 
le,  or  quiet,  or 
)plied ;  and  are 
Botton,  and  Tre- 
nding before  ii 

[lead  of  recipes. 

*,  and  dissolve  it 
I  fluid  ounce  of 


ices  and  a  half 
en  fluid  ounces 
on  of  ammonia, 
d  the  ammonia, 

I  pains,  particu- 

fluid  ounces  of 
lire  of  camphor, 
n  well  together, 
it,  or  even  vesi- 
inflaramations. 

croton  oil  and 
ihake  them  well 

to  apply  to  the 

e  soap,  an  ounce 
iiid  drams  of  oil 
)  soap  and  opium 
oil  and  camphor, 

aent  for  bruises, 

powdered  Span- 
and  apply  gentle 
Then  strain, 
ing  stage  of  ty- 
it  may  be  weak- 


Llniment  of  Turpentine.  —  Take  half  a  pint  of  oil  of  turpentine, 
and  a  pound  of  resin  cerate.  Melt  the  cerate,  and  add  the  oil  to  it, 
mixing  them  well. 

This  is  a  valuable  remedy  for  scalds  and  burns,  and  should  be 
applied  soon  after  the  accident,  and  be  discontinued  when  the  inflam- 
mation excited  by  the  fire  <  removed.  The  buined  or  scalded  sur- 
face should  be  covered  with  lint  wet  with  the  liniment.  • 

Opodeldoc.  —  Take  three  ounces  of  white  bai-  soap,  sliced,  an 
ounce  of  ca  iphor,  a  fluid  dram  each  of  oil  of  rosemary  and  oil  of 
origanum,  and  a  pint  of  alcohol.  Digest  the  soap  in  the  alcohol  by 
means  of  a  gentle  heat  until  it  is  dissolved  ;  then  add  the  camphor 
and  oils,  and  when  they  are  dissolved  pour  the  whole  into  broad- 
mouthed  vials. 

This  is  the  camphorated  soap  liniment,  and  is  used  as  an  anodyne 
application  to  sprains,  bruises,  painful  tumora,  ate. 

Medicated  Waters. 

Those  preparations  consisting  of  \vater  impregnated  with  some 
medicinal  substance  are  called  medicated  watera.  They  are  pre- 
pared from  volatile  oils  by  triturating  in  a  mortar  a  dram  of  the  oil, 
more  or  less,  with  a  small  quantity  of  carbonate  of  magnesia,  and 
then  very  gradually  pouring  on  one  quart  of  water,  while  the  tritura- 
tion is  continued.  At  last  the  preparation  is  filtered  through  paper. 
The  quantity  of  oil,  magnesia,  and  water,  used  for  each  preparation, 
is  as  follows : 

Oil  of  bitter  almonds,  sixteen  minims;  carbonate  of  magnesia,  a 
dram  ;  water,  one  quart. 

Oil  of  cinnamon,  half  a  fluid  dram ;  carbonate  of  magnesia,  a 
dram  ;  water,  one  quart. 

Twenty  minims  of  oil  of  roses,  a  dram  of  carbonate  of  magnesia, 
and  one  quart  of  water. 

Oil  of  fennel,  half  a  fluid  dram ;  carbonate  of  magnesia,  a  dram ; 
water,  a  quart. 

Peppermint-water,  speai-mint-water,  and  pennyroyal-watei,  are 
all  prepared  from  the  same  quantities  of  their  several  oils  as  cinna- 
mon-water. 

The  dose  of  these  waters  is  half  a  fluid  ounce  to  two  fluid  ounces, 
except  the  bitter  almond  water,  which  if  one  or  two  fluid  drams. 

Camphor  Water  —  Take  two  drams  of  camphor,  forty  minims  of 
alcohol,  four  drams  of  carbonate  of  magnesia,  and  one  quart  of 
water.  Rub  the  camphor  first  with  the  alcohol,  afterwards  with  the 
carbonate  of  magnesia,  and  lastly  with  the  water,  gradually  added. 
Then  filter  through  paper. 


^'ii^-ifmii^'mi.ie^&'.d:.:,^!^ 


i 


898 


MKUICINES   A..D   THEIK   PKEPAKATI0N8. 

Medicated  Wines. 


Wines  are  used  in  making  certain  preparations,  because  the  al(!o- 
hol  they  contain  will  extract  from  plants,  etc.,  some  medicinal  pioi)- 
erties  which  water  will  not,  and  at  the  same  time  is  less  timulutiiig 
than  the  tinctures,  etc.,  made  from  alcoholic  spirit*. 

Compound  Wine  of  Comfrey  (  Rptstorative  Wine  bUten).  —  'i'like 
one  ounc(!  each,  bruised,  of  comfrey,  Solon,  n's  seal,  and  spikenard ; 
and  half  an  ounce  each,  bruised,  of  chamomile  flowers,  columbo,  and 
gentian.  Cover  these  with  Imiling  water,  and  let  them  stand  twenty- 
four  houm  in  a  covered  vessel.  Then  add  two  (piarts  of  sherry  wine. 
Macerate  fourteen  days,  express  and  strain. 

Valuable  in  leucorrhcua  and  other  female  complaints.  Dose,  from 
half  a  fluid  ounce  to  two  fluid  ounces,  three  or  four  times  a  day. 

Compound  Wine  of  Qolden  Seal.  —  Take  one  dram  each,  bruised, 
of  golden  seal  root,  tulip-tree  bark,  and  bitter-root,  half  a  dmm  of 
pulverized  cayenne,  and  two  quarts  of  sherry  wine.  Macerate  for 
fourteen  days,  with  occasional  shaking ;  then  express  and  strain. 

This  is  a  pleasant  bitter  tonic  in  dysi)ep8ia,  etc.  Dose,  from  half 
a  fluid  ounce  to  two  fluid  ounces,  three  times  a  day. 

Wine  of  Ipecacuanha.  —  Take  two  ounces  of  bruised  ipecai;,  and 
one  quait  of  sherry  wine.  Macerate  fourteen  days,  with  occasional 
shaking.     Then  express,  and  filter  through  paper. 

This  is  a  valuable  emetic  preparation,  —  especially  for  children. 
Dose,  as  an  emetic,  for  an  adult,  one  fluid  ounce ;  as  an  expectorant, 
from  ten  to  thirty  minims ;  for  a  child  two  years  old,  as  an  emetic, 
one  fluid  dram,  repeated  every  fifteen  minutes  till  it  operates. 

Mixtures. 

Thesk  i>re  prepamtions  in  which  medicinal  substances  whicli 
cannot  be  dissolved  in  water  are  suspended  in  it  by  means  of 
some  vi8(;id  matter,  like  sugar  or  gum-arabic.  Their  object  is  to 
conceal  the  taste,  prevent  the  sickening  effect,  and  make  it  more  easy 
to  take  disagreeable  medicines.  To  make  a  perfect  mixture  requires 
skill.  Generally,  the  medicines  to  be  suspended  should  be  tritur- 
ated in  a  mortar  with  the  sugar,  gum-aiabic,  etc.,  before  the  water  is 
added. 

Almond  Mixture.  —  Take  half  an  ounce  of  sweet  almonds,  half  a 
dram  of  powdered  gum-arabic,  two  drams  of  sugar,  and  eight  fluid 
ounces  of  water.  '  Soak  the  almonds  in  the  water,  and,  having  re- 
moved their  external  coat,  beat  them  with  the  gum-arabic  and  sugar 
in  a  mortar,  till  they  are  thoroughly  mixed  ;  then  rub  the  mixture, 
gradually  adding  the  water,  and  lastly,  strain. 

This  i's  an  agreeable,  nutritive  demulcent,  in  bronchial,  dysenteric, 
an  1  uiinary  affections.  It  must  be  u*ed  freely,  the  dose  being  from 
two  to  five  fluid  ounces. 


wwtjMw'wrmn 


J 


MRDIC1NK8   AND   THBIR   PHRPARATTONS. 


899 


iecHU8»  the  al(!o- 
rnedicinivl  pioj)- 
le»8    tiinulutiiig 

Hhter»}.  —  Tii\n' 
and  Hpikeiianl ; 
IS,  coluinbo,  and 
Jill  stand  tweiitv- 
8  of  sherry  wine. 

nts.  Dose,  from 
times  a  day. 

[vm  each,  bruised, 
half  a  dram  of 
!.     Macerate  for 
38  and  strain. 
Dose,  from  half 

lised  ipecai!,  and 
with  occasioiiiil 

dly  for  children. 
<  an  expectorant, 
Id,  as  an  emetic, 
;  operates. 


ubetances  which 
it  by  means  of 
heir  object  is  to 
make  it  more  easy 
mixture  requires 
should  be  tritur- 
efore  the  water  is 

3t  almonds,  half  a 
,  and  eight  fluid 
,  and,  having  re- 
i-arabic  and  sugar 
rub  the  mixture, 

ichial,  dysenteric, 
I  dose  being  from 


Chalk  Mixture.  —  Take  half  an  oui.je  of  prepared  chalk,  two 
fh-ams  each  of  refined  sugar  and  pow<lcred  gum-arabic,  and  four 
tluid  ounces  each  of  cinnamon-water  and  water.  Ri'b  then,  together 
till  they  are  thoroughly  mixed. 

This  is  much  used  in  hiosenjrfs  of  the  IniweLs,  accompanied  with 
acidity,  particularly  among  (diildreii.  If  an  incnjase  of  iu  iistrin- 
geucy  be  required,  add  laudanum,  or  kino,  or  catecdiu. 

Compound  Mixture  of  Iron.  —  Take  a  dram  of  myrrh,  twenty-five 
gmins  of  carlionate  of  potassa,  one  scruple  of  powdered  sulphate  of 
iron,  half  a  fluid  ounce  of  spirit  of  lavender,  one  dram  of  rehned 
.sugar,  and  seven  and  a  half  fluid  ounces  of  rose-water.  Rub  tlie 
myrrh  in  a  mortar,  gradually  adding  the  rose-water,  then  mix  with 
these  the  opirit  of  lavender,  sugar,  and  carlninate  of  potsissa,  and 
lastly,  the  sulphate  of  iron.  Pour  the  whole  into  a  glass  bottle,  and 
keep  it  well  stopped. 

This  is  considerably  used  in  chlorosis,  and  other  affections  requir- 
ing the  use  of  iron. 

Brandy  Mixture.  —  Take  four  fluid  ounces  each  of  brandy  and 
cinnamon  water,  the  yolks  of  two  eggs,  half  an  ounce  of  refined 
sugar,  and  three  drops  of  oil  of  cinnamon.     Mix  them. 

A  useful  stimulant  and  nutritive  draught,  to  be  used  in  the  sink- 
ing stage  of  low  forms  of  .fever. 

Extract  of  Rhubarb  and  Potassa  (Neutralizing  Extract).  —  Take 
two  pounds  of  the  best  rhul)arb,  one  pound  each  of  cinnamon  and 
golden  seal.  Grind  or  coai-sely  bruise  the  articles,  and  mix  them; 
macerate  them  for  two  days  in  one  gallon  of  the  best  fourth  proof 
brandy.  Then  express  the  tincture  with  strong  pressure,  and  add 
to  it  one  fluid  dram  of  oil  of  peppermint,  previously  dissolved  in  a 
Uttle  alcohol.  Break  up  the  compressed  residue  from  the  press,  and 
place  it  in  a  percolator,  and  gradually  run  warm  water  through  it 
until  the  strength  is  exhausted.  Evaporate  this  solution  to  four 
pints,  and  while  the  liquor  is  still  hot,  dissolve  in  it  two  pounds  of 
bicarbonate  of  potassa,  and  three  pounds  of  refined  sugar.  Continue 
the  evaporation,  if  necessary,  until,  when  added  to  the  tincture  fii-st 
obtained,  it  will  make  a  gallon  and  a  half,  then  mix  the  two  solu- 
tions together. 

This  is  a  useful  preparation  for  diaiihcea,  dysentery,  cholera  morbus. 
Hummer  complaints  of  children,  acidity  of  the  stomach,  heartburn, 
etc.     Dose,  one  fluid  dram. 

Metauer's  Aperient.  —  Take  one  ounce  and  a  half  of  pulverized 
aloes,  four  ounces  of  bicarbonate  of  soda,  two  fluid  ounces  of  com- 
[lound  spirits  of  lavender  and  two  quarts  of  water.  Place  the  whole 
in  a  jar  or  jug,  and  let  them  stand  fourteen  days,  shaking  well  once 
a  day.     Then  pour  off  from  the  dregs.     It  improves  by  age. 


f 


900 


MKDICINKS    AND   THKIR   PRKPARATT0K8. 


This  preparation  ih  one  of  the  hcHt-known  aperienU  for  coslive- 
ness, — particularly  wlion  conneoted  with  liiliouH  dyHpt;|)8ia.  For 
that  class  of  hilioiia  pcrMoiiH  who  overeat,  and  have  acid  HtomachN,  it 
hiiN  great  value.  In  bilious  ciihuh,  tho  nitro-miiriatic  acid,  taken 
before  meals  (tho  aperient  after  meals)  may  Ihj  usefully  asHociated 
with  it.  In  the  couHtipation  of  hysteria  and  hypoclioiidiiiiHlH,  tlie 
fluid  extract  uf  valuriun  may  be  added  to  it.  Dose,  from  two  dranm 
to  an  ounce.  • 

Saline  Mixture  (  White  Liquiii  Phytic).  —  Take  half  a  pound  of 
sulphate  of  soda,  and  one  and  a  half  pints  of  Water.  Mix,  and  dis- 
solve the  soda ;  then  add  two  fluid  ounces  of  nitro-muriati«'  acid,  and 
one  dram  and  eight  grains  of  powdered  alum. 

Used  to  allay  nausea  and  vomiting,  and  as  a  cooling  j  •  i^ative; 
also  for  colic,  diseases  of  the  liver,  diarrhoea,  dysentery,  intermittent 
fevers,  etc. 

This  is  one  of  tiie  remedies  of  the  Eclectic  school  of  physicians, 
and  is  held  by  them  in  high  esteem.  Dose,  a  tablespoonful  in  a  gill 
of  water,  to  be  repeated  everj'  hour  or  two  until  it  causes  one  or  two 
evacuations  from  the  bowels. 


Ointments. 

Ointments  are  composed  of  fatty  substances,  about  the  consistente 
of  butter,  impregnated  with  medicine.  All  gritty  matter  shn.ld  be 
exc'uded  from  them.  To  prevent  the  rancidity  to  which  they  are 
liable,  a  little  glycerin  is  now  frequently  added. 

Ointment  of  Acetate  of  Lead.  —  Take  two  ounces  of  white  wax 
and  four  ounces  of  lard  ;  melt  them  together,  and  add  two  and  a  half 
drams  of  finely-powdered  acetate  of  lead ;  stir  constantly  till  cold. 
This  is  useful  for  burns,  scalds,  ulcers  and  excoriations. 

Ointment  of  Bayberry.  —  Take  half  a  pound  each  of  tallow, 
white  turpentine  and  bayberry,  and  four  ounces  of  olive-oil ;  melt 
together  and  strain. 

Good  for  scrofulous  and  indolent  ulcei-s. 

Ointment  of  Belladonna. — Take  a  dram  of  extract  of  belladonna 
and  an  ounce  of  lard  ;  mix  them. 

A  useful  anodyne  application  for  painful  tumors,  neuralgia,  etc. 

Ointment  of  Creosote.  —  Take  half  a  fluid  dram  of  creosote  and 
an  ounce  of  lard  ;  mix  them. 

A  useful  application  for  syphilitic,  scrofulous  and  cancerous  ulcers. 

Compound  Ointment  of  Qalls Take  six  drams  of  finely-pow- 
dered galls,  six  ounces  of  lard,  and  a  dram  and  a  half  of  pulverized 
opium  ;  rub  them  together. 

A  valuable  prepai-ation  in  irritable  piles. 


entH  for  coBlivo- 
lyspupKin.  For 
iicid  stomacliN,  it, 
atic   iicid,   tiikeii 

fully  aHMOciatt'd 
)cli()iidi'i)iHiH,  tilt; 

from  twu  di'uiiiH 

half  a  pound  of 

Mix,  and  dis- 

iui'iati'<  acid,  and 

oling  t"  native; 
ery,  intermittent 

nl  of  physiciaiiH, 
joonful  in  a  gill 
lUHBH  one  or  two 


t  the  consisttnice 

natter  she  uld  Ik; 

which  they  are 

cefl  of  white  wax 
d  two  and  a  half 
atantly  till  cold. 
)ns. 

each  of  ttillow, 
:   olive-oil ;  melt 


let  of  belladonna 

neuralgia,  etc. 
I  of  creosote  and 

jancerous  ulcers. 

s  of  finely-pow- 
If  of  pulverized 


MEDICINES   AND   THKIK   PKRPARATI0N8. 


901 


Ointment  of  Red  Iodide  of  Mercury.  —  Take  one  dntni  of  red 
iodide  of  mercury,  and  Hcven  drams  of  ointment  of  white  wax  ;  in- 
corporate them  thoroughly  together  by  trituration  in  a  mortar. 

Used  as  a  dressing  for  indolent  scrofulous  ulcers. 

Ointment  of  Nitrate  of  Mercury.  —  Take  one  ounce  of  mercury, 
eleven  fluid  ounces  of  nitric  acid,  nine  fluid  ounces  of  fresh  neatii- 
foot  oil,  three  ounces  of  lard.  Dissolve  the  mercury  in  the  acid,  then 
heat  the  oil  and  lard  together  in  an  earthen  vessel  to  200°  F. ;  then 
add  the  mercurial  solution,  and  stir  with  a  wooden  spatula,  constantly, 
as  long  as  effervescence  continues,  and  afterward  occasionally  till  the 
ointment  stiffens. 

Milder  Ointment  of  Nitrate  of  Mercury.  —  Take  an  ounce  of  oint- 
ment of  nitrate  of  mercury,  and  seven  ounces  of  lard ;  rub  them 
together. 

The  first  of  the  above  two  preparations  is  the  citrine  ointment,  and 
is  much  and  advantageously  employed  as  an  external  application  in 
porrigo,  impetigo,  psoriasis  and  pityriasis.  It  is  nearly  a  specific  for 
inflammation  of  the  eyeliuo  connected  with  the  formation  of  scaly 
matter  about  the  lashes.  The  second  of  these  two  preparations  is 
merely  a  dilution  of  the  first. 

Ointment  of  Oxide  of  Zinc  —  Take  half  an  ounce  of  oxide  of 
zinc  and  three  ounces  of  lard ;  rub  them  togetiier. 

This  is  a  mild  astringent  application  in  chronic  ophthalmia,  erup- 
tions of  the  skin,  sore  nipples,  and  other  excoriatioas. 

Ointment  of  Poison  Hemlock.  —  Tpke  one  dram  of  extract  of 
poison  hemlock  and  one  ounce  of  lard ;  rub  them  together. 
An  anodyne  application  for  painful  swellings,  ulcers  and  piles. 

Ointment  of  Poke.  —  Take  a  dram  of  the  extract  of  poke  and  one 
ounce  of  lard ;  mix  them. 

For  malignant  ulcers,  scaldhead,  itch,  etc. 

Ointment  of  Stramonium.  —  Take  one  dram  of  the  extract  of 
stramonium  leaves,  and  one  ounce  of  lard ;  rub  the  extract  with  a 
little  water  till  it  is  uniformly  soft,  and  then  with  the  lard. 

Used  as  an  external  application  in  irritable  ulcers,  painful  piles  and 
skin  eruptions. 

Simple  Ointment.  —  Take  a  pound  of  white  wax,  and  four  pounds 
of  lard ;  melt  them  together  with  a  gentle  heat,  and  stir  constantly 
till  cold. 

Ointment  of  Rose- Water.  —  Take  a  fluid  ounce  of  rose-water,  two 
fluid  ounces  of  oil  of  almonds,  half  an  ounce  of  spermaceti,  one  dram 
of  white  wax ;  melt  together,  by  means  of  rater-bath,  the  oil,  sper- 
maceti, and  wax ;  then  add  the  rose-water,  and  stir  the  mixture  con- 
stantly till  cold. 


H' 


gaaasweaagUife. 


902 


MEDICINES   AND   THEIR   PREPARATIONS. 


This  is  the  well-known  preparatit)n  called  cold  cream,  and  is  used 
with  much  advantage  for  chapped  lips  and  hands,  excoriations,  ett;. 

Spermaceti  Ointment.  —  Take  live  ounces  of  spermaceti,  fourteen 
of  white  wax,  and  a  pint  of  olive-oil ;  melt  them  together  over  a  slow 
fire  and  stir  constantly  till  cold. 

A  mild  dressing  for  blisters,  wounds  and  excoriated  surfaces. 

Tar  Ointment.  —  Take  a  pound  each  of  tar  and  suet;  melt  the 
suet  with  a  gentle  heat,  and  add  the  tar  to  it ;  then  stir  constantly 
till  they  are  cold. 

A  useful  stimulating  application  to  various  scaly  and  «^  abby  erup- 
tions, particularly  leprosy  and  scaldhead. 

Ointment  of  White  Hellebore.  —  Take  one  ounce  of  powdered 
whit*  hellebore  root,  four  ounces  of  lard,  and  twelve  drops  of  oil  of 
lemons ;  rub  them  thoroughly  together. 

A  useful  ointment  for  the  cure  of  itch. 

Ointment  of  Wild  Indigo. —  Take  one  pound  of  powdered  wild- 
indigo  root,  moisten  it  thoroughly  with  alcohol  and  let  it  stand 
twenty-four  hours;  then  put  it  in  a  percolator  and  add  alcohol  as 
long  as  the  liquid  which  passes  contains  the  taste  of  the  root.  Distil 
the  alcohol  from  this  filtered  tincture  until  half  a  gallon  of  tincture 
is  obtained.  Melt  one  pound  of  fresh  butter,  without  salt,  add  the 
above  tincture,  and  carefully  evaporate  the  rest  of  the  alcohol ;  stir 
constantly  till  cold,  after  the  alcohol  has  nearly  passed  off. 

This  is  one  of  the  preparations  of  the  Eclectics,  and  is  a  cleansing, 
detergent,  antiseptic  and  discutient  ointment,  useful  in  scrofulous, 
erysipelatous  and  malignant  ulcers,  eruptions  of  the  skin,  etc. 

Pile  Ointment.  —  Take  three  handfuls  each  of  witch-hazel  bark, 
white-oak  bark  and  sweet-appletree  bark ;  bruise  or  grind  them,  and 
add  to  them  three  pints  of  water ;  boil  down  to  one  pint  and  strain ; 
add  to  this  liquid  half  a  pound  of  lard,  and  simmer  till  the  water  all 
disappears,  stirring  continually  both  before  and  after  removing  from 
the  fire  till  it  cools. 

This  forms  a  brick-colored  anodyne,  astringent  ointment,  admirably 
adapted  to  the  cure  of  pile-tumore. 

Compound  Lead  Ointment.  —  Take  two  and  a  half  pounds  of 
olive-oil,  four  ounces  each  of  beeswax  and  unsalted  butter,  and  half 
a  pound  of  white  turpentine;  melt  them  together,  strain,  and  then 
heat  to  nearly  the  boiling  point ;  then  gradually  add  one  pound  of 
red  lead,  stirring  constantly  till  the  mixture  becomes  black  or  brown ; 
then  remove  from  the  fire,  and  when  it  is  partly  cool,  add  to  it  a 
mixture  of  twelve  ounces  of  honey  and  half  a  pound  of  powdered 
camphor. 

This  is  a  very  healing  ointment,  and  is  much  used  for  ulcers,  bums, 
wounds,  aud  skin-diseases. 


mm 


*atlia*- 


%  and  is  used 
)nation8,  etc. 

aceti,  fourteen 
ler  over  a  slow 

surfaces. 

met;  melt  the 
stir  constAutly 

i  '^  abby  erup- 

of  powdered 
iropa  of  oil  of 


lowdered  wild- 
':  let  it  stand 
idd  alcohol  as 
e  root.  Distil 
on  of  tincture 
-J  salt,  add  the 
3  alcohol ;  stir 
off. 

is  a  cleansing, 
in  sci-of ulcus, 
dn,  etc. 

xjh-hazel  bark, 
ind  them,  and 
nt  and  strain ; 
1  the  water  all 
emoving  from 

lent,  admirably 

lalf  pounds  of 
utter,  and  half 
rain,  and  then 
one  pound  of 
lack  or  brown; 
ol,  add  to  it  a 
of  powdered 

r  ulcers,  burns, 


MEDICINES   AND   THEIR   PREPARATIONS. 


903 


Compound  dulphurOintment.  — Take  one  ounce  of  sulphur,  one 
(li-am  each  of  ammoniated  mercury  and  benzoic  acid,  one  Huid  dram 
each  of  sulphuric  acid  and  oil  of  bergamot,  two  drams  of  nitrate  of 
potassa  and  half  a  pound  of  lard.  Fii-st  melt  the  lard  with  a  gentle 
heat,  then  add  the  other  ingredients,  stirring  constantly  till  they  are 
cold. 

A  sovereign  remedy  for  itch. 

Pills. 

Pills  ''.re  small  masses  of  medicinal  substances  'n  globular  shape, 
and  of  ^  -ize  convenient  for  swallowing.  Each  pill  generally  weighs 
from  four  to  five  grains.  Those  medicines  wliich  cannot  lie  dissolved 
in  water,  and  are  particulaiiy  unpleasant  to  the  taste,  are  usually  given 
in  the  form  of  pill.  Sugar,  or  gelatine  coated,  as  now  very  exten- 
sively used  for  every  important  medicine,  and  in  a  great  variety  of 
combinations,  they  are  a  very  popular  form  of  taking  medicine.  Phy- 
sicians 'cannot  do  better  than  to  use  the  pills  when  made  by  a  reliable 
firm. 

The  method  of  making  pills  is  as  follows :  If  the  substance  to  be 
worked  into  pills  be  a  solid  extract,  add  a  few  drops  of  water  to  it, 
and  rub  it  to  the  right  consistence  ;  if  it  be  a  resin,  add  to  it  a  few 
drops  of  alcohol ;  if  it  be  a  soft  or  liquid  substance,  rub  up  with  it 
some  inert  substance,  or  crumb  of  bread,  or  wheat  flour,  or  starch,  or 
pulverized  gum-arabic ;  if  it  be  a  powder,  mix  it  with  some  soft  sub- 
stance, as  confection,  or  syrup,  molasses,  honey,  or  mucilage  of  gum- 
arabic.  The  materials  must  be  well  mixed  and  rubbed  into  a  uniform 
mass,  which  should  be  rolled  with  a  spatula  or  knife  into  a  cy- 
linder of  just  the  same  size  throughout.  This  is  to  be  divided 
equally  into  the  number  of  pilL?  required,  each  of  which  is  rolled 
into  a  spherical  foini  between  the  thumb  and  finger,  or  upon  the  palm. 

So  many  valuable  pills  are  prescribed  among  the  "  Recipes,"  that 
it  is  not  necessary  here  to  add  to  their  number. 

Plasters^ 

Plasters  are  composed  of  wax,  resins,  gums,  fats  and  oils,  and 
sometimes  medicinal  substances,  and  are  spread  upon  linen,  muslin, 
or  leather.  When  cold  they  are  hard ;  but  when  brought  to  the 
warmth  of  the  human  body,  they  so  far  soften  as  to  adhere  firmly  to 
the  skin,  but  do  not  "  run  "so  as  to  spread  outward  and  soil  the 
under-clothes.  They  are  intended  generally  to  excite  and  irritate 
the  skin;  sometimes  as  mechanical  supporters,  and  sometimes  to 
affect  the  system  by  having  their  medicinal  matters  absorbed. 

Be'Uxdonna  Piaster. —  Take  three  ounces  of  resin  plaster,  and  an 
oun't  and  a  half  of  extract  of  belladonna,  add  the  extract  to  the 
plaster  previously  melted  by  a  gentle  heat,  and  mix. 


n 


904  MEDICINES   AND  THEIR   PREPARATIONS. 

A  useful  anodyne  application  in  neuralgia,  rheumatic  pains,  and 
dysmenorrhoea.  , 

Compound  Capsicum  Plaster.  —  Melt  together  half  a  pound  of 
resin  and  two  ounces  of  beeswax ;  to  this  add  one  pint  of  spirit  in  which 
two  ounces  of  powdered  cayenne,  enclosed  loosely  in  a  liuen  bag,  has 
been  digested  one  hour  by  a  gentle  heat ;  evaporate  the  spirit  by  a 
moderate  heat,  and  add  one  ounce  of  powdered  camphor  and  one 
fluid  dram  and  a  half  of  oil  of  sassafras ;  stir  constantly  till  cold. 

This  may  be  used  whenever  a  stimulating  plaster  is  required. 

Compound  Qalbanum  Plaster.  —  Take  two  ounces  of  galbanum, 
three  ounces  of  burgundy  pitch,  half  an  ounce  of  resin,  half  an  ounce  of 
yellc"  wax,  and  four  ounces  of  lead  plaster ;  melt  them  all  together 
over  a  gentle  fire. 

This  is  a  valuable  strengthening  plaster,  and  may  be  used  for 
weakness  of  various  parts,  as  well  as  for  scrofulous  enlargement  of 
glands  and  joints. 

Compound  Lead  Plaster.  —  Take  one  pound  of  lead  plaster;  melt 
it  by  a  moderate  heat,  and  then  add  two  fluid  ounces  each  of  linseed 
oil  and  tincture  of  opium,  six  fluid  ounces  of  oil  of  turpentine,  and 
two-thirds  of  a  pound  of  oil  of  origanum ;  stir  together  till  cold. 

Used  for  burns,  scalds,  chilblains,  etc. 

Compound  Resin  Plaster. — Take  three  pounds  of  resin,  four  ounces 
each  of  beeswax  and  hemlock  gum ;  melt  the  articles  together,  then 
remove  from  the  fire,  and,  whsn  nearly  cold,  add  gradually  one  fluid 
ounce  each  of  oil  of  hemlock,  oil  of  sassafras,  and  olive  oil,  with  half 
an  ounce  of  camphor,  dissolved  in  them,  and  half  a  fluid  ounce  of  oil 
of  turpentine.  Pour  the  whole  into  cold  water,  and  work  in  the 
hands  till  cold,  forming  it  into  rolls. 

This  is  an  excellent  strengthening  plaster,  useful  for  rheumatism, 
enlarged  joints,  glands,  and  wherever  a  weakened  part  needs  gentle 
stimulation  and  support- 
Spiced  Plaster. —  Take  one  ounce  each  of  powdered  ginger,  cloves, 
cinnamon  and  black  pepper;  one  di-am  of  pulverized  cayenne;  half 
a  fluid  ounce  of  tincture  of  ginger,  and  a  sufficient  quantity  of  honey. 
Mix  the  powders,  and  then  add  the  tincture  and  honey  to  form  a  stiff 
poultice. 

This  is  applied  with  great  advantage  over  the  stomach  in  cases  of 
nausea  and  vomiting. 

Compound  Tar  Plaster.  — Boil  three  pounds  of  tar  half  an  hour, 
then  add  one  pound  and  a  half  of  burgundy  pitch,  one  pound  of  white 
gum  turpentine  (after  having  melted  them  together  and  strained). 
Stir  together,  then  remove  from  the  fire  and  add  ten  ounces  each  of 
finely-powdered  mandrake-root,  bloodroot,  poke-root  and  Indian  tur- 
nip ;  mix  thoroughly  together. 


wmMaimmmmmmmmmmmmmmmmmmmmmmmMimm^' 


T 


MEDICINES   AND   THEIR   PKEPABATI0N8. 


905 


tic  pains,  and 

f  a  pound  of 
spirit  in  which 
linen  bag,  has 
tie  spirit  by  a 
phor  and  one 
y  till  cold, 
required. 

of  galbanum, 
alf  an  ounce  of 
m  all  together 

'  be  used  for 
inlargement  of 

I  plaster;  melt 
lach  of  linseed 
urpentine,  and 
•  till  cold. 

lin,  four  ounces 
together,  then 
uaUy  one  fluid 
5  oil,  with  half 
id  ounce  of  oil 
work  in  the 

>r  rheumatism, 
t  needs  gentle 

ginger,  cloves, 
cayenne;  half 
utity  of  honey, 
to  form  a  stiff 

kch  in  cases  of 

half  an  hour, 
jound  of  white 
and  strained), 
ounces  each  of 
ad  Indian  tur- 


This  is  an  irritant,  rubefacient,  suppurative  plaster,  and  is  con- 
siderably used  by  the  Eclectics  to  i)roduce  counter-irritation  and  re- 
vulsion in  aeumlgia,  rheumatism  and  other  painful  affections,  as  well 
as  in  chronic  inflammation  of  internal  organs.  To  be  spread  thinly 
on  soft  leather,  and  renewed  daily  on  the  same  leather.  Four  days 
are  required  to  produce  suppuration.  If  it  produce  gi-eat  pain  or 
inflammation,  remove  it,  and  apply  mutton-tallow  or  elm-poultice. 

Lead  Plaster.  —  Take  one  pound  and  a  quarter  of  very  finely  pow- 
dered semivitrified  oxide  of  lead,  one  quart  of  olive  oil  and  half  a 
pint  of  water.  Boil  together  over  a  gentle  fire,  stirring  constantly 
till  the  oil  and  litharge  unite  and  form  a  plaster.  If  the  water  nearly 
all  evaporates  before  the  process  is  completed,  add  a  little  boiling 
water. 

A  useful  plaster  for  ulcers,  bums,  excoriated  surfaces,  etc. 

Red  Oxide  of  Lead  Plaster.  — Melt  together  one  quart  of  oliveK>il 
and  one  ounce  each  of  beeswax  and  resin ;  heat  to  the  boiling  point,  and 
then  add  g^dually  three-quarters  of  a  pound  of  powdered  red-lead. 
Stir  constantly,  and  when  the  oil  has  taken  up  the  lead,  the  mixture 
will  be  brown  or  shining  black ;  then  remove  from  the  fire,  and  when 
nearly  cold  add  four  scruples  of  powdered  camphor,  and  stir  together. 
It  should  not  be  removed  from  the  fire  until  it  has  acquired  a  proper 
consistence  for  spreading,  which  may  be  easily  ascertained  by  allow- 
ing a  portion  of  it  to  cool  on  a  knife. 

This  is  a  valuable  plaster  for  scrofulous  and  sj^hilitic  ulcers,  also 
for  bums,  scalds,  and  several  skin-diseases. 

Poultices.  —  Cataplasms. 

Bread-and- Water  Poultice.  —  Put  the  needed  quantity  of  boiling 
water  in  a  basin ;  throw  in  crumbled  Avhite  bread,  or  cracker,  and 
cover  with  a  plate.  When  the  bread  or  cracker  has  soaked  up  all  it 
will,  drain  off  the  remaining  water.  Spread  one-third  of  an  inch 
thick,  and  apply. 

Flaxseed  Poultice.  —  Put  boiling  water  in  a  basin,  and  stir  in 
flaxseed  meal  to  make  a  thick  paste.     Spread  on  linen  and  apply. 

Yeast  Poultice.  —  Mix  half  a  pint  of  yeast  with  one  pound  of 
flaxseed-meal.    Stir  carefully  while  heating. 

Carrot  Poultice.  —  Boil  the  proper  quantity  of  caiTots  till  they  are 
quite  soft.  Strain  off  the  water,  mash  them  to  a  pulp,  and  add  a 
little  lard  or  sweet  oil  to  prevent  them  from  getting  hard,  then 
spread.     A  good  application  for  malignant  and  offensive  sores. 

Oatmeal  Poultice —  Place  hot  water  in  a  basin,  and  stir  in  oat- 
meal slowly,  while  it  boils,  till  the  poultice  is  of  the  right  thickness ; 
that  is,  till  it  will  not  run  on  the  rag  on  which  it  is  spread. 


..tjpW>4 


r 


906  MEDICINES    AND  THEIR   PREPAKATT0N8. 

Indian-Meal  Poultice Made  the  same  as  oatmeal  poultice  . 

Arrow-Root  Poultice Mix  two  or  more  tablespoonfuls  of  arrow- 
root with  a  little  cold  water,  in  a  basin,  till  it  is  all  united  with  the 
water.  Then  add  boiling  water,  and  stir  till  the  whole  becomes  a 
thick  paste. 

Slippery  Elm  Poultice Stir  ground  slippery-elm  bark  into  hot 

water,  and  let  it  swell.    This  is  a  very  soothing  poultice  for  irritable 
sores. 

Onion  Poultice.  —  Made  in  the  same  way  as  the  carrot  poultice. 
This  is  quite  stimulating,  and  induces  indolent  sores  to  maturate 
more  freely.     It  is  excellent  for  slow  boils. 

Charcoal  Poultice Take  either  the  bread-and-milk,  or  the  In- 
dian-meal poultice,  and  stir  into  it  one-quarter  its  bulk  of  finely  pul- 
verized clmrcoal.  Excellent  for  thoroughly  cleansing  a  foul  sore  or 
ulcer. 

Anodyne  Poultice.  —  Take  half  an  ounce  of  the  extract  either  of 
foxglove,  or  henbane,  or  stramonium,  or  coniuni,  or  belladonna,  and 
mix  it  with  half  a  pint  of  tepid  water.  Then  stir  in  as  much  flax- 
seed meal  as  will  make  a  poultice  of  the  right  thickness.  Always 
be  careful  not  to  apply  this  poultice  where  there  is  much  skin  off, 
lest  the  extract  used  be  so  much  absorbed  as  to  produce  poisonous 
effects.    These  poultices  allay  the  pain  of  cancerous  and  other  sores. 

Lobelia  Poultice.  —  Powdered  lobelia  and  ground  slippery-elm 
bark,  each,  one  ounce.  Stir  these  into  hot  weak  lye,  to  make  a  poul- 
tice. For  wounds,  fistula,  whitlow,  boils,  erysipelas  and  stings  of 
insects. 

Poke-Root  Poultice Roast  a  sufficient  quantity  of  fresh  poke- 
root  in  hot  ashes.  When  it  is  quite  soft,  pound  it,  and  make  a  poul- 
tice. To  be  applied  to  tumors  to  scatter  them,  or  hasten  their  suppu- 
ration.    To  be  removed  every  four  hours. 

Mustard  Poultice.  —  Stir  up  a  tablespoonful  of  ground  mustard 
with  a  little  water,  to  the  consistence  of  paste.  Spread  upon  linen 
or  brown  paper,  and  cover  with  thin  muslin,  that  the  mustard  may 
not  stick  to  the  skin  when  the  poultice  is  removed.  They  can  now 
be  bought  all  prepared,  either  on  paper  or  cloth,  of  several  different 
degrees  of  strength,  and  are  much  better  than  the  home-made. 

Powders. 

A  SINGLE  substance  used  as  a  powder  is  called  a  simple  powder ; 
two  or  more  united,  a  compound  powder.  Under  the  above  head,  I 
shall  describe  only  compound  powders.  In  preparing  compound 
powders,  the  substances,  if  of  different  degrees  of  hardness,  should 


^ 


toultice . 

als  of  arrow- 
ted  with  the 
}  becomes  a 


lark  into  hot 
for  irritable 


rat  poultice, 
to  maturate 


t,  or  the  In- 
if  finely  pul- 
foul  sore  or 

act  either  of 
adonna,  and 
much  flax- 
ss.  Always 
ch  skin  off, 
se  poisonous 
other  sores. 

slippery-elm 
nake  a  poul- 
id  stings  of 

fresh  poke- 
nake  a  poul- 
their  suppu- 

md  mustard 
upon  linen 
lustard  may 
bey  can  now 
sral  different 
made. 


%ple  powder  ; 
bove  head,  I 
J  compound 
Iness,  should 


MEDICINES   AND   THEIR   PREPAKATIONS. 


907 


generally  be  pulverized  separately.  Many  powdei-s  i-equire  to  be  ex- 
cluded from  the  light,  which  may  be  done  by  covering  the  bottles  in 
which  they  are  kept  with  black  varnish. 

Aromatic  Powder Take  two  ounces  each  of  cinnamon  and  gin- 
ger, and  an  ounce  each  of  cardamom  deprived  of  the  capsules,  and 
grated  nutmeg.  Rub  them  together  into  a  very  fine  powder,  and 
keep  in  well-stopped  bottles. 

The  powder  is  stimulant  and  carminative,  and  in  cases  of  weak- 
ened digestion,  may  be  given  in  ten  to  thirty-grain  doses. 

Compound  Powder  of  Aloea  and  Canella — Take  a  pound  of  aloes 
and  three  ounces  of  canella.  Rub  them  separately  to  a  fine  powder, 
and  mix  them. 

This  is  the  preparation  known  as  hiera  picra,  ov  simply  picra.  It 
may  be  used  for  anienorrhoea,  or  generally  as  a  bitter  to  correct  cos- 
tiveness,  and  improve  the  appetite. 

Compound  Powder  of  Catechu — Take  two  ounces  each  of  catechu 
and  kino,  and  half  an  ounce  each  of  cinnamon  and  nutmeg.  Reduce 
all  to  a  fine  powder,  mix  and  pass  them  through  a  fine  sieve. 

F^or  chronic  diarrhoea,  dysentery,  etc.  Dose,  from  fifteen  to  thirty 
grains. 

Compound  Powder  of  Chalk.— Take  half  a  pound  of  prepared 
chalk,  four  ounces  of  cinnamon,  three  ounces  each  of  tornientil  and 
gum-arabic,  and  half" an  ounce  of  long  pepper.  Rub  them  separately 
into  a  veiy  fine  powder,  and  mix. 

This  powder  is  warm,  stimulant,  astringent  and  antacid,  and  is 
well  fitted  for  diarrhoea  not  connected  with  inflammation. 

Compound  Powder  of  Chalk  with  Opium —  Take  six  ounces  and 
a  half  of  compound  powder  of  chalk,  and  four  scruples  of  powdered 
opium.     Mix  them. 

The  opium  in  this  preparation  increases  the  elficacy  of  the  com- 
pound powder  of  chalk  in  diarrhoea.  Dose  for  an  adult,  ten  to  fif- 
teen grains,  and  repeated  after  each  discharge. 

Compound  Powder  of  Qolden  Seal.  —  Take  two  drams  each  of 
powdered  golden  seal,  blue  cohosh  and  helonias,  and  mix  them. 

Useful  in  dyspepsia,  chronic  inflammation  of  the  mucous  mem- 
brane of  the  stomach,  etc.  Dose,  half  a  teaspoonful  to  a  teaspoonful, 
three  or  four  times  a  day. 

Compound  Powder  of  Hydrastin.  —  Take  half  a  dram  each,  in 
powder,  of  hydrastin,  leptandrin,  rhubarb  and  myricin.  Mix  thor- 
oughly, and  divide  into  thirty-two  powders. 

This  is  tonic  and  laxative,  and  is  useful  in  dyspepsia,  jaundice, 
(ihronic  inflammation  of  the  bowels,  and  during  recovery  I'lom  ex- 
hausting complaints.  One  powder  may  be  taken  often  enough  to 
produce  one  movement  of  the  bowels  a  day. 


!■  Li  ! 


'     }^ 


908 


MEDICINES  AND  THEIR   PREPARATIONS. 


InhaliiiK  Powder.  — Take  one  dram  of  crystals  of  nitrate  of  silver, 
and  two  and  a  half  drams  of  lycopodium.  Work  the  lycopodium 
into  a  very  stiff  paste,  with  a  little  warm  water,  in  which  the  nitrate 
is  dissolved.  Spread  this  thin  in  a  shallow  dish,  cover  it  so  as  to  shut 
out  the  light,  and  set  it  where  it  will  dry ;  when  thoroughly  dry,  pul- 
verize. 

I  have  used  this  powder  with  great  advantage  in  many  cases  of 
bronchitis,  by  directing  three  to  four  grains  of  it  to  be  inhaled  once 
a  day,  in  an  instrument  constructed  for  that  purpose.  This  is  the 
only  really  valuable  catarrh  muff  ever  used.  A  pinch  of  it  taken 
once  a  day  (never  oftener)  for  nasal  catarrh,  will  often  do  excellent 
service. 

Compound  Powder  of  Ipecacuanha.— Take  a  dram  each  of  pow- 
dered ipecacuanha  and  opium,  and  one  ounce  of  sulphate  of  potassa. 
Rub  them  together  into  a  fine  powder. 

This  is  the  well  known  Dover's  powder.  It  is  an  admirable  ano- 
dyne and  diaphoretic,  and  is  much  used  in  inflammatory  complaints, 
particularly  rheumatism  and  pneumonia,  complicated  with  low  ty- 
phoid symptoms.     Dose,  from  five  to  ten  grains. 

Compouad  Powder  of  Jalap.  —  Take  half  an  ounce  of  pulverized 
jalap  and  senna,  one  ounce  of  pulverized  bitartrate  of  potassa,  half  a 
dram  of  pulverized  ginger,  and  ten  grains  of  pulverized  cayenne. 
Mix  thoroughly. 

This  is  a  valuable  purgative  medicine,  and  may  be  used  in  most 
cases  where  a  simple  cathartic  is  required.  Dose,  half  a  teaspoonful 
to  a  tablespoonful. 

Compound  Powder  of  Kino.  —  Take  fifteen  drams  of  kino,  half  an 
ounce  of  cinnamon,  and  a  dram  of  dried  opium.  Rub  them  sepa- 
rately to  a  very  fine  powder,  and  mix  them. 

This  is  anodyne  and  astringent,  and  is  useful  in  diaiThoea,  etc. 

Compound  Powder  of  Rhubarb. —  Take  four  ounces  of  powdered 
rhubarb,  one  pound  of  magnesia,  and  two  ounces  of  finely  powdered 
ginger.     Mix  thoroughly,  and  preserve  in  well  stopped  bottles. 

An  excellent  laxative  and  antacid,  and  well  adapted  to  the  bowel- 
complaints  of  children. 

Compound  Powder  of  Rhubarb  and  Potassa  {Neutralizing  Pow- 
,ier). —  Take  half  an  ounce  each  of  powdered  rhubarb,  bicarbonate 
of  potassa  and  peppermint  leaves.     Mix  thoroughly. 

Valuable  in  diarrhoea,  cholera  morbus,  dysentery,  summer  com- 
plaint of  children,  sour  stomach,  heartburn,  etc. 

Worm  Powder.  —  Take  one  ounce  each  of  powdered  white  Indian- 
hemp  root  (^Asclepias  incamata),  mandrake,  pink-root,  and  bitter-root ; 
two  ounces  of  powdered  balmony,  and  four  scruples  of  powdered 
aloes.     Mix  thoroughly. 


fmsmsmmmm 


[>rir('-;:WKMIMMrkai«>swiJnn«iJi  .ihpih  ' 


MEDICINES   AND   THEIK  PUEPABATIONS. 


909 


ate  of  silver, 
lycopodium 
b  the  nitrate 
JO  as  to  shut 
hly  dry,  pul- 

any  cases  of 

inhaled  once 

This  is  the 

of  it  taken 

do  excellent 

each  of  pow- 
Q  of  potassa. 

Imirahle  ano- 
r  complaints, 
with  low  ty- 

jf  pulverized 
itassa,  half  a 
zed  cayenne. 

ised  in  most 
i  teaspoonful 

kino,  half  an 
3  them  sepa- 

hoea,  etc. 

i  of  powdered 
sly  powdei-ed 
bottles, 
to  the  bowel- 

ralizing  Pmo- 
),  bicarbonate 

ummer  com- 


white  Indian- 
id  bitter-root ; 
of  powdered 


A  very  good  remedy  for  all  kinds  of  worms.  A  teaspoonful  of 
the  powder  may  be  mixed  with  a  gill  of  molasses,  and  a  teaspoonful 
of  this  given  to  a  child  every  hour  or  two  till  it  operates.  After 
this,  give  a  teaspoonful  three  times  a  day,  for  a  few  days. 

Syrups. 

A  STRONG  solution  of  sugar  and  water  is  a  simple  syrup.  When 
the  water  is  first  charged  with  some  medicinal  substance,  and  sugar 
is  added  to  this,  we  have  a  medicated  syrup.  Refined  sugar  should 
always  be  preferred  in  preparing  medicated  syrups. 

Simple  Syrup.  —  Take  two  and  a  half  pounds  of  refined  sugar,  and 
a  pint  of  water ;  dissolve  the  sugar  in  the  water  by  heat,  remove  any 
scum  that  may  arise,  and  strain  while  hot. 

Syrup  of  Almonds.  —  Take  a  pound'of  sweet  almonds,  four  ounces 
of  bitter  almonds,  three  pints  of  water,  and  six  pounds  of  refined 
sugar.  Blanch  the  almonds,  then  rub  them  in  a  mortar  to  very  fine 
paste,  and  add,  during  the  trituration,  three  fluid  ounces  of  the  water, 
and  one  pound  of  the  sugar.  Mix  the  paste  thoroughly  with  the 
remainder  of  the  water.  Strain  with  strong  expression,  add  the 
remainder  of  the  sugar  to  the  strained  liquor,  and  dissolve  by  a 
gentle  heat.  Strain  through  fine  linen,  and  after  it  is  cool,  put  it 
into  bottles,  thoroughly  stopped,  and  keep  in  a  c«  »!  place. 

This  is  demulcent,  nutritive  and  sedative,  and  is  sometimes  added 
to  cough  mixtures,  etc. 

Syrup  of  Citric  Acid Take  two  drams  of  powdered  citric  acid, 

four  minims  of  oil  of  lemons,  and  two  pints  of  syrup.  With  one 
fluid  ounce  of  the  syrup,  rub  the  citric  acid  and  oil  of  lemons,  then 
add  the  remainder  of  the  syrup,  and  dissolve  by  a  gentle  heat. 

This  is  much  employed  as  an  agreeable  and  cooling  addition  to 
drinks,  especially  to  carbonic-acid  water.  Tartaric  acid,  being  cheaper 
than  citric  acid,  is  often  substituted  for  it,  and  the  preparation  thus 
made  is  much  sold  under  the  name  of  lemon  syrup. 

Syrup  of  Garlic.  —  Take  six  ounces  of  fresh  garlic,  sliced  and 
bruised,  one  pint  of  diluted  acetic  acid,  and  two  pounds  of  refined 
sugar.  Macerate  the  garlic  in  ten  fluid  ounces  of  the  diluted  acetic 
acid  in  a  glass  vessel,  four  days,  and  express  the  liquor.  Then  mix 
the  rest  with  what  remains  of  the  acid,  and  again  express,  till  sufficient 
has  passed  to  make  the  whole  when  filtered  measure  a  piht.  Then 
pour  the  filtered  liquor  on  the  sugar  in  a  bottle,  and  shake  till  it  i? 
dissolved. 

Excellent  in  the  bronchial  affections  of  children.  Dose,  a  tea- 
spoonful, for  a  child  a  year  old'. 

Syrup  of  Qinger.  —  Add  two  fluid  ounces  of  tincture  of  ginger  to 
a  quart  of  simple  syrup ;  evaporate  the  alcohol  by  a  gentle  heat. 


>  (' 


I 


910 


MKD10INE8   AND   THEIR   PREPARATIONS. 


This  is  carminative  and  stimulant,  and  gives  tone  to  the  debilitated 
stomach,  removing  wind,  etc.  It  is  added  to  other  medicines  to  im- 
prove their  flavor. 

Compound  Syrup  of  Hypophosphites. —  Take  266  grains  of  hypo- 
phosphite  of  lime,  192  grains  of  hypophosphite  of  soda,  128  gniiiis 
of  hypophosphite  of  potassa,  96  grains  of  recently  precipitated  hypo- 
phosphite  of  iron,  240  grains  of  hypophosphorous  acid  solution,  12 
ounces  of  white  sugar,  half  an  ounce  of  extract  of  vanilla,  and  a 
sufficient  quantity  of  water.  Dissolve  the  salts  of  lime,  soda  and 
potassa,  in  six  ounces  of  water ;  put  the  iron  salt  into  a  mortar  and 
gradually  add  solution  of  hypophosphorous  acid  till  it  is  dissolved  ;  to 
this  add  the  solution  of  the  other  salts,  after  it  has  been  rendered 
slightly  acidulous  with  the  sam<3  acid,  and  then  water,  till  the  whole 
measures  nine  fluid  ounces.  Dissolve  this  in  sugar,  with  heat,  and 
flavor  with  the  vanilla.  Without  flavoring,  this  syrup  is  not  unpleasant, 
being  slightly  saline,  and  not  at  all  ferruginous.  Any  other  flavor- 
ing may  be  used,  as  orange-peel,  orange-flower  or  ginger.  It  is  also 
suggested  to  physicians  that  glycerine  may  be  used,  wholly  or  par- 
tially, in  place  of  sugar,  when  indicated,  six  ounces  and  a  half  of 
glycerine  being  substituted  for  twelve  ounces  of  sugar.  Dose,  a  tea- 
spoonful,  three  times  a  day  befoie  meals. 

Syrup  of  Ipecacuanha.  —  Take  one  ounce  of  ipecacuanha,  in 
coarse  powder,  one  pint  of  dilut<Kl  alcohol,  two  pounds  and  a  half  of 
sugar,  and  one  pint  of  water.  Macerate  the  ipecacuanha  in  the  alco- 
hol, fourteen  days,  and  filter ;  evaporate  th3  filtered  liquor  to  six  fluid 
ounces,  filter  again,  and  add  water  to  make  the  liquor  measure  a  pint ; 
then  add  the  sugar,  and  proceed  as  directed  for  syrup. 

This  is  chiefly  used  in  compl-  ints  of  children.  Dose,  as  an  emetic, 
for  an  adult,  two  fluid  ounces ;  for  a  child  a  year  or  two  old,  one  or 
two  fluid  drams.  As  an  expecto;  nt,  for  an  adult,  two  fluid  drams ; 
for  a  child,  flve  to  twenty  minims. 

Syrup  of  Lemons. — Take  a  pint  of  strained  lemon-juice,  two 
pounds  and  a  half  of  refined  sugar,  and  two  and  a  half  fluid  ounces 
of  rectified  spirit ;  boil  the  juice  ten  minutes,  and  strain ;  then  add 
the  sugar,  and  dissolve.  After  the  syrup  has  cooled,  mix  the  spirit 
with  it. 

A  cooling  and  grateful  addition  to  drinks  in  fevers,  and  serves  to 
cover  the  taste  of  salts  and  other  purgatives. 

Aromatic  Syrup  of  Rhubarb.  —  Take  two  ounces  and  a  half  of 
bruised  rhubarb,  half  an  ounce  each  of  bruised  cloves  and  cinnamon, 
two  drams  of  bruised  nutmeg,  two  pints  of  diluted  alcohol,  and  six 
pints  of  syrup.  Macerate  the  rhubarb  and  aromatics  in  the  alcohol 
for  fourteen  days,  and  strain  ;  then,  by  a  gentle  heat,  evaporate  the 
liquor  to  a  pint,  and,  while  hot,  mix  it  with  the  syrup  previously 
heated. 


MEDICINES   AND   THEIU   PKEl'AHATIONS. 


911 


ho  debilitated 
iicinsH  to  im- 

mins  of  hypo- 
a,  128  gniiim 
pitated  liypo- 

solution,  12 
anilla,  and  a 
me,  8oda  and 
IV  mortar  and 
[lissolved  ;  to 
een  rendered 
till  the  whole 
ith  heat,  and 
it  unpleasant, 

other  flavor- 

iT.     It  is  also 

'holly  or  par- 

and  a  half  of 

Dose,  a  tea- 

(cacuanha,  in 
and  a  half  of 
la  in  the  alco- 
or  to  six  fluid 
ga«ure  a  pint ; 

,  as  an  embtic, 

vo  old,  one  or 

fluid  drains; 


iOn-juice,  two 

fluid  ounces 

in;  then  add 

nix  the  spirit 

a,nd  serves  to 


and  a  half  of 
nd  cinnamon, 
ohol,  and  six 
in  the  alcohol 
svaporate  the 
ip  previously 


This  is  a  warm  cordial  laxative,  admirably  fitted  for  the  bowel 
complaints  of  infants.  Dose,  a  fluid  dram,  lepeated  every  two  hours 
till  it  operates. 

Syrup  of  Seneka.  —  Take  four  ounces  of  fluid  extract  of  seneka, 
and  one  pint  of  water ;  mix,  and  dissolve  in  the  liquid  one  pound  of 
refined  sugar,  and  proceed  as  directed  for  syrup. 

This  is  a  stimulating  expectorant,  used  in  colds,  coughs,  etc.,  after 
inflammatory  symptoms  have  sulwided.  Dose,  for  an  adult,  one  or 
two  teaspoonfuls,  as  often  as  necessary. 

Syrup  of  5qulll.  —  To  one  pint  of  vinegar  of  squill,  add  two 
pounds  of  refined  sugar,  and  proceed  as  directed  for  syi'Up. 

It  is  a  useful  expectorant  for  coughs  and  bronchial  affections  of 
infants  and  children.     Dose,  half  a  dram  to  a  dram. 

Syrup  of  Tolu.  —  Take  two  fluid  ounces  of  tincture  of  tolu,  and 
one  pint  of  simple  syrup  ;  mix,  and  gently  heat  the  mixture  to  evapo- 
rate the  alcohol. 

This  is  chiefly  used  to  flavor  other  preparations. 

Syrup  of  Wild-Cherry  Bark.  —  Place  two  pounds  and  a  half  of 
coarsely  powdered  wild-cherry  bark  in  a  percolator,  and  pass  through 
it  one  gallon  of  water.  Strain  this  and  dissolve  in  it  by  heat  sixteen 
pounds  of  refined  sugar. 

This  makes  an  elegant  tonic  and  sedative  preparation,  and  is  mixed 
with  various  other  articles  in  prescribing  for  dyspepsia,  consumption, 
etc. 

Compound  Syrup  of  Partridge  Berry. — Take  half  a  pound  of 
partridge  berry,  and  two  ounces  each  of  helonias,  blue  cohosh,  and 
high  cranberry  bark ;  add  to  them  one  quart  of  brandy,  and  macerate 
four  days.  Press  out  the  brandy ;  and  place  the  herbs  in  three  quarts 
of  boiling  water,  and  boil  down  to  two  and  a  half  pints.  Strain,  add 
one  pound  of  sugar,  and  evaporate  to  two  and  a  half  pints.  Remove 
from  the  fire,  and  when  nearly  cold,  add  the  brandy  previously  pressed 
out. 

This  is  considerably  used  by  the  Eclectic  physicians,  under  the 
name  of  mother's  cordial,  and  may  be  usefully  employed  by  all 
physicians  in  suppression  of  the  menses,  painful  menstruation,  pro- 
fuse menstruation  and  habitual  abortions.  Dose,  from  one  to  two 
ounces,  two  or  three  times  a  day. 

Compound  Syrup  of  Phosphates  (Chemical  Food). — Take  ten 
drams  of  protosulphate  of  iron,  twelve  drams  of  phosphate  of  soda, 
twelve  drams  of  phosphate  of  lime,  twenty  drams  of  phosphoric 
acid  (glacial),  two  scruples  of  carbonate  of  soda,  one  dram  of  car- 
bonate of  potassa,  sufficient  quantity  of  muriatic  acid,  sufficient 
quantity  of  water  of  ammonia,  two  drams  of  powdered  cochineal, 
sufficient  water  to  make  twenty  fluid  ounces,  three  pou'  '.a  of  sugar, 


:■ 


912 


MBDIOINKS   AND  THEIR   PRKPARATI0N8. 


and  fifteen  drope  of  oil  of  orange.  Dissolve  the  sulphate  of  iron  in 
two  fluid  ounneu  of  boiling  wate**,  and  the  phosphate  of  soda  in  four 
fluid  ounces  of  boiling  water.  Mix  the  solutions,  and  wash  the  pre- 
cipitated phosphate  of  iron  till  the  washings  are  tAsteless. 

Dissolve  the  phosphate  ol  liMie  in  four  fluid  ounces  of  boiling 
water,  with  suflicient  muriatic  acid  to  make  a  clear  solution,  precij)!- 
tatt  it  with  water  of  ammonia,  and  wash  the  precipitate. 

I'o  the  freshly  precipitated  phosphates,  as  thus  prepared,  add  tlic 
phosphoric  acid,  previously  dissolved  in  the  water.  When  clear,  add 
the  carbonates  of  soda  and  potassa,  and  aftei'wards  sufficient  muriatic 
acid  to  dissolve  the  precipitate. 

Now  add  the  cochineal  mixed  with  the  sugar,  apply  heat,  and  when 
the  syrup  is  formed,  strain  and  flavor  it. 

This  is  an  elegant  syrup,  agreeable  both  to  the  eye  and  taste,  and 
has  been  extensively  sold  and  used  as  a  nutritive  tonic,  in  chronic 
debility,  in  cases  of  broken  down  constitution,  wasting  of  the  flesh, 
etc. 

Compound  Syrup  of  Rhubarb  and  Potassa  (^Neutralizing  Cor- 
dial). —  Take  half  a  pound  each  of  powdered  rhubtvrb  and  bicarbonate 
potassa,  and  four  ounces  each  of  cinnamon  and  golden  seal ;  macerate 
for  four  days  in  one  gallon  of  best  fourth  proof  brandy.  Express 
the  tincture  with  strong  pressure,  and  add  to  it  two  fluid  drams  of 
oil  of  peppermint,  previously  dissolved  in  a  little  alcohol.  Break  up 
the  cake  from  the  press,  place  it  in  a  percolator,  and  gradually  pass 
through  it  warm  water  till  the  strength  is  exhausted.  Evaporate 
this  solution  to  four  quarts,  and  while  the  liquor  is  still  hot,  dissolve 
in  it  six  pounds  of  refined  sugar.  Continue  the  evaporation,  if  neces- 
sary, till  the  addition  of  the  tincture  first  obtained  will  make  three 
gallons.     Then  add  the  tincture. 

A  valuable  antacid  and  laxftive  Ln  diarrhoja,  dysentery,  cholera 
morbus,  and  summer  complaint  of  children.  Dose,  for  an  adult,  a 
tablespoooful,  to  be  taken  as  circumstances  require. 

Compound  Syrup  of  Sarsaparilla.  —  Take  a  pound  each  of  sarsa- 
parill^t,  yellow  parilla,  and  pipsissewa;  an  ounce  and  a  half  of  guaia- 
cum ;  one  ounce  each  of  red  roses,  senna,  and  liquorice  root ;  and 
three  minims  each  of  oil  of  sassafras,  anise,  and  partridge  berry ;  di- 
luted alcohol,  five  pints,  and  four  pounds  of  refined  sugar.  Grind 
and  mix  the  sarsaparilla,  yellow  parilla,  pipsissewa,  guaiacum,  roses, 
senna,  and  liquorice,  and  add  to  them  the  alcohol.  Let  the  whole 
stand  fourteen  days,  then  express  and  filter.  Evaporate  by  a  water- 
bath  to  one  quart,  and  add  the  sugar.  Lastly,  rub  the  oils  in  a  mor- 
tar with  a  little  of  the  syrup,  and  thoroughly  mix  with  the  remainder. 

This  is  a  valuable  alterative  syrup,  and  is  used  lor  syphilis,  scrofula, 
diseases  of  the  skin,  etc.  •  It  is  much  improved  by  adding  half  an 
ounce  of  the  iodide  of  potassium  to  each  pint  of  the  syrup.  Dose,  a 
tablespoonful. 


■ 


IT:- 


MEDICINKS   AND   TtlEIll    PRErAKATTONB. 


913 


)hate  of  iron  in 

of  aoda  in  foiir 

d  wash  the  pre- 

leas. 

nces  of  boiling 

olution,  preci[)i- 

ate. 

(>piired,  add  tlu- 

rVhen  clear,  add 

fficient  niiiriatic 

^  heat,  and  when 

B  and  taste,  and 
X)nic,  in  chronic 
ing  of  the  flesh, 

Teutralizing  Cor- 
)  and  bicarbonate 
1  seal ;  macerate 
randy.  Express 
'0  fluid  drams  of 
ohol.  Break  up 
I  gradually  pass 
ted.  Evaporate 
itill  hot,  dissolve 
oration,  if  neces- 
will  make  three 

rsentery,  cholera 
for  an  adult,  a 


nd  each  of  sarsa- 

a  half  of  guaia- 

lorice  root ;  and 

tridge  berry;  di- 

sugar.     Grind 

guaiacum,  roses. 

Let  the  whole 

orate  by  a  water- 

;he  oils  in  a  mor- 

;h  the  remainder. 

yphilis,  scrofula, 

adding  half  an 

syrup.    Dose,  a 


Compound  Aromatic  Syrup  of  Senna.  —  Take  four  ounces  of 
senna,  one  ounce  and  a  half  of  jalap  root,  half  an  ounce  of  rhubarb, 
one  dram  of  cinnamon,  one  dnini  of  cloves,  and  half  a  dram  of  nut- 
meg. Reduce  these  articles  to  a  coarse  powder ;  add  one  quart  of 
diluted  alcohol.  Let  the  whole  stand  two  days  iviid  percolate.  Filter, 
dissolve  in  it  one  pound  of  refined  sugar,  and  add  one  dram  of  oil  of 
lemons. 

An  excellent  cordial  physic. 

Compound  Syrup  of  Stilllngia.  —  Take  a  pound  each  of  queen's 
root  and  tnrkey  corn ;  half  a  pouml  each  of  pi{)HiHsewa  leaves  and 
elder  flowers  ;  and  four  ounces  eai^li  of  prickly-ash  Iwrries  and  carda- 
mom seeds.  Oiind  all  the  articles,  mix,  and  place  them  in  a  jar,  and 
moisten  them  well  with  alcohol.  Let  them  stand  two  days ;  then 
place  them  in  a  percolator,  and  gmduuUy  add  hot  water  till  two  pints 
are  obtained,  which  must  be  stniined  and  set  aside.  Then  continue 
the  percolation  so  long  as  there  is  a  sensible  taste  of  the  spirit.  Re- 
serve this  also.  Then  continue  the  percolation  till  what  is  obttiined 
is  almost  tasteless.  Boil  down  this  last  till  the  addition  of  the  two  * 
reserved  tinctures  will  make  two  gallons  of  th§  whole.  Now  add 
twelve  pounds  of  refined  sugar,  and  make  a  syrup. 

This  is  one  of  the  Eclectic  medicines ;  and  is  quite  an  effective 
alterative  for  syphilis,  scrofula,  etc.  Improved  by  adding  iodide  of 
potassium.     Dose,  from,  a  teaspoonful  to  a  tablespoonful. 

Compound  Syrup  of  Yellow  Dock.  —  Take  two  pounds  of  yellow- 
dock  root,  one  pound  of  the  bark  of  the  root  of  false  bittersweet,  and 
half  a  pound  each  of  American  ivy  and  flgwort.  Make  a  syrup 
according  to  the  directions  for  compound  syrup  of  stillingia,  using 
sixteen  pounds  of  sugar,  and  making  two  gallons  of  syrup. 

A  valuable  preparation  for  scrofula.  Improved  by  iodide  of  potas- 
sium.    Dose,  a  tablespoonful,  three  or  four  times  a  day. 

Tinctures. 

An  ethereal  tincture  is  one  which  is  made  with  ether  as  the  solvent 
instead  of  alcohol,  and  an  ammoniated  tincture,  one  made  with  water 
of  ammonia  as  the  solvent. 

Simple  tinctures,  in  which  only  one  medicinal  article  is  used,  are 
made  thus: 

Tincture  of  Aconite. —  Take  eight  ounces  of  powdered  aconite- 
root,  and  one  pint  of  alcohol.  Mix,  and  let  them  stand  for  two  weeks, 
frequently  stirring.     Then  express,  and  filter  through  paper. 

Given  in  fovers  and  inflammatory  diseases.  Dose,  three  drops 
every  hour  or  two  in  a  little  water.  • 

In  the  above  manner  all  simple  tinctures  are  made.  Some  medi- 
cines require  alcohol  to  extract  their  active  principle  ;  some  only 
diluted  alcohol. 


I ' , 


t>  i 


»aawfi- 


tu 


MK1)IC1NK«   AND  THEIK   FKKPAKATIONS. 


One  Ounce  to  the  Pint  of  Alcohol.  —  In  piepariiijf  «iniple  t;:\iUn(!« 
from  the  following;  articles,  alcohol  ie  used,  and  one  oun»Ht  only  of  the 
m«dicine  is  employed  to  the  pint,  namely : 

Ciistot.  Saffron,  Leptandria. 

One  Ounce  to  the  Pint  of  Diluted  Alcohol.  —  In  making  tinctures 
from  the  following  articles,  one  ounce  is  used  to  the  pint  of  diluted 
alcohol: 

Iodine,  Quabsia. 

Two  Ounces  to  a  Pint  of  Alcohol : 

Assafffitida,  Camphor,  Oil  of  Peppermint,  Oil  of  Spearmint,  Ben- 
zoin, Colchicum  seeds,  Lupulin.  ' 

Two  Ounces  to  a  Pint  of  Diluted  Alcohol : 

Cardamom,  Cotton-Bark,  Cochineal,  Colombo,  Colchicum,  Ergot, 
Galls,  Hemlock,  CuIhjIw,  Foxglove,  Black  Hellebore,  Henbane,  Lactu- 
carium,  Lobelia,  Poke,  Shrubby  Trefoil,  Bloodroot,  Squill,  Valerian, 
Bittersweet,  Belladonna. 
Three  Ounces  to  a  Pint  of  Diluted  Alcohol : 

Peruvian  Bark,  Rhatiny,  Poison  Hemlock,  Sheep  Laurel,  Stramo- 
nium, White  Hellebore,  Yarrow,  Prickly  Elder,  Jalap. 

Four  Ounces  to  a  Pint  of  Alcohol : 

Nux  Vomica,  Ginger,  Guaiacum,  Black  Cohosh. 

Four  Ounces  to  a  Pint  of  Diluted  Alcohol : 

Yellow  Jessamine,  Prickly-ash  Berri«i8,  Ergot,  Matico. 

The  following  tinctures  embrace  those  which  vary  from  the  above 
proportions  among  the  simple  tinctures,  and  also  the  compound 
tinctures :  » 

Tincture  of  Orange-Peel.  —  Take  three  and  a  half  ounces  of  dried 
orange-peel  and  one  quart  of  diluted  alcohol.  Macerate  for  seven 
days,  express  and  filter. 

Tincture  of  Buchu. —  Take  five  ounces  of  buchu,  and  one  quart 
of  diluted  alcohol.  Digest  seven  days ;  pour  off  the  clear  liquor,  and 
filter. 

Tincture  of  Indian  Hemp.  —  Take  of  extract  of  Indian  Komp 
(Cannabis  Indica)  one  ounce,  and  one  pint  of  alcohol.  Dissolve  the 
extract  in  the  spirit.     Dose,  from  twenty  to  thirty  drops. 

Tincture  of  Cantharides.  —  Take  an  ounce  of  bruised  Spanish 
flies,  and  two  pints  of  diluted  alcohol.  Macerate  for  fourteen  days, 
express  and  filter  through  paper. 

Dose,  from  twenty  drops  to  a  dram,  three  or  four  times  a  day. 


MRDICINK8   AND   THKIK    HHKl'AKATIONH. 


915 


iiiiple  tinctui'eH 
n(!«  only  of  the 


aking  tiiuttureH 
[)int  of  diluted 


pearmint,  Ben- 


ichicum,  Ergot, 
lenbane,  Lactu- 
quill,  Valerian, 


Laurel,  Stramo- 


[>• 


ICO. 

from  the  above 
the   compound 

ounces  of  dried 
erate  for  seven 


I,  and  one  quart 
:;lear  liquor,  and 


[  Indian  Komp 
I.  Dissolve  the 
rops. 

bruised  Spanish 
r  fourteen  days, 

times  a  day. 


Tincture  of  Cayenne  Pepper. — Tako  an  ounce  of  pulverized 
cayiMiiit;,  and  two  piiitM  of  diluted  alcohol.  Macerate  fourtetii  (lays, 
and  filter  through  paper. 

Tincture  of  Catechu.  — Take  an  ounce  and  a  half  of  catechu,  an 
ounce  of  bruised  cinnamon,  and  one  pint  of  diluted  alcohol.  Lei 
them  stand  together  two  weeks,  frequently  shaking;  then  express 
and  filter. 

Dose,  from  thirty  drops  to  a  taLlespoonful. 

Tincture  of  Cinnamon.  — Take  an  ounce  and  a  half  of  powdered 
ciiuiamon,  and  one  pint  of  diluted  alcohol.  Let  them  sUind  together 
for  two  weeks  ;  expresH  and  filter. 

Dose,  from  one  to  three  tcaspoonfuls  in  sweetened  water. 

Elixir  Vitriol.  —  Take  "f  a  pint  of  alcohol;  drop  into  it  seven 
Huid  dmms  of  sulphuric  acid,  and  let  the  mixture  stand  threr  days 
in  a  close  vessel ;  then  add  two  drams  of  po\\('  <id  ginjift'r,  and  tlnee 
drams  of  powdered  cinnamon.     Macerate  scvcii      .ys,  and  filter. 

Useful  in  diarrhoea,  dysentery,  etc.  Dose,  from  five  to  fifteen 
drops.  To  avoid  injury  to  the  teeth,  it  should  be  taken  through  u 
quill,  or  glass  tul)e,  or  else  the  moutli  should  l)e  rinsed  immediately 
after  swallowing  it.     Use  with  care. 

Tincture  of  Lobelia.  —  Take  four  ounces  of  lobelia,  and  one  pint 
each  of  distilled  vinegar  and  alcohol.  Macerate  two  weeks,  express 
and  filter. 

Dose,  as  a  nauseant  or  expectorant,  from  thirty  to  forty  drops. 

Tincture  of  Opium.  (Laudanum).  —  Take  two  and  a  half  ounces 
of  opium,  and  two  pinfej  of  diluted  alcohol.  Macerate  fouiteen  days, 
e:;^.  ess,  and  filter  through  paper.     Dose,  from  ten  to  twenty  drops. 

Tincture  of  Tolu  —  Dissolve  one  ounce  of  balsam  of  tolu  in  one 
pint  of  alcohol,  and  filter. 

Tincture  of  Rhubarb.  —  Take  three  ounces  of  bruised  rhubarb, 
half  an  ounce  of  bruised  cardamom,  and  a  quart  of  diluted  alcohol. 
Macerate  two  we^ks,  express,  and  filter  through  paper. 

Tincture  of  Virginia  Snake-Root.  —  Take  three  ounces  of  bruised 
Virginia  snake-root,  and  one  quart  of  diluted  alcohol.  Macerate  tw^o 
weeks,  express,  and  filter  through  paper. 

This  is  advantageously  added  to  the  Infusion  of  Peruvian  bark,  in 
low  states  of  the  system.     Dose  one  to  two  fluid  drams. 

Compound  Tincture  of  Aloes.  —  Take  three  ounces  of  powdered 
aloes,  one  ounce  of  saffron,  and  two  pints  of  tincture  of  myrrh. 
Macerate  fourteen  days,  and  filter. 

This  is  the  well-known  elixir  proprietatis,  or  more  commonly,  elixir 
pro.  It  is  considerably  used  in  female  disorders,  connected  with  sup- 
pressed, retained,  or  deficient  menstruation.  Dose,  one  to  two  fluid 
dmms. 


916 


MEDICINES  AND  THEIR   PREPARATIONS. 


Compound  Tincture  of  Assafoetida- — Take  half  an  ounce  eacli 
of  lupulin,  assafffitida,  in  small  pieces,  bruised  stramonium  seeds, 
powdered  valerian  root,  and  one  pint  and  a  half  of  alcohol ;  macerate 
two  weeks,  shaking  frequently,  then  express  and  filter. 

This  is  anodyne  and  antispasmodic,  and  is  used  in  epilepsy,  St. 
Vitus's  dance,  and  hysterics.     Dose,  a  teaspoonful. 

Compound  Tincture  of  Benzoin.  —  Take  three  ounces  of  benzoin, 
two  ounces  of  purified  storax,  one  ounce  of  balsam  of  tolu,  half  an 
ounce  of  powdered  aloes,  and  two  pints  of  alcohol.  Macerate  two 
weeks  and  filter. 

This  is  used  in  chronic  diseases  of  the  air-passages.  Dose,  from 
thirty  to  fifty  drops. 

Compound  Tincture  of  Cardamom.  —  Take  six  drams  of  bruised 
cardamom,  two  ounces  of  bruised  caraway,  five  drams  of  bruised  cin- 
namon, five  ounces  of  seeded  i-aisins,  one  dram  of  bruised  cochineal, 
and  two  pints  and  a  half  of  diluted  alcohol.  Macerate  two  weeks, 
and  filter. 

This  is  a  very  agreeable  aromatic ;  used  as  a  carminative,  and  to 
improve  other  preparations.     Dose,  one  or  two  fluid  drams. 

Compound  Tincture  of  Catechu.  —  Take  three  ounces  of  catechu, 
two  ounces  of  bruised  cinnamon,  and  two  pints  of  diluted  alcohol. 
Macerate  fourteen  days,  express  and  filter. 

This  is  frequently  added  to  chalk  preparations  for  diarrhoBa,  etc. 
Dose,  from  one  to  three  fluid  drams. 

Compound  Tincture  of  Cinnamon.  —  Take  one  ounce  of  bruised 
cinnamon,  half  an  ounce  of  bruised  cardamom  seeds,  three  drams  of 
bruised  ginger,  and  two  pints  of  proof  spirits.  Macerate  fourteen 
days,  express,  and  filter. 

This  is  a  warm,  aromatic  tincture,  useful  in  spasms  and  debility 
of  the  stomach.     Dose,  one  to  two  fluid  drams. 

Compound  Tincture  of  Black  Cohosh.  —  Take  one  fluid  ounce 
of  tincture  of  black  cohosh,  'ialf  a  fl-^id  ounce  of  tincture  of  blood- 
root,  and  two  fluii  drams  of  tincture  of  poke-root.  *  Mix. 

This  is  used  in  uiseases  of  the  lungs,  liver,  and  stomach.  Dose, 
from  twenty  to  fifty  drops,  three  or  four  times  a  day. 

Compound  Tincture  of  Blue  Cohosh.  —  Take  one  ounce  of  pow- 
dered blue-cohosh  root,  half  an  ounce  each  of  bruised  water-pepper 
and  ergot,  two  fluid  drams  of  oil  of  savin,  and  twelve  fluid  ounces  of 
alcohol ;  mix,  macerate  for  a  fortnight,  and  filter. 

A  uterine  tonic,  used  for  suppressed  and  painful  menstruation,  etc. 
Dose,  a  teaspoonful,  two  or  three  times  a  day. 

Compound  Tincture  of  Colchicum.  — Mix  one  fluid  ounce  each 
of  tincture  of  black  cohosh  and  tincture  of  colchicum-seed. 

Used  for  inflammatory  rheumatism  and  gout.  Dose,  ten  to  fifty 
drops. 


<.■ 


NAM 


iMtwuTiiariitr' 


,n  ounce  each 
ionium  seeds, 
liol ;  macerate 

n  epilepsy,  St. 

ces  of  benzoin, 
[  tolu,  half  an 
Macerate  two 

.     Dose,  from 

ims  of  bruised 
)f  bruised  cin- 
ised  cochineal, 
te  two  weeks, 

ttative,  and  to 
'ams. 

jes  of  catechu, 
luted  alcohol. 

diarrhoBa,  etc. 


nee  of  bruised 
;hree  drams  of 
jrate  fourteen 

8  and  debility 

le  fluid  ounce 

ture  of  blood- 

[ix. 

)mach.     Dose, 

ounce  of  pow- 

water-pepper 

luid  ounces  of 

istruation,  etc. 

id  ounce  each 

leed. 

36,  ten  to  fifty 


MEDICINES   AND  THEIR   PREPARATIONS. 


917 


Compound  Tincture  of  Qentian. — Take  two  ounces  of  bruised 
gentian,  one  ounce  of  orange-peel,  half  an  ounce  of  bruised  carda- 
mom seeds,  and  two  pints  of  diluted  alcohol.  Macerate  fourteen 
days,  express,  and  filter. 

An  elegant  bitter,  much  used  in  dyspepsia,  and  as  an  addition  tn 
tonic  mixtures  for  a  weakened  state  of  the  stomach.  Dose,  one  or 
two  fluid  drams. 

Compound  Tincture  of  Qolden  Seal.  —  Take  one  ounce  each  of 
powdered  lobelia-seed  and  golden  seal,  and  one  pint  of  diluted  alco- 
hol.    Macerate  two  weeks,  express,  and  filter. 

This  is  used  as  a  local  application  to  diseased  mucous  mesnbranes, 
in  leucorrhcea,  gleet,  etc. 

Ammonisted  Tinctur#  of  Quaiac.  —  Take  four  ounces  of  pow- 
dered guaiac,  and  a  pint  and  a  half  of  aromatic  spirits  of  au^monia. 
Macerate  for  two  weeks,  and  filter. 

This  tincture  has  considerable  reputation  in  the  treatment  of 
chronic  rheumatism.     Dose,  one  or  two  fluid  drams. 

Compound  Tincture  of  Hemlock  (^0-olden  T}incture).  —  Take  one 
ounce  each  of  powdered  balsam  of  tolu,  guaiacum,  gum  hemlock,  and 
gum  myrrh,  one  ounce  and  a  half  of  oil  of  hemlock,  one  ounce  of  oil 
of  wintergreen,  and  four  pints  of  alcohol.  Mix,  let  them  stand  four- 
teen days,  shaking  frequently,  then  filter. 

This  is  used  by  the  Eclectics  for  rheumatism,  wind  colic,  water- 
brash,  soreness  of  the  chest,  etc.  Dose,  a  teaspoonf ul  in  a  wineglass- 
ful  of  in'ater. 

Compound  Tincture  of  High  Cranberry.  —  Take  one  ounce  of 
high  cranberry  bark,  powdered,  half  an  ounce  each  of  powdered 
lobelia-seed  and  bruised  skunk-cabbage  seed,  two  drams  each  of 
bruised  stramonium-seed,  powdered  bloodroot  and  capsicum,  and  two 
pints  of  alcohol.     Macerate  two  weeks,  express,  and  filter. 

This  is  an  Eclectic  remedy,  and  is  useful  in  nervous  and  spasmodic 
complaints,  particularly  hystaiics,  etc.  Dose,  from  twenty  drops  to 
a  teaspoonful. 

Compound  Tincture  of  Lavender Take  three  fluid  drams  of 

oil  of  lavender,  one  dram  and  a  halv  of  oil  of  anise,  one  ounce  of 
powdered  cloves,  three  drams  of  mace,  one  ounce  of  raisins,  two 
ounces  of  red  saunders,  and  one  gallon  of  Jamaica  rum.  Mix,  and 
macerate  fourteen  days,  then  express  and  filter. 

This  is  often  used  for  flatulence,  hysterics,  and  faintness.  Dose, 
from  one  to  three  teaspoonfuls,  in  water. 

Compound  Tincture  of  Lobelia.  —  Take  one  ounce  each  of 
coarsely  powdered  lobelia,  bloodroot,  skunk-cabbage,  wil'l  ginger, 
and  pleurisy  root.  Place  tliem  in  a  vessel,  and  pour  over  them  one 
pint  of  boiling  water  or  vinegar,  and  cover  tightly.  Wher  cold,  add 
three  pints  of  alcohoL     Macerate  two  weeks,  then  ex^.-  i.  and  filter. 


UM. 


w 

\ 

I 

\ 

1 

] 

m 


MEDICINES   AMD  THEIR   PREPABATIONS. 


A  valuable  emetic  for  infants  and  children,  in  croup,  wlioopiiig- 
cough,  bronchitis,  and  convulsions.  Used  also  as  an  expectomnt,  in 
coughs,  pleurisy,  etc.  Dose,  as  an  emetic  for  a  child,  half  a  teaspoon- 
ful  and  upwards. 

Compound  Tincture  of  Lobelia  and  Capsicum.  — Take  one  ounce 
each  of  powdered  lobelia,  capsicum,  and  skunk-cabbage,  and  one  pint 
of  diluted  alcohol.     Mix,  macerate  fouHeen  days,  and  filter. 

A  prompt  antispasmodic  in  cramps,  spasms,  lock-jaw,  etc.  Dose, 
half  a  dram  to  a  dram. 

Compound  Tincture  of  Myrrh  {Hot  Dropis).  —  Take  four  ounces 
of  bruised  myrrh,  two  ounces  of  capsicum,  and  four  pints  of  alcohol. 
Mix,  macemte  a  fortnight,  and  filter. 

Applied  externally,  and  occasionally  given  internally  for  distress 
of  stomach,  flatulence,  etc. 

Campiiorated  Tincture  of  Opium. —  Take  one  dram  each  of  pow- 
dered opium  and  benzoic  acid,  one  fluid  dram  of  oil  of  anise,  two 
ounces  of  cl»jified  honey,  two  scruples  of  camphor,  and  two  pints  of 
diluted  alcohol.     Macerate  fourteen  days,  and  filter. 

This  is  known  to  all  the  world  as  paregoric  elixir.  It  is  an  agree- 
able anodyne  and  antispasmodic,  and  a  good  deal  used  among  cliil- 
dren  to  allay  cough,  and  to  relieve  pains,  diarrhoea,  etc. 

Compound  Tincture  of  Peruvian  Baric. — Take  two  ounces  of 
red  bark,  powdered,  one  ounce  and  a  half  of  bruised  orange-peel, 
three  drams  of  bruised  Virginia  snake-root,  one  dram  each  of  saffron, 
cut,  and  red  saunders,  rasped,  and  twenty  fluid  ounces  of  diluted 
alcohol.     Macerate  two  weeks,  express,  and  filter. 

This  is  ffuxham's  tincture.  It  is  an  excellent  stomach  cordial,  and 
is  used  with  advantage  in  low  forms  of  fever,  etc.  Dose,  from  one 
to  three  fluid  drams. 

Compound  Tincture  of  Rhubarb  (^Sweet  Tincture  of  BkubarV).  — 
Take  two  ounces  and  a  half  of  bruised  rhubarb,  six  drams  of  bruised 
liquorice  root,  three  drams  each  of  bruised  ginger  and  saffron,  two 
ounces  of  refined  sugar,  and  one  quart  of  diluted  alcohol.  Macerate 
one  week,  expi-ess,  and  filter. 

A  warm,  gentle  aperient,  well  fitted  for  debilitated  states  of  the 
stomach.     Dose,  from  a  dram  or  two  to  an  ounce. 

Tincture  of  Senna  and  Jalap  {Elixir  Salutis).  —  Take  three 
ounces  of  senna,  one  ounce  of  powdered  jalap,  half  an  ounce  each  of 
bruised  coriander  and  caraway  seeds,  two  drams  of  bruised  cardamom 
seeds,  four  ounces  of  sugar,  and  three  pints  of  diluted  alcohol.  Mace- 
rate two  weeks,  express,  and  filter. 

This  is  a  warm  cordial  purgative,  useful  in  costiveness,  and  gout 
attended  with  debility.     Dose,  two  fluid  drams  to  an  ounce. 

Compound  Tincture  of  Tamarac  {Boners  Bitters).  —  Take  three 
ounces  each  of  tamarao-bark  and  juniper-benies,  two  ounces  of 


mp,  wlioopiiig- 
expectomnt,  in 
lalf  a  teaspoon- 

Fake  one  ounce 
e,  and  one  pint 
filter, 
iw,  etc.     Dose, 

ke  four  ounces 
tints  of  alcohol. 

illy  for  distress 

-m  each  of  pow- 
il  of  anise,  two 
ad  two  pints  of 

It  is  an  agree- 
id  among  cliil- 

pC. 

two  ounces  of 
3d  orange-peel, 
each  of  saffron, 
ices  of  diluted 

ich  cordial,  and 
Dose,  from  one 

yf  Rhvharh). — 
rams  of  bruised 
nd  saffron,  two 
hoi.     Macerate 

d  states  of  the 

—  Take  three 
1  ounce  each  of 
lised  cardamom 
alcohol.    Mace- 


MEDICINES   AND   THEIR   PREPARATIONS. 


919 


priokly-ash  bark,  one  ounce  and  a  half  eacli  of  wild-cherry  l)ark  and 
seneca  snake-root,  and  half  an  ounce  of  tansy  ;  powder  coaiwely,  and 
mix ;  then  add  one  pint  and  a  half  of  whiskey,  and  let  them  stand 
twenty-four  hours;  then  place  the  whole  in  a  vapor  displacement 
apparatus,  and  force  through  the  mixture  the  vapor  of  another  pint 
of  whiskey,  after  which  steam  from  water  enough  to  make  the  tinc- 
ture equal  to  six  quarts.  To  this  add  twelve  ounces  of  molasses,  and 
six  ounces  of  thoroughly  dissolved  alcoholic  extract  of  mandrake. 

This  is  tonic,  diuretic,  and  aperient.  Useful  in  dyspepsia,  etc. 
Dose,  a  tablespoonful  three  times  a  day. 

Ammoniated  Tincture  of  Valerian.  —  Take  four  ounces  of 
bruised  valerian,  and  one  quart  of  aromatic  spirit  of  ammonia.  Mace- 
rate two  weeks,  express,  and  filter. 

This  is  iised  as  an  antispasmodic  in  hysterics  and  other  nervous 
diseases.     Dose,  one  or  two  fluid  drams,  in  sweetened  water. 

Compound  Tincture  of  Virginia  Snalce-root  (^Sudorific  Tincture). 
—  Take  oight  scruples  each,  in  coarse  powder,  of  Virginia  snake- 
root,  ipejacu.'  nha,  saffron,  opium,  and  camphor,  and  one  pint  of  Hol- 
land gin  or  proof  spirit.  Mix,  macerate  two  weeks,  express,  and 
filter. 

This  tincture  tends  powerfully  to  induce  perspiration,  and  is  used 
for  such  purpose  when  it  is  desirable  to  procure  sleep,  etc.  Dose, 
from  ten  drops  to  a  teaspoonful,  every  hour  or  two,  in  catnip  or 
balm  tea 

Vinegars. 

Vinegar  of  Lobelia.  —  Take  two  ounces  of  powdered  lobelia-seed, 
and  one  pint  of  distilled  vinegar.  Macerate  in  a  close  vessel  one 
week ;  then  express  and  filter,  and  add  one  fluid  ounce  of  alcohol. 
This  is  useful  as  an  emetic  and  expectorant ;  externally,  it  is  valua- 
ble in  skin  diseases.  Dose,  one  to  four  teaspoonf uls,  as  often  as 
necessary. 

Vinegar  of  Squill. — Take  two  ounces  of  sliced  squill,  and  one 
pint  of  distilled  vinegar ;  macerate  in  a  close  glass  vessel  one  week ; 
then  express,  strain,  and  add  one  fluid  ounce  of  alcohol. 

This  is  expectorant  and  diuretic,  and  is  sometimes  used  for  coughs 
and  diseases  of  the  chest. 


^i 


{ r 


mess,  and  gout 
ounce. 

.  —  Take  three 
two  ounces  of 


1i!lf 


M 


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•»"51Fl|B?,iJMikJL'l,'l  I. 


PRESCRIPTIONS.  —  RECIPES. 


These  prescriptions  are  numbered,  and  referred  to  by  correspond- 
ing numbers  in  the  treatment  of  the  various  diseases.  This  arrange- 
ment saves  the  trouble  of  writing  out  each  prescription  every  time  it 
is  wanted  under  the  several  disordei-s.  When  there  are  several 
recipes,  each  of  which  is  suitable  in  a  certain  stage  of  a  complaint, 
this  plan  affords  the  means  of  referring  to  them  all  in  a  little  space, 
by  simply  giving  their  numbers.  The  doses  named  are  always  for 
grovm  persons,  unless  it  is  otherwise  stated.  For  young  people,  from 
15  to  21,  give  §  of  dose.  For  childien,  from  7  to  15,  ^  of  dose. 
In  administering  medicines  of  all  kinds,  the  strength  and  condition 
of  the  patient  should  be  taken  into  consideration. 

Great  pains  have  been  taken  in  preparing  these  prescriptions.  A 
considerable  portion  of  them  are  the  favorite  recipes  of  the  most  dis- 
tinguished physicians,  the  world  over.  They  have  been  thoroughly 
revised,  newly  discovered  remedies  added,  and  those  which  time  has 
proved  not  as  valuable  have  been  omitted. 

The  classification  of  these  recipes  under  separate  heads  is  necessa- 
rily very  imperfect,  and  has  been  attempted  only  to  make  it  more 
easy  for  me  to  refer  to  them  while  writing  the  book.  The  classifica- 
tion could  only  be  applied  to  a  part  of  them,  however ;  the  rest  are 
indiscriminately  mixed. 

Emetics. 

1.  Ipecac  powder,  in  30-grain  doses,  taken  in  lukewarm  water  and 
repeated  every  20  minutes  if  needed.  Wine  or  syrup  of  ipecac  is  a 
more  useful  and  palatable  emetic  for  infants  and  children :  it  may  be 
given  in  1  to  2  teaspoonfuls  as  a  dose.  Useful  in  poisoning,  overloaded 
stomach,  croup,  etc. 

2.  Mustard  flour  is  a  very  prompt  emetic  and  always  on  band  for  &a 
emergency.  Dose,  1  dessertspoonful  in  J  pint  of  warm  water;  repeated  in 
10  minutes  if  needed. 

3.  Sulphate  zinc  is  a  very  prompt  emetic  producing  little  irritation ;  80 
grains,  with  thirty  of  Ipecac,  generally  suffice,  but  the  dose  may  be  re- 
peated. 

920 


mtimm 


mmm 


MEDICINES   AND  THEIR   PREPARATIONS. 


921 


ES. 


by  correspond- 
This  arrange- 
1  every  time  it 
'e  are  several 
)f  a  complaint, 
a  little  space, 
ire  always  for 
g  people,  from 
15,  ^  of  dose, 
and  condition 

scriptions.  A 
•  the  most  dis- 
en  thoroughly 
■hich  time  has 

ids  is  necessa- 
make  it  more 
The  classificBr 
;  the  rest  are 


inn  water  and 
of  ipecac  is  a 
en :  it  may  be 
ing,  overloaded 

n  band  for  an 
er ;  repeated  in 

i  irritation ;  SO 
jse  may  be  re- 


4.  Apomorphia,  when  injected  under  the  skiu  in  doses  of  J  grain, 
produces  vomiting  in  3  to  10  minutes.  It  may  also  be  given  by  the  mouth 
in  dosea  of  ^  of  a  grain. 

Purges.     Cathartics. 

5.  Precipitated  sulphur,  15  grains ;  magnesia,  1  scruple.  Mix.  To  be 
taken  each  night  at  bedtime,  for  costiveness  and  bleeding  piles. 

6.  Confection  of  senna,  2  ozs. ;  bream  of  tartar,  1  oz. ;  sylphur,  1  oz. ; 
syrup  of  ginger  enough  to  make  a  stiff  paste.  Mix.  A  piece  as  large  as 
a  nutmeg  is  to  be  taken  as  often  as  necessai-y  to  keep  the  bowels  open. 
One  of  the  very  best  remedies  for  piles. 

7.  Rochelle  salts,  2  drams ;  bicarbonate  of  soda,  2  scruples ;  water,  ^ 
pint.  Mix.  To  this  mixture  add  35  grains  of  tartaric  acid,  and  take  the 
whole  foaming.     This  is  the  recipe  for  Seidlitz  powders. 

8.  Calcined  magnesia,  1  dram ;  water,  2  ozs.  Mix.  To  be  taken  at  a 
draught.  Husband's  magnesia,  in  powder  form,  taken  in  teaspoonful 
doses  every  2  hours  till  bowels  move,  is  a  excellent  mild  saline. 

9.  Sulphate  of  magnesia  (epsom  salts),  2 drams;  freshly  roasted  coffee 
in  coarse  powder,  2  scruples ;  hot  water,  4  ozs.  Mix  and  boil  for  three 
minutes,  and  strain.  This  may  be  sweetened,  and  taken  every  morning 
for  habitual  costiveness,  or  repeated  once  in  three  hours,  if  an  immediate 
effect  is  desired. 

10.  Castor-oil,  1  oz. ;  the  yolk  of  one  egg;  put  together,  and  add 
simple  syrup,  ^  oz. ;  peppermint  water,  2  ozs.  Mix.  To  be  taken  at  a 
draught,  after  being  well  stirred  or  shaken.  Equally  palatable  is  a  table- 
spoonful  or  two  of  castor-oil  between  2  layers  of  lemon  juice. 

11.  Sulphur,  1  dram;  cream  of  tartar,  2  drams.  Mix.  To  be  taken 
in  syrup  or  molasses. 

12.  Rhubarb,  10  grains;  calcined  magnesia,  J  dram.  Mix.  To  be 
taken  in  syrup  or  molasses. 

13.  Powdered  senna,  ^  dram;  powdered  jalap,  10  grains;  powdered 
cloves,  10  grains.     Mix.     To  be  taken  in  sweetened  water. 

14.  Compound  licorice  powder,  or  so-called  German  powder,  is  a 
thorough  physic  in  heaping  teaspoonful  doses.  It  is  a  physic  very  com- 
monly used.    Best  taken  in  milk,  but  not  bad  in  water. 

15.  Garfield  tea,  bought  in  packages  and  steeped  per  directions,  is  also 
a  simple  carthartic,  and  may  be  continued  for  a  while  each  night.  No 
physic  proper  should  be  so  used  for  any  great  length  of  time. 

16.  Castor-oil,  1  dessert  spoonful  to  2  tablespoonfuls. 

17.  Castoria  is  a  proprietary  medicine,  yet  one  which  children  and  in- 
fants take  readily  and  without  any  deleterious  effect. 

18.  Sulphate  of  magnesia,  1  oz. ;  cream  of  tartar,  1  oz. ;  pure  water, 
1  pint.     Mix.     A  wine-glassful  occasionally. 

19.  Compound  extract  of  colocynth,  ^dram;  aloin,  2  grains;  extract 
of  belladonna,  2  grains.     Mix,  and  divide  into  8  pills.     One  as  required 


I'M  H 


nif 


>*i(SEJ»li" 


mmm 


H^-^ 


i.  Jljill 


MEnrCINES   AND  THEIR   PREPAKATI0N8. 

20.  The  Boliition  of  citrate  of  magncBia,  which  all  dniggiBts  keep  in 
stock  in  pint  bottles,  is  the  most  palatable,  the  simplest,  and  moat  effcca 
cious  saline  we  have.     The  ordinary  dose  is  ^  bottle ;  this  may  be  repeated 
in  4  hours. 

21.  Syrup  of  figs  is  another  proprietary  medicine  of  some  value;  it  con- 
tains senna.     Dose,  2  to  4  teaspoonfuls.     Is  agreeable  to  children. 

2'2.  Aloin,  strychnia  and  belladonna,  in  pill  form,  is  sold  everywhere 
by  druggists,  and  is  a  suitable  mild  cathartic.  The  pill  is  put  up  in  vary- 
ing strengths,  but  that  which  contains  aloin,  ^  grain,  is  a  moderate  strength 
piU. 

J.  Sulphur,  1  teaspoonful;  cream  of  tartar,  10  grains;  saltpetre,  5 
grains.     Mix.     To  be  taken  at  a  dose. 

24.  Manna,  2  drams ;  fennel  water,  1  oz.  Mix.  One  dessert  spoon- 
ful, as  a  cathartic  for  an  infant. 

25.  Castoria  (See  No.  17)  and  aromatic  syrup  of  rhubarb  are  good  laxa- 
tives for  children. 

26.  Cascam  sagrada  is  an  herb  which  has  become  extremely  popular 
and  useful  in  constipation,  as  it  is  a  tonic  laxative.  It  is  given  in  various 
forms,  of  which  the  best  are  the  aromatic  preparations  of  cascara,  in  tea- 
spoonful  doses  at  night,  the  solid  extract  in  pill  form,  in  doses  of  J  to  ^ 
grain,  1  to  3  three  times  daily,  or  Maltine  with  cascara,  in  I  to  4  teaspoon- 
ful doses  at  bedtime.  These  preparations  may  be  contined  for  long  inter- 
vals if  need  be. 

27.  Epsom  salts,  2  drams;  dissolve  in  pure  water,  1  oz.  Then  add 
sweet  spirits  of  nitre,  2  drams;  laudanum,  10  drops.  Dose,  a  tea- 
spoonful,  to  be  repeated  according  to  circumstances. 

28.  Aromatic  syrup  of  rhubarb,  in  teaspoonful  doses  to  a  young  child, 
or  in  tablespoonful  doses  to  an  older  child,  is  a  good  corrective. 

29.  Compound  extract  of  colocynth,  ^  dram ;  extract  of  jalap,  15  grains. 
Mix.  Make  12  pills.  Two  or  three  pills  will  produce  active  operation  of 
the  bowels.     Add  ext.  belladonna,  2  grs.,  to  prevent  gripes. 

30.  Solution  of  tiie  citrate  of  magnesia,  in  wineglass  doses,  every  two 
hours,  till  it  operates,  or  in  ^  bottle  dose  for  a  single  dose. 

81.  Pulverized  gamboge,  12  grs.;  pulv.  scammony,  12  grs.;  elate- 
rium,  2  grs. ;  croton  oil,  8  drops ;  ext.  of  stramonium,  3  grs.  Mix.  Make 
12  pills.     One  pill  is  a  dose,  repeated  every  hour  until  it  operates. 

32.  Compound  cathartic  pills,  improved,  in  doses  of  two  to  three  pills, 
produce  in  four  hours  one  or  two  complete  and  full  operations. 

83.  See  Nos.  17,  20,  21,  and  25. 

84.  Leptandrin,  ^  grain;  podophyllin,  ^  gr. ;  euonymin,  ^  grain;  in- 
spissated ox-gall,  2  grains,  is  an  admirable  liver-pill,  taken  one  to  three 
times  daily. 

35.  Pulverized  rhubarb,  2  scruples;  bicarbonate  of  potassa,  1  scruple; 
ext.  of  nux  vomica,  5  grs.     Mix.     Make  20  pills.     One  pill  twice  a  day. 

86.  Leptandrin,  |  grain;  ext.  nux  vomica,  J  grain;  euooymin,  ^  grain; 
iridin,  ^  grain ;  ext.  cascara  sagrada,  J  grain,  makes  also  a  very  good  bil- 
ious pill ;  it  may  be  taken  as  often  as  three  times  a  day,  if  needed. 


mssms^msm 


iiggiHts  keep  in 
ind  moat  effcca 
may  be  repeated 

ie  value ;  it  con- 
children. 

sold  everywhere 
1  put  up  in  vary- 
loderate  strength 

ns;  saltpetre,  5 

i  dessert  spoon- 

b  are  good  laxa- 

ctremely  popular 
given  in  various 
cascara,  in  tea- 
doses  of  J  to  I 
I  to  4  teaspoou- 

id  for  long  inter- 

oz.  Then  add 
.     Dose,  a  tea- 

»  a  young  child, 
ective. 

jalap,  15  grains, 
itive  operation  of 
)es. 

doses,  every  two 
e. 

12  grs. ;  elate- 
;rs.  Mix.  Make 
operates. 

wo  to  three  pills. 
Lions. 

ain,  ^  grain;  in- 
cen  one  to  three 

tassa,  1  scruple; 
pill  twice  a  day. 

joymin,  \  grain ; 
»  a  vei'y  gooid  bil- 
if  needed. 


MEDICINES    AND   THEIK   PKEI'ARATIONS. 


87.  Sweet  tinct.  of  rhubarb,  4  ozs. ;  bicarbonate  of  soda,  2  drams.  Mix. 
From  a  teaspoonful  to  a  tablespoonful,  as  occasion  may  require. 

38.  Pulverized  rhubarb,  2  ozs. ;  bicarbonate  of  potassa,  1  oz.  Mix.  Of 
this  take  enough  to  produce  one  movement  of  the  bowels  per  day. 

89.  Leptandrin,  30  grs. ;  podophyllin,  5  grs. ;  pulv.  cayenne,  10  grs. ; 
ext.  nux  vomica,  6  grs. ;  quinine,  12  grs.  Mix.  Make  24  pills.  One, 
two  or  three  times  a  day. 

40.  Podophyllin,  2  grs. ;  leptandrin,  10  grains ;  cream  of  tartar,  5  scru- 
ples.    Mix.     Divide  into  10  powders.     One  is  a  dose. 

41.  Comp.  powder  of  jalap,  1  oz. ;  cream  of  tartar,  1  oz.  Mix.  One 
teaspoonful  is  a  dose,  to  be  taken  in  sweetened  water. 

42.  Pulverized  charcoal,  \\  drams;  pulv.  rhubarb,  2  scruples;  pulv. 
ipecac,  6  grains;  extract  of  hyoscyamus,  12  grs.  Mix.  Divide  into  12 
portions.     Give  one  every  three  or  four  hours. 

43.  Pulverized  blood-root,  1  dram  ;  pulv.  rhubarb,  1  dram;  caatile  soap, 
2  scruples.  Mix,  and  divide  into  32  pills.  Take  one  morning  and  night. 
Excellent  for  costiveness. 

44.  Rochelle,  14  drams;  magnesia,  11  drams;  powdered  charcoal,  8 
drams.  Mix.  Dose,  a  heaping  teaspoonful,  in  dyspepsia  and  coftive- 
ness,  with  foul  breath,  etc. 

45.  Pulverized  rhubarb,  8  grs. ;  pulv.  guaiacum,  8  grs. ;  galbanum,  2 
grs. ;  pulv.  ipecac,  2  grs.  Mix.  Make  8  pills.  Take  one  or  two  pills 
night  and  morning.     For  a  weak  stomach  and  a  bilious  condition. 


Tonic  and  Cathartic. 

46.  Podophyllin,  4  grs. ;  leptandrin,  8  grs. ;  quinine,  8  grs. ;  ext.  nux 
vomica,  2  grs.  Mix.  Make  16  pills.  One,  two,  or  three  pills  at  bedtime, 
according  to  the  requirements  of  the  case. 

47.  Sulphate  of  iron,  1  scruple;  ext.  cascara,  7  grains.  Mix  and  make 
into  20  pills.  One  pill  twice  a  day.  An  excellent  remedy  in  chlorosis, 
when  the  bowels  are  confined. 

48.  Carbonate  of  iron,  1  dram ;  pulverized  rhubarb,  \  dram ;  aloin,  6 
grains;  extract  of  hops,  ^  dram.  Mix.  Make  30  pills.  One  pill  three 
times  a  day. 

49.  Fluid  extract  of  senna,  1  dram;  compound  fluid  extract  of  gentian, 
\  dram ;  fluid  extract  of  ginger,  ^  dram ;  aromatic  spirits  of  ammonia, 
I  dram.     Mix.     To  be  taken  in  a  wineglassful  of  sweetened  water. 

50.  Aromatic  syrup  of  rhubarb,  1  oz. ;  tincture  of  Colombo,  1  oz.  Mix. 
Dose,  two  teaspoonfuls  three  times  a  day. 

51.  Compound  infusion  of  gentian,  6  ozs. ;  epsom  salts,  4  drams;  di- 
luted sulphuric  acid,  16  drops.     Mix.     A  tablespoonful  every  six  hours. 

52.  Tr.  aloes,  ^  oz. ;  pulv.  gum-arabic,  5  grs.;  magnesia,  1  dram; 
white  sugar,  5  grs. ;  comp.  infusion  of  gentian,  1^  ozs. ;  water,  1^  oza. : 
tinct.  of  ginger,  1^  ozs.  Mix.  From  a  teaspoonful  to  a  tablespoonful  to 
be  taken  night  and  morning. 


m\  ' 


m 


924 


MBDIOINEB   AND   THEIR   PREPAKATIONB. 


58.  Pulverized  Peruvian  bark,  1  oz. ;  pulv.  rhubarb,  ^  dram ;  pulv.  mn- 
riate  of  ammonia,  1  dram.  Mix.  Divide  into  eight  powders.  Take  one 
three  times  a  day. 

54.  Oxide  of  zinc,  2  drams ;  magnesia,  ^  oz. ;  quinine,  1  scruple.  Mix. 
Divide  into  32  powders.     Take  one  four  times  a  day. 

55.  Spnulel  salts,  1  teaspoonful  in  ^  glass  warm  water  on  arising;  crab- 
orchard  water,  1  tablespoonful  in  ^  glass  water  on  arising;  Hunyadi 
Janos,  ^  glass  or  more  in  water;  1  teaspoonful  phosphate  of  sodium  in  a 
glass  of  hot  water  on  arising ;  are  all  good  saline  remedies  for  biliousness. 


Carminatives. 

56.  Manna,  1  oz. ;  aniseed,  bruised,  1  dram ;  ooiling  water,  ^  pint. 
Mix.  Let  the  mixture  stand  for  half  an  hour,  then  strain,  and  add  three 
drams  of  carbonate  of  magnesia,  so  as  to  make  a  perfect  mixture.  Take 
a  wineglass  full  every  two  or  three  hours  till  it  operates.  For  the  drum- 
head Gtate  of  the  bowels. 

57.  Thoroughwort,  2  ozs. ;  ginger  and  cloves,  each,  ^  oz. ;  ext.  dan- 
delion, 4  ozs. ;  water,  1^  pints.  Boil  to  one- third,  and  add  sugar,  1^ 
pounds,  and  brandy,  ^  pint.  An  excellent  cordial  cathartic  to  act  upon 
the  liver. 

Tonics. 

58.  Chamomile  flowers,  i^  oz. ;  cold  water,  1  pint.  Macerate  for  one 
hour  and  strain.     A  wineglassful  to  be  taken  several  times  a  day. 

59.  Sulphate  of  quinine,  15  grains;  diluted  sulphuric  acid,  15  drops; 
compound  tincture  of  cardamom,  3  drams ;  tincture  of  hops,  3  drams ;  com- 
pound infusion  of  roses,  6  ozs.  Mix.  A  teaspoonful  two  or  three  times  a 
day,  in  chlorosis. 

60.  piluted  sulphuric  acid,  2  drams ;  syrup  of  orange-peel,  2  ozs. ;  cin- 
namon-water, 1  oz.  Mix.  A  teaspoonful  or  two  in  a  wineglass  of  water 
two  or  three  times  a  day. 

61.  Bland's  iron  pill,  3  grains,  three  times  daily.  This  pill  is  often 
united  with  strychnia,  -^  grain,  and  arsenious  acid,  -^g  grain,  which  adds 
to  its  efficiency.  If  constipation  exists,  there  may  also  be  added  ext.  cas- 
cara,  ^  grain,  in  chlorosis,  anaemia,  and  conditions  requiring  iron. 

62.  Sulphate  of  quinine,  12  grains;  aromatic  sulphuric  acid,  24  drops; 
syrup,  1  oz. ;  peppermint  water,  1  oz.  Mix.  In  intermittent  fever,  take 
one  tablespoonful  once  in  three  hours.  Ordinarily,  one  teaspoonful  is  a 
sufficient  dose.    Or  quinine,  10  grains,  four  hours  before  the  expected  chill. 

63.  Compound  infusion  of  gentian,  8  ozs. ;  nitro-muriatic  acid,  30 
drops.     Mix.     Take  one  tablespoonful  three  times  a  day. 

64.  Bicarbonate  of  soda,  ^  oz. ;  compound  infusion  of  gentian,  4  ozs. ; 
tincture  of  Colombo,  1  oz. ;  syrup  of  orange-peel,  ^  oz.  Mix.  Take  a 
tablespoonful  three  times  a  day. 

65.  Sulphate  of  quinine,  1  scruple;  alcohol,  4  ozs.;  sulphuric  acid,  5 
drops ;  Madeira  wine,  1  quart.     Mix.     Two  wineglassfuls  a  day. 

66.  Tinct.  gentian  compound,  teaspoonful  in  wineglass  water  before 
eating. 


MEDICINES   AND  THEIK   PREPARATIONS. 


925 


Iram ;  pulv.  mil- 
lers.    Take  one 

1  scruple.    Mix. 

n  arising ;  crab- 
sing  ;    Hiinyadi 
of  sodium  in  a 
for  biliousneas. 


water,  J  pint. 

and  add  three 

mixture.     Take 

For  the  druni- 

oz. ;  ext.  dan- 
add  sugar,  1| 
tic  to  act  upon 


icerate  for  one 
I  a  day. 

Eusid,  15  drops; 
3  drams :  com- 
)r  three  times  a 

el,  2  ozs. ;  cin- 
eglasB  of  water 

s  pill  is  often 
in,  which  adds 
idded  ext.  cas- 
iig  iron. 

cid,  24  drops; 
»nt  fever,  take 
easpoonful  is  a 
I  expected  chill, 
riatic  acid,  30 

;entian,  4  ozs. ; 
Mix.     Take  a 

Iphuric  acid,  5 
a  day. 

water  before 


67.  Quinine,  1  scruple;  alcohol,  4  ozs. ;  sulphuric  acid,  it  drops.  Mix. 
Take  a  teaspoonfui  three  times  a  day,  or  quinine  pills,  2  grs.  each,  one 
three  times  a  day. 

68.  Arseniate  of  iron,  3  grains;  extract  of  gentian,  2  drams;  pulver< 
ized  licorice,  1  dram.  Mix.  Make  20  pills.  Take  one  pill  three  times 
a  day.  If  the  eyelids  become  inflamed,  discontinue  for  a  few  days,  and 
then  begin  again.   . 

69.  Soft  water,  3  ozs. ;  quinine,  10  grains;  diluted  sulphuric  acid,  10 
drops;  simple  syrup,  1  oz.  Mix.  A  teaspoonfui  every  two  or  three 
hours. 

70.  Quinine,  10  grains ;  diluted  sulphuric  acid,  10  drops;  white  sugar, 
4  drams ;  cinnamon  water,  4  ozs. ;  tincture  of  kino,  2  drams.  Mix.  One 
teaspoonfui  every  three  hours. 

71.  Tartrate  of  iron,  40  grains;  aoft  water,  2  ozs. ;  Hyrup  of  ginger, 
i  oz.     Mix.     20  to  40  drops  every  three  hours. 

72.  Potassio-tartrate  iron,  4  scruples ;  quinine,  4  scruples ;  alcoholic  ext. 
of  black  cohosh,  4  scruples.     Mix.     Make  48  pills. 

73.  Pill,  citrate  of  iron,  quinine,  and  strychnia,  2  grains.  One  pill  three 
times  daily. 

74.  Precipitated  carbonate  of  iron,  30  drams ;  ext.  of  conium,  15  drams ; 
syrup  of  balsam  of  tolu,  6  ozs. ;  oil  of  cinnamon,  12  drops;  oil  of  lemon, 
12  drops;  alcohol,  2  ozs.;  water,  1  pint;  brandy,  ^  pint;  loaf-sugar, 
4  ozs.  Mix.  Give  from  one  to  three  tablespoonfuls  three  or  four  times  a 
day,  in  insanity. 

75.  Citrate  of  iron,  1  dram ;  sulphate  of  quinine,  1  scruple ;  ext.  of  nux 
vomica,  8  grs.    Mix.    Make  32  pills.    One  pill  three  times  a  day. 

76.  Nitric  acid,  1  dram ;  hydrochloric  acid,  J  dram ;  comp.  infusion  of 
gentian,  1 J  ozs.    Mix.    One  teaspoonfui  in  water  is  a  dose. 

77.  Sulph.  quinine,  1  dram ;  tartaric  acid,  6  grs. ;  water,  1  drop.  Mix. 
Make  30  pills.     Dose,  one  pill,  to  be  repeated  as  often  as  needed. 

■  78.  Diluted  nitric  acid,  4  drams ;  diluted  muriatic  acid,  4  drams ;  syrup 
of  orange-peel,  1  dram  ;  water,  1^  ozs.  Mix.  One  teaspoonfui  in  a  wine- 
glass of  water,  taken  before  meals. 

General  and  Nerve  Tonics. 

79.  Valerianate  of  iron,  quinine  and  zinc,  of  each  1  grain  in  pill  form, 
taken  three  times  daily,  is  an  excellent  nervine ;  or  pill  sumbul  comp. ,  one 
three  times  daily. 

80.  Iron  by  hydrogren,  48  grs. ;  arsenious  acid,  1  gr. ;  ext.  of  nux 
vomica,  5  grs.  Mix.  Make  24  pills.  For  an  adult,  one  pill  three  times 
a  day. 

81.  Valerinate  quiuiue,  1  grain;  extract  valerian,  1  grain;  extract  of  hy- 
oscyamus,  ^  grain.  One  pill  evpry  two  or  three  hours  till  quiet,  then  one 
every  four  or  six  hours. 

82.  White  vitriol,  1  dram ;  ext.  of  nux  vomica,  8  grs.  Mix.  Make  32 
pills.     One  pill  three  times  a  day. 


r 


ijB»»-- 


926 


MKHIClNKb   AND   TIIEIK    PKKrAUATlONS. 


83.  Strychnia,  2  ri-b.  ;  oxt.  of  aconite,  16  grs. ;  ext.  of  hyoBcyainiis,  IC. 
gni. ;  quinine,  ^  dram.     Mix.     Make  .S2  pills.    One  pill  three  times  a  day. 

84.  Citrate  of  iron,  1  dram;  trisnitrate  of  bismuth,  1  dram;  sulphate  of 
quinia,  1  scruple ;  ext.  of  nux  vomica,  (i  grs.  Mix.  Make  32  pills.  Take 
one  pill  three  tiroes  a  day. 

Nerve-Tonics  and  Antispasmodics. 

85.  Strychnine,  2  grs. ;  ext.  belladonna,  i)  grs. ;  alcoholic  extract  of 
black  cohosh,  2  scruples.  Mix.  Make  40  pills.  One  pill  four  times 
a  day. 

86.  Strychnine,  2  grs. ;  diluted  phosphoric  acid,  1  oz. ;  peppermint 
water,  3  pints.  Dissolve  the  strychnine  in  the  acid  ;  then  add  the  pepper- 
mint water.  A  tahlespoonful  to  be  taken  three  times  a  day,  in  palsy,  dyn- 
pepsia,  neuralgia,  and  in  most  states  of  the  nervous  system  requiring  tone. 
Also  in  fever  and  ague. 

87.  High-cranberry  bark,  1  oz. ;  skunii-cabbnge  root,  ^  oz. ;  scullcap, 
^  oz. ;  cardamom  seeds,  2  drams ;  pulv.  cayenne,  2  drams.  Put  these  to 
a  pint  of  wine ;  shake  well  every  day  for  three  or  four  days.  A  table- 
spoonful  four  times  a  day. 

88.  Aconitia,  ^^^  grain;  antifebrin,  2  grains;  quinine,  1  grain;  ar- 
senic chlorophos.,  j^  grain;  strychnia,  yjo  grain.  One  pill.  Take  one 
such  pill  every  two  to  four  hours,  according  to  pain.     Used  in  neuralgia. 

89.  Extract  of  valerian,  12  grs.;  extract  of  hyoscyamus,  12  grs.; 
oxide  of  zinc,  24  grs.     Mix.     Make  12  pills.     One  pill  twice  a  day. 

90.  Extract  of  hyoscyamus,  48  grs. ;  extract  of  valerian,  24  grs. ; 
camphor,  24  grs.     Divide  into  24  pills.     Take  one  every  four  hours. 

9 1 .  Extract  of  hyoscyamus,  ^  dram ;  aconitia,  I  gr. ;  strychnine,  2 
grs. ;  pulverized  cayenne,  ^  dram ;  phosphide  of  zinc,  5  grs.  Make  80 
pills.     Take  one  four  times  a  day.     Excellent  in  neuralgia. 

92.  Antikamnia,  60  grs. ;  caffein,  24  grs. ;  divide  into  12  capsules. 
Take  one  every  two  hours  for  neuralgia  of  face.     See  also  88. 

93.  Valerianate  of  iron,  valerianate  of  zinc,  valerianate  of  quinine;  of 
each,  30  grs.,  to  be  divided  into  30  pills  or  capsules.  Take  one  three 
times  a  day  for  the  neuralgic  condition. 

94.  Tincture  of  veratrum  viride,  2  drams;  bromide  of  soda,  4  drams; 
elixir  of  anise,  1  oz. ;  syrup  of  orange,  2  ozs.  Take  a  teaspoonful  in 
wineglass  of  water  every  two  to  four  hours  according  to  nervousness. 

95.  Strychnine,  1  gr. ;  arsenious  acid,  1  gr. ;  quinine,  20  grs. ;  reduced 
iron,  20  grs. ;  extract  cannabis  indica,  5  grs.  Divide  into  30  pills  or 
capsules.    Take  one  three  times  daily. 

96.  Simple  syrup,  1  oz. ;  prussic  acid,  1  drop.  Mix.  A  teaspoonful 
morning  and  evening.  If  no  dizziness  or  sickness  is  produced  within 
forty-eight  hours,  repeat  the  done  three  times  a  day.  This  is  for  a  child 
six  months  old ;  add  one  drop  more  of  the  acid  for  each  additional  year  of 
the  child's  age. 

97.  Phosphide  of  zinc,  5  grs. ;  extract  of  nux  vomica,  7  grs. ;  extract 
of  cannabis  indica,  5  grs.  Divide  into  30  pills  or  capsules,  and  take  one 
three  times  daily  as  a  nerve  tonic. 


m^^^Sm^^^^^^mi^iiSSSSi^Sssie^Siiir 


r  hyoHcyanuiit,  lii 
bree  times  a  day. 

Iratn ;  sulphate  of 
e  32  pills.    Take 


lies. 

Qholic  extract  of 
e  pill  four  times 

oz. ;  peppermint 
1  add  the  pepper- 
ay,  in  palsy,  dys- 
m  requiring  tone. 

^  oz. ;  Bcullcnp, 

ns.    Put  these  to 

days.     A  table- 

ne,   1   grain ;  iir- 
>  pill.     Take  one 
led  in  neuralgia, 
yam  us,   12   grs. ; 
twice  a  day. 

derian,  24   grs. ; 
y  four  hours, 
r. ;  strychnine,  2 
)  grs.     Make  80 
;ia. 

ito  12  capsules. 
JO  88. 

;e  of  quinine ;  of 
Take  one  three 

'  soda,  4  drams; 

a  teaspoonful  in 
nervousness. 
20  grs. ;  reduced 

into  30  pills  or 

A  teaspoonful 
produced  within 
["his  is  for  a  child 
additional  year  of 

I,  7  grs. ;  extract 
lies,  and  take  one 


MRDIC1NE8   ANU   THEIK   Pi:RPAKATI0N8. 


927 


9M.  Quinine,  12  grs.;  reduced  iron,  10  grs.;  arsenious  acid,  ^  gr. ; 
phosphide  of  zinc,  2  grs.  Divide  into  24  pills.  Take  one  three  tini':" 
dully  for  ft  child  from  8  to  12  years  of  ago.  For  St.  N'itus's  dance.  Or, 
Fowler's  solution,  1  oz.  (iive  3  drops  to  a  child  of  8  to  12  years  in  a 
little  water  three  times  daily,  and  increase  dose  by  one  drop  every  third 
diiy  till  eyes  become  puffy  or  nose  waters.  Then  stop  for  three  days  and 
begin  again,  (iive  also  pepto-mangan,  1  bottle;  a  teaspoonful  three 
times  daily.  This  latter  is  an  elegant  form  of  mild  iron,  and  does  not 
Htuiu  the  teeth  or  constipate. 

!)!>.  Phenacetin,  50  grs.;  divide  into  6  powders:  give  one  every  two 
houi  «  till  pain  ceases.  Or  chlorodyne,  one  dram ;  aromatic  spirits  of 
anim..nia,  one  dram ;  elixir  simplex,  I  oz.  Mix.  One  teaspoonful  in  a 
tublespoonful  of  hot  water  every  20  minulea  till  relieved. 

100.  Extract  of  high  cranberry  bark,  1  scr. ;  cuocymiu,  ^  scr. ;  iridin, 
J  Mcr. ;  pulverized  cayenne,  1  scr.  Mix.  Make  20  pills.  Take  one  pill 
nil  hour  after  each  meal.  Simpler  yet  is  a  tablesiH>onful  of  crab-orchard 
water  in  ^  glass  plain  water  once  or  twice  a  day. 

101.  Iodide  of  potash,  peppermint  water;  ofeach2ozs.  Give  10 to  30 
drojis  in  J  glass  water  three  times  daily  on  a  full  stomach ;  for  secondary 
and  tertiary  syphilis  and  similar  complaints.  For  a  child  give  5  to  10 
drops. 

102.  Elixir  of  the  three  iodides,  6  ozs. ;  one  teaspcwnful  in  water  three 
times  daily. 

103.  Syrup  of  iodide  of  iron,  1  oz.  Thirty  drops  three  times  a  day,  in 
water.  An  excellent  remedy  in  chlorosis,  and  all  other  low  states  of  the 
bloo<1  connected  with  scrofula.  Or,  a  pill  of  iodide  of  iron,  1  gr.,  three 
times  daily. 

Expectorants  and  Cough  Preparations. 

104.  Apomorphia,  1  gr. ;  chloroform,  10  drops;  elixir  yerba  santa, 
2  ozs.     Take  one  teaspo  )uf ul  every  two  hours. 

105.  Infusion  of  sen'^ga,  4  ozs. ;  syrup  of  ipecac,  1  dram ;  syrup  of 
squills,  3  drams;  tartar  emetic,  1^  grs.  Mix.  A  teaspoonful  every 
ten  minutes. 

106.  Wine  of  ipecac,  IJ  drams;  chloroform,  5  drons;  syrup  of  tolu 
suflicient  to  make  1  oz.  Give  J  teaspoonful  every  two  hours  for  a  child 
three  years  old. 

107.  Tincture  aconite,  20  drops;  wine  of  antimony,  1^  drams;  chloro- 
form, 10  drops;  elixir  terpin  hydrate,  enough  to  make  2  ozs.  Give  tea- 
spoonful every  two  hours. 

108.  Bromoform,  1  oz.  Give  5  drops  in  tablespoonful  of  water  four 
times  daily  to  a  child  eight  years  old  suffering  with  whooping  cough. 
This  dose  is  to  be  well  mixed  and  quickly  given,  because  bromoform  does 
not  mix  well  with  water.  It  is  to  be  increased  by  1  drop  every  other  day 
till  about  10  drops  are  given  at  a  dose.  Other  ages  in  proportion.  Burn 
also  a  cresolene  lamp. 

109.  Tincture  bloodroot,  4 J  ozs.;  wine  of  ipecac,  2  drams;  tincture  of 
aconite  20  drops;  honey,  ^  oz. ;  McMunn's  elixir,  IJ  drams;  elixir  yerba 
santa  to  make  3  oze.     Take  teaspoonful  every  two  hours. 


I.     ■, 


:);. 


'5-1, 


'<<nps<IW(mi 


MKDICINK8    AND  THEIK   PKKFARATIONS. 

110.  Wine  of  ipeonc,  2  drams;  chloroform,  1ft  drops;  liquid  Dover's, 

1  dram ;  linoline,  or  compound  emulsion  of  flax-seed  (omitting  the  chloral 
and  morphine)  enough  to  make  3  ozs.  One  teaspoouful  every  two  hours: 
for  hard,  dry  cough. 

111.  Tincture  of  lobelia,  2  drams;  tincture  of  bloodroot,  4  drams; 
honey,  1  oz. ;  dilute  hydrocyanic  acid,  1^  drams;  cherry-laurel  water 
enough  to  make  3  ozs.     Give  one  teasi)oonful  every  two  hours. 

112.  Syrup  of  tolu,  1  oz. ;  syrup  of  squills,  ^  oz. ;  wine  of  ipecac, 
2dr>imH;  codeia,  2  grs. ;  mucilage  of  gum-arabic,  1^'ozs.  Mix.  Take 
a  tenspoonful  occasionally. 

118.  Tincture  bloodroot,  2  drams;  syrup  of  tolu,  1  oz. ;  mucilage  of 
gum-arabic,  3  ozs. ;  diluted  hydrocyanic  acid,  40  drops ;  codeia,  4  grs. 
Mix.     Dose,  from  oue  to  two  teaspoonfuls. 

Carminatives. 

Aromatic  spirits  of  ammonia,  2  drams ;  tincture  of  cardamom  com- 
pound, 1  oz. ;  tincture  of  capsicum,  10  drops;  chloroform,  15  drops; 
spirits  of  lavender  compound  enough  to  make  2  ozs.  Give  teaspoonful  iu 
wineglass  of  hot  water  every  fifteen  minutes  till  relieved. 

115.  Compound  tincture  of  cardamom,  2  ozs.;  compound  tincture  of 
lavender  2  ozs ;  Hayden's  Viburnum  Compound,  2  ozs.  Mix.  One  tea- 
spoonful  at  a  time,  as  occasion  may  require. 

Narcotics  and  Anodynes. 

116.  Hayden's  viburnum  compound,  or  dioviburnum.  One  teaspoon- 
ful every  ^  hour  while  in  pain.  Two  tablespoonfuls  of  gin,  and  even  of 
brandy  in  hot  water  also  relieve  at  times. 

117.  Powdered  camphor,  12  grs.;  powdered  Castile  soap,  12  grs.; 
codeia,  4  grs. ;  syrup,  2  scrs.  Mix.  Make  into  12  pills.  Take  oue 
every  hour  till  the  eflfects  of  opium  are  experienced. 

118.  Laudanum,  ^  oz. ;  wine  of  ipecac,  ^  oz. ;  spirits  of  nitric  ether, 
}  oz.    Mix.    One  teaspoonful  every  hour,  till  narcotic  effects  are  observed. 

119.  Camphor,  2  drams;  chloroform,  1  dram;  the  yoke  of  an  egg. 
Mix,  and  rub  together ;  and  then  add,  MoMunn's  elixir,  3  drams ;  aromat- 
ic spirits  of  ammonia,  1  oz.  Mix  well.  Take  one  teaspoonful  every 
hour  until  it  proves  anodyne. 

120.  Camphor,  ^  dram ;  extract  of  hyoscyamus,  20  grs. ;  mucilage  of 
gum-arabic,  2  scrs.     Make  10  pills. 

121.  Chloroform,  2  ozs. ;  compound  sulphuric  ether,  2  ozs. ;  cardamom, 

2  ozs. ;  tincture  cayenne,  1^  ozs. ;  hydrocyanic  acid,  diluted,  ^  oz.  Mix. 
Dose,  half  a  teaspoonful  every  three  hours  till  anodyne  effects  are  exper- 
ienced. 

122.  Extract  of  belladonna,  10  grs.;  hydrocyanic  acid,  40  drops; 
tincture  Colombo,  1  oz. ;  simple  syrup,  1  oz. ;  soft  water,  2  ozs.  Mix. 
One  teaspoonful  three  or  four  times  a  day.  Excellent  in  gastralgia  and 
irritable  dyspepsia.     Also  in  asthma. 

123.  Extract  of  belladonna,  6  grs. ;  pulverized  ipecac,  10  grs. ;  con- 
fection of  roses,  2  grs.     Mix.     Make  30  pills.     Take  1  pill  twice  a  day. 


TTfA. 


;  liquid  Dover's, 
litting  the  chloral 
Bvery  two  hours : 

Jroot,  4  drnniH; 
Grry-laurel  water 
liours. 

wine  of  ipecac, 
18.     Mix.     Taice 

9Z. ;  mucilage  of 
I ;  codeia,  4  grs. 


f  cardamom  com- 
'orm,  15  drops; 
/e  teaspoonful  iu 

ound  tiucture  of 
Mix.     One  tea- 


One  teaepoon- 
;in,  and  even  of 

soap,    12  grs. ; 
pills.     Take  one 

I  of  nitric  ether, 
cts  are  observed. 

oke   of   an  egg. 

drams ;  aromat- 

laspoonful  every 

rs. :  mucilage  of 

)Z8. ;  cardamom, 
ited,  i  oz.  Mix. 
ffects  are  exper- 

acid,  40  drops; 
er,  2  OZ8.  Mix. 
in  gastralgia  and 

c,  10  grs. ;  cou- 
pill  twice  a  day. 


MKUIC1NK8   AND  THEIR  PREfAKATIONB. 


Diaphoretics  and  Sedatives. 


929 


124.  Tincture  of  American  hellebore,  1  dram;  tinctureof  blank  cohosh, 
2  oza.  Mix.  Take  one  teaspoonful  from  three  to  six  times  a  day. 
Excellent  for  neuralgia. 

I2fi.  I*idverized  gum  arabic,  1  scr. ;  soft  water,  2  ozs. ;  sweet  spirits 
of  nitre,  ^  oz. ;  tincture  of  veratrum  viride,  20  drops.  Mix.  Give  half 
a  tetispoonful  every  half  hour. 

12(>.  Phenaoetine,  10  grs.  taken  on  tongue  with  a  glass  of  hot  lemon- 
ade ;  children  in  proportion  to  uge. 

127.  Dover's  powder,  10  grs.  on  retiring,  taken  with  hot  drink. 


Diuretics. 


Tea- 


128.  Spirits  of  Mindererus,  2  02.3. ;  sweet  spirits  of  nitre,  1  oz. 
spoonful  every  three  hours.     10  to  80  drops,  diluted,  for  children. 

12*J.  Diuretin,  10  grs,  every  two  hours. 

1<)0.  Infusion  of  digitalis,  4  ozs.;  acetate  of  potash,  2  drams;  sweet 
spirits  of  nitre,  2  drams;  cinnamon  water,  1^  ozs.  Mix.  A  tablespoon- 
ful  every  four  or  five  hours. 

131.  Acetate  of  potash,  4  drams;  lemon  juice,  1  oz. ;  syrup  and  water 
of  each,  1  oz.     Teaspoonful  iu  wineglass  of  water  every  two  hours. 

Refrigerants. 

132.  Cream  of  tartar,  2  scrs. ;  water,  1  quart.     Mix.     Flavor  to  suit. 

133.  Bicarbonate  of  soda,  30  grs. ;  water,  6  ozs.  Mix.  To  this  mix- 
ture adi  25  grs.  of  tarte.ric  acid,  and  take  the  whole  foaming. 

Stimulants. 

134.  Muriate  of  ammonia,  1  oz. ;  soft  water,  9  ozs.  Mix.  Ir.l.e  one 
tablespoonful  three  or  four  times  a  day. 

135.  Aromatic  spirits  of  ammonia,  2  drams;  ethei,  1  dram;  chloro- 
dyne,  20  drops ;  spirits  of  camphor,  1  dram.  Mix.  Half  a  teaspoonful 
as  often  as  required. 

Alteratives. 

136.  Proto-iodide  of  mercury,  5  grs. ;  extract  of  opium,  5  grs.  Mix. 
Make  20  pills.     Take  one  pill  night  and  morning.     For  syphilis. 

137.  Biniodide  of  mercury,  5  grs.;  extract  of  conium,  2  scrs.  Mix. 
Make  20  pills.     Take  one  pill  night  and  morning.     For  syphilis. 

138.  Compound  infusion  of  sarsaparilla,  1  pint;  iodide  of  potassium, 
i  oz.    Mix.     Take  a  teaspoonful  after  each  meal. 

139.  Compound  infusion  of  sursaparilla,  1  pint;  corrosive  sublimate, 
4  grs.     Mix.     Take  a  teaspoonful  four  times  a  day.     For  syphilis. 

140.  Compound  infusion  of  gentian,  4  ozs. ;  iodide  of  potassium,  J  oz. 
Mix.     One  teaspoonful  after  each  meal,  well  diluted. 


930 


MEDICINES  AND  THEIR   PREPARATIONS. 


141.  Iodide  of  arsenic,  5  grs. ;  soft  water,  1  pint.  Mix.  One  tea- 
spoonful  three  times  a  day. 

142.  Blue  pill,  12  grs. ;  pulverized  ipecac,  3  grs. ;  extract  of  hy^s- 
cyarauB,  4  grs.  Mix.  Divide  into  12  parts,  one  to  be  given  every  three 
hours.     For  syphilis. 

143.  Pulverized  bloodroot,  1  scr. ;  iodide  of  arsenic,  2  grs. ;  extract 
of  cicuta,  2  scrs.     Mix.     Make  40  pills.     One  pill  three  times  a  day. 

144.  Iodide  of  potassium,  1  dram ;  water,  J  oz.  Mix.  Thirty  drops 
to  a  child  7  years  old,  every  hour. 

145.  Compound  syrup  of  stillingia,  1  pint;  iodide  of  potassium,  1  oz. 
Mix.     A  tablespoonful  after  each  meal. 

146.  Fluid  extract  of  sarsaparilla,  4  ozs. ;  fluid  extract  of  pipsissewa, 
1  oz. ;  water,  1  quart ;  iodide  of  potassium,  2  ozs.  Mix.  Take  a  table- 
spoonful  three  times  a  day. 

147.  Bicarbonate  of  potassa,  3  drams;  water,  4  ozs.  Mix.  Add  a 
tablespoonful  of  the  solution  to  the  same  quantity  of  lemon  juice,  pre- 
viously mixed  with  a  tablespoonful  of  water.  To  be  taken  foaming, 
several  times  a  day. 

148.  Blue  pill,  ^  dram;  extract  of  henbane,  1  scr.  Make  10  pills. 
One  pill  at  night.     For  syphilis. 

149.  Mercury  with  chalk,  J  dram;  extract  of  conium,  1  scr.  Make 
into  8  pills.     Take  one  pill  night  and  morning.     For  syphilis. 

150.  Corrosive  sublimate,  4  grs. ;  extract  of  opium,  5  grs.  Mix,  and 
make  into  20  pills.     Take  one  pill  night  and  morning.     For  syphilis. 

151.  Iodide  of  potassium,  1  dram;  syrup  of  sarsaparilla,  4  ozs.  Mix. 
Take  two  teaspopnfuls  three  times  a  day.    For  syphilis. 


Astringents. 

152.  Sugar  of  lead,  2  scrs.;  ergotine,  1  scr.;  conserve  of  red  roses, 
1  scr.  Beat  into  a  mo'!S,  which  is  to  be  divided  into  30  pills.  Take  one 
every  hour,  until  beneficial  effects  are  observed. 

153.  TuUy's  powder,  J  dram;  prepared  chalk,  1  scr.  Mix,  and  divide 
into  12  equal  powders. 

154.  Chalk  mixture,  4  ozs. ;  tincture  of  catechu,  ^  oz. ;  papiue,  3 
drams.  Mix.  Dose,  in  diarrhoea,  two  to  four  teaspoonfuls  three  times 
a  day. 

155.  Oil  of  turpentine,  1  dram;  mucilage  of  gum  arable,  1  dram; 
simple  syrup,  ^  oz. ;  cinnamon  water,  2  ozs.  Mix.  To  be  taken  at  a 
draught. 

156.  Sugar  of  lead,  16  grs.;  prepared  chalk,  1  dram;  pulverized  ipe- 
cac, 4  grs.;  pulverized  opium,  2  grs.  Mix.  Divide  into  16  portions, 
one  to  be  given  every  three  or  four  hours. 

157.  Sugar  of  lead,  8  grs.;  vinegar,  8  drops;  white  sugar,  1  dram; 
soft  water,  1  oz.  Mix.  A  teaspoonful  three  or  four  times  a  day,  until 
the  discharges  are  abated. 

158.  Prepared  chalk,  ^  dram ;  pulverized  ipecac,  3  grs.  Mix.  Make 
12  powders.     (Jive  one,  two  or  three  times  a  day. 


MEDICINES   AND   THEIR   PREPARATIONS. 


931 


Mix.  One  tea- 
extract  of  hy^a- 
given  every  three 

c,  2  grs. ;  extnict 
;e  times  a  clay. 
[ix.     Thirty  drops 

)f  potassium,  1  oz. 

•act  of  pipsissewa, 
ix.     Take  a  table- 

iZ8.  Mix.  Add  a 
f  lemon  juice,  pre- 
)e  taken   foaming, 

•.     Make   10  pills. 

um,  1  scr.     Make 

yphilis. 

1,  5  grs.     Mix,  and 

For  syphilis, 
irilla,  4  ozs.    Mix. 

3. 


jerve  of  red  roses, 

0  pills.     Take  one 

Mix,  and  divide 

^  oz. ;  papine,  3 
>onfuls  three  times 

1  arable,  1   dram; 
To  be  taken  at  a 

,m;  pulverized  ipe- 
B  into  16  portions, 

ite  sugar,  1  dram; 
times  a  day,  until 

grs.     Mix.     Make 


159.  Pulverized  catechu,  2  drams ;  bruised  cinnamon,  ^  dram ;  boiling 
water,  5  ozs.  Steep  in  a  covered  vessel  for  one  hour  and  strain.  A  tea- 
spoonful  every  two,  three,  or  four  hours,  according  to  age,  nature  of  the 
case,  etc. 

160.  Soft  water,  1  oz. ;  sugar  of  lead,  5  grs.;  vinegar,  6  drops;  loaf 
sugar,  3  drams.     Mix.     A  teaspoonful  every  hour  or  two. 

161.  Tincture  of  catechu,  ^  oz. ;  laudanum,  2  drams;  spirits  of  cam- 
plior,  2  drams;  tincture  of  myrrbse,  2  drams;  tincture  of  cayenne,  2 
drams.  Mix.  Dose,  from  half  a  teaspoonful  to  a  teaspoonful,  for 
diavrha'a. 

162.  Syrup  of  orange-peel,  1  oz. ;  tincture  of  catechu,  2  grs. ;  tincture 
of  cinnamon,  6  drams;  tincture  of  cardamom,  2  drams.  Mix.  Dose,  a 
teaspoonful.     A  valuable  remedy  in  diarrhoea. 

.  Counter-irritants. 

163.  T'licture  of  Spanish  flies,  1  oz. ;  olive  oil,  2  ozs. ;  alcohol,  4  pint. 
Miv  To  be  applied  externally,  watching  the  effect,  so  as  not  to  produce 
a  blister. 

164.  Water  of  ammonia,  1  dram;  olive  oil,  1  oz.  Mix.  Apply  to 
the  skin. 

165.  Mustard  powder,  1  tablespoonful.  Mix  with  a  little  water  to 
make  a  thick  paste.  Then  spread  upon  a  piece  of  brown  paper  or  cotton 
cloth,  and  cover  its  surface  with  a  piece  of  thin  muslin  to  prevent  the 
mustard  from  sticking  to  the  flesh.  Place  it  upon  the  sore  or  painful  part, 
and  keep  it  on  fifteen  or  twenty  minutes,  or  till  a  good  degree  of  redness 
is  produced. 

166.  Vinegar  of  Spanish  flies,  1  oz. ;  spirits  of  camphor,  1  oz.  Mix. 
To  be  rubbed  gently  upon  the  skin.  If  applied  freely,  and  rubbed 
thoroughly  in,  it  may  produce  a  blister. 

167.  Yellow  wax,  rosin,  lard,  each,  6  drams.  Melt  over  a  slow  fire, 
and  then  stir  in  slowly,  when  at  a  very  moderate  degree  of  warmth,  1  j 
drams  of  pulverized  Spanish  flies,  to  make  an  ointment. 

168.  Water  of  ammonia,  strong,  1  oz. ;  alcohol,  1  oz.  Mix.  Wet  a 
piece  of  cotton  cloth,  and  lay  it  upon  the  painful  part,  and  cover  it  with 
flannel  to  prevent  evaporation. 

Ointments. 

169.  Mercurial  ointment,  1  oz. ;  extract  of  belladonna,  1  oz. ;  extract 
of  henbane,  1  oz. ;  camphor,  10  grs.     Mix.     For  external  use. 

170.  Extract  of  belladonna,  J  dram;  vaseline,  ^  oz.  Mix.  To  be 
rubbed  on  the  neck  of  the  womb  in  painful  menstruation. 

171.  Prussic  acid, -2  drams;  sugar  of  lead,  1  dram;  cocoanut  oil,  J 
oz. ;     aseline,  ^  oz.     Make  an  ointment. 

172.  Neapolitan  ointment,  2  drams,  extract  of  belladonna,  1  dram. 
Mix. 

173.  Extract  of  belladonna,  15  grs. ;  vaseline,  1  oz.     Mix. 


i  IREi 


932 


MBmriNRS   AND   THEIR   PREPARATIONS. 


174.  Sulphuret  of  lime,  1  dram;  camphor,  in  powder,  l.*)  grs. ;  vaseline, 

1  oz.     Make  an  ointment. 

175.  Elder-flower  ointment,  1  oz. ;  oxide  of  zinc,  1  dram.  Malce  an 
ointment. 

176.  Oxide  of  zinc,  ointment,  1  oz. 

177.  Naphthaline,  2  scrs. ;  vaseline,  1  oz.  Make  an  ointment.  To  be 
spread  upon  linen,  and  applied  to  the  diseased  skin  night  and  morning. 

178.  Mild  nitrate  of  mercury  ointment,  3  drams;  sugar  of  lead,  16 
grs. ;  rose-water  ointment,  1  oz. 

179.  Laudanum,  ^dram;  sulphur,  ^dram;  oxide  of  zinc,  1  dram;  oil 
of  almonds,  1  oz. ;  vaseline,  3  ozs.     Make  in  ointment. 

180.  Olive  oil,  4  ozs. ;  white  wax,  2  drams.  Melt  these  together,  and 
then  add  honey,  2  drams ;  croton  oil,  20  drops. 

181.  Elder-flower  ointment,  1  oz. ;  pulverized  blue  vitriol,  1  scr. 
Make  an  ointment. 

182.  Purified  beeves'  marrow,  or  lard,  6  drams;  oil  of  sweet  almonds, 

2  drams ;  pulverized  Peruvian  bark,  1  dram.     Mix. 

183.  Pulverized  sulphate  of  copper,  10  grs.;  extract  of  Spanish  flies, 
5  grs. ;  vaseline,  1  oz.     Mix.     Rub  into  the  scalp. 

184.  Iodide  of  lead,  1  dram;  vaseline,  2  ozs.  Mix.  To  be  rubbed 
on  the  surface. 

185.  Iodide  of  potassium,  1  dram;  vaseline,  2  ozs.     Mix. 

186.  Basilicon  ointment,  1  oz. ;  red  precipitate,  1  dram.     Mix. 

187.  Iodide  of  potassium,  ^  dram ;  vaseline,  1  oz.     Mix. 

188.  Veratria,  4  grs. ;  vaseline,  5  drams.     Mix. 

189.  Tobacco  leaves  (fresh  and  sliced),  10  ozs. ;  diluted  acetic  acid,  4 
pints;  basilicon  ointment,  13  ozs.  Boil  the  tobacco  in  the  acid,  strain, 
and  evaporate  the  decoction  to  six  ounces.  Add  this  to  the  basilicon 
ointcient,  heated,  and  stir  till  cold.     For  gathered  breasts. 

Liniments. 

190.  Sweet  oil,  1  oz. ;  strong  water  of  ammonia,  1  oz.  Mix.  To  be 
robbed  on  with  a  piece  of  flannel. 

191.  Lime-water,  2  ozs. ;  flax-seed  oil,  2  ozs.    Mix.    Apply  outwardly. 

192.  Olive-oil,  1  oz. ;  solution  of  potassa,  2  drams;  strong  mercurial 
ointment,  1  dram.     Mix. 

193.  Olive-oil,  4  ozs. ;  oil  of  amber,  2  drams ;  oil  of  rosemary,  2 
drams.     Mix. 

194.  Spirits  of  turpentine,  1  oz. ;  linseed  oil,  1  oz. ;  lime-water,  1  oz. 
Mix.     For  external  use. 

195.  Oil  of  hemlock,  2  drams;  oil  of  origanum,  1  dram;  camphor,  1 
dram ;  opium,  1  dram ;  alcohol,  4  ozs.     Mix. 

196.  Soap  liniment,  2  ozs.;  chloroform,  1  dram.     Mix. 

197.  Tincture  of  aconite-root,  <^  oz. ;  opium  liniment,  ^  oz.  Mix. 
For  neuralgia,  etc.     Apply  a  teaspoonful  to  tlic  ]>ninful  part. 


'^'iiut^i^^  ■  .vv^^>M.  .>.-  ^,KMm^^i^mM^<mm^iMYmi^ii!iiM»a  'mismiMSsm< 


l/i  grs. ;  vaseline, 
dram.     Make  an 

ointment.     To  be 
t  and  morning, 
ugar  of   lead,  16 

zinc,  1  dram ;  oil 

ese  together,  and 

?    vitriol,    1     scr. 

f  sweet  almonds, 

of  Spanish  flies, 

:.     To  be  rubbed 

Mix. 

.m.     Mix. 
lix. 

ited  acetic  acid,  4 
.  the  acid,  strain, 
to  the  basilicoD 
ts. 


>z.     Mix.     To  be 

Apply  outwai-dly. 
strong  mercurial 

I   of   rosemary,  2 

lime-water,  1  oz. 

iram ;  camphor,  1 

iz. 

ent,  ^  oz.     Mix. 

part. 


MEDICINES   AND  THEIR   PREPARATIONS. 


933 


198.  White  soap,  12  ozs. ;  camphor,  6  ozs. ;  oil  of  rosemary,  1^  ozs. ; 
alcohol,  4  pints ;  opium,  3  ozs.  Mix  and  filter.  An  excellent  liniment, 
acting  at  times  like  a  charm  in  the  removal  of  local  pains. 

199.  Sulphuric  acid,  1  dram;  spirits  of  turpentine,  1  dram;  olive  oil, 
3  drams.  Mix  the  oil  and  spirits  of  turpentine  first,  then  gradually  add 
the  sulphuric  acid.  A  valuable  liniment  for  chilblains.  To  be  rubbed  on 
two  or  three  times  a  day. 

Washes,  Lotions,  Gargles,  etc. 

200.  Bruised  white-oak  bark,  1  oz. ;  water,  1^  pints.  Boil  down  to  a 
pint,  and  strain.     To  be  used  as  a  wash. 

201.  Borate  of  soda  or  borax,  2  drams;  water,  4  ozs.  Mix.  To  be 
used  as  a  lotion. 

202.  Alum,  2  drams ;  water,  4  ozs.     Mix.     To  be  used  as  a  lotion. 

203.  Tannin,  1  ecr. ;  water,  4  ozs.     Mix.     For  external  use. 

204.  Biborate  of  soda,  ^  oz. ;  rose  water,  6  ozs. ;  sulphate  of  morphia,  6 
grs.     Mix.     To  be  used  as  a  wash  in  itching  of  the  female  privates. 

205.  Chlorinated  soda,  1  oz. ;  water,  12  ozs.  Mix.  Rinse  the  mouth 
with  it  two  or  three  times  a  day,  but  do  not  swallow. 

207.  Rose-water,  5  ozs.;  sugar  of  lead,  8  grs.;  sulphate  of  zinc,  8 
grs.     Mix. 

208.  Rose-water,  4  J  ozs. ;  nitrate  of  silver,  2  grs.     Mix. 

209.  Sulphate  of  zinc,  8  grs. ;  tannin,  1  scr. ;  water,  5  ozs.     Mix. 

210.  Chloride  of  zinc,  6  grs. ;  soft  water,  2  ozs.     Mix. 

211.  Nitrate  of  silver,  10  grs. ;  soft  water,  1  oz.     Mix. 

212.  Corrosive  sublimate,  5  grs. ;  soft  water,  1  pint.     Mix. 

213.  Alcohol,  1  pint;  soft  soap  of  potash,  1  pint.  Dissolve  and  filter, 
then  add  oil  of  citron,  1  oz.  Mix.  It  will  answer  a  good  purpose  if  the 
oil  of  citron  be  omitted. 

214.  Nitrate  of  silver,  2  scr. ;  nitric  acid,  12  drops;  soft  water,  1  oz. 
Mix.    Apply  with  a  piece  of  lint  tied  to  the  end  of  a  stick. 

215.  Copperas,  1  oz. ;  soft  water,  1  pint.     Mix. 

216.  Alcoho'.,  Ij  ozs. ;  rose-water,  4  ozs.     Mix. 

217.  Corrosive  sublimate,  6  grs. ;  spirits  of  rosemary,  1  oz. ;  alcohol,  1 
oz. ;  emulsion  of  bitter  almonds,  6  ozs.     Mix. 

218.  Solution  of  Buga;r  of  lead,  12  drops;  laudanum,  1  dram;  water,  4 
ozs.     Mix.     To  be  applied  exterijally  only. 

219.  Nitrate  of  silver,  1}  drams  ;  soft  water,  1  oz.     Mix. 

220.  White  vitriol,  1  dram  ;  rose-water,  3  ozs.    Mix.    Apply  outwardly. 

221.  Hydrocyanic  acid,  4  drams ;  sugar  of  lead,  15  grs. ;  alcohol,  4 
drams ;  water,  7  ozs.     Mix.     Apply  externally. 

222.  Corrosive  sublimate,  5  grs. :  almond  mixture,  •}  pint.  Mix.  Ap- 
ply externally. 

223.  Rose-water,  4  ozs. ;  pulverized  borax,  }  oz. ;  sulphate  of  morphine, 
6  grs.     Mix.     To  be  applied  to  the  parts  many  times  a  day. 


a^iiasE 


934 


MEDICINES   AND   THEIR   PREPARATIONS. 


224.  Sugar  of  lead,  2  drams ;  laudanum,  1  dram ;  soft  water,  i  piut. 
Mix.     For  external  use. 

225.  Corrosive  sublimate,  5  grs. ;  cologne,  2  ozs. ;  soft  water,  6  ozs. 
Mix.     For  external  use  only. 

226.  Acid  nitrate  of  mercury,  1  dram ;  soft  water,  4  ozs.  Mix.  Apply 
every  second  day. 

227.  Sugar  of  lead,  3  grs. ;  soft  water,  1  oz.  Mix.  As  a  wash  in  in- 
flammation of  the  mouth  in  infants. 

228.  Mucilage  of  gum  arabic,  1  oz. ;  syrup  of  orange-peel,  i  oz. ; 
chloride  of  lime,  15  grs.     Mix. 

229.  Decoction  of  Peruvian  bark,  3  ozs. ;  syrup  of  orange-peel,  1  oz. ; 
chloride  of  soda,  1  oz.     Mix. 

230.  Creosote,  4  drops  ;  mucilage  of  gum-arabic,  i  oz. ;  camphor-water, 
8  ozs.     Mix. 

231.  Vinegar,  1  dram;  alcohol,  3  drams;  simple  syrup,  1  oz. ;  water, 
8  ozs.     Mix. 

232.  White-oak  bark,  1  oz. ;  water,  1  pint.  Boil  away  one  quarter,  and 
strain ;  then  add  alum,  1  scr.  Apply  to  the  parts  with  a  soft  sponge,  or 
dossil  of  lint,  several  times  a  day. 

233.  Hydrochloric  acid,  i  dram ;  honey,  1  oz. ;  rose-water,  1  oz.  Mix. 
Apply  three  or  four  times  a  day. 

234.  Sulphate  of  copper,  i  dram ;  soft  water,  1  oz.  Mix.  To  be  ap- 
plied twice  a  day  to  the  ulcers  in  gangrene  of  the  mouth. 

235.  White  vitriol,  1  dram ;  soft  water,  2  drams.  Mix.  Then  add 
honey,  2  drams ;  tincture  of  myrrh,  2  drams.  To  be  applied  twice  a  day 
to  the  ulcers  in  gangrene  of  the  mouth. 

236.  Creosote,  1  dram ;  alcohol,  1  dram.  Mix.  To  be  applied,  with  a 
camel's-liair  pencil,  to  the  gangrenous  ulcers  of  the  mouth,  after  running  a 
lancet  through  the  sloughs,  and  touch  with  a  little  strong  carbolic  acid  till 
surface  is  white.     Can  repeat  next  day. 

237.  Acid  nitrate  of  mercury,  i  dram  ;  soft  water,  1  oz.  Mix.  To  be 
injected  into  the  throat  with  the  shower-syringe,  or  applied  to  ulcers  with 
a  camel's-hair  pencil. 

238.  Rose-water,  4  ozs. ;  sugar  of  lead,  2  drams.  Mix.  For  external 
use. 

239.  Rose-water,  ?,  ozs.;  sugar  of  lead,  1  scruple.  Mix.  For  ex- 
ternal use. 

240.  Tincture  of  arnica,  J  oz. ;  cold  water,  4  ozs.  Mix.  For  external 
use. 

241.  Tincture  bloodroot,  2  ozs.;  solution  chloride  of  soda,  2  ozs.; 
tinct.  henbane,  2  ozs.     Mix. 

2ci!.  Bucket  of  warm  water ;  cayenne  pepper,  pulverized,  1  tablespoou- 
ful ;  ground  mustard,  2  tablespoonfuls.  Mix.  As  a  foot-bath  in  sup- 
pression, etc. 

243.  Chlorate  of  potash,  i  oz. ;  strong  hydrochloric  acid,  40  drops; 
water,  1  pint.  Mix.  An  excellent  wash  for  chronic  fetid  ulcers,  — soon 
converting  a  foul  ulcer  to  a  healthy-looking  one.     A  good  gargle. 


ft  water,  i  pint. 

ft  water,  6  ozs. 

8.    Mix.    Apply 

s  a  wash  in  in- 

ge-peel,    i   oz. ; 

inge-peel,  1  oz. ; 

camphor-water, 

p,  1  oz. ;  water, 

one  quarter,  and 
soft  sponge,  or 

iter,  1  oz.     Mix. 

lix.    To  be  ap- 

lix.  Then  add 
lied  twice  a  day 

s  applied,  with  a 
,  after  running  a 
carbolic  acid  till 

5.  Mix.  To  be 
d  to  ulcers  with 

I.     For  external 

Mix.     For  ex- 

X.    For  externiil 

f  soda,  2  ozs. ; 

id,  1  tablespoon- 
oot-bath  in  sup- 
acid,  40  drops; 
d  ulcers,  —  soon 
gargle. 


MEDICINES   AND  THEIR   PREPARATIONS. 


935 


244.  Powdered  golden  seal,  1  dram ;  powdered  cranesbill,  1  dram ; 
powdered  witch-hazel  bark,  1  dram.  Mix.  Pour  upon  these  half  a  pint 
of  boiling  water.  Let  them  stand  till  cold.  To  swab  an  ulcerated  throat 
in  scarlet  fever,  and  for  other  purposes.  Still  better,  listerine,  1  oz. ;  per- 
oxide c '  '  "'I'-ogen,  2  ozs. ;  water,  1  oz.     Use  as  a  gargle. 

245.  Pulverized  cayenne,  1  dram;  salt,  1  dram;  boiling  water,  1  gill. 
Mix,  and  let  them  stand  fifteen  minutes.  Then  add  one  gill  of  vinegar. 
Let  them  stand  an  hour,  and  strain.  Put  a  teaspoonful  in  a  child's  mouth 
once  an  hour,  in  maliguant  scarlet  fever. 

Injections.    ^  " 

246.  Castor  oil,  1  gill;  pulv.  cayenne,  10  grs. ;  molasses,  1  gill;  table 
salt,  1  teaspoonful ;  warm  water,  1  pint.     Mix. 

247.  Senna  leaves,  2  drams.  Steep  in  a  pint  of  water.  Then  add  one 
ounce  of  epsom  salts,  and  strain.  A  quarter  of  this  may  also  be  taken  as 
a  brisk  purge. 

248.  Castor  oil,  2  ozs. ;  tincture  prickly-ash  bark,  J  oz. ;  comp.  tinct. 
of  Virginia  snake-root,  2  drams ;  infusion  of  boneset  and  senna,  equal 
parts,  J  pint.     Mix. 

249.  Castor  oil,  1  oz. ;  salts  of  tartar,  ^  oz. ;  warm  water,  1  pint.    Mix. 

250.  Epsom  salts,  1  oz. ;  senna  leaves,  ^  oz. ;  pulv.  cayenne,  10  grs. ; 
boiling  water,  1  pint.  Let  the  water  stand  upon  the  senna  and  cayenne 
fifteen  minutes.     Then  pour  it  off,  and  add  the  salts. 

251.  Thoroughwort,  1  oz. ;  senna,  1  oz. ;  lobelia,  ^  dram ;  cayenne,  10 
grs. ;  epsom  salts,  1  tablespoonf ul ;  molasses,  J  pint ;  boiling  water,  1 
pint.  Make  a  strong  decoction  of  the  herbs,  and  then  add  the  salt  and 
molasses. 

252.  Wine  of  ipecac,  1  oz. ;  spirits  of  turpentine,  1  oz. ;  castor  oil,  1 
oz. ;  molasBcs,  J  pint;  warm  water,  J  pint.    Mix. 

253.  Flax-seed  tea,  i  pint;  laudanum,  40  drops.     Mix. 

254.  Nitrate  of  silver  Crystals,  10  grains;  corrosive  sublimate,  5  grs.; 
sugar  of  lead,  IJ  drams;  white  vitriol,  IJ  drams;  soft  water,  6  ounces. 
Mix.  An  injection  for  certain  forms  of  whites,  etc.  Or  corrosive  sublimate 
tablets,  1  to  3  pints  of  water  used  night  and  morning. 

255.  Bruised  galls,  J  oz. ;  two  large  poppy-heads ;  watt  "  pint.  Boil 
a  quarter  of  an  hour,  and  strain.     For  piles. 

256.  Common  salt,  1  oz. ;  chamomile  flowers,  ^oz. ;  pulv.  aioes,  1  dram. 
Boil  the  chamomile  and  aloes  five  minutes,  in  one  pint  of  water,  then  strain 
and  add  the  salt. 

Hair-Oils,  Washes,  etc. 

257.  Cologne,  2  ozs. ;  tincture  of  Spanish  ilies,  2  drams ;  oil  of  rose- 
mary, 10  drops;  oil  of  lavender,  10  drops.  Mix.  Apply  cautiously.  If 
soreness  of  the  scalp  is  produced,  omit  for  a  short  time. 

258.  Castor  oil,  2 J  pounds;  strongest  alcohol,  2 J  pints;  pulverized 
Spanish  flies,  J  oz. ;  oil  of  bergamot,  2^  ozs. ;  otto  of  roses,  20  drops. 


936 


MEDICINES   AND   THEIR   PKEPARATI0N8. 


Mix.     Let  them  stand  for  a  few  days,  and  filter.     A  superior  preparation 
for  keeping  ttie  hair  from  falling,  and  to  prevent  dandruff. 

259.  Tincture  benzoin  comp.,  2  drams;  tinct.  Spanish  flieti,  2  drams; 
castor  oil,  6  ozs. ;  oil  bergamot,  1  drtim;  oil  of  cassia  or  verbena,  15 
drops ;  strong  alcohol,  9^  ozs.  Mix.  As  a  hair  wash,  better  even  than 
the  above. 

260.  Slaked  lime,  2  drams ;  bicarbonate  of  soda,  8  drams ;  lard,  2  ozs. 
Mix. 

261.  Slaked  lime,  1  oz. ;  bicarbonate  of  potassa,  2  ozs.;  charcoal  in 
powder,  1  dram.  Mix.  Apply  to  the  parts,  and  wash  off  when  dry. 
Keep  in  well  stopped  bottles. 

26?  Slaked  lime,  4  ozs. ;  orris  powder,  IJ  ozs.  Mix.  Apply  to  the 
parts,  and  wash  off  when  dry. 

263.  Spanish  white,  ^  pound ;  litharge,  ^  pound ;  slaked  lime,  ^  pound. 
Mix.  Pulverize  in  a  mortar.  To  be  kept  dry.  When  used,  mix  with 
water  to  a  paste  the  thickness  of  cream.  Spread  on  the  hair  and  lay  over 
it  a  wet  cloth  over  night. 

264.  Sulphur,  1  oz ;  sugar  of  lead,  1  oz. ;  rose-water,  4  ozs.  Mix. 
Apply  to  the  hair. 

266.  Nitrate  of  silver,  1  dram;  nitric  acid,  1  dram;  soft  water,  1  pint; 
sap  green,  8  drams;  pulverized  gum-arabic,  1  dram.  Mix.  Keep  well 
corked. 

266.  Hydrosulphuret  of  ammonia,  1  oz. ;  liquor  potassa,  3  drams;  soft 
water,  1  oz.  Mix.  Apply  this  with  a  tooth-brush  fifteen  or  twenty  minutes. 
Then  brush  the  hair  over  with  the  following :  nitrate  of  silver,  1  dram ; 
soft  water,  2  ozs.,  using  ^  clean  comb  to  separate  the  hair. 


niscellaneous. 

267.  Fluid  extract  of  spurred  rye,  2  ozs.  Dose,  one  teaapoonfnl  three 
times  a  day.    For  profuse  menstruation  from  a  relaxed  state  of  the  womb. 

268.  Sulphate  of  iron,  1  dram ;  su b- carbonate  of  potash,  1  dram.  Mix, 
and  make  into  38  pills.  One  pill  twice  a  day,  and  gradually  increasing  to 
four  a  day,  in  chlorosis. 

269.  Sulphate  of  iron,  1  dram;  extract  of  hops,  15  grs. ;  extract  of 
poppies,  15  grs. ;  oil  of  cinnamon,  15  drops.  Mix,  and  make  into  24 
pills.     One  pill  two  or  three  times  a  day. 

270.  Oxide  of  zinc,  2  drams ;  extract  of  cicuta,  2  scruples.  Mix.  Make 
48  piUs. 

271.  Pulverized  savin,  1  scruple;  sulphate  of  copper,  1  scruple.  To 
be  sprinkled  on  venereal  lumps  or  tumors,  called  condylomata,  on  the 
female  genitals,  or  elsewhere. 

272.  Balsam  of  copaiba,  1  oz. ;  oil  of  cubebs,  2  drams ;  laudanum,  1 
dram;  mucilage  of  gum  arable  2  ozs. ;  sweet  spirits  of  nitre,  ^  oz. ;  com- 
pound spirits  of  lavender,  8  drams ;  camphor-water,  4  ozs.  ;  white  sugar, 
2  drams ;  oil  of  partridge-berry,  5  drops.  Mix.  Take  a  tablespoonful 
three  or  four  times  a  day.  For  gonorrhoea ;  or  capsules  of  copaiba  and 
cubebs. 


i'!smsm^fi<f«fim* 


MEDICINES   AND   THEIR   PREPARATIONS. 


937 


rior  preparation 

flieii,  2  drams; 

or  verbena,  15 

etter  even  than 

ns ;  lard,  2  ozs. 

8. ;  charcoal  in 
off  when   dry. 

Apply  to  the 

lime,  i  pound, 
used,  mix  with 
lir  and  lay  over 

',  4  ozs.     Mix. 

t  water,  1  pint; 
ix.     Keep  well 

,  3  drama ;  soft 
twenty  minutes, 
silver,  1  dram; 


ispoonful  three 
e  of  the  womb. 
1  dram.  Mix, 
y  increasing  to 

rs. ;  extract  of 
make  into  24 

8.  Mix.    Make 

I  scruple.  To 
[omata,  on  the 

;  laudanum,  1 
•e,  ^  oz. ;  com- 
;  white  sugar, 
.  tablespoonful 
>f  copaiba  and 


273.  Bttlsttui  of  copaiba,  1  oz. ;  pulverized  cubebs,  2  ozs. ;  essence  of 
peppermint,  30  drops.     Make  a  thick  paste,  like  dough,  or  get  capsules. 

274.  Pulverized  borax,  1  oz. ;  pulverized  white  sugar,  1  oz.  Mix.  A 
little  to  be  dissolved  on  the  tongue. 

275.  Pulverized  borax,  ^  oz. ;  honey,  4  ozs.     Mix. 

276.  Hydrochloric  acid,  1  dram;  honey,  1  oz.  Mix.  For  touching 
large  curdy  patches  in  sore  mouth  of  children. 

277.  Pulverized  ipecac,  3  grains;  precipitated  sulphur,  2  scruples; 
extract  of  hyoscyamus,  6  grains.  Mix.  Divide  into  12  parts.  One  to 
be  taken  every  three  or  four  hours. 

278.  Pulverized  belladonna-root,  6  grains ;  compound  ipecac  powder,  10 
grains;  precipitated  sulphur,  ^  dram;  white  sugar,  2  scruples.  Mix. 
Make  20  powders.     One  every  three  hours  to  a  child  two  years  old. 

279.  Pulverized  alum,  25  grains ;  extract  of  cicuta,  12  grains;  syrup  of 
red  poppies,  2  drams;  spearmint  water,  3  ozs.  Mix.  A  dessert-spoonful 
every  six  hours  for  a  child  two  or  three  years  old. 

280.  Camphor,  1  dram;  sulphuric  ether,  1  oz.  Mix.  Ten  drops  every 
half  hour. 

281.  Pulverized  rhubarb,  1  scruple;  one  half  scruple  Gray  powders; 
aromatic  powder,  5  grains.  Mix.  Divide  into  10  powders.  One  every 
four  or  five  hours. 

282.  Pulverized  bloodroot,  ^  to  1  oz. ;  chloride  of  zinc,  J  to  2  ozs. ; 
water,  2  ozs.  Add  enough  wheat  flour  to  make  a  paste  as  thick  as  mo- 
lasses. 

283.  Sal.  volatile,  ^  dram ;  camphor-water,  1  oz.     Mix. 

284.  Tincture  of  mix  vomica,  J  oz. ;  tinct.  aconite,  2  drams ;  volatile 
tinct.  of  guaiacum,  2  drams.     Mix.     Thirty  drops  every  three  hours. 

285.  Tincture  of  black  cohosh,  2  ozs. ;  tinct.  of  digitalis,  2  drams. 
Mix.    One  teaspoonful  from  two  to  five  times  a  day. 

286.  Barberry  bark,  1  oz. ;  pipsissewa  herb,  2  ozs. ;  wild  cherry  bark, 
1  oz. ;  bitter-root,  1  oz.  Mix.  Infuse  for  several  hours  in  4  pints  of 
water.     One  tablespoonful  three  or  four  times  a  day. 

287.  Horse-radish  root,  1  oz. ;  bayberry  bark,  1  oz. ;  barberry  bark,  1 
oz. ;  wild  cherry  bark,  1  oz. ;  prickly-ash  bark,  1  oz.  Reduce  the  whole 
to  a  coarse  powder,  and  infuse  for  several  hours  in  4  pints  of  cider.  A 
tablespoonful  three  or  four  times  a  day. 

288.  Mercury,  95  parts ;  balsam  of  storax,  48  parts ;  diacalon  plaster, 
312  parts;  wax,  rosin,  turpentine,  each,  16  parts;  ammonia,  bdellium, 
each,  5  parts ;  olibanum  and  myrrh,  each,  5  parts ;  saffron,  3  parts ;  spirits 
of  lavender,  2  parts.     Mix,  and  spread.     For  external  use  only. 

289.  Populin,  20  grs. ;  sanguinarin,  10  grs. ;  pulv.  white  sugar,  30  grs. 
Rub  well  together,  and  divide  into  16  powders.  Take  one  four  times  a 
day.     At  the  same  time  use  prescription  73. 

290.  Ptelein,  24  grs. ;  bydrastin,  24  grs. ;  extract  of  belladonna,  3  grs. ; 
extract  of  nux  vomica,  2  grs.  Mix.  Make  24  pills.  Take  one  three 
times  a  day. 

291.  Strychnia,  2  grs.;  pulv.  canthandes,  4  grs. ;  pulv.  arnica-leaves, 
1  dram.  Mix.  Divide  into  32  powders.  One  to  be  taken  three  times  a 
day. 


,i  I 


nwn&ir^ra^iy 


988 


MEDICINES   AND  THEIB  PREPARATIONS. 


292.  Wine  of  colchicum  seeds,  1  oz. ;  fluid  extract  of  dandelion,  1  oz. 
Mix.     One  teaspoonful  three  times  a  day. 

293.  Willow-bark,  1  oz. ;  boiling  water,  1  pint.  Boil  for  ten  minutes, 
and  strain.     Dose,  a  wineglassfiil  once  in  three  hours. 

294.  Canada  balsam,  1  dram;  slaked  lime,  1  dram.  Mix,  to  form  a 
paste.  An  excellent  remedy  for  toothache,  when  pressed  into  the  cavity ; 
or  use  a  drop  or  two  of  a  4  %  cocaine  solution. 

295.  Tincture  black  cohosh,  1  oz. ;  iodide  of  potassium,  2  drams;  syrup 
of  ipecac,  1  oz. ;  spring  water,  2  ozs.  Mix.  A  teaspoonful  three  or  four 
times  a  day,  in  rheumatism  and  cell-dropsy. 

296.  Tincture  black  cohosh,  1  oz. ;  tinct.  myrrh,  6  drams ;  camphor,  1 
dram ;  tinct.  cayenne,  I  dram.  Mix.  Take  30  or  40  drops  four  times  a 
day,  for  dropsy. 

297.  Solution  chloride  of  soda,  6  drops;  water,  2  ozs.     Mix.     To  be, 
taken  at  a  draught.     A  sure  remedy  for  offensive  breath  from  deranged 
stomach. 

298.  Cream  of  tartar,  J  oz. ;  fresh  lemon-peel,  bruised,  4  ozs. ;  white 
sugar,  4  ozs. ;  boiling  water,  3  pints.  Mix,  and  after  standing  a  while, 
strain. 

299.  Citric  acid,  ^dram ;  bi-carbonate  of  potassa,  |  dram ;  lemon  syrup, 

1  oz. ;  soft  water,  6  ozs. ;  epsom  salts,  1  oz.     Mix.     Two  tablespoonfuls, 
to  be  repeated  every  four  hours,  if  necessary. 

300.  Hardwood  ashes,  1  quart ;  common  soot,  J  gill ;  water,  6  pints. 
Digest,  settle,  and  filter.  Take  one  tablespoonful  three  times  a  day,  in 
acidity  of  stomach.  Milk  of  magnesia  is  also  a  very  simple  and  eflScient 
remedy. 

301.  Peppermint  water,  IJ  ozs. ;  wine  of  colchicum-root,  ^  oz. ;  iodide 
of  potash,  3  drs. ;  magnesia,  1  scruple.  Dose.  —  One  teaspoonful  three 
or  four  times  a  day.  Excellent  for  rheumatism  of  a  chronic  or  gouty  type. 
For  the  acute  form  of  ordinary  rheumatism,  some  form  of  salicylic  acid 
must  be  used,  like  the  following :  Salicylate  of  soda,  4  drs. ;  tinct.  carda- 
mom comp.,  tinct.  gent.  comp.  of  each,  2  oz.  Mix,  and  take  one  tea- 
spoonful in  water  every  two  hours,  till  ears  ring,  then  once  in  three  or  four 
hours.  Tongaline  in  one-dram  doses,  every  two  hours,  is  an  excellent  all- 
round  rheumatic  medicine. 

302.  Cream  of  tartar,  IJ  ozs.;  sulphate  potassa,  ^  oz. ;  pulv.  squills, 

2  drs.;  tartar  emetic,  2  gvs.     A  teaspoonfulof  this  mixture  to  be  taken 
four  or  five  times  a  day,  in  dropsy. 

308.  Pulv.  alum,  J  dram;  white  precipitate,  1  grain.  Rub  these  well 
together,  and  place  the  powder  in  a  bottle;  then  add  IJ  drams  of  glycerin. 
Shake  the  bottle  until  the  mixture  is  of  the  consistence  of  ci'eam,  and  re- 
peat the  shaking  whenever  it  is  about  to  be  applied  to  the  skin.  For  ex- 
ternal use  in  erysipelas. 

804.  Copaiba,  5  drams;  yolk  of  one  egg;  gum  of  extract  of  opium,  1 
grain ;  water,  7  ounces.  Mix.  To  be  used  as  an  injection  several  times 
a  day  in  gonorrhoea. 

305.  Tannin,  8  grains;  extract  belladonna,  f  gr. ;  extract  conium,  2^ 
grains ;  infusion  of  senna,  3  ozs. ;  fennel-water  and  syrup  of  marshmallow, 
each  H  ozs.  Mix.  A  tablespoonful  to  be  taken  every  two  hours,  in  chronic 
bronchitis  and  other  complaints. 


ittgg;.-;A';!ufe'. 


Wmi.'mmmM!is^&ssi^mm!rrim'mi>i 


^^^ 


MEDICINES    AND  THEIR   PREPARATIONS. 


939 


Idndelion,  1  oz. 

or  ten  minutes, 

Mix,  to  form  a 
into  the  cavity ; 

2  drams ;  syrup 
ul  three  or  four 

ns;  camphor,  1 
)B  four  times  a 

Mix.     To  be 
from  deranged 

,  4  ozs. ;  white 
ending  a  while, 

1 ;  lemon  syrup, 
tablespoonfuls, 

ivater,  6  pints, 
imes  a  day,  in 
tie  and  efficient 

;,  ^  oz. ;  iodide 
ispoonful  three 
!  or  gouty  type, 
f  salicylic  acid 
. ;  tinct.  carda- 
take  one  tea- 
in  three  or  four 
in  excellent  all- 


;  pulv.  squills, 
re  to  be  taken 


Rub  these  well 
ms  of  glycerin, 
cream,  and  re- 
skin.     For  ex- 

ct  of  opium,  1 
1  several  times 

ict  conium,  2^ 
'  marshmallow, 
}urs,  in  chronic 


306.  Glycerin,  1  dram ;  tnnnin,  1  dram.  Dissolve  the  tannin  in  the 
glycerin.  Excellent  for  sore  nipples,  and  for  chaps  and  excoriations 
generally. 

807.  Collodion,  1  oz. ;  Venice  turpentine,^  oz. ;  castor  oil,  2  drams. 
Mix.  To  be  applied  outwardly,  for  chilblains  and  chaps.  For  cancer, 
manganic  acid.     Not  as  painful  as  other  caustics. 

308.  Sulphate  of  copper,  2  grains ;  wine  of  opium,  1  dram  ;  soft  water, 
2  drams.  Mix.  Apply  freely  with  a  soft  camel  hair  brush,  three  times  a 
day,  for  purulent  ophthalmia. 

309.  Pure  acetic  acid,  2  drams;  soft  water,  3  ozs.;  simple  syrup,  3 
drams.  Mix.  A  teaspoonful  is  to  be  taken  every  three  hours,  in  scar- 
let fever,  at  the  same  time  using  sheet  baths  with  tepid  water. 

310.  Compound  tincture  of  Peruvian  bark,  4  ozs. ;  citrate  of  iron,  44 
grains ;  citric  acid,  20  grains.  Dissolve  the  citric  acid  in  the  tincture,  and 
then  the  citrate  of  iron.  After  a  few  days  filter.  Dose,  one  to  two  tea- 
spoonfuls. 

311.  No.  1.  Gallic  acid,  10  grains;  dissolve  in  alcohol,  2  drams; 
water,  6  drams.  No.  2.  Crystals  of  nitrate  of  silver,  ^  dram ;  water,  ^ 
oz.  Dissolve  and  add  strong  liquor  of  ammonia  till  it  becomes  clear ; 
then  add  powdered  gum-arabfc,  and  dilute,  if  necessary,  to  6  drams. 
This  will  color  black ;  to  color  brown,  reduce  it.  An  excellent  hair-dye. 
Use  the  common  directions-where  there  is  a  No.  1  and  No.  2. 

312.  Epsom  salts,  2  drams;  magnesia,  1  scruple;  syrup  of  ginger,  1 
dram;  spearmint  water,  11  drams.  Mix.  To  be  taken  at  a  draught. 
This  will  be  retained  .by  the  stomach  when  most  other  things  are  rejected. 

313.  Diluted  nitro-muriatic  acid,  2  drams;  sweet  spirits  of  nitre,  2 
drams ;  simple  syrup,  ^  oz.,  water,  7^  ozs.  Mix.  Two  tablespoonfuls 
are  to  be  taken  three  times  a  day.  Excellent  in  dyspepsia,  with  foul 
tongue  and  inactive  liver. 

314.  Rose-leaves,  1  scruple;  boiling  water,  8  ozs. ;  diluted  nitric  acid, 
2^  drams.  Mix.  After  standing  half  an  hour,  strain,  and  use  as  a  wash 
for  ulcers. 

315.  White  vitriol,  1  dram;  water,  1  pint.  Mix.  To  be  used  as  a 
wash  for  ulcers,  etc. 

316.  Citrate  of  iron  and  strychnine,  1  dram;  syrup  of  orange-peel,  2 
ozs. ;  soft  water,  J  pint.  Mix.  Givt  jne  teaspoonful  three  times  a  day 
in  neuralgia,  and  in  other  cases  in  which  a  nerve-tonic  is  needed. 

317.  Aloes  and  soap  pill,  10  grains.  Divide  into  two  pills ;  or,  com- 
pound pill  of  aloes,  10  grs.     Divide  into  two  pills. 

318  Compound  colocynth  pill,  2^  scruples ;  castile  soap,  9  grs. ;  oil 
of  t.  ;e,  2  drops.  Mix,  and  make  12  pills.  Two  to  be  taken  at  bed- 
time. 

319.  Compound  tincture  of  senna,  2  drams;  epsom  salts,  2  drams; 
diluted  sulphuric  acid,  8  drops ;  spirits  of  nitric  ether,  J  dram ;  infusion 
of  rhubarb,  10  drams.     Mix.     To  be  taken  at  a  draught. 

320.  Sulphate  of  iron,  2  grs. ;  epsom  salts,  2  scr. ;  diluted  sulphuric 
acid,  10  drops;  compound  tincture,  1  dram;  syrup  of  poppies,  IJ  drams; 
pimento  water,  9  drams.     To  be  taken  at  a  draught  twice  a  day. 


m 


'Ml 


j:3«gB>ii*i^sigBTa«E!S!3sr 


940 


MEDI0IM8S   AND  THEIK   PHBPAKATIOKS. 


3'21.  Pulverized  rhubarb,  12  gra. ;  carbonate  of  inagneBia,  10  grs. ; 
aromatic  spirit  of  ammonia,  ^  dmni ;  Bynip  of  ginger,  1  dram  ;  Bpearmint 
water,  10  driimfl.     Mix.     To  be  taken  at  a  drauglit. 

322.  Comp.  infuBion  senna,.')  drams;  infiiBion  rhubarb,  r»  drams;  comp. 
tincture  cardamon,  ^dram;  ayrup,  1^  drams.  Mix.  To  be  taken  at  u 
draught,  by  dyspeptic  persons. 

323.  Carbonate  of  soda,  10  grs;  aromatic  spirit  of  ammonia,  ^dram; 
tincture  of  orange-peel,  1  dram  ;  syrup  of  oronge-peei,  1  dram  ;  compound 
infusion  of  gentian,  10  drams.  Mix.  To  be  taken  at  a  draught  twice 
a  day. 

824.  Trisnitrate  of  bismuth,  1  dram;  comp.  tragacanth  powd?r,  2 
drams;  compound  tincture  cardamom,  ^  ounce;  tincture  of  ginger,  ^  oz. ; 
spearmint  water,  7  ounces.  Mix.  Two  tablespoonfuls  to  be  taken  twice 
a  day,  in  dyspepsia. 

Sio.  Solution  of  acetate  of  ammonia,  J  oz. ;  tincture  of  orange-peel,  1 
dram;  syrup  of  orange-peel,  1  dram;  tincture  of  cayenne,  20  drops; 
comp.  infusion  of  orange-peel,  6  drams.  Mix.  The  whole  to  be  taken  to 
relieve  headache,  after  intoxication. 

326.  Magnesia,  15  grs. ;  solution  of  potassse,  15  drops;  comp.  tincture 
of  senna,  1  dram ;  comp.  infusion  of  senna,  6  drams ;  syrup  of  ginger, 
1  dram  ;  comp.  infusion  of  orange-peel,  ^  oz.  Mix.  Taken  at  a  draught, 
as  an  aperient,  in  sick  and  bilious  headaches. 

327.  Aromatic  spirits  of  ammonia,  1  dram  ;  tincture  of  Colombo,  1  dram  ; 
infusion  of  Colombo,  10  drams;  syrup  of  poppies,  1  dram.  Mix.  To  be 
taken  itt  a  draught,  three  times  a  day. 

328.  Diluted  sulphuric  acid,  15  drops;  diluted  hydrochloric  acid,  10 
drops  ;  tincture  of  orange-peel,  1  dram ;  comp.  infusion  of  gentian,  6  drams  ; 
syrup  of  poppies,  1  dram.  To  be  taken  at  a  draught,  three  times  a  day, 
half  an  hour  before  meals. 

329.  Diluted  nitric  acid,  12  drops;  diluted  hydrochloric  acid,  8  drops; 
infusion  of  cascarilla,  11  drams;  syrup  of  poppies,  1  dram.  Mix.  To  be 
taken  at  a  draught,  twice  a  day. 

330.  Colocynth  co.,  6  grs. ;  comp.  pill  of  rhubarb,  4  grs. ;  ext.  hyoscy- 
amus,  2  grs.     Mix.     Make  two  pills ;  1  pill  to  be  taken  at  night. 

331.  Ext.  Lyoscyamus,  2J  grs. ;  pul v.  camphor,  2 1  grs.  Mix.  Make 
two  pills ;  one  t,v  be  taken  when  the  pain  is  most  severe,  in  nervous  head- 
ache ;  or  even  better,  acetanilid,  8  grs. ;  camphor,  2  grs. ;  citrate  of  caf- 
feine, 4  grs.  Divide  in  four  capsules,  one  every  half-hour,  for  three  or 
four  times. 

332.  Comp.  tragacanth  powder,  8  grs. ;  oil  of  lemon,  3  drops ;  camphor- 
water,  1 1  drams  ;  comp.  tinct.  cardamom,  ^  dram  ;  tincture  hyoscyamus, 
J  dram;  chloroform,  15  drops.     Mix. 

333.  Tinct.  hyoscyamus,  ^  dram ;  aromatic  spirit  of  ammonia,  ^  dram ; 
syrup  of  orange-peel,  ^  dram  ;  peppermint  water,  10  drams.  Mix.  In 
nervous  and  hysterical  cases. 

334.  Soap  liniment,  2^  ozs. ;  liquor  ammoaia,  ^  dram ;  laudanum,  ^  oz. 
Mix.     Make  a  liniment. 


MKDIOINBS   AND   THEIR   PREPARATIONS. 


941 


Bia,    10   gn.; 
in ;  Bpcariiiint 

drams;  comp. 
be  taken  at  u 


onia,  ^  dram ; 
m ;  compoinxl 
draught  twice 


ith  powd»r,  2 
finger,  ^  oz. ; 
ie  taken  twice 

orange-peel,  1 
le,  20  dropB ; 
to  be  taken  to 

!omp.  tincture 
■up  of  ginger, 
1  at  a  draught, 

tmbo,  1  dram ; 
Mix.     To  be 

loric  acid,  10 
bian,  6  drams ; 
I  times  a  day, 

icid,  8  drops; 
Mix.     To  be 

;  ext.  hyoscy- 
light. 

Mix.  Make 
nervous  head- 
iitrate  of  caf- 

for  three  or 

ps;  camphor- 
hyoscyamus, 

onia,  ^  dram ; 
B.     Mix.     In 

idanum,  ^  oz. 


33fi.  Comp.  pill  of  colocyuth,  7  grs. ;  ext.  of  colcbicum,  'igra. ;  oil  of 
caraway,  1  drop.  Mix,  and  make  two  pilla.  To  be  taken  at  bedtime  in 
rheumatic  headaches. 

886.  Chloride  of  zinc,  6  oz. ;  pulv.  bloodroot,  2  ozb.  ;  myrtle  wax,  1 
oz. ;  water  of  extract  of  opium,  6  drams ;  extract  of  conium,  6  drama. 
Mix,  and  make  an  ointment. 

837.  Iodide  of  lead,  1  scr. ;  glycerin,  1  dram;  spermaceti  ointment,  2 
ozs.     Make  an  ointment. 

838.  Rhubarb  pulv.,  ^  oz. ;  spearmint  herb,  pulv.,  ^  oz. ;  pulv.  casca- 
rilla,  ^  oz. ;  pulv.  bicarlK)nate  of  potassa,  ^  oz. ;  pulv.  wild-cherry  bark,  ^ 
oz.  Mix,  and  pour  on  one  quart  of  hot  water.  Let  this  stand  till  cold, 
and  add  half  a  pint  of  brandy.     Dose,  ha'f  a  wineglassful. 

339.  Ext.  belladonna,  6  grs. ;  pulv.  ipecac,  10  grs. ;  confection  of 
roses,  2  grs.     Mix.     Make  30  pills,  one  pill  to  be  taken  twice  a  day. 

340.  Dioscorein,  12  grs.;  pulv.  camphor,  4  grs.;  pulv.  cayenne,  12 
grs. ;  white  sugar,  1  scr.  Mix.  Diviue  into  four  powders.  Give  one 
every  fifteen  minutes. 

841.  Leptandrin,  12  grs. ;  geranium,  12  grs.;  myricin,  12  grs.  Mix. 
Divide  into  twelve  powders,  of  which  one  may  be  given  three  or  four 
times  a  day. 

842.  Quinine,  ^  dram;  pulv.  catechu,  1  dram;  pulv.  opium,  15  grs. 
Mix.     Make  32  pills.     Give  one  pill  three  times  a  day. 

343.  Compound  syrup  of  rhubarb  and  potassa,  4  ozs. ;  tincture  of 
prickly-ash  berries,  1  oz. ;  essence  of  peppermint,  1  dram;  paregoric,  4 
drams.  Mix.  A  tablespoonful  should  be  given  every  hour  until  it  oper- 
ates gently  on  the  bowels. 

344.  Pulv.  camphor,  J  dram;  pulv.  opium,  16  grains;  pulv.  cayenne, 
^  dram.     Mix.     Make  16  pills;  one  every  hour,  in  cholera. 

345.  Rhubarb,  4  ozs. ;  black-cohosh  root,  2  ozs. ;  wild-cherry  bark,  2 
ozs. ;  geranium,  2  ozb.  :  coarsely  powder  them,  and  mix.  Add  two  pints 
of  brandy  and  two  pinta  of  water.  Let  the  mixture  stand  five  or  six  days, 
stirring  often,  and  then  strain.  Add  four  pints  of  water  'o  the  dregs,  boil 
slowly  to  two  pints,  strain,  and  add  to  this  the  previous  tincture.  Sweeten 
with  white  sugar.     Take  a  tablespoonful  every  one,  two,  or  three  hours. 

346.  Beth  root,  1  oz. ;  geranium,  1  oz. ;  blackberry-root,  1  oz. ;  wild- 
cherry  bark,  1  oz. ;  cinnamon,  1  oz.  Powder  the  whole,  and  add  to  them 
1^  pints  brandy,  and  IJ  pints  water.  Let  them  stand  several  days,  stir- 
ring frequently.  Add  sweetening  if  preferred.  Dose,  one  or  two  tea- 
spoonfuls  every  two  or  three  hours. 

347.  Raspberr  T  leaves,  1  oz. ;  geranium,  1  oz. ;  blackberry-root,  1  oz. ; 
leptandra  root,  1  oz.  Mix,  and  make  three  pints  of  strong  decoction. 
Dose,  a  teaspoonf  al  e  ery  hour.     Suitable  for  a  gargle. 

348.  Sugar  of  lead,  24  grs. ;  vinegar,  1  dram;  syrup  of  poppies,  1  oz. ; 
rose-water,  3  ozs. ;  soft  water,  4  ozs.  Mix.  Dose,  one  or  two  table- 
spoonfuls. 

349.  Potassio-tartrate  of  iron,  J  oz. ;  syrup  of  orange-peel,  1  oz. ;  water, 
4  oz.     Mix.     Take  two  teaspoonfuls  three  times  a  day. 


( 


th 


% 


"ill 


Mfi 


niafeM5bfe.v 


M2 


MRDI0INE8  AND  THEIR   PREPARATIONS. 


860.  Geranium,  goldon  seal,  marHhmallow,  wild-indigo  root,  rosemary, 
eacb  half  an  ounce.  Mix,  and  make  one  pint  of  utroug  iufuHiou.  After 
straining,  add  two  drams  powdered  borax  aud  oue  gill  of  '  ^uey.  An 
excellent  astringent  gargle. 

tlfil.  Bromide  of  Hoda,  3  dramu  ;  nyrup  of  orange,  or  any  other  ttyriip, 
three  ounces.  Take  one  teaspoouful  in  water  as  often  as  needed.  Koi- 
beadache,  nervousness,  etc.,  cau  take  every  half-hour. 

862.  Wine  of  ipecac,  10  drops  in  water  every  half-hour  to  croupychilil, 
one  year  old ;  30  drops  to  vomit  the  child. 

353.  Hydrochlornte  of  ammonia,  ^  oz. ;  diluted  acetic  acid,  ^  oz. ;  al- 
cohol, ^  oz. ;  camphorated  mixture,  15  ozs.  Mix.  A  good  scattering 
wash  for  hydrocele,  etc. 

854.  Chloride  of  soda,  nitrate  of  potash,  and  hydrochlorate  of  ammonia, 
equal  parts,  and  water  ouough  to  diHsolve  them.  Mix.  Au  excellent 
freezing  mixture. 

355.  Antipyrin,  3  drams;  syrup  or  water,  2  ozs.  Teaspoonful  every 
hour  till  fever  is  less ;  or  pbcnacetine,  8  grs. ,  every  two  hours  till  fever  is 
subdued,  then  once  in  four  hours. 

856.  Chloral  hydrate,  4  drams;  syrup  acacia  and  syrup  checkerberry,  of 
each,  1  oz. ;  Teaspoonful  in  water  every  hour  till  asleep.  If  the  taste  is 
very  objectionable  it  may  be  taken  in  two  teaspoonful  doses  by  rectum  in 
a  little  cold  starch-water. 

357.  Bromidia;  teaspoonful  in  water  every  hour  till  asleep. 

358.  Jaborandi,  fluid  extract,  3  drams ;  syrup,  1  oz.  Teaspoonful  every 
hour,  to  produce  sweating. 

859.  Pill,  compound  cathartic.     Two  for  a  dose. 

360.  "  Green  Soap."  Riib  well  in  at  night  and  wash  off  in  the  morning 
with  water. 

861.  Powdered  camphor  and  chloral,  equal  parts,  sufflcieut  quantity  to 
make  a  liniment,  rubbed  well  together.     External  use. 

362.  Wilkinson's  Ointment.     (See  Scabies.) 

363.  Dilute  hydrocyanic  acid,  1  dram ;  solution  acetate  of  ammonia,  2 
ozs. ;  tincture  digitalis,  3  drams  ;  rose-water,  5  ozs.  For  pruritus,  itch- 
ing, etc. 

364.  Corrosive  sublimate,  2  grs. ;  tincture  benzoin,  ^  dram ;  almond 
emulsion,  1  oz.  Used  to  destroy  the  epidermis  in  cases  of  freckles,  acne, 
pimples,  etc. 

865.  Alum,  5  parts ;  salicylic  acid,  45  parts.     Dust  on  freely. 

366.  Corrosive  sublimate,  4  f,.^. ;  dissolved  in  1  oz.  tincture  of  myrrh. 
Paint  on  to  the  part  affected  by  ringworm  night  and  morning. 

367.  Bromide  of  soda  and  ammonia,  20  grs.  each,  in  a  cup  of  valerian 
tea  four  times  a  day.  Increase  up  to  8  or  10  times  a  day  if  former  dose 
proves  insufScieuk.  Take  also  daily  oxide  of  zinc  and  extract  of  bella- 
donna, of  each  ^  gr.,  morning  aud  night.  In  bad  cases  use  pill  4  times 
daily. 


MED10INB8    AND   THEIK    PRKPARATI0N8. 


943 


0  root,  rosemary, 

iaftmiou.     Afu-r 

II  of  ■  iney.     An 

any  other  syrup, 
as  needed.     For 


r  to  croupycbild, 

c  acid,  i  oz. ;  al- 
L  good  scattering 

rate  of  amaiotiia, 
c.     An  exceliout 


.168.  Fluid  extract  gelseminuin,  ;J  drops  in  water  every  half  hour  for 
.'lor  four  times.  UHoful  in  facial  neuralgia;  or  exalgine,  4  grs.  every 
liour  for  two  or  three  times. 

369.  Atropia,  yj„  of  a  gr.  One  such  pill  each  night  for  sweating;  one 
Hiich  pill  2  or  3  times  a  day  for  acute  cold  in  head,  with  watery  secre- 
tions; or  pill  "coryza,"  one  every  half  hour  for  three  times,  then  once  an 
hour  till  throat  is  dry,  afterwards  once  in  three  or  four  hours. 

370.  Sulphate  quinine,  J  gr. ;  ext.  belladonna,  X  gr. ;  pulv.  ipecac,  ^ 
gr. ;  comp.  ipecac  powder,  -^  gr.  One  such  pill  every  two  hours,  for 
chronic  bronchitis  and  emphysema. 

371.  Carron  oil.  Made  by  adding  equal  parts  linseed-oil  and  lime-water. 
For  burns,  apply  freely;  also  boracic  acid,  18  grs.,  dissolved  in  1  dram 
hot  glycerin  and  olive-oU,  1  oz. 


easpoonful  every 
lours  till  fever  is 

checkerberry,  of 

If  the  taste  is 

ses  by  rectum  in 

leep. 
easpoonful every 


flf  in  the  moruinu; 
cient  quantity  to 


i  of  ammonia,  2 
)r  pruritus,  itch- 
dram;  almond 
f  freckles,  acne, 


freely. 

Bture  of  myrrh, 
ing. 

cup  of  valerian 
5^  if  former  dose 
xtract  of  bella- 
ise  pill  4  times 


••m^ 


PROPRIETARY  AND  PATENT  MEDICINES. 


Nothing  in  the  world  has  given  rise  to  so  much  superstition  and 
blind  folly  as  the  following  of  fanatic  leaders  in  the  curing  of  disease. 
Since  Hippocrates,  and  even  back  to  Apollo  himself,  if  we  may  be- 
lieve old  Grecian  and  Roman  tales,  quackery  in  medicine  has  reigned 
supreme. 

It  pleases  people  to  follow  up  what  appears  miraculous  in  life. 
Results  are  more  important  to  the  minds  of  many  people  than  the 
circumstances  effecting  results ;  hence,  if  a  person  by  hook  or  crook 
recovers  from  a  disease  while  using  some  patent  medicine,  he  as- 
cribes to  its  employment  some  specific  usefulness,  irrespective  of  the 
natural  course  of  the  malady,  or  whatever  else  he  may  or  may  not 
have  done. 

In  this  way  ancient  amulets  and  modern  patent  medicines  have 
seemed  to  cure  cancer,  leprosy,  liver  and  kidney  and  other  diseases  ; 
and  in  this  way  enormous  fortunes  have  been  made  by  advertising  in 
gorgeous  attiie  some  specific  oil  or  oalsam,  the  apparent  defendei-s  of 
health  and  strength.  Patent  medicines  are  sold  to  make  money,  and 
not  to  cure  the  public  ;  their  usefulness  is  generally  in  inverse  ratio 
to  their  labels. 

There  are,  however,  some  good  patent  medicines.  In  some  cases 
they  will  prove  just  the  thing  the  system  needs,  but  the  risk  is  too 
great  unless  recommended  by  some  physician.  It  is  their  blind,  in- 
discriminate use  that  we  condemn.  Their  formula  not  being  known 
is  what  makes  them  dangerous.  They  usually  are  made  up  of  some 
powerful  stimulant  which  makes  the  patient  feel  better  for  a  time, 
and  then  leaves  the  system  mor-e  relaxed  than  ever,  and  hurts  the 
nerves  or  digestion.     We  will  point  out  a  few  that  are  useful. 

There  is  another  class  of  medicines  which  are  put  up  by  the 
great  pharmaceutical  houses,  which  deserve  popular  use.  Their  com- 
position being  known,  there  is  no  secrecy  about  them.  They  are 
prepared  in  the  most  scientific  manner.  These  houses  have  a  name 
to  preserve,  and  have  ample  means  to  procure  the  services  of  the  best 
chemists,  and,  using  such  large  quantities  of  drugs,  they  can  procure 
the  best  and  most  uniform.  They  do  not  claim  to  be  cure-alls,  but 
are  compounded  for  special  diseases  or  conditions,  which  are  plainly 
stated,  and  are  only  claimed  to  be  a  remedy  for  such  diseases  or  con- 

944 


wn'imifiiigimmftm 


PROPRIETARY   AND   PATENT  MEDICINES. 


945 


IDIOINES. 


iperstition  and 
riagof  disease. 
,  if  we  may  be- 
ine  has  reigned 

sulcus  in  life. 
3ople  than  the 
hook  or  crook 
edicine,  he  as- 
spective  of  the 
ay  or  may  not 

aedicines  have 
3ther  diseases ; 
advertising  in 
it  defenders  of 
ke  money,  and 
1  inverse  ratio 

In  some  cases 
the  risk  is  too 
iheir  blind,  in- 
being  known 
ie  up  of  some 
ter  for  a  time, 
and  hurts  the 
useful. 

at  up  by  the 
;.  Their  cora- 
u.  They  are 
have  a  name 
368  of  the  best 
y  can  procure 
cure-alls,  but 
h  are  plainly 
seases  or  con- 


ditions of  the  system.  They  are  just  what  your  physician  would 
prescribe.    The  difficulty  is  in  rightly  choosing  from  the  vast  number. 

Of  late  there  has  sprung  up  a  class  of  houses  who  make  it  a  cus- 
tom to  imitate  any  well-known  medicine  which  has  proved  valuable, 
and,  by  selling  their  imitations  cheaper  and  using  some  flaring  label, 
palm  off  these  imitations  as  being  just  as  good.  We  would  advise 
that  they  be  shunned  like  the  plague.  If  there  is  anything  that 
ought  to  be  pure,  it  is  the  drugs,  stimulants  and  nourishment  that  we 
take  as  medicine. 

While  we  do  not  claim '  to  give  a  list  in  this  chapter  of  all  valu- 
able remedies,  we  recommend  several  of  the  best  and  most  valuable, 
which  have  stood  the  test  of  use,  and  can  be  taken  with  safety  and 
benefit.  Read  '  !^he  front  part  of  the  book  a  description  of  your 
trouble,  then  turn  to  the  department  in  this  chapter  corresponding 
to  it,  and  choose  the  remedy.  In  all  cases  the  directions  will  be 
found  on  the  wrapper  of  the  remedy. 

Asthma.  —  Kola-Koloid  (T.  Metcalf  Co."/.  The  well-known  integrity 
of  this  bouse  is  a  siifflcient  guarantee  of  the  value  of  this  remedy.  Soden's 
Mineral  Pastilles  are  also  good. 


Thyroid  Tablets  of  5 


Anti-Fat Phytoline  is  used  very  extensively. 

grains  each  3  times  a  day  are  very  effectual. 

Anti-Scrof ulcus.  —  Succus  Alterans  (Lilly),  anti-syphilitic  and  al- 
terative. This  is  a  purely  vegetable  medicine  and  will  not  hurt  the  most 
delicate  stomach.  It  contains  no  mercu<-y  or  iodide  of  potash.  It  elim- 
inates specific  poison  from  the  blood  and  its  tonic  power  increases  the  red 
corpuscles  and  enables  the  system  to  throw  off  disease.  It  attacks  the 
seat  of  the  disease,  which  is  impure  blood.  Chapoteant  Sol.  Iodide  Stron- 
tium is  much  used,  is  easily  digested,  but  is  rather  expensive. 

Also  iodia,  an  alterative  and  tonic,  is  much  used  by  the  best  physicians. 
It  improves  the  nutrition  and  eliminates  waste.     Is  purely  vegetable. 

Biliousness.  —  Garfield  Tea  and  Fig  Syrup  contain  no  salicylic  acid, 
minerals  or  opium.  Are  purely  vegetable  remedies,  and  can  be  used  by 
infants,  children  and  adults  with  safety.  India  Cholagogue  is  an  old 
remedy  of  worth. 

Consumption.  —  Cod  Liver  Oil  is  an  old  and  much-used  remedy,  not 
only  for  consumption  but  for  all  wasting  diseases.  It  nourishes  the  body 
and  builds  up  the  tissues.  The  trouble  is  to  get  it  pure.  The  pure,  pale 
oil,  extracted  from  the  fresh,  healthy  livers  of  the  fish,  known  as  Burnett's, 
sold  by  Theo.  Metcalf  Co.,  Boston,  is  the  most  desirable.  It  can  be  emul- 
sionized  with  an  egg-beater.  The  dose  should  rarely  be  over  a  table- 
spoonful  and  can  be  combined  with  coffee,  eggs,  milk  or  ice  cream  well 
beaten  together  to  make  it  more  palatable  and  more  easily  digested. 

Cougha.  —  King's  Consumption  Cure  is  one  of  the  best  cough  mixtures. 
Linonine  is  composed  of  flaxseed-oil  combined  with  chloroform,  and  is 
good  to  soften  and  allay  a  common  hard  cough. 

Diabetes.  —  Gluten  Flour  (Metcalf)  is  the  best  food  and  is  free  from 


fiv- 


m 


•  I 


,i>- 


946 


PROPRIETARY    AND   PATENT   MEDICINES. 


i 
ffll 


starch.  In  making  the  bread  it  should  be  mixed  with  a  spoon  with  wlieat 
bran.  The  hands  should  never  touch  the  Gluten  Flour.  No  other  biead 
should  be  eaten,  or  potatoes  or  other  starchy  foods.  If  the  patient  gets 
tired  of  Gluten  Flour  alternate  with  Soga  Bean  Meal. 

Digestive  Medicines.  —  Horsford's  Acid  Phosphate.  It  promotes  di- 
gestion without  injury  and  thereby  relieves  the  diseases  caused  by  indiges- 
tion. It  is  excellent  for  acidity  of  the  stomach  and  is  a  very  pleasant  and 
healthful  drink  combined  with  some  syrup  and  soda.  "  There  are  so  many 
different  causes  of  dyspepsia,  it  is  often  necessary  to  try  several  remedicH. 
The  following  are  good :  Liquid  Lactopeptine,  Liquid  Pancreaticus  more 
especially  for  bowel  indigestion.  The  various  preparations  of  pepsin  are 
good. 

Disinfectants.  — Eucaline  (T.  Metcalf  Co.)  is  used  around  the  house 
as  a  disinfectant  during  disease  as  a  preventative  from  contagion.  Diluted 
it  makes  a  good  tooth  and  mouth  wash,  a  few  drops  in  a  tumbler  of  water. 
Is  good  to  sweeten  bowls  and  bath-tubs.  Can  be  used  in  the  water-pan 
of  furnaces  to  cleanse  the  air  and  in  fact  where  any  disinfectant  is  tised. 
Chloride  of  lime  and  Bulpho-naphthol  are  also  much  used. 

Poods,  Invalid  and  Baby.  — Mellin's  Food  is  one  of  the  oldest  and 
best ;  it  needs  no  cooking.  Mixed  with  milk  it  contains  all  that  is  neces- 
sary to  nourish  the  body.  It  is  the  best  known  baby  food  and  is  invalu- 
able for  those  suffering  from  nervous  prostration  or  non-assimilation  of 
food.  Malted  Milk  is  a  good  food  for  all  ages  but  is  more  particulai-ly 
adapted  for  adult  invalids.  Bartlett's  Food  is  good  for  nervous  children. 
Robinson's  Groats  and  Barley,  intended  for  children,  is  a  laxative  food. 

Headaches.  —  The  remedies  for  headaches  are  numberless.  If  they 
are  constant  or  chronic  it  is  well  to  leave  oflf  smoking,  tea  or  coffee  drink- 
ing for  three  months  and  see  if  that  is  not  the  sole  cause.  If  a  female-, 
have  a  physician  and  see  if  they  are  not  caused  by  some  womb  trouble. 
For  immediate  relief  a  cup  of  black  coffee  without  sugar  or  milk  is  as  safe 
and  good  as  anythin"  Most  of  the  headache  powders,  pills,  etc.,  are 
made  up  of  caffeine,  ^ruinides,  guarana  and  the  cootar  products. 

Quinacetine  (Metcalf)  is  one  of  the  best  remedies  and  has  the  advantage 
of  leaving  no  unpleasant  effects. 

The  following  are  good  fov  immediate  relief :  Bromo-Caffeine,  Bromo- 
Seltzer,  Elixir  Cuarana,  Nev  ease  and  Phenacctine.  The  last  two  should 
be  used  sparingly. 

Hypnotic  and  Sleep-Producing  Medicines.  —  Bromidia  is  much 
used.  It  is  composed  of  chloral  and  the  bromides.  Every  fluid  dram 
contains  15  grains  each  of  pure  chloral  hydrate  and  purified  bro.  pot., 
and  if  grain  each  of  gen.  imp.  ex.  cannabis  ind.  and  hyoscyam.  In  the 
restlessness  and  delirium  of  fevers  it  is  invaluable.  It  is  well  to  take  out- 
door rzoTise  and  drink  a  cupful  of  Mellin's  Food,  warm  or  malted  milk 
jv  St  oefore  retiring. 

lijii  Preparations.  —  Elixir  Thi-ee  Chlorides  is  a  good  blood-maker. 
Schlotterbeck's  Syrup,  Phospho-Chloride  of  Iron  is  a  good  preparation  of 
liquid  u'on  and  easily  digested. 

Liquid  Beef  Preparations Beef  Peptonoids,  Liquid  Beef  Pepto- 

noids,  and  Liqaid  Peptonoids  with  Creosote,  are  pieparations  of  beef  in  a 


HMIW«^4 


PKOPRIETARY   AND   PATENT  MEDICINEa 


947 


ipoon  with  wlieat 
No  other  bread 
the  patient  gets 

It  promotes  di- 
iiised  by  indiges- 
ery  pleasant  and 
ere  are  so  many 
several  remedies, 
ancreaticus  more 
ns  of  pepsin  are 

iround  the  house 
tagion.  Diluted 
umbler  of  water. 
in  the  water-pan 
nfectant  is  used. 

)f  the  oldest  and 
all  that  is  ueces- 
d  and  is  iuvalu- 
n-assimilation  of 
lore  particulai'ly 
lervous  children, 
laxative  food. 

)erless.  If  they 
I  or  coffee  drink- 
e.  If  a  female-, 
le  womb  trouble. 
>r  milk  is  as  safe 
,  pills,  etc.,  are 
^ducts. 
as  the  advantage 

Daffeine,  Bromo- 
i  last  two  should 

omidia  is  much 
Ivery  fluid  dram 
urified  bro.  pot., 
jscyam.  In  the 
well  to  take  out- 
1  or  malted  milk 

od  blood-maker, 
d  preparation  of 

uid  Beef  Pepto- 
lons  of  beef  in  a 


very  digestible  form,  palatable  and  very  nourishing.  Bovox,  Bovinine 
and  Wyeth's  Beef  Juice  are  very  nourishing  and  are  valuable  for  travellers 
and  to  take  between  meals  when  faint. 

Liver  and  Kidney  Medicines.  —  Garfield  Tea  is  a  good  family  med- 
icine, is  harmless,  contains  no  minerals  and  clears  the  liver  and  kidney  of 
effete  matter.  Buchu  and  Hyoscyamus  Comp.  (Tyree's)  to  soothe  an  irri- 
table bladder.     In  kidney  troubles  consult  the  best- physicians  obtainable. 

Liquid  Malts.  —  Are  chiefly  serviceable  in  inability  to  digest  starchy 
foods,  and  in  convalescence.  All  of  the  following  are  good :  Tarrant's 
and  Hoff's  Malts,  Liquid  Bread,  Trommer's  Malt  with  Iodides,  Trammer's 
Citrate  of  Iron  and  Quinine,  and  Trommer's  Malt  with  Pepsin. 

Laxative)^.  —  For  chronic  constipation  there  Is  nothing  more  useful 
than  Rhamnus  Fragula  (Metcalf ) ,  made  from  buckthorn  bark.  It  is  a 
simple  and  harmless  remedy,  the  results  good  and  sure,  and  invigorates  the 
bowels.  —  Glycones  (Lilly) .  Frequently,  especially  for  babies  and  young 
children,  it  is  well  to  move  the  bowels  without  taking  medicine  internally. 
Glycones  are  the  best.  They  are  in  two  sizes,  children's  and  adults'. 
They  are  invaluable  for  travellers.  They  produce  prompt,  painless  and 
copious  stools.  Garfield  Tea  is  mild,  harmless  and  sure.  One  of  the  best 
and  pleasant  to  take,  and  has  no  nauseating  effects.  For  babies,  Garfield 
Fig  Syrup. 

Loss  of  Nervous  Energy,  and  Impotency.  —  Sterility  in  both  the 
male  and  female.  The  first  thing  to  do  is  to  break  off  at  once  and  forever 
even  the  thoughts  of  what  causes  impotency  and  loss  of  energy.  If  male, 
bathe  the  parts  in  cold  water  night  and  morning  and  pay  no  attention  to 
various  advertisements  of  free  remedies,  etc.  See  chapter  on  Masturbation 
and  Impotency.  The  best  remedy  for  loss  of  energy  and  impotency  is  Kola 
(Metcalf).  Nothing  can  compare  with  Kola  Koloid.  Its  use  by  the 
negro  in  Africa  has  extended  all  over  the  world.  It  is  well  known  that 
they  raise  the  largest  families  and  their  energy  in  this  respect  can  perhaps 
be  traced  to  the  use  of  Kola. 

Nerve  Tonics.  —  Coca  Wine.  As  a  stimulating  tonic  there  is  perhaps 
no  better  remedy  known  than  Metcalf's  Coca  Wine.  It  is  an  invigorator 
for  the  aged,  a  quick  builder  for  the  enfeebled,  is  a  palliation  for  mental 
troubles,  and  is  valuable  to  tone  up  the  system  after  a  tun  of  fever. 
Chapoteant  Sol.  Bromide  Strontium  is  a  good  and  agreeable  preparation 
and  is  well  tolerated  by  the  stomach.  Phillips*  Phospho. -Muriate  Quinine 
Compound  is  a  good  general  tonic.  Of  the  bromides  the  following  are 
good :  Elixir  Potassium  Bromide,  Elixir  Sodium  Bromide,  Elixir  Ammo- 
nium Bromide.     Coca  Wine  is  the  safest  and  best. 

Neuralgia.  —  Is  usually  caused  by  poverty  of  the  blood.  See  Nerve 
Tonics.  Quinacetine  (Metcalf)  is  one  of  the  best  remedies.  Its  use  is 
not  followed  by  any  unpleasant  effects. 

Painful  Menstruation  and  Vaginal  Remedies.  —  Orange  Blossoms 
(J.  A.  McGill)  come  in  the  form  of  suppositories  and  is  administered 
direct  tothe  seat  of  the  disease.  They  are  safe  and  harmless.  Have  stood 
the  test  of  use,  can  easily  be  administered  by  the  patient  and  are  a  specific 
for  profuse  ineuatruatiou.     Wine  of  American  Ash  (Metcalf) ,  made  from 


mm 


948 


PROPRIETARY   AND   PATENT   MEDICINES. 


the  outside  bark  of  the  white  ash,  is  used  in  the  treatment  of  the  ions 
uterine  affections,  namely,  prolapsus,  versions,  menstrual  irreguiu.ities, 
inflammation,  leucorrhoea,  etc.,  depending  upon  chronic  enlargement  for 
their  basis.  While  relief  and  marked  benefit  may  be  obtained  by  a  few 
weeks'  use  it  may  be  as  many  months  before  absolute  freedom  from  suffer- 
ing may  result.  lodia  is  much  used.  It  is  a  combination  of  the  active 
principles  obtained  from  the  green  roots  of  stillingia  helonias,  saxifraga 
menispermum  and  aromatics.  Each  fluid  dram  also  contains  five  grains 
each  iod.  potas.  and  phos.  iron.  Used  especially  for  leucorrhcea,  impaired 
vitality,  habitual  abortion  and  general  uterine  debility.  The  surgical 
craze  for  the  treatment  of  diseases  of  the  pelvic  organs  has  prevented  phy- 
sicians from  studying  as  carefully  as  they  should  the  medical  treatment. 
At  least  it  would  be  well  to  see  what  medicines  will  do  before  resorting  to 
the  knife.  Antiseptic  Vaginal  Cones  and  Boro-Glyceride  Suppositories 
are  also  good. 

Piles.  —  Hamamelis  Suppositories  and  Comfort  Powder  are  both  good 
remedies.     See  chapi  >t  on  Hemorrhoids. 

Plasters.  —  Their  number  is  legion.  Bell-Capsic,  Cuticura  and  Cap- 
sicum are  all  good. 

Pain  Medicines.  —  One  of  the  very  best  of  all  opium  preparations  is 
Papine  and  it  is  efficacious  in  most  cases.  Papine  is  the  anodyne  or  pain- 
relieving  principle  of  opium,  the  narcotic  and  convulsive  elements  being 
eliminated.  One  fluid  dram  is  equal  in  anodyne  power  to  ^  of  a  grain  of 
moi'phine. 

Prostate  QIand  Diseases.  - 

troubles,  especially  for  the  aged. 

Rheumatic  Medicines.  —  Quinacetine  (Metcalf).  This  remedy  is 
safe  and  has  no  unpleasant  or  injurious  effects.  Merrill's  Alkaline  Elixir 
is  a  pleasant  and  effective  remedy  in  many  varieties  of  rheumatism. 
Tongaline  is  used  in  both  rheumatism  and  gout.  It  is  laxative  if  taken 
too  often.     lodia  is  a  good  remedy  for  chronic  rheumatism. 

Salves.  —  Cuticura  and  Salvacea. 

Stimulants.  —  Coca  Wine  (Metcalf)  is  one  of  the  best  and  most 
harmless.  Kola  Koloid  is  another  excellent  preparation.  Vin  de  Cbapo- 
teant  is  a  good  stimulant  on  the  old  beef,  iron  and  wine  plan. 

Skin  Diseases.  —  The  very  best  remedy  we  consider  is  Succus  Alter- 
ans  (Lilly)  as  it  strikes  at  the  root  of  the  trouble  —  impoverished  and  im- 
pure blood.  Skin  troubles  cured  by  this  remedy  are  likely  to  remain  so. 
Hamamelis  for  an  external  application  is  soothing  and  cooling.  It  is  ex- 
cellent for  reducing  inflammation. 

Syphilis.  —  lodia  is  a  purely  vegetable  remedy  made  from  the  juices  of 
the  green  herbs.  Can  be  taken  for  a  long  time  without  injury  to  any 
organs  of  the  body.  It  improves  the  nutrition,  purifies  the  blood  and  is  a 
specific  for  syphilis  in  all  stages.  Succus  Alterans  is  another  good 
remedy.  It  is  a  vegetable  remedy,  anti-syphilitic  and  alterative.  It 
builds  up  the  system  by  purifying  and  enriching  the  blood. 


Sommetto   is   used    largely  for  these 


^ 


PROPRIETARY   AND   PATENT  MEDICINES. 


"lift' 


nt  of  the  ions 
ual  irregui...itie8, 
!  enlargement  for 
•btained  by  a  few 
idom  from  sufifer- 
ion  of  the  active 
ilonias,  saxifraga 
itains  five  grains 
torrhoea,  impaired 
The  surgical 
18  prevented  phy- 
ledical  treatment. 
sfore  resorting  to 
ide  Suppositories 

ler  are  both  good 


Stomach  Tonics.  —  Horsford'B  Acid  Phosphate  for  indigcetion,  Tar- 
rant's Seltzer  Aperient  for  acidity  and  belching  of  wind.  For  a  strict  tonic 
the  following  are  good :  Elixir  Calisaya  Bark  and  Bismuth,  Elixir  Calisaya 
and  Iron,  Elixir  Calisaya,  Bismuth  and  Pepsin. 

Throat  Tablets.  —  Chloramine  Tablets,  Wyeth'sRed  Gum  Lozenges, 
and  Troches  Guaiac  are  all  good. 

Vaginal  Remedies.  —  Orange  Blossoms  are  the  best  for  general  use. 
Antiseptic  Vaginal  Cones  and  Boro-Glyceride  Suppositories  are  also  largely 
used. 

Whooping  Cough.  —  Vapo-Cresoline.  Is  a  liquid  to  be  burned  over 
a  night-lamp.     It  relieves  the  cough  and  hastens  recovery. 

Wounds.  —  Aristol,  Dermatol  and  Iodoform  are  used  to  promote 
healing. 


i 


uticura  and  Cap- 

n  preparations  is 

anodyne  or  pain- 

5  elements  being 

1^  of  a  grain  of 

irgely  for  these 

This  remedy  is 
Alkaline  Elixir 
of  rheumatism, 
axative  if  taken 
a. 


best  and  most 
Vin  de  Chapo- 
an. 

is  Succus  Alter- 
erished  and  im- 
iy  to  remain  so. 
oling.    It  is  ex- 


..«-'!**•-■ 


>m  the  juices  of 

It  injuiy  to  any 

5  blood  and  is  a 

another  good 

alterative.     It 


:  Jl 


R. 


"wasKHsaBEs:-. 


wwrs- 


> 


PHYSICAL  CULTURE  —  GYMNASTICS. 


In  America  the  noblest  interests  of  the  race  have  :'eached  unpar- 
alleled development.  In  no  other  country,  in  no  other  age,  has 
mental  culture  been  so  complete  and  universal.  It  is  an  era  in  the 
progress  of  the  race.  The  fruits  of  labor  which  in  other  times  and 
lands  have  been  wasted  upon  the  abnormal  life  of  the  few,  have  here, 
like  air  and  light,  the  two  great  repr.isentative  gifts  of  Heaven,  found 
their  way  to  the  normal  life  of  the  million. 

But  in  this  hour  of  triumph  the  national  life  is  jeopardized  by 
physical  exhaustion.  While  the  admiring  world  looks  on,  our  bodies 
upon  which  as  a  foundation  our  higher  faculties  must  rest,  crumble 
and  give  way.  Precocious  brains  are  borne  about  by  doubtful  spines; 
brilliant  talents  are  linked  with  dying  bodies. 

Men,  women,  and  children  should  be  strong,  but  it  should  be  the 
strength  of  grace,  flexibility,  agility,  and  endurance ;  it  should  not  be 
the  strength  of  a  great  lifter.  Let  me  allude  to  the  gymnastics  of  the 
circus.  Permit  me  to  call  special  attention  to  three  features  —  to  the 
man  who  lifts  the  cannon,  to  the  india-rubber  man  and  to  the  general 
performer.  The  lifter  and  the  india-rubber  man  constitute  the  two  mis- 
chievous extremes.  It  is  impossible  that  in  either  there  should  be 
the  highest  physiological  conditions  ;  but,  in  the  persoixs  of  general 
performers,  is  found  the  model  gymnast.  They  can  neither  llrt  great 
weights  nor  tie  themselves  into  knots,  but  they  occupy  a  point 
between  these  two  extremes.  They  possess  both  strength  and  flexi- 
bility, and  resemble  fine,  active,  agile,  vigorous  carriage-horses,  which 
occupy  a  point  between  the  slow  cart-horse  and  the  long-legged,  loose- 
jointed  animal.  The  race-hoi-se  has  a  much  more  vigorous  circula- 
tion than  the  cart-horse.  It  is  a  fact  not  unfamiliar  to  horsemen, 
that  when  a  horse  is  transferred  from  slow,  heavy  work  to  the  car- 
riage, the  surface  veins  about  the  neck  and  legs  begin  at  once  to  en- 
large ;  when  the  change  is  made  from  the  carriage  to  the  cart,  the 
reverse  is  the  result. 

And  when  we  consider  that  the  principal  object  -of  all  physical 
training  is  an  elastic,  vigorous  condition  of  the  nervous  system,  the 
superiority  of  light  gymnastics  becomes  still  more  obvious.  The 
nervous  system  is  the  fundamental  fact  of  our  earthly  life.     All  other 

950 


^ 


PHYSICAL  CULTURE. 


951 


8TICS. 


iched  unpar- 
lier  age,  has 
m  era  in  tlui 
!r  times  and 
(v,  have  here, 
eaven,  found 

)pardized  by 
n,  our  bodies 
'est,  crumble 
btful  spines; 

lould  be  the 
bould  not  be 
astics  of  the 
res  —  to  the 
>  the  general 
the  two  mis- 
e  should  be 
i  of  general 
ler  lirt  great 
ipy  a  point 
th  and  flexi- 
orses,  which 
jgged,  loose- 
ous  circula- 
)  horsemen, 
to  the  ear- 
once  to  en- 
le  cart,  tlie 

ill  physical 
system,  the 
ious.  The 
All  other 


parts  of  the  organism  exist  and  work  for  it.  It  controla  all,  and  is 
the  seat  of  pain  and  pleasure. 

The  impressions  upon  the  stomach,  for  example,  resulting  in  a  bet- 
ter or  worse  digestion,  must  be  made  through  the  nerves.  This  su- 
preme control  of  the  nervous  system  is  forcibly  illustrated  in  the 
change  made  by  joyful  or  sad  tidings. 

Could  we  have  an  unbroken  succession  of  good  news,  we  should 
all  have  good  digestion  without  a  gymnasium.  But  in  a  world  of 
vexation  and  disappointment,  we  are  driven  to  the  necessity  of  muscle 
culture,  and  other  hygienic  expedients,  to  give  the  nervous  system 
that  support  and  vitality  which  our  fitful  surroundings  deny. 

If  we  would  make  our  muscle-training  contributive  in  the  highest 
degi'ee  to  the  healthful  elasticity  of  our  nerves,  the  exercise  must  be 
such  as  will  bring  into  varied  combinations  and  play  all  our  muscles 
and  nerves.  Those  exercises  which  require  great  accuracy,  skill  and 
dash  are  just  those  which  secure  this  happy  and  complete  intermar- 
riage of  nerve  and  muscle. 

Another  point  I  take  the  liberty  to  urge.  Without  accuracy  in  the 
performance  of  the  feats,  the  interest  must  be  transient.  This  prin- 
ciple is  strikingly  exemplified  in  military  training.  Those  who  have 
studied  our  infantry  drill  have  been  struck  with  its  simplicity,  and 
have  wondered  that  men  could  go  through  with  its  details  every  day 
for  years  without  disgust.  If  the  drill-master  permits  carelessness, 
then  authority  alone  can  force  the  men  through  the  evolutions  ;  but 
if  he  enforce  the  greatest  precision,  they  return  to  their  task  every 
morning  for  yeare  with  cheerfulness. 

At  this  point  it  may  be  urged  that  those  exercises  which  hasten  the 
action  of  the  thoracic  viscera  to  any  considerable  degree  are  simply 
exhaustive.  This  is  another  blunder  of  the  "  big-muscle  "  men.  They 
seem  to  think  you  can  determine  every  man's  constitution  and  health 
by  the  tape-line ;  and  that  all  exercises  whose  results  are  not  deter- 
minable by  measurement  are  woi-thless. 

I  need  scarcely  say  there  are  certain  conditions  of  brain,  muscle, 
and  of  every  other  tissue,  far  moie  important  than  size ;  but  what  I 
desire  to  urge  more  particularly  in  this  connection  is  the  importance, 
the  great  physiological  advantages,  of  just  those  exercises  in  which 
the  lungs  and  heart  are  brought  into  active  play.  These  organs  are 
no  exceptions  to  the  law  that  exercise  is  the  principal  condition  of 
development.  Their  vigorous  training  adds  more  to  the  stock  of 
vitality  than  that  of  other  organs. 

I  have  said  an  elastic  tone  of  the  nervous  system  is  the  physiolog- 
ical purpose  of  all  physical  training.  If  one  may  be  allowed  such  an 
analysis,  I  would  add  that  we  exercise  our  muscles  to  invigorate  the 
thoracic  and  abdominal  viscera.  These  in  their  turn  support  and  in- 
vigorate the  nervous  system.  All  exercises  which  operate  more  di- 
rectly upon  these  internal  organs,  as,  for  example,  laughing,  deep 
breathing,  and  running,  contribute  most  effectively  to  the  stamina  of 


SI3iiBj»W«HMMMAa!WfeijM^ 


952 


PHYSICAL  CITLTURK. 


the  brain  and  nerves.  Tt  is  only  this  mania  for  monstrous  arms  and 
shoulders  that  could  have  misled  the  intelligent  gymnast  on  t'-is 
point. 

As  our  artificial  training  is  designed  to  fit  us  for  the  more  succiess- 
ful  performance  of  the  business  of  life,  I  suggest  that  the  training 
should  be,  in  character,  somewhat  preparatory  for  those  duties.  If 
you  would  train  a  horse  for  the  carriage,  you  would  not  do  it  by 
driving  at  a  slow  pace  before  a  heavy  load.  If  you  did,  the  first  fust 
drive  would  go  hard  with  him. 

Just  so  with  a  man.  If  he  is  to  lift  barrels  of  flour,  or  kegs  of 
nails,  as  a  business,  he  may  be  trained  by  heavy  lifting ;  but  if  his 
business  requires  the  average  velocity  and  free  motions  of  human 
occupations,  then  upon  the  basis  of  his  heavy  slow  training,  he  will 
find  himself,  in  actual  life,  in  the  condition  of  the  dray-horse,  who  is 
pushed  before  the  light  carriage  at  a  high  speed. 

Is  it  true  that  in  either  intellectual  or  phjrsical  training,  bold, 
brilliant  efforts,  under  proper  conditions  and  limitations,  exhaust  the 
powers  of  life?  On  the  contmry,  is  it  not  true  that  we  find  in  vigor- 
ous, bold,  dashing,  brilliant  efforts  the  only  source  of  vigorous,  bold, 
dashing  and  brilliant  powers  ? 

In  this  discussion  I  have  not  considered  the  treatment  of  invalids. 
The  principles  presentcvi  arc  applicable  to  the  training  of  children 
and  adults  of  average  vitality. 

I  will  rest  upon  the  general  statement  that  all  persons  of  both 
sexes,  and  of  every  age,  who  are  possessed  of  average  vitality,  should, 
in  the  department  of  physical  education,  employ  light  apparatus,  and 
execute  a  great  variety  of  feats  which  require  skill,  accuracy,  cour- 
age, dash,  presence  of  mind,  quick  eye  and  hand, —  in  brief,  which 
demand  a  vigorous  and  complete  exercise  of  all  the  powers  and 
faculties  with  which  the  Creator  has  endowed  us ;  while  deformed 
and  diseased  persons  shoul4  be  treated  in  consonance  with  the  phi- 
losophy of  the  Swedish  Movement  Cure,  in  which  the  movements  are 
slow  and  limited. 

We  rejoice  to  see  that  the  American  people  of  all  classes  and  both 
sexes  are  taking  more  and  more  interest  in  outdoor  sports.  The 
bicycle,  if  used  in  reasonable  moderation,  will  prove  a  great  factor 
in  the  physical  development  of  both  sexes ;  but  the  danger  is  that 
the  American  idea  of  trjHing  to  outdo  others  will  cause  the  young 
vidth  untried  muscles  to  attempt  century  runs  and  generally  to  overdo ; 
while,  if  they  should  take  reasonable  rides,  and  enjoy  the  fresh  air 
and  scenery,  it  would  prove  a  benefit  to  mind  and  body. 

There  are  many  simple  contrivances  to  use  at  home,  if  not  conven- 
ient to  take  full  gymnastic  courses.  We  give  a  description  of  two, 
either  of  -which,  if  faithfully  used,  will  be  of  great  benefit. 


■^i^i^la^i^BM 


PHYSICAL  CULTURE.  ^^'i 


trous  arms  and 
^mnaBt  on  tl'is 

e  more  succtess- 
it  the  training 
ose  duties.  If 
1  not  (]o  it  by 
id,  the  first  fust 

)ur,  or  kegs  of 
ing  ;  but  if  his 
ions  of  human 
raining,  he  will 
.y-horse,  who  is 

training,  bold, 
ns,  exhaust  the 
^e  find  in  vigor- 
vigorous,  bold, 

ent  of  invalids, 
ing  of  children 

lersons  of  both 
vitality,  should, 
I  apparatus,  and 
accuracy,  cour- 
in  brief,  which 
he  powers  and 
irhile  deformed 
e  with  the  phi- 
movements  are 

lasses  and  both 
sports.  The 
a  great  factor 
danger  is  that 
,use  the  young 
rally  to  overdo ; 
y  the  fresh  air 

if  not  conven- 
ription  of  two, 
lefit. 


i. 


The  Whitely  Exerciser. 

As  this  method  is  introduced  with  the  strictly  American  idea  of 
furnishing  "  the  shortest  route  and  fastest  time "  to  health  and 
strength,  you  may  expect  some  radical  departures  from  older  meth- 
ods. 

After  your  regular  day's  work  is  ended,  you  are  not  aaked  to  do 
another  each  evening,  performing  feats  of  strength  which  tax  your 
endurance  to  the  utmost,  and  leave  you  "  all  broke  up  "  the  next 
day.  It  has  been  demonstrated  that  heavy  gymnastics,  like  numer- 
ous other  ponderous  and  unwieldy  things  of  the  past,  are  by  no  means 
the  liest.  On  the  contrary,  exercises  that  admit  of  numerous  move- 
ments of  the  muscles  without  greatly  taxing  the  vital  fokces, 
produce  lai-ger  development  and  better  quality.  Muscular  tissue 
built  in  this  way  is  not  ordy  strong,  but  quick  and  active,  while  that 
developed  with  heavy  weights  is  hard  and  slow. 

You  are  not  required  to  waste  time  in  the  preliminary  study  of 
an  intricate  system  of  movements.  For  brain-workers,  a  system  that 
requires  study  is  directly  at  variance  with  one  of  the  prime  objects 
of  musculcr  exercise,  namely,  entire  relief  from  mental  strain.  But, 
if  you  dcn't  have  to  think,  it  is  because  someone  has  done  it  for 
you ;  for  the  exercises,  howbeit  simple,  are  scientifically  arranged  to 
bring  into  action  every  muscle  in  your  body. 

Dumb-bells  and  Indian  clubs  exercise  the  muscles  of  the  arms  and 
shoulders  but  do  not  reach  the  muscles  that  pull  the  arms  down- 
ward. 

The  Whitely  Exerciser  is  at  once  complete,  compact  and  noiseless ; 
requiring  no  floor-room,  no  changing  of  weights,  for  it  adjusts  itself 
to  any  degree  of  resistance ;  no  buckling  of  straps  or  other  parapher- 
nalia ;  can  be  put  up  in  two  minutes  without  the  use  of  a  single  tool, 
and  if  desired  can  be  removed  from  the  hooks  and  put  out  of  sight  in 
a  moment  and  readjusted  for  use  just  as  quickly.  It  imparts  an  easy, 
gliding  motion,  necessary  to  successful  development. 

It  is  equally  adapted  to  ladies,  gentlemen  and  children. 

Directions  for  Putting  up.  —  The  Exerciser  will  work  at  any 
angle,  so  select  any  place  in  your  room  that  permits  an  unobstructed 
floor  space  in  any  direction.  Better  work  toward  a  window  that  will 
permit  of  ventilation  from  above  than  away  from  it. 

Standing  on  an  ordinary  chair,  screw  two  hooks  into  the  door  or 
window-frame  on  a  level  with  your  nose  and  from  two  to  six  inches 
apart  as  best  suits  the  form  of  the  woodwork  ;  lower  hooks  two  inches 
from  the  floor,  or  in  the  floor  if  you  are  short  of  stature. 

Should  there  be  a  sill  or  other  obstruction  to  be  avoided,  put  the 
lower  hooks  in  the  floor  at  sufficient  distance  from  the  wall  to  make 
the  cords  clear  the  obstruction. 

The  middle  pulley  is  purposely  made  without  a  swivel  to  prevent 


IS 

? 


954 


PHY8I0AL  CULTURE. 


twisting  of  the  cord  when  in  iiae,  so  run  out  dny  twist  between  it 
and  the  pulleys  attached  to  the  triangle  l)efore  putting  it  on  the 
hook.  The  pulleys  on  the  triangle  are  swiveled  that  the  Exerciser 
may  adjust  itwelf  to  any  movement  or  work  in  any  direction,  and  if 
the  cords  twist  together  between  them  and  the  handles  a  pull  on  the 
latter  will  untwist  them. 

The  rubl)er  cord,  or  rather  cable,  is  calculated  to  withstand  unlim- 
ited use  and  a  much  greater  tension  than  required  for  ordinary  exer- 
cise, but  don't,  on  that  acco;  at,  abuse  it  unnecessarily. 

Don't  use  a  cord  that  is  too  strong  for  you.  If  you  do  you  will 
be  exhausted  but  not  benefited  by  your  exercise.  The  cords  are  made 
of  various  strengths,  be  sure  you  obtain  one  adapted  to  you ;  that  is, 
one  that  pulls  easily  when  close  to  the  Exerciser.  As  you  grow 
stronger,  you  have  only  to  stand  a  little  further  from  the  Exerciser 
to  obtain  a  re^  Istsmce  suited  to  your  increasing  strength. 

It  is  not  how  much  you  pull,  but  how  often,  so  use  no  more  force 
than  is  agreeable. 

If  your  exercise  is  too  vigorous  or  too  heavy,  you  will  be  exhausted 
before  you  can  complete  it.  It  is  better  to  exercise  all  parts  of  the 
body  a  little  than  a  few  much.  If  you  are  sick  or  weak,  exercise 
very  moderately,  and  stop  the  moment  you  feel  the  least  exhausted. 
If  well  and  strong,  be  moderate  for  the  first  week  or  two,  or  exercise 
will  make  you  sore.  When  a  muscle  is  tired  it  hurts,  and  to  force 
it  beyond  that  point  is  harmful. 

Exercise  when  you  have  time  for  it.  Not  for  an  hour  after  meals, 
certainly,  unless  it  be  very  moderately.  After  eating,  your  stomach 
needs  all  your  force,  and  much  of  your  blood,  which  under  exercise 
would  be  drawn  to  the  muscles. 

Perhaps  the  most  convenient  time  to  exercise  is  just  before  retir- 
ing, as  it  puts  the  body  and  brain  in  condition  for  refreshing  sleep. 
Sedentary  people  should  keep  the  apparatus  in  the  office,  if  possible, 
to  exercise  when  they  feel  the  need  of  it,  —  that  is  when  your  br.iin 
is  tired,  and  your  thoughts  refuse  to  flow  freely.  A  little  vigorous 
exertion  will  renew  the  supply  of  blood  in  the  brain,  and  with  new 
blood  will  come  clear  thought  and  new  ideas. 

A  tired  feeling  is  not  always  due  to  exhaustion ;  it  is  more  fre- 
quently due  to  congestion  of  the  blood  in  some  particular  spot,  and 
is  quickly  dispelled  by  exercise.  Make  the  attempt,  but  if  the  tired 
feeling  does  not  soon  disappear,  you  will  understand  that  it  is  true 
exhaustion  for  which  sleep  is  the  only  remedy. 

Make  up  your  mind  that  you  will  exercise,  be  it  midnight  or  morn- 
ing, when  you  retire,  and  you  will  be  repaid  for  it  in  the  quality  of 
sleep  that  follows ;  though  at  such  times,  unless  excited,  it  is  well  to 
somewhat  curtail  the  amount  of  each  movement,  or  you  will  tire  be- 
fore you  finish  the  list.  At  such  times,  also,  some  regard  to  the  mus- 
cles that  have  beeen  used  during  the  day  is  p  .jable ;  but  when  you 
have  time  to  exercise  each  group  of  muscles  completely,  this  matter 


PHYSICAL  CULTURE. 


955 


St  between  it 
ing  it  on  the 
ttie  Exerciser 
ection,  and  if 
a  pull  on  the 

hstand  iinliin- 
ordinary  exer- 

u  do  you  will 
Drds  are  made 
you ;  that  is, 
As  you  grow 
the  Exerciser 
1. 
ao  more  force 

be  exhausted 
1  parts  of  the 
/eak,  exercise 
st  exhausted, 
o,  or  exercise 
and  to  force 

r  after  meals, 
your  stomach 
nder  exercise 

;  before  retir- 
reshing  sleep. 
0,  if  possible, 
en  your  br.iin 
ittle  vigorous 
md  with  new 

;  is  more  fre- 
ilar  spot,  and 
it  if  the  tired 
lat  it  is  true 

ight  or  iBorn- 
;he  quality  of 
,  it  is  well  to 
I  will  tire  be- 
i  to  the  mus- 
jut  when  you 
r.  this  matter 


will  regulate  itself,  for  those  that  have  l)een  used  during  the  day 
will  tire  sooner  than  the  othera.  Nature  ])uts  a  limit  to  muscular 
development,  beyond  which  no  amount  of  exercise  will  force  it,  and 
it  is  therefore  only  necessary  to  exercise  all  the  muscles  regularly,  to 
eventually  bring  the  entire  body  to  a  symmetrical  shape,  and  tlie 
liighest  stage  of  development. 

If  practicable,  take  your  exercise  in  the  condition  indicated  in  tlie 
cuts ;  for  at  least  once  a  day  the  l)0(ly  should  be  free  to  act  without 
restraint  of  clothing,  and  moreover,  fresh  air  is  a  tonic  to  the  skin 
which  lessens  your  chances  of  taking  cold. 

Fresh  air  is  an  indispensable  adjunct  to  exercise,  but  the  room 
should  never  be  chilly. 

Never  exercise  beyond  the  ability  of  the  heart  to  keep  pace  with 
yoij ;  palpitation  is  a  sure  indication  of  excess.  Exercise  only  as 
vigorously  as  is  agreeable,  and  in  keeping  with  your  strength. 

Do  not  exercise  long  or  h  :'d  early  in  the  morning,  as  it  is  apt  to 
exhaust  you  bexore  the  vital  forces  are  fully  aroused,  and  you  do  not 
recover  during  the  day.  If  you  rise  as  late  as  half  past  eight  or  nine, 
vigorous  exercise  is  not  likely  to  hurt  you,  unless  you  Ixdt  your 
breakfast,  and  rush  off  to  work  immediately  following  it. 

In  making  the  movements,  endeavor  to  forget  you  are  exercising, 
and,  if  possible,  imagine  you  are  doing  the  things  the  movements  in- 
dicate. 

Exercise  No.  1. — Throwing.  Suspend  the  apparatus  as  in  posi- 
tion No.  4,  grasp  the  handles  with  either  hand,  and  make  a  mo^  e- 
ment  exactly  as  though  throwing  a  ball  or  light  stone.  Having  tired 
the  muscles  on  one  side,  change  to  the  other  and  repeat  the  move- 
ment until  that  side  is  tired,  also. 


This  movement  brings  into  play  the  muscles  in  front  of  the  neck, 
the  large  muscles  on  the  front  of  the  chest,  the  muscles  on  the  front 


'm 


■^i'mi-^^-i 


966 


PHYSICAL  CULTUHK. 


and  side  of  the  abdomen,  nearly  all  the  muscles  of  the  legs,  and  broad- 
ens  the  chest.  Draw  in  the  breath  as  you  take  the  first  position,  and 
blow  it  out  forcibly  as  you  make  the  movement. 

If  the  tension  is  not  strong  enough  with  one  handle,  it  may  be 
doubled  by  taking  both  in  one  hand. 

Before  releasing  your  hold  on  the  handles  relax  the  tension  and 
give  the  cords  time  to  untwist.  If  oiled  the  Hwivels  will  revolve 
without  assistance. 

Exercise  No.  2.  —  Houting.  —  Take  a  handle  in  each  hand  and 
make  a  movement  as  though  hoisting  a  bucket  of  pitch  or  gravel  to 
the  roof  of  a  high  building. 


This  exercise  brings  into  action  the  muscles  on  the  sides  of  the 
neck,  muscles  of  the  fore-arms,  back-arms,  muscles  of  the  bac'c  that 
draw  the  shoulders  together,  side  muscles,  and  muscles  on  front  of 
thighs.  In  making  this  movement,  endeavor  to  send  the  "  bucket " 
as  high  as  possible  at  each  sweep  of  the  arm.  In  doing  so,  you  will 
diaw  the  arm  back  and  around  in  a  way  that  is  necessary  to  develop 
the  particular  muscles  which  this  movement  is  intended  to  reach. 

Take  in  the  breath  as  one  hand  is  drawn  down,  and  as  the  other 
comes  down,  expel  it. 

Exercise  No.  3 Suspend  Exerciser  as  per  cut,  and  use  each  hand 

alteinately.  This  exercise  strengthens  the  muscles  of  the  arm, 
shoulder  and  thigh.  Another  exercise  is  made  by  turning  the  back 
to  the  Exerciser.  Putting  the  cords  over  the  shoulders,  hands  on 
back,  then  bend  foi-ward  and  back.  This  movement  is  particularly 
intended  to  reach  the  large  muscles  on  the  front  of  the  chest  and 
abdomen. 


m^^m^m^mm^mm 


knees  as  you  draw  the  arms  down,  and  as  the  arms  go  up,  bring  them 
together.      This  latter  part  of  the  movement  exercises  the  muscles 


"f^«Mi>|B««lMMjiiaMIMi 


958 


PHYSICAL  CULTURE. 


on  the  inside  of  the  legs  which  are  much  used  in  swimming.     Draw 
in  the  breath  as  the  arms  go  up,  and  expel  it  as  you  draw  them  down. 
This  movement  is  a  good  chest-expander. 

Exercise  No.  S.~  Putting  the  shot.  —  Shift  the  apparatus  to 
position  No.  6.  Grasp  the  handle  in  one  hand,  and  make  a  move- 
ment as  though  throwing  a  heavy  stone  or  shot.  Draw  in  the  breath 
as  you  begin  the  movement,  expel  it  as  you  finish.  When  the 
muscles  of  one  side  are  tired,  change  to  the  other  and  repeat  the 
movement. 


The  exercise  expands  particularly  the  upper  portion  of  the  chest, 
exercises  the  fore-arm  and  biceps,  or  front  muscles  of  the  upper  arm, 
triceps,  or  back  muscles  of  the  upper  arm,  the  upper  portion  c'  the 
large  muscles  on  front  of  the  chest,  and  muscles  on  side  of  shoulder ; 
also  the  side  muscles  of  the  body,  and  nearly  all  the  muscles  of  the 
legs  and  feet 


Exercise  No.  6.  —  Romng. 


This  movement  may  be  made  either 
sitting  or  standing,  though  it  is 
better  made  sitting.  With  a 
handle  in  each  hand,  make  a 
movement  as  you  would  in 
rowing:  as  the  body  goes  for- 
ward spread  the  knees,  as  re^ 
resented  in  the  first  cut,  and  as 
you  go  back,  bring  them  to- 
gether as  shown  in  the  second. 
The  breath  may  be  drawn  in 
either  as  the  body  goes  forward 
or  backward,  but  as  a  rule,  in 
any  exercise,  it  is  better  to  take 


I   ', 


PHYSICAL  CULTURE. 


m 


imming.     Draw 
raw  them  clown. 


e  apparatus  to 
1  make  a  move- 
iw  in  the  breath 
sh.  When  the 
and  repeat  the 


n  of  the  chest, 
the  upper  arm, 
■  portion  c'^  the 
de  of  shoulder ; 
muscles  of  the 

be  made  either 
ttg,  though  it  is 
iting.     With  a 

hand,  make  a 
y^ou  would  in 
body  goes  for- 

knees,  as  re^ 
first  cut,  and  as 
)ring  them  to- 
in  the  second, 
ay  be  drawn  in 
y  goes  forward 
t  as  a  rule,  in 
i  better  to  take 


the  breath  before  the  exertion.  In  this  movement  be  careful  to  draw 
tlie  arms  and  shoulders  well  back ;  for  rowing,  as  it  is  generally  per- 
formed with  the  sliding  seat,  tends 
to  contract  the  front  of  the  chest. 
The  movement  made  as  indicated 
in  the  cuts,  or  in  rowing  without 
the  sliding  seat,  overcomes  that 
objection  to  the  sport.  In  rowing, 
we  use  the  muscles  of  the  fore-arm, 
biceps,  back  muscles  of  the  shoul- 
ders, nearly  all  the  muscles  of  the 
back,  and  the  muscles  of  the  back 
of  the  neck  have  considerable  to 
do.  With  the  sliding  seat,  the 
muscles  in  front  of  the  legs  do 
much  of  the  work,  but  as  all  the 
other  movements  exercise  the  legs, 
there  would  be  nothing  gained  in 
having  the  seat  for  this  exercise. 
In  fact,  the  development  of  the 
muscles  on  the  inside  of  the  legs,  as  is  done  in  the  way  the  move- 
ment is  here  described,  is  much  more  to  the  point ;  for  with  the 
exception  of  exercise  No.  4,  these  muscles  have  had  little  work. 

Exercise  No.  7 Lie  down  on  floor.     Head  to  Exerciser.     Lift 

hands  straight  over  head,  touch  the  floor  and  sink  to  hips.      Raise 
body  to  sitting  position  without  lifting  feet  from  the  floor. 


This  exercise  plaj^s  particularly  on  t^  front  muscles  of  the  shonl- 
jlers,  and  some  muscles  in  the  back,  and  is  specially  designed  to 
strengthen  the  abdominal  muscles. 


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f-Jf'/r^'^ 


>'.i^-'.t.>-.M:. 


960 


PHYSICAL  CULTURE. 


£ 


Inhale  the  breath  fully  as  the  arms  ascend,  and  expel  it  forcibly  as 
they  descend.  '' 

Exercise  No.  8.— Bowling.  — Suspend  one  handle  again  as  in 
position  No.  6  ;  with  the  other  hand  free,  make  a  movement  as  though 


to  throw  a  ball  as  in  bowling.     Draw  in  the  breath  and  expel  it  in 
the  forward  movement. 

This  exercise  develops  the  muscles  of  the  arms  and  legs. 

As  a  finishing  touch,  this  old-fashioned  exercise  for  expanding  the 
chest  is  given.  From  a  position  with  the  hands  down  at  the  sides, 
raise  the  arms  laterally  to  a  position  high  over  your  head,  keeping 


the  elbows  straight.  Inhale  all  the  breath  you  possibly  can  as  the  arms 
go  up ;  bring  the  arms  down  again  to  the  position  first  indicated,  but 
retain  the  breath  for  a  moment  after  you  have  finished  the  movement. 


•rnism 


PPP?^ 


ni^ 


pel  it  forcibly  as 

le  again   as   in 
ment  as  though 


PRONOUNCING  DICTIONARY.  -  GLOSSARY. 


md  expel  it  in 

legs. 

expanding  the 

n  at  the  sides, 

head,  keeping 


an  as  the  arms 
indicated,  but 
he  movement. 


Ab-do'&eo.    The  belly. 

A-ce-tab'u-lum.  The  socket  for  the 
head  of  the  thigh  bone. 

Ab-dom'i-oal  c«v'i-ty.  The  cavity  of 
the  belly. 

Ab-duc'tor.  A  muscle  which  draws  one 
part  of  the  body  towards  another. 

Ab-sor' bents.  Qlands  and  vessels 
which  absorb  or  suck  up  substances 
from  within  or  without;  also,  medicines 
which,  though  nearly  or  quite  inactive 
themselves,  absorb,  or  combine  with 
acid  matter  in  the  stomach  or  bowels, 

A-cro'mi-on.  That  part  of  the  scapula, 
or  shoulder-blade,  which  unites  with  the 
collarbone. 

Al-bu-gin'e-a.    The  white  of  the  eye. 

Al'ter-a-tives.  Medicines  which  gradu- 
ally reestablish  health,  without  sensibly 
increasing  the  circulation,  or  augment- 
ing the  perspiration,  urine,  or  other  ex- 
cretions. 

Al'  ve-o-lar.  Relating  to  the  sockets  of 
the  teeth. 

Al'vine  (Al'vin) .  Relating  to  the  Intes- 
tines, as  alvine  diachargea,  —  discharges 
from  the  bowels. 

A-mor'phou8.  Having  no  regular  form. 

Am-ni-ot'ic  liq'uid.  The  fluid  sur- 
rounding the  fetus  in  the  womb. 

An-jes-the'aia.    Suspended  sensibility. 

An-as'to-mose.  The  uniting  of  arteries 
and  veins  by  joining  their  mouths. 

An-chy-lo'sis.     A  stiff  or  useless  joint. 

An-i-mal'cu-ls,  Animals  so  small  that 
they  can  only  be  seen  with  a  microscope. 

An-ae'mi-a.  Privation  of  blood;  a  com- 
paratively bloodless  state. 

An'o-dynes.  Medicines  which  diminish 
sensibility,  abate  pain,  and  induce  sleep. 
It  should  always  be  remembered  that 
anodynes  when  frequently,  and  long 
taku,  lose  their  influence  in  disease. 

Ant-a'cids.  Preparations  which  neu- 
tralize acidity  of  the  stomach  and  bowels. 

Ant-al'ka-Iies.  Agents  which  neutral- 
ize alkalies. 

An-ta-phro-ais'i-aca.  Agents  which  les 
sen  or  blunt  the  sexual  propensities. 


An-thel-min'tics.  Medicines  which  de- 
stroy and  expel  worms. 

An'ti-dotes.  Medicines  which  counter- 
act and  destroy  the  effects  of  poison. 

An-ti-pe-ri-od'ics.  Medicines  which  pre- 
vent or  cure  diseases  of  a  periodical  char- 
acter. 

An-ti-pMo-gis'tics.  Medicines  or  diet 
which  remove  or  appease  inflamma- 
tion. 

An-ti-spos-mod'ics.  Medicines  which 
prevent  or  allay  spasms,  commonly 
called  cramps. 

An-ti-«yph-i-lIt'iC8.  Medicines  which 
cure  syphilis. 

An-ti-s«p'tic.  Whatever  checks  or 
counteracts  putrefaction. 

An-ti-8cor-bu'tics.  Articles  which  pre- 
vent and  cure  scurvy. 

A-pe'ri-«nt8.  Medicines  wliioh  gently 
open  the  tiowels. 

A-pho'ni-a.    A  loss  of  the  voice. 

Aph-ro-dis'i-acs.  Medicines  supposed 
to  excite  and  promote  the  sexual  aone- 
tlte.  '^^ 

A-pon-eu-ro'sis.  The  membranous  ex- 
pansion of  tendons  and  muscles. 

A-re-o'la.  A  colored  circle,  as  the  cir- 
cle around  the  nipple. 

Ar-o-mat'ic8.  Medicines  which  have  a 
grateful,  spicy  smell,  and  an  agreeable, 
pungent  taste. 

As-phyx'i-a.  Suspended  animation; 
apparent  death. 

As-then'ic.  Relating  to  debility ;  or  to 
disease  marked  by  debility. 

As-trin' gents.  Medicines  which  have 
the  power  to  constringe  or  pucker  up  the 
ti8suet»  of  the  body,  and  thereby  check 
discharges. 

At'ro-phy.  A  wasted  condition ;  lean- 
ness. 

Ax-il'la.    The  arm-pit. 

Atts-cul-ta'tion.  The  art  of  detecting 
disease  by  listening  to  the  sounds  of  the 
lungs,  heart,  etc. 

Au-top'sy.  Personal  inspection, —  used 
in  the  sense  of  a  post-mortem  examina- 
tion. 

961 


•'nm 


962 


QLOSSABT 


A-zo'te.  Nitrogen ;  one  of  the  oonatlt- 
uents  of  the  atmosphere. 

Bron'chi-a.  The  pipes  which  convey 
the  air  through  the  lungs. 

Bnr'sae  mu-co'sa.  Small  sacs,  situated 
under  tendons,  about  the  joints,  contain- 
ing a  sticky  Quid. 

Cal'cu-lus.  A  solid,  unorganized  body 
formed  in  the  kidneys,  or  bladder,  and 
called  a  stone.    The  plural  is  calcuU. 

Cap'il-la-ry.   Small,  resembling  a  hair. 

Cap' sale.  A  membranous  bag,  enclos- 
ing a  part. 

Car'ti-lage.  Gristle  attached  to  the 
ends  of  the  bones. 

Car  min'a-tives.  Medicines  which  ex- 
pel wind  from  the  stomach  and  bowels, 
and  allay  the  pain  caused  by  it. 

Ca-thar'tic8.  Medicines  which  purge 
the  bowels. 

Cer'vix.  The  neck.  Oer'vix  Vter-i. 
The  neck  of  the  womb. 

Car'di-ac.    Belating  to  the  heart. 

Car' pal.    Belating  to  the  wrist. 

Cat-a-me'ni-a.  The  monthly  flow  of 
females. 

Purging. 
A  tvibe  for  drawing  off  the 


Ca-thar'sis 
Cath'e-ter. 
urine. 
Cel-la'lar. 
Cer'e-bral 


Belating  to  cells. 
Belating  to  the  brain. 

Cha-Iyb'e-ate.  Containing  Iron  or  steel. 

Che-mo 'sis.  A  swelling  of  the  eye,  in 
which  the  eye  projects,  with  a  depression 
in  th(  centre. 

Cho'  la-gogne.  A  medicine  which  causes 
a  discharge  of  bile. 

Clo'nic  spasms.  Spasms  which  are 
rigid  and  relaxed  alternately. 

Col-li'  qua-tive.  This  term  Is  applied  to 
excessive  and  exhausting  discharges. 

Co-los'tnun.  The  flrstsecretion  of  milk. 

Co' ma.    Profound  stupor,  or  sleep. 

Con'dyle  (kon'dil).  A  knob;  applied 
to  certain  projections  of  bones  at  joints. 

Con'flu-«nt.  Not  distinct ;  running  to- 
gether. 

Con-gen't-tal.  Existing  at  the  time  of 
birth. 

Con-ges'tion.  Distention  of  parts  by 
an  accumulation  of  blood  in  them. 

Con-janc'ti-va.  The  membrane  which 
covers  the  eye  and  lines  the  eyelid. 

Con'tra-in'di-ca-ted.  Not  indicated ; 
the  opposite  implied. 

Cord'ials.  Medicines  which  have  a 
grateful,  warming  and  exhilarating  ef- 
fect upon  the  stomach. 

Conn'ter-ir'ri-tants.  Articles  which  by 
irritating  one  part,  withdraw  blood  from, 
and  relieve  another. 

Cri'sis.  The  turning  point  of  a  disease. 

Cn'ti-cla.  The  epidermis;  the  seart- 
Bkln. 


De-cid'n-a.  A  thin,  external  membrane, 
within  the  womb,  thrown  off  after  child- 
bearing. 

De-liq'ui-um.    Fainting. 

De-mul'cents.  Medicines  of  a  softening 
nature,  which  correct  acrid  coudltionB, 
and,  by  their  bland  effects,  soothe  in- 
flamed and  irritated  parts. 

De-ple'tlon.  Diminishing  the  fullness 
of  a  part  or  parts,  as  by  purgatives,  or 
bleeding. 

De-sqna-ma'tion.  Separation  of  the 
skin  in  scales;  scaling  off. 

De-ter'gents.  Medicines  which  cleanse. 

Di-ag-no'sls.  The  art  of  determining 
the  nature  of  diseases. 

Di-a-pho-ret'ics.  Medicines  which  pro- 
mote sweating. 

Di-ath'e-sis.  Any  particular  disposi- 
tion, state,  or  habit  of  body. 

Di-u-re'sis.     CJopious  flow  of  urine. 

Dil'u-ents.  Watery  drinks,  which  in- 
crease the  fluidity  of  the  blood,  and  ren- 
der several  of  the  secretive  and  excretive 
fluids  less  viscid. 

Dis-cu'  tients .  Medicines  which  scatter, 
resolve,  or  disperse  tumors. 

Dis-in-fec'tants.  Articles  which  purify 
or  cleanse  Infected  places. 

Di-u-ret'ics.  Medicines  which  increase 
urinary  secretions. 

Dras'tics.    Strong  and  violent  purga- 


tives. 
Dysp-noe'a. 
E-me'sis. 
£-met'ics. 


DiflSculty  of  breathing. 
Vomiting. 

Medicines  which  cause  the 
stomach  to  reverse  Its  action,  and  throw 
its  contents  up  through  the  mouth. 

Em-men'a-gogues.  Medicines  supposed 
to  have  the  power  of  e.\  siting  or  increas- 
ing the  menses. 

E-mol'lients.  Those  substances  which 
have  the  power  of  softening  or  relaxing 
the  animal  fibre,  when  applied  externally. 

En-dem'ic  dis-eas'es.  Diseases  pre- 
vailing in  certain  localities  or  districts. 

Ep-i-dem'ic  dis-eas'es.  Diseases  ex- 
tending over  a  large  extent  of  country. 

Ep-i-glot'tis.  The  cartilage,  which,  in 
the  act  of  swallowing,  shuts  down  upon 
the  top  of  the  wind-pipe,  and  prevents 
food  from  going  into  the  breath-passage. 

£p-ls-pas'tic8.  Substances  which  in- 
flame thu  skin,  and  raise  the  cuticle,  and 
cause  what  is  called  a  blister. 

Es-cha-rot'ics.  Articles  which  bum, 
corrode,  disorganize,  and  destroy  the 
animal  tissues,  causing  what  is  called  an 
eschar,  or  slough,  which  Ib  dead  matter, 
and  falls  off. 

Ex-pec' to-rants.  Articles  which  act 
upon  the  system,  so  as  to  make  the  dis- 
charge of  mucus  and  other  substances 
from  the  air-tubes  more  easy. 


£i\ififi''rfi,iiaMlif^:f*r'ry.-^.jjirr,!f,'^  ,  ,^,, 


GLOSSARY. 


963 


xtemal  membrane, 
own  off  after  chlld- 

tlng. 

ciaes  of  a  softening 

t  acrid  conditions, 

effects,  soothe  In- 

>arts. 

Ishlng  the  fullness 

}  by  purgatives,  or 

Separation  of 
goff. 
ines  which  cleanse, 
art  of  determinlcg 
i. 

jdlcines  which  pro- 
particular  disposl- 
f  body. 

18  flow  of  urine. 
Y  drinks,  which  In- 
the  blood,  and  ren- 
etlve  and  excretive 

jines  which  scatter, 

iimors. 

■tides  which  purify 

aces. 

nes  which  increase 

md  violent  purga- 

ilty  of  breathing. 

les  which  cause  the 
3  action,  and  throw 
gh  the  mouth, 
iiledicines  supposed 
Bx<;itlng  or  Increas- 

B  substances  which 
ftening  or  relaxing 
1  applied  externally. 
B.  Diseases  pre- 
illties  or  districts. 
es.  Diseases  ex- 
extent  of  country, 
cartilage,  which,  in 
,  shuts  down  upon 
pipe,  and  prevents 
the  breath-passage, 
bstances  which  In- 
liee  the  cuticle,  and 
i  blister. 

sides  which  bum, 

and   destroy  the 

>g  what  is  called  an 

lich  is  dead  matter, 

Lrtlcles  which  act 
is  to  make  the  dis- 
1  other  substances 
)re  easy. 


the 


the 


Er'rhines.  Substances  whicli  cause 
sneezing  and  a  discharge  of  mucus 
from  the  nose  when  snuffed. 

Es'char.  The  dead  part,  killed  by 
caustic  or  mortiflcation,  which  falls  off; 
a  slough. 

£x-f o-ll-a  'tion .  A  sealing  off,  as  a  piece 
of  dead  bone. 

Fau'ces.    The  back  part  of  the  mouth. 

Fe'brile.     Belonging  to  fever. 

Fe'ces.  The  matter  discharged  from 
the  bowels. 

Feb'ri-fu-ges.  Medicines  which  assuage 
or  remove  fevers. 

Fla'tus.  Wind,  or  rather,  gas,  In  the 
stomach  or  bowels. 

Fol'li-cle.     A  little  bag  or  sac. 

Fo-ra'men.     A  hole  or  opening. 

For-mi-ca'tion.     A  sensation  like 
creeping  of  ants. 

Fur-fu-ra'ceous.    Branny  or  scaly. 

6ang'li-on.      An   enlargement  In 
course  of  a  nerve. 

Gan'grene.  Mortiflcation;  partial  death. 

Gas'tric.     Belonging  to  the  stomach. 

Ges-ta'tion.     The  period  of  pregnancy. 

Glot'tis.  The  opening  into  the  wind- 
pipe, covered  by  the  epiglottis. 

Gran'tt-lar.     Like  small  grains. 

Gran'u-la-ted.  CJovered  with  granula- 
tions. 

Gran-u-la'  tion.  The  filling  up  or  cover- 
ing of  a  wound  or  ulcer,  with  small,  red 
elevations,  looking  like  grains. 

Hae-mop'ty-sis.  Baising  blood  from 
the  lungs. 

Haem'or-ihage. 

Haem-or-rba'gic. 
bleed. 

He-mi-cra'ni-a.  Fain  on  one  side  of  the 
bead. 

He-pat' ic.    Belonging  to  the  liver. 

Hy-per-ca-thar'sis.  Excessive  purg- 
ing. 

Hy-per'tro-phy.  An  unnatural  enlarge- 
ment of  an  organ,  without  change  of 
structure. 

Hyp-not'ics.  Medicines  which  cause 
sleep. 

Ich'or  (Ik'or).  A  thin,  watery,  and 
acrid  discharge. 

In-ter-cos'tal.    Between  the  ribs. 

Lar'ynx.  The  top  of  the  windpipe; 
the  cavity  which  contains  the  vocal  liga- 
ments. 

Laz'a-tiVes.  Medicines  which  render 
the  bowels  a  little  more  relaxed  than 
natural,  but  do  not  purge. 

Lig'ate.    To  secure  with  a  ligature. 

Lig'a-ture.     A  cord  or  thread. 

Lo~chi-a.  The  bloody  discharge  from 
the  womb  for  some  time  after  child- 
birth. 

Lo'chi-al.    Belatlng  to  the  lochia. 


A  flow  of  blood. 
Having  a  tendency  to 


Lymph.  A  whitish  fluid  contained  by 
the  lymphatic  vessels. 

Lym-phat'ics.  The  vessels  which  carry 
lymph. 

Hac-er-a'tion.  The  act  of  softening  or 
soaking  a  thing  by  letting  it  stand  in 
water. 

Mac'u-lae.    Colored  spots;  blemishes. 

Ma-la' ri-a.  Noxious  gases  from  de- 
composed matter. 

Mam'nut.     The  female  breast. 

Man-dib'u-Ur.     Relating  to  the  jaw. 

Mas-ti-ca'tion.     The  act  of  chewing. 

Mas-tur-ba'tion.  The  act  of  exciting 
the  genital  organs  with  the  hands. 

Men'stni-um.     Any  solvent,  or  vehicle. 

Met-a-car'pus.  The  hand,  between  the 
wrist  and  the  fingers. 

Me-tas'ta-sis.  The  changing  of  a  dis- 
ease from  one  place  to  another. 

Met-a-tar'sus.  That  part  of  the  foot 
between  the  ankle  and  the  toes. 

Mi-as-mat'  ic.  Partaking  of  the  nature 
of  miasm. 

Mu'co-pu'ri-form.  Composed  of  both 
muciis  and  pus. 

Mu'co-se'ro-lent.  Composed  of  both 
mucus  and  serum. 

Nar-cot'ic8.  Medicines  which  relieve 
pain  and  produce  sleep. 

Nau'se-ants.  Medicines  which  cause 
sickness  at  the  stomach,  or  a  disposition 
to  vomit.  They  are  often  used  as  ex- 
pectorants. 

Nos-ol'o-gist  (Noae-ol'o-giat).  One  who 
explains  and  classifies  diseases. 

Ntt'cle-us.     A  central  spot. 

Nu-cle-o'lus.    A  spot  within  a  nucleus. 

Or-thop-noe'a.  Great  difficulty  of 
breathing. 

Os-si-fi-ca'tion.  Tlie  formation  of 
bone. 

Os  u'ter-i.    The  mouth  of  the  womb. 

O'va.    Eggs. 

O'vum.    An  egg. 

Pa-pil'la.  A  red,  elevated  point  upon 
the  tongue,  or  elsewhere.  Certain  dis- 
eases make  these  points  more  promi- 
nent. 

Par-a-cen-te'sis.  The  operation  of 
puncturing  the  chest,  or  the  abdomen, 
for  the  purpose  of  drawing  off  water. 

Par-a-phle'gi-a.  Paralysis  of  the  lower 
half  of  the  body. 

Par'ox-ysm.  A  fit  of  disease  taking 
place  periodically. 

Par-tu'ri-ent.  Bringing  forth,  or  giv- 
ing birth. 

Par-tu'ri-ents.  Medicines  which  pro- 
mote child-bed  labor,  by  causing  con- 
tractions of  the  womb. 

Par-tu-ri'tion.    Child-birth. 

Pec'to-rals.  Medicines  Intended  (o  cure 
or  relieve  diseases  of  the  chest. 


■^in 


964 


GLOSSARY. 


Pel'rls.  The  bony  cavity,  or  basin,  at 
the  lower  part  of  the  body,  oontalning 
the  womb,  abdomen,  rectum,  etc. 

Per-i-ne'um.  The  part,  or  space,  be- 
tween the  anaa  and  testicles. 

Per-i-os'te-um.  A  thin,  hard  mem- 
brane, covering  the  bones. 

Per-i-os-ti'tis.  Inflammation  of  the 
periosteum. 

Per-l-to-ne'um.  A  serous  membrane 
lining  the  cavity  of  the  belly,  and  folded 
over  most  of  the  organs  contained  in  it. 

Pet-e'chi-s.  Purple  spots  which  ap- 
pear upon  the  skin  In  low  fevers,  looliing 
lllie  llea-bites ;  called  also  ecchymoses. 

Pha-ge-den'ic.  Corroding,  eating,— ap- 
plied to  ulcers. 

Pha-Un'ges.  The  bones  of  the  Angers 
and  toes. 

Phar'ynz.  The  upper  part  of  the 
throat. 

Phleg-mo'nons  in-flam-ma'tion.  Inflam- 
mation marlied  by  redness,  heat,  and 
pain,  and  a  tendency  to  form  matter. 

Prog-no'sis.  The  art  of  foretelling  the 
termination  of  diseases. 

Pty'a-lism.    Salivation. 

Pri'a-pism.  A  continued  erection  of 
the  penis  from  exciting,  morbid  causes. 

Re-friz' er-ants.  Medicines  which  les- 
sen the  neat  of  the  >>ody. 

Re-lax'ants.  Medicines  which  relax 
the  tension  of  the  muscles. 

Re-mis'sion.  A  lessening  or  mitiga- 
tion of  the  severity  of  the  symptoms  of 
s  disease. 

Res-o-lu'tion.  Dispersion  of  an  inflam- 
mation before  pus  is  formed. 

Re-Yul'  sives.  Medicines  or  appliances 
which  remove  a  disease  by  causing  a  de- 
termination to  some  other  part. 

Ru-be-fa'cients.  Applications  which  ex- 
fllte  the  skin,  causing  the  blood  to  flow 
to  it,  and  making  it  red. 

Sa'nies.  A  thin  fluid  disoharijed  from 
ulcers,  having  some  of  the  properties  of 
pus  and  blood. 

Sed'a-tives.  Medicines  which  dimin- 
ish the  action  of  the  heart  and  nerves, 
and  which  are  used  when  we  wish  to 
allay  any  excited  action  in  the  system. 

Se'roas.    Watery. 

Scro'tnm.  The  bag  which  contains 
the  testicles. 

Scyb'a-1«.  Hard,  round  lumps  in  the 
feces. 

Si'a-la-gogues.  Medicines  which  in- 
crease the  flow  of  saliva. 

Slough  (Sb^ff).  Any  part  of  the  body 
killed  by  mortiflcation,  or  caustic,  and 
cast  off. 

Sper-mat'ic  cords.  Two  cords,  com- 
posed of  nerves,  veins,  and  arteries,  de- 
scending, one  on  each  side,  from  the  a1t>- 


domen  into  the  scrotum,  and  suspetiiling 
the  testicles. 

Squa'mous.    Scaly ;  having  scaler. 

Sor'des.  The  dark  matter  di>|iohited 
upon  the  lips  and  teeth,  in  low  fu\ tMs. 

Ster'num.     The  breast-bone. 

Ster'tor.  Noisy  breathing,  as  in  apo- 
plexy.    Snoring. 

Ster*  tor-ous.  Snoring  and  noisy,  as 
applied  to  breathing. 

Stim'u-lants.  Medicines  which  in- 
crease the  activity  of  the  system. 

Sto-mach'ic8.  Medicines  which  sup- 
port and  renovate  the  stomach,  making 
its  action  healthy. 

Stru'ma.     Scrofula. 

Styp'tics.  Substances  which,  when 
applied  externally,  have  the  power  to 
constringe  or  pucker  up  bleeding  ves- 
sels, and  stop  the  loss  of  blood. 

Sub-cu-ta' ne-out.     Under  the  skin. 

Sub-max' il-Ia-ry.  Under  the  lower 
jaw. 

Sub-snl'tus  ten'di-num.  Slight  twitch- 
Ings  of  the  tendons,  which  occur  in  low 
forms  of  fever. 

Su-do-rif'ic8.  Medicines  wliicb  cause 
a  flow  of  perspiration,  rather  more  free 
than  that  produced  by  diaphoretics. 

Sup-pos'i-to-ries.  Solid  medicinal  sub- 
stances, of  a  conical  or  cylindrical  shape, 
which  are  placed  in  the  rectum  for  the 
purposeof  relieving  constipation  and  the 
piles,  and  for  removing  stricture. 

Syn'co-pe.     Fainting;  swooning. 

Te-nes'mus.  A  painful  bearing  down 
in  the  lower  bowel,  and  a  distressing  de- 
sire to  go  to  stool. 

Ton'ics.  Medicines  which  gradually 
give  tone  and  strength  to  weakened  or- 
gans, or  to  the  whole  system.  Some  act 
upon  the  nervous  system,  and  some  upon 
the  other  tissues,  by  condensing,  hard- 
ening, and  invigorating  them. 

Tor'mi-na.     Griping  pain. 

U-re'ters.  The  tubes  wliich  convey  the 
urine  from  the  kidneys  to  the  bladder. 

U-re'thra.  The  canal  which  conveys 
the  urine  from  the  bladder  out  of  the 
body. 

U'ter-ns.    The  womb. 

V«g'i-na  {Vadgfi-na).  The  passage 
from  the  external  genital  organs  to  the 
womb. 

Va'ri-C08«  veins.  Veins  which  are 
morbidly  enlarged,  and  present  along 
their  course  soft,  knotty,  purplish  tu- 
mors. 

Ver'ti-go.     Dizziness;  giddiness. 

Ve-si-ca'tion.     Blistering. 

Vi'ms.    Poison;  contagion. 

Vis'cus.  A  liver,  stomach,  kidney, 
heart,  or  any  organ  within  one  of  the 
cavities  of  the  body. 


1  1  .imjifj,^ 


,  and  suspeinling 

lavlng  scales, 
natter  deposited 
,  in  low  fevers. 
3t-bone. 
thing,  as  In  ape- 

;  and   noisy,  as 

lines    vhlch    in- 
he  system. 
Ines  which  sup- 
stomach,  mailing 


GENERAL  nLEX. 


B8    which,  when 
ve  the  power  to 
ap  bleeding  ves- 
)f  blood, 
ider  the  skin. 
Oder    the   lower 

I.    Slight  twitch- 
ich  occur  in  low 

les  which  cause 
'atber  more  free 
liaphoretics. 
id  medicinal  sub- 
ylindrlcal  shape, 

rectum  for  the 
itipationand  the 
stricture. 

Bwooning. 
il  bearing  down 
a  distressing  de- 

pihich  gradually 
to  weakened  or- 
Btem.  Some  act 
I,  and  some  upon 
mdensing,  hard- 
them. 
ain. 

hlch  convey  the 
o  the  bladder, 
which  conveys 
Ider  out  of  the 


The   passage 
1  organs  to  the 

ns   which    are 

present  along 

y,  purplish  tu- 

{iddiness. 

'g- 

Btlon. 

raach,    kidney, 

hin  one  of  the 


Abbreviations  and  signs, 
810. 

Abdominal  cavity.  122,  291 ; 
Diseases  of,  291-369. 

Abies  Canadensis,  840 ;  Ex- 
celsa,  824 ;  Picea,  824. 

Abortion,  428. 

Abscesses,  626;  Of  brain, 
167. 

Absence  of  menses,  394. 

Absorbent  vessels,  40. 

Abstinence  demanded  by 
anger,  76. 

AcacU  catechu,  827. 

Accidents,  509-616 ;  On 
water,  512;  By  poison- 
ing. 513. 

Acetate  of  ammonia,  816;. 
Of  copper,  poisoning  by, 
514;  Of  lead,  poisoning 
by,  514;  Of  lead  oint- 
ment, 900. 

Acetum,  883. 

Achillea  millefolium,  888. 

Acid,  acetic,  813 ;  Benzoic, 
819 ;  Citric,  813 ;  Diluted 
hydrochloric,  813;  Di- 
luted hydrocyanic,  813; 
Diluted  nitric,  813;  Di- 
luted sulphuric,  813 ;  Di- 
luted nltro  -  muriatic, 
813;  Tannic,  814;  Tar- 
taric, 814. 

Acids,  poisoning  by,  515. 

Acne,  spotted,  166. 

Aconite,  856 ;  Poisoning  by, 
515 ;  Tincture  of,  91S. 

Aconitum  napellus,  887. 

Acorus  calamus,  881. 

Adenoid  growths,  212. 

Adipose  tissue,  18. 

Adipous  sarcoma,  676. 

Advanced  life,  changes  in, 
500. 

ACusion,  752. 

Age,  influence  of,  126. 

Ague,  brow,  204 ;  Fever  and, 
473. 

Ague-cake,  474. 

Ague-root,  879. 


Air,  supply  of,  115;  In 
chest,  260 ;  Swellings, 
321 ;  And  ventilation, 
112. 

Air-cells  or  vesicles,  36; 
Enlargement  of,  258. 

Albinos,  164. 

Albumen,  16. 

Albuminous  foods,  69. 

Albuminuria,  338 ;  Dieting 
in,  802. 

Alcohol,  814. 

Alder,  Ug,  881. 

Aletris  farinosa,  879. 

Alexander's  operation,  412. 

Alimentary  tube,  32. 

Aliments,  fluid,  779. 

Allium  cepa,  859 ;  Sativum, 
837. 

Almond  mixture,  898. 

Almonds,  814;  Syrup  of, 
009. 

Alnus  rubra,  881. 

Aloes,  814 ;  Gomp.  tinct.  of, 
915 ;  And  canella,  comp. 
powder  of,  907. 

Alpinia  cardamomum,  826. 

Alterative  inhalant.  243. 

Alteratives,  926,  929. 

Althaea  officinalis,  854. 

Alum,  814 ;  Whey,  795. 

Amaurosis,  691. 

Amenorrhcea,  394. 

American  hellebore,  814 ; 
Ipecacuanha,  815;  Ivy, 
815 ;  Valerian,  888. 

Ammonia,  aromatic  spirit 
of,  816;  Carbonate  of, 
816;  Comp.  liniment  of, 
896;  Muriate  of,  816; 
Poisoning  by,  613 ;  Solu- 
tion of  acetate  of,  816; 
Water  of,  816. 

Amount  of  food  to  be  taken, 
83. 

Ampelopsis  quinquefolia, 
815. 

Amusements,  118;  Oames 
for,  119;  SelecMon  of, 
119;  Want  of,  li.x. 


Amygdalus  communis,  814 ; 

Pdrsica,  861. 
Ansmia,  288. 
Anaesthetics,  600. 
Anagallis  arvensis,  870. 
Anasarca,  358. 
Anatomy,  14 ;  Of  the  bones, 

18. 
Anchylosis,  573. 
Aneurismal  tumors  of  heart, 

280. 
Aneurisms,  577. 
Anger  demands  abstinence, 

76. 
Angina  pectoris,  2S'j  ;  Diet 

in,  786. 
Anidrosis,  154. 
Animal  food,  84. 
Anise,  816. 

Ankle,  dislocation  of,  568. 
Annual    plants,    when    to 

gather,  808. 
Anodyne  poultice,  906. 
Anodynes,  928. 
Anteflexion  of  womb,  411. 
Anteversion  of  womb,  410. 
Anthemis  nobilis,  829. 
Anthrax,  534. 
Antidotes  of  poisons,  513. 
Antihemorrhagic  inhalants, 

244. 
Antimony,    poisoning  by, 

613. 
Antipathies,  770. 
Antiseptic  dressings,    433, 

642;  Inhalant,  244. 
Antiseptics,  518. 
Antispasmodics,  926. 
Aorta,  37,  38. 
Aperient,  Metauer's,  899. 
Apocrnum,  819 ;  Audrosee- 

miiolium,    819 ;    Canna- 

blum,  844. 
Apoplexy,  177 ;  Of  the  old, 

607;  Diet  iu,  785;    Pul- 

monary,  259. 
Apothecaries'  weights,  810. 
Apparent   death  from  va- 
rious causes,  509-512. 
Appendicitis,  816. 

966 


'W^lfM' 


-A 


966 


GENEKAL   INDEX. 


Apple-water,  792. 

Approximate  measures,  811. 

Aptha  coinuiuuiB,  491. 

Apthae,  468. 

Aqua  oalcis,  861. 

Arachnitis,  165. 

Arachnoid,  46;  Inflamma- 
tion of,  166. 

Aralia  hlspida,  836;  Nudl- 
caulis,  876;  Bacemosa, 
876 ;  Spinosa,  868. 

Arbutus,  trailing,  882; 
Comp.  infusion  of,  896. 

Argenti  nitras,  867. 

Aristolochia  serpentarla, 
884. 

Arm,  fractures  of,  663-564. 

Arnica,  617. 

Aromatic  confection,  892; 
Powder,  907;  Spirit  of 
ammonia,  816. 

Arrowroot,  817 ;  Gruel,  792 ; 
Poultice,  906. 

Arsenic,  poisoning  by,  514. 

Arsenical  solution,  877. 

Artemisia  absinthium,  887. 

Arteries,  37,  38;  Pulmo- 
nary, 37,  38. 

Articles  for  a  medicine- 
chest,  809. 

Arum  triphyllum,  844. 

Asarum  canadeuse,  886. 

Ascaris  (pin-worm),  332. 

Asclepias,  iucamata,  881 ; 
Syriaca,  831 ;  Tuberosa, 
864. 

Asclepidin,  864. 

Ascites,  366. 

Asepsin,  249. 

Aseptic  and  septic,  518. 

Asiatic  cholera,  329. 

Asphyxia,  609. 

Aspidum  fllix  mas,  853. 

Assafcetida,  817 ;  Comp. 
tlnct.  of,  916. 

Asthma,  270 ;  of  the  aged, 
607 ;  diet  in,  786. 

Astringent  inhalant,  244. 

Astringents,  640,  930. 

Atmosphere,  pressure  of, 
112.  I 

Atmospheric  inhalation, ' 
260.  I 

Atropa  belladonna,  835.        I 

Atrophy,  of  brain,  173 ;  of 
heart,  281. 

Attendants,  unhired,  769. 

Aurantii  cortex,  860. 

Auricles,  37,  274. 

Auscultation,  280. 

Bacteria,  cause  inflamma- 
tion, 525. 
Baldness,  163. 
Balm,  817 ;  of  Gllead,  817. 


Balmony,  817. 

Balsam,  copaiba,  817 ;  Tolu, 
818. 

Balsamodendron  myrrha, 
85C. 

Bandages,  wot,  741. 

Banting  treatment  for  cor- 
pulence, 799. 

Baptisia  tinctoria,  886. 

Barberry,  818. 

Barber's  itch,  166. 

Bark,  when  to  gather,  808. 

Barley,  80;  -coffee,  790; 
-water,  789. 

Barosma  orenata^  823. 

Barrenness,  419. 

Base-ball,  94. 

Basilicon  ointment,  892. 

Bath,  cataract,  747;  Cold, 
733  ;  Effects  of  cold,  734 ; 
Cold  foot,  763 ;  Douche, 
747;  Eye  and  ear,  764; 
Half,  748;  Head,  760; 
Hose,  747;  Hot,  734; 
Effects  of  hot,  736 ;  Leg, 
750;  Mouth  or  oral, 
755;  Uose,  754;  Pall 
douche,  748 ;  Plunge, 
749;  Bestoration  of  de- 
sirable, 111;  Shower, 
747;  «liz,  750;  Tepid, 
734;  Effects  of  tepid, 
736;  Towel  and  spongo, 
762 ;  Vapor,  734 ;  Warm, 
734;  Effects  of  warm, 
736;  Wading  foot,  753; 
Warm  foot,  754 ;  Wash- 
tub,  751 ;  Wave  or  sluice, 
748. 

Bathing  and  cleanliness, 
106;  sea,  736;  with  ref- 
erence to  Turkish  and 
BuBsian  baths,  803. 

Baths  of  the  ancients,  107 ; 
Cold,  109,  733;  Division 
of,  732 ;  Names  of,  108 ; 
Neglect  of,  108;  Beac- 
tion  after.  111 ;  Shower, 
806;  Sponge,  109;  Vap- 
or, 804;  Warm,  805; 
Warm  for  children,  467. 

Bayberry,  818;  ointment, 
900. 

Bean,  St.  Ignatius',  879. 

Beans,  73,  82. 

Bearberry.  818. 

Beds  and  bedding,  758. 

Bedbugs,  160. 

Bed-sores,  774. 

Beef,  Essence  of,  793,  797 ; 
-galls,  818;  -tea,  793,  797. 

Beets,  82. 

Belladonna  atropa,  835 ; 
Ointment,  900;  Plaster, 
903  ;  Poisoning  by,  616. 


Belly,  dropsy  of,  356; 
Symptoms  affecting,  V2h. 

BeUy-«che,  320. 

Benzoic  acid.  819. 

Benzoin,  880;  Comp.  tine 
ture  of,  916. 

Berberis  vulgaris,  818. 

Bethroot,  819. 

Bichloride  of  gold,  839 ;  of 
Mercury,  832. 

Biennial  plants,  when  to 
gather,  808. 

Big  ivy,  856. 

Bile  In  stomach,  67. 

Biliary  calculi,  299. 

Bilious  colic,  321;  Head- 
ache, 203,  206;  Beinit- 
tent  fever,  471. 

Binary  compounds,  14. 

Bismuth,  820. 

Bites  of  insects  and  snakes, 
645. 

Bitter-root,  819. 

Bittersweet,  820. 

Black  alder,  820. 

Black  cohosh,  821 ;  Comp. 
tincture  of,  916. 

Black  root,  821. 

Black  willow,  821. 

Blackberry,  82U. 

Black  vomit,  475. 

Bladder,  35 ;  Acute  inflam- 
mation of,  335;  Chronic 
inflammation  of,  336. 

Bleeding  from  kidneys, 
341 ;  Nose,  597 ;  Wounds, 
699. 

Blenorrhagia,  369. 

Blistering  plaster,  892. 

Blood,  buffy  coat  of,  52J; 
Composition  of  humau, 
247;  in  Scrotum,  580; 
Need  of  a  good  supply 
of,  69,  61;  Poisoning, 
438. 

Bloodroot,  821. 

Bloody  flux,  330. 

Blue  cohosh,  822;  Comp. 
tincture  or,  916. 

Blue  disease,  467. 

Blue  flag,  822. 

Blue  pill,  823. 

Body,  structure  of,  14 ; 
Chemical  properties  of. 
14;  Lice,  159;  Physical 
properties  of,  16;  Tem- 
perature of,  132 ;  Vital 
properties  of,  18. 

Boiled  flour,  793. 

Boils,  633. 

Bone's  bitters,  918. 

Bones  and  muscles,  122; 
Anatomy  of,  18 ;  Broken, 
how  they  unite,  649; 
Diseases  of,  670;  Death 


GKNKUAL   INDKX. 


967 


tl  ropey    of,      356; 
oms  affectiDg,  lan. 
le,  320. 
icid.  819. 

880;  Comp.  tluc- 
r,  916. 

vulgaris,  818. 
,819. 

le  of  gold,  839 ;  of 
ry.  832. 

plants,   wheu  to 
•.  808. 
856. 

bomach,  67. 
alculi,  299. 
solic,  321;    Head- 
203,   206;   Remit- 
iver,  471. 
^mpouods,  14. 
,820. 
nstictB  and  snakes, 

»t,  819. 

eet,  820. 

ler,  820. 

hosh,  821;  Oonip, 

re  of,  916. 

)t,  821. 

How,  821. 

ry,  820. 

mit,  475. 

35 ;  Acute  intlani- 

1  of,  335;  Chronic 

mation  of,  336. 

from     kidneys, 
fose,  597 ;  Wounds, 

Bigia,  369. 
SpUster,  892. 
uffy  coat  of,  522; 
sition  of  humau, 
n  Scrotum,  580 ; 
of  a  good  supply 
,    61 ;    Polsoniug, 

t,  821. 
ux,  330. 

osh,    822;    C!omp. 
•e  of,  916. 
ase,  467. 
,822. 
823. 

trueture  of,  14 ; 
jal  properties  of. 
5e,  159;  Piiysical 
Lies  of,  16;  Tern- 
re  of,  132;  Vital 
ties  of,  18. 
ur,  793. 
t. 

tters,  918. 
id    muscles,   122 ; 
ay  of,  18 ;  Broken, 
hey    unite,    549 ; 
BS  of,  570 ;  Dentil 


of,  670 ;  of  Head,  20 ;  of 
Trunk,  21;  of  Upper 
extremltiee,  23 ;  of  Low- 
er extremities,  24 ;  Time 
required  for  uniting, 
550;  Unnatural  growth 
of,  570;  Ulceration  of, 
570 ;  Uses  of,  27. 

Boneset,  823. 

Bony  formations  In  heart, 
281. 

Borax,  876. 

Bowel,  falling  of,  465. 

Bowels,  affections  of,  787 ; 
Acute  inilammatiou  of, 
314;  Chronic  inflamma- 
tion of,  315;  Looseness 
of,  327 ;  Looseness  of,  in 
Infants,  463. 

Brachial  plexus,  48. 

Brain,  45, 122, 164 ;  Abscess 
of,  167  ;  Diet  in  affections 
of,  785 ;  Dropsy  of,  175 ; 
Enlargement  of,  173 ; 
Exercise  of,  60,  61 ; 
Fever,  165;  Health  of, 
59 ;  Induration  of,  167  ; 
Inflammation  of,  165 ; 
And  nerves,  diseases  of, 
164-207;  Need  of  a 
healthy,  59;  Need  of 
exercise  for,  60 ;  Old 
people's,  61;  Ovei-work- 
iug,  61;  Shrinking  of, 
173;  Softening  of,  166; 
Tumors  of,  167. 

Bran,  decoction  of,  789. 

Brandy  mixture,  899. 

Bread,  Franklin  Mills,  796. 

Bread-and-water  poultice, 
905. 

Breast,  broken,  441 ;  In- 
flammation of,  441. 

Breastbone,  fracture  of,  656. 

Breathing  murmurs,  232; 
Objects  of,  113;  Phi- 
losophy of,  112 ;  Symp- 
toms alTecting,  129. 

Bright's  disease  of  kidneys, 
338. 

Broiled  beef  essence,  797. 

Broken  bones,  546-661 ; 
Breast,  441. 

Bronchial  consumption, 
237;  Flux,  506;  Tubes, 
36. 

Bronchitis,  209 ;  Acute, 
255 ;  Chronic,  257. 

Broncbocele,  678. 

Broncho-pneumonia,  269. 

Bronchorrhoea,  506. 

Broth,  'lam,  797 ;  Mutton, 
797. 

Brow-ague,  204. 

Bruises,  669. 


Babo,  361-369. 

Buchp,  823 ;  Tlnct.  of,  914. 

Buckhorn  brake,  824. 

Buckthorn,  824. 

Buckthorn  bark, 

Buckwheat,  81. 

Buffy  coat  of  blood,  622. 

Bugleweed,  824. 

Bulbous     roots,    when    to 

gather,  608. 
Bunions,  161. 
Burdock,  824. 
Burgundy  pitch,  824. 
Burns  and  scalds,  535. 
Butternut,  824. 

Cabbage,  82. 

Calamine  cerate,  891 ;  Pre- 
pared, 889. 

Calcined  deer's  horn,  826. 

Calculus,  299-354. 

Calendar  for  married  ladies, 
443. 

Calf'8-feet-jelly,  794. 

Calico  bush,  856. 

Calomel,  825. 

CalTities,  167. 

Calx,  861 ;  Ohlorinata,  851. 

Camphor,  826;  Liniment, 
890 ;  Water,  897. 

Camphorated  soap  liniment, 
897. 

Canada  balsam,  826 ;  Flea- 
bane,  826  ;Snakeroot,886. 

Canal,  alimentary,  32. 

Canals,  semicircular,  63. 

Cancer,  673 ;  Of  intestines, 
317 ;  Of  womb,  413. 

Canella,  826. 

Canker,  491;  Lettuce,  871; 
Of  mouth  (cancrum  oris), 
458. 

Cannabis  indica,  tlnct.  of, 
914. 

Cantharides,  tinct.  of,  914. 

Cantharis  vesicatoria,  877. 

Capillaries,  38. 

Capsicum  annum,  827 ;  Plas- 
ter, comp.,  904. 

Capsules,  supra-venal,  dis- 
eases of,  337. 

Caput  obstipum,  686. 

Caraway,  826. 

Carbo  ligni,  829. 

Carbonate  of  ammonia,  816. 

Carbuncle,  634 ;  malignant, 
635. 

Cardialgia,  308. 

Cardamom,  826 ;  Compound 
tiact.  of,  916. 

Carditis,  283. 

Care  of  children,  and  their 
diseases,  445-468;  Teeth, 
601;  Of  the  sick,  67;  Of 
the  skin,  503. 


Caries,  570;  Of  teeth,  602. 
Carminatives,  924,  928. 
Carriage-riding  as  exercise, 

97. 
Carrots,  82 ;  Poultice  of,  906. 
Cartilage,    26 ;    Arytenoid, 

42 ;  Cricoid,  42 ;  Thyroid 

cartilaginous  tissue,  17; 

Productions  in  heart,281. 
Carum  carui,  826. 
Caryophyllus    aromaticus, 

830. 
Cascarilla,  826. 
Casein,  16. 
Cassia      acutlfoila,     874 ; 

Buds,  829. 
Castor,  827. 
Castor-oil,  827. 
Castoreum,  827. 
Catalepsy,  186. 
Cataplasms,  905. 
Cataract  bath,  747. 
Catarrh,     nasal,    209;    Of 

bladder,  336. 
Catarrhal  ophthalmia,  589. 
Catechu,  827 ;  Confection  of, 

893;  Comp.  infusion  of, 

894;  Tinct.  of,915 ;  Comp. 

tlnct.    of,    916;    Comp. 

powder  of,  907. 
Cathartics,  921. 
Catnip,  915. 
Caulophyllum  thalictroides, 

822. 
Caulophyllin,  822. 
Caustic  potassa,  865. 
Cayenne  pepper,  827 ;  Tinct. 

of,  915. 
Ceanothus  Americanus,  870. 
Celandyne,  828. 
Cellular  tissue,  16. 
Cerates,  891. 
Cerebellum,  46. 
Cerebrum,  46. 
Cerevisae  fermentum,  888. 
Cessation  of  menses,  403. 
Cetaceum,  878. 
Cetraria  islandlca,  844. 
Chafing,  598. 
Chalk,  828;  Mixture,  899; 

Comp.  powder  of,  907. 
Chalk-stones,  479. 
Chamomile,  829. 
Chancre,  361. 
Change   of    circumstances, 

badf  effect  of,  60. 
Changes  occurring  in  ad- 
vanced life,  600. 
Charbon,  636. 
Charcoal,    829 ;     Apparent 

death  from  burning,  509 ; 

Poultice,  906. 
Chelidonium  majus,  828. 
Chelone  glabra,  817. 
Chemical    Food,    911 ;    In- 


968 


OENKRAL  INDEX. 


juriOB,  636 ;  PropertieB  of 
tho  body,  14. 

Chenopodium  antbolmlntl- 
cum,  887. 

Cherry,  cordial,  pulmonic, 
249 ;  Wild,  885. 

Cheat,  affectlonB  of,  786; 
Air  In,  260 ;  Diseases  of, 
229-273 ;  Sounds,  philoso- 
phy of,  232;  Bymptoms, 
affecting,  128 ;  Water  in, 
261. 

Chtcken-poz,  141. 

Chicken-water,  794. 

Chlckweed,  red,  870. 

ChilbUina,  537. 

ChUd-bed  fever,  438. 

Children,  care  and  diseases 
of,  446-468 ;  Clothing  of, 
445;  Food  of,  446;  Nurs- 
ing sick,  453 ;  Weaning 
of,  460. 

Children's  sore  mouth,  457. 

Chimaphila  umbellata,  863. 

Chloride  of  zinc,  889. 

Chloroform  (chloroform- 
um),  601,  829. 

Chloroais,  401;  Diet  In,  784. 

Choice  of  sick-room,  766. 

Cholera.  Asiatic,  329 ;  Diet 
in,  788;  Infantum,  463; 
Morbus,  328. 

Chorea,  187 ;  Chronic,  188. 

Choroid  coat,  50. 

ChromidrosiB,  164. 

Chyle,  67. 

Chyme,  66. 

Ciliary  processes,  51. 

Cimicifvga  racemosa,  821. 

Cimicifnsin,  821. 

Cinchona,  862. 

Cinchonia,  862. 

Cinnamon,  829;  Tinct.  of, 
916 ;  Gomp.  tinct.  of,  916. 

Circulation,  organs  of,  37- 
39. 

CirrhOBiB  of  liver,  296. 

CiTBOcele,  684. 

Citrate  of  potassa,  867. 

Citric  acid,  813;  Syrup  of, 
909. 

Citrine  ointment,  901. 

Citrus  llmonum,  860. 

Clam- broth,  797. 

Clap,  369. 

Clavicle,  fracture  of,  662. 

Cleaning  the  teeth,  606. 

CleanlinesB,  106;  In  sick- 
room, 760. 

Cleavers,  830. 

Clergymen's  sore  throat, 
212. 

Climate,  74,  126. 

Clothing,  101 ;  As  con- 
ductors of  '  heat,     102 ; 


Catching  lire,  512;  Color 
of,  104;  Cotton,  102 
Hair  as,  103 ;  Linen,  102 
Should  bo  porous,  104 
Silk,  103;  Tight,  105 
Woollen,  103. 

Clover,  red,  870. 

Cloves,  830. 

ClOVUB,  162. 

Clystere,  896. 

Coaptation,  547. 

Coats  of  the  eye,  60. 

Coca  Wine, 

Cocaine,  601. 

CocculuB  palmatus,  S.'il. 

Coccus  cacti,  830. 

Cochineal,  830. 

Cochlea,  63. 

Cochlearia  armoracia,  843. 

Cod-liver-oil,  830,  946. 

Coffee,  88, 780 ;  Barley,  790 ; 
Crust,  790 ;  Milk,  796. 

Cohosh,  black,  821;  Blue, 
822 ;  Tincture  of,  916. 

Colchicnm  autumnale,  866 ; 
Coinp.  tinct.  of,  916. 

Cold,  effects  of,  536  ;  Baths, 
109;  Crodm,  901;  Foot- 
bath,  763;  Water  at 
meals,  66. 

Colds,  224. 

CoUc,  464 ;  Bilious,  321 ;  Of 
infants,  464;  Painters', 
322 ;  Wind,  320. 

Colitis,  330. 

Collar-bone,  fracture  of, 
562 ;  Dislocation  of,  663. 

Collodion,  830. 

Colocynth,  831. 

Colombo,  831. 

Colon,  33,  291. 

Color  of  clothing,  104 ;  Of 
skin,  disorders  affect- 
ing, 163. 

Colored  patches  on  skin, 
163. 

Coltsfoot,  831,  886. 

Coma,  an  alarming  symp- 
tom, 773. 

Comedones,  156. 

Comfrey,  831;  Compound 
wine  of,  898. 

Common  silk-weed,  831. 

Comptonia  asplenifolla,881. 

Compound  fractures,  550. 

Compound  infusion  of  cate- 
chu, 894;  Of  gentian, 
894;  Of  geranium,  r95; 
Of  parsley, 895 ;  Of  senna, 
896 ;  Of  trailing  arbutus, 
896 ;  Besin  cerate,  892. 

Compresses,  741. 

Compression,  540. 

Conception,  421. 

Condoms,  430. 


Confections,  892 ;  Aronrnttc, 
892;  Of  catHohu,  coni- 
pound,  893 ;  Or  senna, 
893. 

Congestive  fever,  473 ; 
Headaches,  205  ;  lullam- 
raation  of  sklu,  135. 

Conium  niaoulatum,  864; 
Poisoning  by,  615. 

Conjunctiva,  62. 

Conservative  leaders,  11. 

Conserves.  H92. 

Constipation,  324. 

Constitution,  122, 124;  Idio- 
syncrasy of,  125. 

Constitutional  differonces, 
238;  Treatment,  245. 

Constriction  of  bowel,  318. 

Consumption,  229-254;  A 
general  disease,  241 ;  Of 
the  bowels,  313;  Bron- 
chial, 237;  Causes  of, 
235,239;  Dieting  lu,  801 ; 
Sweating  In,  773 ;  Tuber- 
cular, 233. 

Contused  wounds,  644. 

Contusions,  669. 

Convalaria  multlflora,  877. 

Convolvulus  scaninionia, 
873. 

Convulsions,  773;  Diet  in, 
783. 

Cookery  for  sick-room,  789- 
797. 

Copaifera  offlcinalls,  817. 

Copper,  832;  Subacetate  of, 
832 ;  Sulphate  of,  832. 

Corallorhiza  odontorhiza, 
833. 

Corn,  Indian,  81. 

Cornea,  60 ;  luHaiuniation 
of  (comeltis),  690. 

Corns,  161. 

Cornu  cervlnee  ustum,  826. 

Cornus  Florida,  835 ;  Seri- 
cea,  881. 

Corpulence,  diet  for,  799. 

Corrosive  sublimate,  83-2; 
Poisoning  by,  514. 

Corydalis  formosa,  883. 

Coryza,  136. 

Cost  of  foods,  77,  79,  80. 

Costiveness,  324;  During 
pregnancy,  425,  42C. 

Cotton,  832 ;  Clothing,  102. 

Cough,  during  pregnancy, 
427 ;  Symptoms  indicated 
by,  130,  772 ;  Whooping, 
462 ;  Preparations,  927. 

Counter  extension,  547 ;  Ir- 
ritation, 624;  IrriUnte, 
931. 

Cow-pox,  141. 

Cozalgia,  671. 

Cramp-bark,  842. 


B.- 


'~^. 


ii,892;  Aroiimtic, 
f  <'atec'lui,  coil,. 
893 ;    Of   senna, 

»       fever,      473 ; 
lies,  ao5 ;  lutlani- 
of  8kln,  135. 
iiaoulatiini,    864; 
ig  by,  515. 
'a,  52. 

Ive  leaders,  11. 
892. 
on,  324. 

111,122, 124;  Idio- 
y  of.  125. 
)nal    ill  (Terences, 
eatuieut,  245. 
in  of  bowel,  318. 
on,    229-254;    A 
disease,  241 ;  Of 
fels,   313;   Brou- 
137;    Causes    of, 
i  Dieting  in,  801 ; 
g  in,  773 ;  Tuber- 
}3. 

vounds,  644. 
I,  569. 

I  multlflora,  877. 
IB     scaniDionia, 

18,  773;  Diet  In, 

"  sick-room,  789- 

Jfflcinalis,  817. 
J;  Subacetateof, 
phate  of,  832. 
a    odontorhlza, 

an,  81. 

;   luflarumation 

Bitis),  690. 

inae  uetum,  825. 
»rida,  835 ;  Seri- 

,  diet  for,  799. 
sublimate,  832; 
g  by,  514. 
ormosa,  883. 

is,  77,  79,  80. 
I,   324;    During 
(y,  425,  42C. 
;.Clotlilng,102. 
■Ing  pregnancy, 
ptonis  indicated 
72;  Whooping, 
paratlons,  927. 
enslon,  547 ;  Ir- 
524;    Irritants, 

il. 
1. 
,842. 


Cramps,  188;  In  stomach, 

309,  497. 
CranesbiU,  833. 
Cranial  neryes,  46,  47. 
Crawley,  833. 
Cream,  777. 
Cream  of  tartar,  8fl6. 
Creosote  (creosotum),  248, 

833 ;  Ointment,  900. 
Cricoid  cartilage 
Crocus  sativus,  b  a 
Croton  cleuteria,  826 ;  Oil, 

834;   Oil  iiuiment,  896; 

Tiglium,  834. 
Croup,    460 ;      Dangerous 

symptoms  in,  772. 
Crow-corn,  879. 
Crural  phlebitis.  437. 
Crust-coffee,  790. 
Crusted  tetter.  148. 
Cubebs  (cubebflB),  834. 
Cucumber,  wild,  885. 
Cucumus  colocynthla,  831. 
Cultivating  trees,  115. 
Culver's  root,  834. 
Cupping  and  leeching,  524. 
Cupri  Bubacetas,  832 ;  Sul- 
phas, 832. 
Cuprum,  832. 
Curcuma  longa,  883. 
Cyanosis,  467. 
Cypripedin,  849,  889. 
Cypripedium      pubescens, 

849,  888. 
Cystine  deposits  in  urine, 

353. 
Cystirrhcea,  336. 
Cystitis,  336. 

Dancing,  95. 

Dandelion,  836. 

Dandruff,  162. 

Darkening  of  sick-room, 
761. 

Datura  stramonium,  880. 

Deadly  nightshade,  836 ; 
Poisoning  by,  616. 

Deafness,  596 ;  Not  an  un- 
favorable symptom,  772. 

Death,  apparent,  from  nox- 
ious vapors,  509 ;  Proofs 
of,  807 ;  Of  bones,  670. 

Decoction  of  bran,  789. 

Decoctions,  893. 

Deformities  of  spine,  684. 

Delivery,  430. 

Delirium  tremens,  167. 

Dementia,  194. 

Dens  leonis,  836. 

Depilatories,  168. 

Deposits,  phosphatio,  349; 
Urinary,  345.  366. 

Derangement  of  mind.  191. 

Derbyshire  neck.  678. 

Dermoid  tissue,  17. 


(iKNKH.M,    INDKX. 

Deshler's  salve,  892. 

DUbetes,  340;  Dieting  In, 
802. 

Diaphoretics  and  sedatives, 
020. 

DUrrhOBa,'327 ;  Diet  in,  788  ; 
In  consumption,  260 ;  Of 
infants,  463  ;WhenadAU- 
gerouH  symptom,  773. 

Dictionary,  000. 

Diet,  a  complex  subject, 
71 ;  In  consumption,  262  ; 
For  the  old,  601 ;  During 
confinement,  436  ;  Of 
nursing  women,  446 ;  In 
disease  and  convales- 
cence, 776;  In  general 
diseases,  781. 

Dieting  in  regard  to  health, 
799;  In  disease,  801. 

Difficult  teeth-cutting,  469. 

Difficulty  of  breathing,  773; 
Of  swallowing,  772. 

DigestibUlty  of  foods,  71, 

Digestion,  64;  Symptoms 
relating  to,  131 ;  Table, 
72. 

Digestive  organs,  31. 

Digitalis  purpurea,  837. 

Dilatation  of  ven '  <icles,278. 

DioscorM  villosa,  'H6. 

Diospyros  Vlrginiu-a,  861. 

Diphtheria,  219,  486. 

Diseases,  general,  469-492; 
Of  children,  445-468 ;  Of 
the  old,  496-608 ;  Of  the 
bones,  570 ;  Of  the  Joints, 
671 ;  Peculiar  to  modem 
times,  493-49R. 

Disinfectants,  7u4. 

Dislocations,  561-568;  Of 
ankle-Jotnt,  668  ;  Of 
bones  of  hand,  665;  Col- 
lar-bone, 563  ;  Elbow- 
Joint,  664  ;  fiip-Jolnt, 
666;  Knee-pan  or  patella, 
567 ;  Knee-joint,  668  ; 
Lower  jaw,  663;  Shoul- 
der-Joint, 663  ;  Wrist, 
666. 

Displacement  of  htort, 
290;  Womb,  411. 

Disturbed  sleep,  200. 

Diuretics,  929. 

Dizziness,  200. 

Dock,  yellow,  888;  Oomp. 
syrup  of,  913. 

Dogwood,  836  ;  Poisoning 
by,  616 ;  Swamp,  881. 

Domestic  management  of 
the  Blck-i-oom,  756-788. 

Domestic  measures,  811. 

Doses,  810, 811;  Frequency 
of,  126. 


m 


Douche  bath,  747  ;  Pali 
748. 

Dover's  powder,  908. 

Dragon-root,  844. 

Dress,  wet,  743. 

Dresses,  tight,  116. 

Dressing  wounds,  rules 
for,  641. 

Dressings,  antiseptic,  642. 

Drinks  for  the  sick,  7H0, 
790. 

Dropsy  of  l.elly,  356;  Of 
brain,  175;  Of  cells, 
358 ;  Oeneral,  358 ;  Diet 
in,  784. 

Drowning,  609. 

Dry  pimples,  160, 

Drunkard's  delirium,  167. 

Dumb-bell  exercises,  96. 

Dura  mater,  46 ;  lutlamnia- 
tlon  of,  164. 

Dwarf  elder,  836. 

Dysentery,  330;  Diet  in, 
788 ;  Chronic,  331. 

Dysmenorroea,  399. 

Dyspepsia,  303 ;  Causes  of, 
304;  Diet  in,  787,  801; 
Treatment  of,  307 ;  Uri- 
nary deposits  in,  304. 

Dyspeptics,  84. 

Dystrichiasis,  587. 

Ear,  affections  of,  594-596 ; 
Bathe,  764;  Drum  of, 
62;  External,  62;  For- 
eign substances  in,  699; 
Wax  in,  696. 

Earache,  696. 

Eating,  rapid,  64. 

Ecletics,  7. 

EcsUsy,  186. 

Ecthyma,  149. 

Eczema,  144. 

Effervescing  draught,  867. 

B|5g»,  777  ;  Egg-nog,  797. 

Egophony,  263. 

Egyptian  ophthalmia,  588. 

Elbow,  fractures  of,  564; 
Joint,  dislocation  of, 
664. 

Elder,  836 ;  Dwarf,  836. ' 

Elecampane.  836. 

Electricity,  504. 

Electro-magnetism,  836. 

Electuaries,  892. 

Electuary,  lenitive,  893. 

Elixir  proprietatls,  916; 
Salutis,  918;  Vitriol, 
916. 

Elm,  slippery,  876. 

Elongation  of  uvula,  221. 

Emetics,  920. 

Emphysema,  268. 

Encephalitis,  166. 

Eucephaloid  tumor,  575 


h 


970 

Encysted  tumor,  677. 

Endocarditis,  383. 

Endosmosis,  738. 

BnUrged  veins,  438,  581. 

EnUrgement  of  air-cells, 
368;  Brain,  173;  Neck 
of  womb,  3H6. 

Enteritis,  314;  Diet  In, 
787. 

Enuresis,  344. 

Epigea  repeuB,  8H:i. 

Epigastrium,  3t)l. 

Epigloitis,  inflammation 
.f,  387. 

Epilepsy,  epileptic  fits, 
1H4. 

Epistazis,  6!)7. 

Epsom  salts,  863. 

Ergot,  878. 

Erigeron,  canadenRc,  836. 

Eruptions,  scaly,  149,  363 ; 
Tubercular,  363 ;  Vestou- 
lar,  363. 

Eruptive  fevers,  Diet  in, 
7H'2. 

Erysipelas,  141 ;  diet  in, 
783. 

Erythema,  144. 

Erythematlc  stomatitis, 
457, 

Essence  of  beef,  793,  797. 

Essences,  893. 

Eucaline,  000. 

Euonymus  atropurpureus. 
884. 

Eupatorln,  823. 

Bupatorium  perfoliatum, 
833;  Furpureum,  869. 

Euphorbia  ipecac,  815. 

Eupurpurin,  869. 

Eustachian  tube,  63. 

EzcorUtion,  698;  When  a 
bad  symptom,  773. 

Exercise,  92-98;  Active  and 
passive,  93,  96;  Exces- 
sive, 92,  96;  In  cold 
weather,  94;  In  con- 
sumption, 262;  In  diet- 
ing, 73;  In-door,  96; 
Mental  cooperation  in, 
98;  Outdoor,  94-98;  Pas- 
sive, 96-98 ;  Pleasurable, 
93,  98;  Regular,  92;  For 
students,  93;  For  the 
aged,  604;  When  to 
take,  93,98;  With  wands, 
94;  For  young  women, 
000. 

Exerciser ,  the  Whitely,  960. 

Exhalants,  41. 

Exhaustion.  headaches 
from,  204. 

Exosmosis,  738. 

Exostosis,  670. 

Extension,  647. 


GENERAL   INUEX. 

Expectorant  inhalant,  343. 

Expectorants,  937. 

Expectoration,  symptoms 
Indicated  by,  130. 

External  Irritants,  250; 
Parts,  itching  of,  417. 

Extracts,  893;  Fluid,  894; 
Of  rhubarb  and  potassa 
(neutralizing),  899. 

Eye,  60-63;  AIToctlonB  of, 
586-693;  Coats  of,  60; 
Diseases  cause  hnad- 
aches,  203 ;  And  ear  bath, 
764;  Foreign  bodies  In, 
686;  Globe  of,  50;  Hu- 
mors of,  61. 

Eyebrows,  53. 

Eyelashes,  disorder  of,  587. 

Eyelids,  62;  Inflammation 
of,  587. 

Faba  Sanctl  Ignatil,  879. 

Face  not  to  be  covered 
while  asleep,  100;  Symp- 
toms affecting,  127. 

Face-ache,  190. 

Fainting,  199,  427;  An 
alarming  symptom,  772. 

Falling  of  bowel,  4C6;  Sick- 
ness, 184;  Of  womb,  409. 

Fallopian  tubes,  383;  In- 
flammation of,  414. 

False  grape,  815;  Joints, 
551;  Measles,  143;  Sarsa- 
parilla,  876;  Unicorn, 
841. 

Fat,  15;  Hqw  to  grow,  798. 

Fathers  of  our  race,  498. 

Fatty  degeneration  of  heart, 
281 

Fatty  foods,  78. 

Fatty  tumor,  676. 

FavUB,  158. 

Febrifuge  inhalant,  244. 

Feeding  infants,  rules  for, 
448. 

Fel  bovinum,  818. 

Felon,  572. 

Female  diseases,  379-442. 

Female  weaknesses,  393. 

Fern,  male,  853. 

Ferri,  ammonio-dtras,  846; 
Cltras,  846;  lodidum, 
846;  Lactas,  846;  Oxi- 
dum  hydratum,  846; 
Oxldum  nigrum,  846; 
Phosphas,  847;  et  Po- 
tassee  tartras,  848;  Pro- 
toxidum,847;  Pulvl8,847; 
et  Quiniee  cltras,  846; 
Subcarbonas,  847;  Sul- 
phas, 848;  Byrupus  io- 
didl,  848. 

Ferrum,  846. 

Ferunculus,  533. 

Fever,  469;  And  ague,  473; 


Bilious  remittent,  471; 
Ohlldbed,438 ;  OongestI  ve, 
473;  Diet  in.  781;  Gim- 
trio,  of  infancy,  465;  lu- 
termlttent,  473;  Ludk, 
266;  Malarial,  473;  I'or- 
nlcious  Intermittent,  47:<; 
PrognoHtIca  In,  771;  Ko- 
freshlng  drinks  In,  790; 
Typhoid,  470;  Typhoid 
lung,    268;    Yellow,  476. 

Feverfew,  836. 

Fibrin,  16. 

Fibrous  tissue,  17. 

Figwort,  836, 

FUling  teeth,  604. 

Fingers,  fracttures  of,  666. 

Fire,  clothes  catching,  61^; 
In  sleeping-rooms,  99. 

FUh,  777. 

Fistula,  527. 

Fits,  184;  Of  children,  468. 

Flag,  sweet,  881. 

Flatulency,  320. 

Flaxseed,  837;  Lemonade, 
797;  Poultice,  906. 

Flesh,  to  reduce,  799. 

Flies,  Spanish,  877. 

Flour,  boiled,  793;  Gruel, 
797. 

Flowers,  when  to  gather, 
809. 

Flooding,  434,  440. 

Fluctuation,  526. 

Fluid  ailments,  779;  Ex- 
tracts, 894;  Nutritive, 
796. 

Fluor  albus,  393. 

Folded  wet  sheet,  744. 

Follicles,  41. 

Follicular  inflammation  of 
mouth,  468. 

Folliculitis,  solutions  for, 
220. 

Fomentations,  894, 

Food,  68;  Adapted  to  dif- 
ferent periods,  76 ;  Albu- 
minous, 69,  77;  Amount 
of,  to  be  taken,  83 ;  And 
digestion,  64;  Animal 
and  vegetable,  fO,  84; 
Articles  of,  79-83;  Azo- 
tlzed  and  non-azotlzed, 
70 ;  Choice  of,  73;  Cost  of, 
77,  79,  80;  Digestibility, 
of,  71,  72;  Fatty,  78; 
in  winter,  75;  For  con- 
valescents, 776;  For  in- 
fants, 447;  Gelatinous, 
69;  Heat-generating,  70; 
Human  structure  de- 
mands mixed,  85;  Na- 
ture and  destination  of, 
68;  Nutritive,  71 ;  Oleag- 
inous, 69;  In  old  age. 


-•.^ 


^ 


,..^^„^. 


IMAGE  EVALUATION 
TEST  TARGET  (MT-3) 


// 


4' 


<p 


1.0 


I.I 


2 


1^ 


2.5 
22 

2.0 
1.8 


L25  111.4    11.6 


Photographic 

Sdences 

Corporation 


23  WEST  MAIN  STREET 

WEBSTER,  N.Y.  14580 

(716)  872-4503 


-  .ViUBWBKTBWrSW^nWllBHB. 


CIHM/ICMH 

Microfiche 

Series. 


CIHM/ICMH 
Collection  de 
microfiches. 


Canadian  Institute  for  Historical  Microreproductions  /  Institut  Canadian  de  microreproductions  historiques 


GENERAL  INDEX. 


971 


76;  Organic,  69;  Propor- 
tions of  animal  and  vege- 
table, 86;  Saccharine, 
69;  Starch  and  sugar, 
69,  78;  Value  of,  VO,  71, 
72,  79,  80;  In  youth  and 
manhood,  76. 

Foot,  fractures  of,  660. 

Foot-bath,cold,753;  Warm, 
754. 

Fore-arm,  fractures  of,  554. 

Foreign  bodies  in  ear,  599; 
In  eye,  586;  In  gullet, 
599;  In  nose,  598;  In 
windpipe,  599. 

Fowler's  solution,  877. 

Foxglore,  837. 

Fractures,  546-561,  Com- 
pound,550,  560;  Of  bones 
of  foot,  660;  Of  bones  of 
no9e,551 ;  Of  breast-bone, 
556;  Of  collar-bone  or 
clavicle,  552;  Of  elbow, 
554;  Of  fore-arm,  554; 
Of  hand  and  fingers,  555 ; 
Of  haunch-bones  or  pel- 
vis, 556;  Of  knee-pan, 
558;  Of  leg,  558;  Of 
lower  jaw,  551;  Reduc- 
tion of,  547;  Of  ribs, 
555;  Of  snoulder-blade, 
553;  Of  skull,  651;  Of 
thigh-bone,  556;  UnlOn 
of,549,550;  Of  upperarm- 
bono,  553;  Of  wrist,  555. 

Franklin  mills  bread,  796. 

Freckles,  154,  160. 

Freezing  miztnres,  765. 

French  decimal  weights, 
811. 

French  milk-porridge,  793. 

Frequency  of  doses,  126. 

Frost-bite,  636. 

Frostweed,  837. 

Fruits,  778. 

Fumigants,  764. 

Fumigation  of  infected 
places,  763. 

Fungus  hematoldes,  675. 

Galbanum  plaster,  comp., 
904. 

Galium  aparine,  830. 

Gall-bladder,  34. 

GtUjstones,  299. 

Gal^,  837;  Comp,  ointment 
of;  900. 

Gamboge,  837. 

Gangrene,  527;  Of  mouth, 
458. 

Gardening  as  exercise,    96. 

Garfield  Tea,  000. 

Garget,  865. 

Gargles,  933. 

Garlic,  837;  Syrup  of,  909. 

Gastric  fever  of    infancy. 


465;  Juice,  64;  Not  se- 
creted without  limit,  66; 
Nor  in  sickness,  66 ; 
Secretion  favored  by 
cheerfulness,  66. 

Gastritis,  301,  302. 

Gastrodynia,  309. 

Gaultheria  procumbens,  886. 

Gelatin,  16. 

Gelatinous  foods,  69. 

Gelseminin,  888. 

Gelseminum  sempervlrens, 
888. 

Gengivitis,  458. 

General  diseases,  diet  in, 
781;  Symptoms,  126; 
And  nerve  tonics,  925. 

General  system,  diseases 
of,  469-492. 

GentiAn,  838;  Comp.  infu- 
sion of,  894;  Tincture  of, 
917. 

Gentiana  lutea,  838. 

Geranium  maeulatum,  833; 
Comp.  infusion  of,  895. 

Geraniin,  833. 

Germ  or  ovum,  382. 

Germ-wheat  bread,  796. 

Gill-over-the-ground,  839. 

Ginger,  838;  Wild,  886;  Syr- 
up of,  909. 

Ginseng,  838. 

Glands,  40,  41,  52. 

Glauber's  Salts,  876. 

Gleet,  371. 

Glossary,  000. 

Glottis,  43;  Spasm  of,  461. 

Gluten  Flour,  000. 

Glycerin,  838. 

Glycerrhiza  glabra,  851. 

Glycones,  000. 

Goitre,  578. 

Gold,  839. 

Golden  seal,  839;  Comp. 
powder  of,  907;  Tinct. 
of,  917;  Wine  of,  898. 

Golden  tincture,  917. 

Gonorrhoea,  369. 

Gossypium  herbaceum,832. 

Goulard's  cerate,  891. 

Gout,  479;  Diet  In,  784, 802. 

Granulation,  544. 

Gravel,  345;  Symptoms  of, 
347;  Uric-acid,  347. 

Gravel-root,  869. 

Green  sickness,  401;  3iet 
In,  78*4. 

Grippe,  la,  226. 

Ground-ivy,  839. 

Ground  ric   milk,  793. 

Grabs  or  worms,  156. 

Gruel,  780;  Arrow-root, 
792;  Flour,  797;  Oat- 
meal, 797;  Bice,  789; 
Sago,  792;    Water,  791. 


Gnaiac,  amiuoniated  tlnct. 

of,  917. 
Guaicol,  248. 
Guaiacum,  840. 
Gullet,    the,    32;    Foreign 

bodies  in,  599. 
Gum-Arabic,  840. 
Gum,  hemlock, 840 ;  Sweet, 

881. 
Gums,    inflammation     of, 

458. 
Gunshot  wounds,  646. 
Gymnastics,  948;   Treatise 

on,  94. 

Habits,  125. 

Hsmastasis,  840. 

Haematocele,  5b0. 

Haematoxylon  Campechia- 
num,  852. 

Haematuria,  341. 

Haemidrosis,  154. 

Hair,  as  clothing,  103. 

Hair  and  hair-tubes,  dis- 
orders of,  157. 

Hair-cap  moss,  840. 

Hair-oils  and  washes,  935. 

Half  bath,  748;  pack,  744. 

Hamamelis  Yirginica,  886. 

Hand,  Dislocation  of  bones 
of,  565;  Fractures  of, 
655. 

Hanging,  apparent  death 
from,  512. 

Hardhack,  841. 

Hardleaf  golden-rod,  841. 

Haunch-bones,  fractures  of,  ■ 
666. 

Hay-asthma  (Hay  fever), 
272. 

Head,  affections  of,  785; 
Bath,  750;  Face  and 
neck,  symptoms  affect- 
ing, 127;  Water  in,  174. 

Headaches,  201-207,  427. 

Hearing,  organs  of,  62. 

Heart,  37;  Diseases,  274- 
290;  Altered  sounds  of, 
276;  Aneurismal  tu- 
mors of,  280 ;  Atrophy  of, 
281 ;  Bone  and  cartilage 
in,  231;  Dilatation  of 
ventricles  of,  278,  279; 
Displacements  of,  290; 
Enlargement  cf  ventri- 
cles of,  276 ;  Fatty  de- 
generatloa  of,  281 ;  Hy- 
pertrophy and  dilata- 
tion of,  279 ;  Impulse  of, 
275 ;  Induration  of,  280 ; 
Inflammation  of,  281, 
282,  283;  Inflammation 
of  lining  of,  283,  284; 
Murmurs,  286;  Neural- 
gia of,  289 ;  Palpitations 


972 


GENERAL  INDEX. 


of,  B88;  Percussion  of, 
276;  Polypus  of,  298; 
Shrinking  of,  281;  Soft- 
,  ening  of,  280;  Sounds 
of.  275;  Valves  of,  274, 
285,  287. 

Heartburn,  308. 

Heart-case,  acute  Inflam- 
mation of,  281;  Chronic 
Inflammation  of,  282; 
Water  in,  287. 

Heat-generating  foods,  70; 
Incompatible  with  ex- 
citement, 76. 

Hectic  Fever,  523. 

Hedeome  pulegiodes,  861. 

Heiianthemum  Canaidense, 
837. 

Heliantbus  anouus,  880. 

Hellebore,  American,  814; 
White,  886;  Ointment, 
902. 

Helonias,  841. 

Helpless  dependence  of  the 
aged,  499. 

Hemicrania,  190. 

Hemiphlegia,  180. 

Hemlock,  comp.  tinci.  of, 
917 ;  Gum,  840 ;  Poison, 
864. 

Hemorrhage,440 ;  Huring  la- 
bor, 434 ;  Of  wounds,  539. 

Hemorrhoids,  325,  576. 

Henbane,  841. 

Hepar,  868. 

Hepatica  Americaoa,  861. 

Hepatitis,  293. 

Herb-teas,  780. 

Hernia,  681. 

Herpes,  146. 

Hiccough,  199  ;When  alarm- 
ing, 772. 

High  cranberry,  842;  Comp. 
tinct.  of,  917. 

Hip-joint,  disease  of,  671; 
Dislocation  of ,  565. 

Hippuric  acid  in  urine,  353. 

Hives  (nettle-rash),  1^1, 
143. 

Hoarseness,  unfavorable  In 
small-pox,  771. 

Homoeopathy,  608. 

Homoeopathic  remedies, 
609. 

Honey-diseases  (honey- 
scab),  148. 

Hopeful  considerations,  63. 

Hops,  842. 

Hordeolum,  687. 

Horehound,  842 ;  Water,884. 

Horn-pox,  141. 

Horse,  should  be  owned,  98. 

Horseback-riding  as  exer- 
cise, 97. 

Horsemint,  843. 


Horseradish,  843. 
Horsford's  Acid  Phoaphate, 

946. 
Hose-bath,  747. 
Hot  Drops,  918. 
Eouseleek,  813. 
Human  blood,  composition 

of,  247. 
Humors  of  the  eye,  61. 
Humulus  lupulus,  842. 
Hnxham's  tincture,  918. 
Hydatids,  uterine,  407. 
Hydrangea,  aborescens, 

843. 
Hydrargyrichlorldum  mite, 

825;  PillulfiB,  823. 
Hydrastin,  comi'    powder 

of,  839,  907. 
HyCrastis  Canadensis,  839. 
Hydriodate  potassa,  846. 
Hydrocele,  679. 
Hydrocephalus,  acute,  174 ; 

Chronic,  175. 
Hydrochloric  acid,  813. 
Hydrocyanic  acid,  813. 
Hydropathic  treatment, 

732-755. 
Hydropathy,  6. 
Hydropericardium,  287. 
Hydrophobia,  182. 
Hydrothorax,  261. 
Hygiene,  54,  121. 
Hyoscyamin,  841. 
Hyoscyamns    nlger,     841 ; 

Poisoning  by,  615. 
Hypertrophy,  of  brain,  173 ; 

Of  heart,  279 ;  Of  lungs, 

259. 
Hypochondria,  197. 
H3rpochondrium,  292. 
Hypogastrium,  292. 
Hypophosphites,comp.  syr- 
up of,  910. 
Hyssop,  843. 

Hyssopus  offlclnalis,  843. 
Hysteria,  405. 
Hysteric  headache,  264. 

Ice,  for  wounds,  640 
Ice-plant,  844. 
Iceland  moss,  844. 
IchthyocolU,  849. 
Icterus,  298. 
Idiocy,  194. 
Idiosyncrasy,  125. 
Idrosis,  154. 
Ignatia  amara,  879. 
Ileum.  33. 
Iliac  fossa,  292. 
Imperfect  vision,  691. 
Impetigo,  148. 
Impregnation,  421. 
Incised  wounds,  639. 
Incontinence  of  urine,  344. 
Incubus,  200. 


Indian  com,  81;  Hemn, 
844 ;  White,  881 ;  Tinct. 
of,  914;  Turnip,  894. 

Indian-meal  poultice,  906. 

Indigestion,  303  ;  Diet  iu, 
787;  Causes  headaches, 
203;  Headaches  from, 
206. 

Indigo,  wild,  886. 

Indolent  ulcers,  532. 

Induration,  of  brain,  167; 
Of  heart,  280. 

Infants,  gastric  fever  of, 
465;  Milk  for,  447;  Moral 
treatment  of,  452 ;  Sum- 
mer complaint  of,  463; 
While  sleeping,  461. 

Inflammation,  520,  626; 
Of  the  arachnoid  or 
pia  mater,  165 ;  Of  the 
bladder,  335;  Of  the 
bowels,  314,  316;  Of 
breast,  441 ;  Of  dura 
mater,  164 ;  Of  epiglottis, 
227 ;  Of  Fallopian  tubes, 
414;  Of  heart-case,  281; 
282;  Of  iris,  591;  Of 
kidneys,  333 ;  Of  lachry- 
mal sac,  588  ;  Of  larynx, 
213;  Of  liver,  293;  Of 
mouth,  457,  468 ;  Of  nock 
of  womb,  386;  Of  ova- 
ries, 390;  Of  perito- 
neum, 312,  313;  Of 
pharynx,  212 ;  Of  spinal 
cord,  176;  Of  spleen, 
297;  Of  stomach,  301, 
302;  Of  tonsils,  222, 223 ; 
Of  tympanum,  596;  Of 
vagina,  416;  Of  veins, 
680;  Of  windpipe,  214; 
Of  womb,  408. 

Inflammatory  blush,  144. 

Influenza,  224. 

Inebriety,  168. 

Infusion  of  malt,  791. 

Infusions,  812,  894. 

Ingrowing  toe-nail,  597. 

Inhalants,  243-246;  Object 
of,  244. 

Inhalation,  atmospheric, 
2C0. 

Inhaling,  mode  of,  246; 
Powder,  908. 

Injections,  ?37,  896,  935. 

Injuries,  chemical,  635 ; 
Mechanical,  638. 

Insanity,  191 ;  Causes  of, 
195;  Cure  of,  196;  On 
one  subject,  193. 

Insects,  bites  of,  545. 

Insensible  perspiration,  106. 

Instruments  for  throat- 
diseases,  216-221. 

Interalgia,  320. 


I'll-   lllglj^ll' 


GKNERAL    INDKX. 


973 


corn,  81 ;  Hemn, 
White,  881;  Tinct. 
4;  Turnip,  894. 
meal  poultice,  906. 
tion,  303 ;  Diet  la, 
Causes  headaches, 

Headaches  from, 

wild,  886. 
t  ulcers,  632. 
ion,  of  brain,  167: 
art,  280. 

,  gastric  fever  of, 
Hilk  for,  447;  Moral 
nent  of,  452 ;  Sum- 
complaint  of,  463; 
I  sleeping,  451. 
tation,  620,  626; 
he  arachnoid  or 
later,  165 ;  Of  the 
er,  335;  Of  the 
8,  314,  316;  Of 
b,  441;  Of  dura 
',164;  Of  epiglottis, 
Of  Fallopian  tubes, 
3f  heart-case,  281; 
Of  iris,  691;  Of 
ya,  333  ;  Of  lachry- 
10,  588 ;  Of  larynx. 
Of  liver,  293;  Of 
J,  457,  458 ;  Of  nocli 
mb,  386;  Of  ova- 

890;    Of    perito- 

312,     313;     Of 

ox,  212 ;  Of  spinal 

176;  Of  spleen, 
3f  stomach,  301, 
'f  tonsils,  222, 223 ; 
npanum,  596;  Of 
I,  416;  Of  veins, 
•f  windpipe,  214; 
nb,  408. 

itory  blosh,  144. 
,  224. 
,  168. 

of  malt,  791. 
,  812,  894. 
g  toe-nail,  697. 
I,  243-246;  Object 

n,     atmospheric, 

mode    of,    246 ; 
r,  908. 
I,  737,  896,  935. 

chemical,     635 ; 
ileal,  638. 

191;   Causes  of, 
ure  of,  196;    On 
)ject,  193. 
ites  of,  645. 
!  perspiration,  106. 
Its     for     throat- 
s,  216-221. 
,320. 


Intermarriages,    improper, 

59. 

Intermittent  fever,  473. 

Intestinal  obstruction,  318. 

Intestines,  32,  291 ;  Cancer 
of,  317. 

Introductory  remarks,  5. 

Inula  ht'lenium,  836. 

Iodide  of  potassium,  845; 
Of  mercury,  ointment, 
901;  Of  zinc,  889. 

Iodine,  891. 

Ipecacuanha,  845 ;  Ameri- 
can, 815 ;  Comp.  powder 
of,  908;  Syrup  of,  910; 
Wina  of  898. 

Ipomcea  jalapa,  849. 

Iridin,  822. 

Iris,  60 ;  Inflammation  of 
591 ;  Versicolor,  822. 

Irish  moss,  Jelly  of,  792. 

Iritis,  591. 

Iron,  845 ;  Ammonlo-citrate 
of,  840;  Black  oxide  of, 
846;  Citrate  of,  846; 
Citrate  of,  and  quinla, 
846;  Citrate  of,  and 
strychnia,  846 ;  Comp. 
mixture  of,  899;  Hy- 
drated.  In  consumption, 
250;  Oxide  of,  846;  Io- 
dide of,  846 ;  Lactate  of, 
846;  Persalt  of,  847; 
Phosphate  of,  847 ;  Pow- 
der of,  847;  Precipitated 
carbonate  ot  847;  Pro- 
toxide of,  847;  Solutions 
of  protoxide  of,  847, 
848;  Suipnate  of,  84S; 
Syrup  of  Iodide,  848; 
Syrup  of  Iodide  of,  and 
manganese,  848;  Tar- 
trate of,  and  potassa, 
848 ;  Tincture  of  muriate 
of,  848;  Valerianate  of, 
848. 

Irritations  of  spine,  684. 

Irritants,  external,  250 ; 
Counter,  931. 

Ischuria  renalis,  342. 

Isinglass,  849 ;  Jelly,  792. 

Itch,  14v ;  Barbers',  156. 

Itching,  153 ;  Of  genitals, 
417,  428. 

Ivy,  American,  815 ;  Big, 
856 ;  Ground,  839  ;  Poi- 
soning oy,  516. 

Jackson's  itch,  156. 
alap,  849 ;  Comp.  powder 
of,  908. 
Jamestown  weed,  880. 
Janipha  manihot,  882. 
Jaundice,  2^8. 
Jaw,   fractures  of    lower. 


661 ;  Dislocation  of  lower, 
663. 
Jejunum,  33. 

Jelly,  calf'8-feet,  794 ;  Irish 
moss,  792;  Isinglass,  792 ; 
Tapioca,  792. 
Jerusalem  oak,  887. 
Jessamine,  yellow,  887. 
Joints,  the,  26 ;  Diseases  of, 
571;False,551;  Stiff,  573. 
uglandin,  825. 
uglans  clnerea,  824. 
uniper,  849. 
uniperus  sabina,  873. 


Kidi 

ted; 

Jin 

fdi 


Calmia  angustifolia,  866; 
Latifolia,  856. 

Kidneys,  36 ;  Acute  inflam- 
^  ation  of,  333;  Bleed- 
ing from,  341 ;  firlght's 
disease  of,  338;  Chronic 
Inflammation  of,  335. 

King's  evil,  480. 

Kino,  849;  Comp.  powder 
of,  908. 

Knee,  fractures  of,  568. 

Knee-joint,  dislocation  of, 
668. 

Knee-pan,  dislocation  of, 
667. 

Kola  Koloid.  946. 

Krameria  trlandra,  870. 

Labor,  430. 

Labyrinth,  B3. 

Lacerated  wounds,  644. 

Lachrymal  canals,  62 ; 
Gland,  62;  Sac,  inflam- 
mation of,  588. 

L&cteals,  33, 67. 

Lactuca  satlva,  850. 

Ladies'  slipper,  849. 

Lappa  minor,  824. 

Laryngeal  shower-syringe, 
216. 

Laryngismus  stridulus, 461. 

Laryngitis,  209;  Follicular, 

Larynx,  36,  42;  Inflamma- 
tion of,  213. 
Laudanum,  916;  Poisoning 

by,  516. 
Laurel,  narrow-lea*,    856; 

SLeep,  856. 
Laurus,    camphoras,   826 ; 

Sassafras,  872. 
Lavender,  comp.  tlnct.  of, 

917. 
Laws,  physiological,  of  life 

and  health,  64. 
Lead,  850;  Acetete  of,  850; 

Colic,     322;     Ointment, 

comp.,  902;  Palsy,  181; 

Pipes,  90;  Plaster,  905; 

Plaster,  comp.,  904. 


Looseness  of  bowels,  327. 

Leaders,  conservative,  11. 

Leaves,  when  to  gather, 
808. 

Leeching,  624. 

Leg,  fractures  of,  658. 

leg-bath,  750. 

Lemon,  850;  Syrup,  910; 
Water,  790. 

Lemonade,  791;  Flaxseed, 
797. 

Lenitive  electuary,  89S. 

Leonurus  cardlaca,  866. 

Leo|)ard's  bane,  817. 

Leprosy  (lepra),  149. 

Leplandra  Vlrglnica,  834. 

Leptandrin,  834. 

Lettuce,  850. 

Leucorrhoea,  393. 

Lice,  159 

Lichen,  160. 

Life,  completeness  of,  121; 
The  Infancy  of  being,  64. 

Life-root,  850. 

Ligaments,  the,  26. 

Ligature,  639. 

Lightning,  apparent  death 
from,  512. 

Lily,  white  pond,  886. 

Limbs,  symptoms  affect- 
ing, 129. 

Lime,  851;  Chloride  of,  851; 
"Water,  851. 

Linen  clothing,  102. 

Liniments,  896,  932. 

Linum  usitatissimum,  837. 

Liquidamber  styraciflua, 
881. 

Liquor  ammoniee,  816; 
Ammonlae  acetatis,  816; 
Potassaa,  867;  Potassee 
arsenltis,  877;  Potassie 
citras,  867. 

Liquorice,  861. 

Liriodendrontullplfera,  882. 

Liver,  34,  291;  Acute  In- 
flammation of,  293; 
Chronic  ii'flammatlon  of, 
294  ;  Cirrhosis  of,  296; 
Congestion  of,  295;  Com- 
plaints, diet  in,  788;  Of 
sulphur,  868. 

Liverwort,  851. 

Lobelia  (inflata) ,  852 ;  poul- 
tices, 906;  Tlnct.  of,  915; 
Comp.  tinct.  of,  917 ;  And 
capsicum,  comp.  tinct. 
of,  918;  Vinegar  of,  919. 

Lobelin,  852. 

Local  palsy,  181. 

Locked  jaw,  181. 

Logwood,  852. 

Loneliness  of  the  aged, 
498. 

Long  sight,  692. 


i 


i 


i 


SSrer 


..J 


974 


GENERAL   INDEX. 


11    'i 


Looseness  of  bowels,  327. 
Lost  parts,  reproduction  of, 

644. 
Lotions,  933,  934. 
Lower  jaw,  dislocation  of, 

663. 
Lumbago,8ee  Biieumatlsm . 
Lumbar  plexus,  48. 
Lumbar  region,  292. 
Lumbricus,  332. 
Lung  fever,  266;  Typhoid, 

268;  Other  forms,  270; 

Diet  in,  785. 
Lungs,  36;  And  heart,  122 ; 

Swelliug  (hypertrophy) 

of,  209;  Should  be  well 

filled,  116. 
Lupulin,  843. 
Lupus,  151. 
Luxations,  661. 
Lycopus  virglnlcus,  824. 
Lye,  poisoning  by,  514. 
Lymphatics,  40. 
Lypemania,  193. 

Macule,  163. 

Uagnesia,  852;   Carbonate 

of,  853;  Sulphate  of,  853. 
Malaria,  473. 
Male  Fern,  853. 
Malignant  pustule,  635. 
Malt,  infusion  of,  791. 
Mammary  abscess,  441. 
Mandrake,  883. 
Mania,  193;  Apotu,167. 
Manna,  864. 

Maranta  arundinacea,  817. 
Marks,  mother's,  162. 
Manied  ladies'  calendar,443. 
Marshmallow,  854. 
Marsh-rosemary,  854. 
Marubium  vulgare,  842. 
Mastic,  854. 
Ma8turb''.don,  375. 
Materia  medica,  808-890. 
Matico,  865. 
Mattery  pimples,  148. 
Meadow     cabbage,     874 ; 

Saffron,  855. 
Meals,  number  of,  780. 
Measles,  136 ;  Diet  in,  782 ; 

False,  143. 
Measures,   domestic,    810, 

811. 
Meat,   80;  Americans  eat 

too  much,  85;  Majority 

of  mankind  eat  no,  86; 

Mode  of  cooking,  501. 
Meatus     auditorius,     62; 

Inflammation  of,  695. 
Mechanical  injuries,  538. 
Mediastinum,  36. 
Medical  knowledge  wanted, 

13;    Treatment   of    the 

old,  605. 


Medicated  waters,  897; 
Wines,  898. 

Medicine,  progress  of,  6-9 ; 
Chest,  articles  for,  809. 

Medicines  and  their  prep- 
arations, 808-943;  Pa- 
tent and  proprietary,944. 

Medulla  oblongata,  46. 

Medullary  cancer,  675. 

Megrims,  204. 

Melancholy,  193. 

Melanosis,  676. 

Melissa  offlcinalis,  817. 

Mellin's  Food,  946. 

Membrane,  synovial,  26. 

Menispermjm  Canadense, 
889. 

Menopause  (turn  of  life), 
413. 

Menorrhagia,  396. 

Menses,  absence  of,  394; 
Oessatlon  of,  403;  Es- 
tablishment of,  380. 

Menstruation,  disturbance 
of,  388;  Painful,  399; 
Profuse,  396. 

Mentha  piperita,  861 ;  Vlr- 
ides,  877. 

Mercury,  bichloride  of,  832 ; 
Nitrate  of,  ointment  of, 
901 ;  Red  iodide  of,  oint- 
ment, 901. 

Mesenteric  disease,  466. 

Mesentery,  34. 

Metastasis,  477. 

Metauer's  aperient,  899. 

Metric  weights,  811. 

Metritis,  408. 

Midwifery,  424. 

Milk,  77  ;  Coffee,  796 ;  Crust, 
148;  For  convalescents, 
777;  For  infants,  447, 
491;  For  old  persons, 
602;  Leg,  437;  Mother's, 
448;  Porridge,  793;  Sick- 
ness, 311 ;  Sterilization 
of,  449;  And  soda-water, 
795 ;  Sugar  of,  247. 

Milkweed,  swamp,  881. 

Mind,  derangement  of, 
191 ;  How  it  gets  knowl- 
edge, 66;  State  of  in 
aieting,  76. 

Mindererus,  spirit  of,  816. 

Miscarriage,  428. 

Miscellaneous  diseases,  469- 
492;  Prescriptions,  936. 

Mitchella  repens,  861. 

Mitral  valves,  diseases  of, 
285. 

Mixtures,  S98. 

Modem  diseases,  493 ;  Sur- 
gery, 617. 

Modus  operandi  of  water, 
737. 


Moles,  154. 

Momordica  elaterlum,  886. 

Monarda  punctata,  843. 

Monkshood,  855, 887. 

Monomania,  193. 

Monotropa  unlflora,  844. 

Monsel's  styptic,  847. 

Moral  treatment  of  Infants, 
452. 

Morphia  (morphine),  860; 
Poisoning  by,  515. 

Mortality  in  cold  weather, 
603. 

Mortification,  524, 527. 

Mosquitos,  bites  of,  646. 

Mother's  cordial,  911; 
Marks,  152. 

Motherwort,  855. 

Mountain  laurel,  856. 

Mouth,  inflammation  of, 
457-  Follicular  Inflam- 
mation of,  458;  Gan- 
grene of,  458. 

Iffouth-bath,  755. 

Mucous  tissue,  16. 

Mucus,  16. 

Mullein,  856. 

Mumps,  228. 

Muriate  of  ammonia,  816; 
Of  soda,  876. 

Muriatic  acid,  poisoning 
by,  516. 

Murmurs,  breathing,  232; 
Of  heart,  286. 

Muscae  volltantes,  591. 

Muscles,  27  ;  Action  ot,  29 ; 
And  bones,  122 ;  Number 
of,  29 ;  Shape  of,  28. 

Muscular  and  nervous  de 
raugements  from 
wounds,  183;  Tissue,  17. 

Mustard,  856 ;  Poultice, 
906;  Volatile  oil  of,  856 ; 
Whey,  794. 

Mutton  broth,  797. 

Myopia,  592. 

Myrica  cerlfera,  818. 

Myricin,  818. 

Myristica  moschata,  858. 

Myrospernum  toluiferum, 
818. 

Myrrh,  856;  Comp.  tinct. 
of,  9i8. 

Naphtha,  857. 
Napthalin,  857. 
Narcotics,  928. 
Nasal  ca'  urh,  209 ;  Duct, 

52 ;  Shower  syringe,  217. 
Natural  surgery,  631. 
Nausea,  during  pregnancy, 

426. 
Week,  symptoms  affecting, 

12'r. 
Necrosis,  570. 


,154. 

rdica  elaterlum,  886. 

da  punctata,  843. 

ihood,  855, 887. 

lania,  193. 

ropa  unlflora,  844. 

I's  styptic,  847. 

treatment  of  infants, 

la  (morphine),  860; 

loning  by,  515. 

lity  in  cold  weather, 

Lcation,  524, 527. 

itos,  bites  of,  546. 

r's      cordial,      911 ; 

kB,  152. 

rwort,  855. 

ain  laurel,  856. 

,    inflammation    of, 

:    Follicular   inflam- 

ion    of,    458;   Gan- 

16  of,  458. 

-bath,  755. 

IS  tissue,  16. 

1,15. 

in,  856. 

IS,  228. 

te  of  ammonia,  816; 

loda,  876. 

tic    acid,    poisoning 

616. 

urs,  breathing,  232; 

leart,  286. 

e  volltantes,  591. 

es,  27  ;  Action  of,  29 ; 

I  bones,  122 ;  Number 

J9 ;  Shape  of,  28. 

liar  and  nervous  de 

igements     from 

mds,  183;  Tissue,  17. 

,rd,     856 ;     Poultice, 

;  Volatile  oil  of,  856 ; 

ey,  794. 

n  broth,  797. 

ia,  592. 

a  cerifera,  818. 

in,  818. 

tica  moschata,  858. 

ipernum    toiuiferum, 

I,  856;  Comp.  tinct. 
)i8. 

tha,  857. 
lalin,  857. 
tics,  928. 
ca'  irrh,  209 ;  Duct, 
Shower  syringe,  217. 
al  surgery,  531. 
la,  during  pregnancy, 

symptoms  affecting. 

Bis,  670. 


Nepeta  cataria,  827;  Glo- 
choma,  839. 

Nephritis,  333. 

Nerve-root,  888 ;  Tonics, 
925. 

Nerves,  cranial,  46,  47; 
Diseases  of  brain  and, 
164;  Optic,  47,  50;  Pain 
of,  189;  Of  skin,  dis- 
ordered, 153;  Spinal,  48 ; 
Sympathetic,  45. 

Nervine  and  tonics,  862, 
925. 

Nervous  complications  in 
dyspepsia,  303  ;  Derange- 
ments from  wounds,  183 ; 
Diseases,  effects  of,  62 ; 
Headaches,  204,  206; 
System,  45,  54 ;  System, 
sympathetic,  62 ;  System, 
symptoms  affecting,  129 ; 
Tissue,  18. 

Nettle-rash,  143. 

Neuralgia,  189;  Of  heart, 
289. 

Neutral  mixture,  867. 

Neutralizing  cordial,  912; 
Extract,  899;  Powder, 
908. 

New  Jersey  tea,  870, 

Nicotiana  tobacum.,  882. 

Nightmare,  200. 

Night-nurse,  757. 

Night-sweats,  250. 

Nipples,  sore,  426,  442. 

Nitrate  of  mercury  oint- 
ment, 901;  Of  potassa, 
858;  Of  potassa,  poison- 
ing by,  515;  Of  silver, 
857. 

Nitre,  858 ;  Sweet  spirit  of, 
858. 

Nitric  acid,  77,  813;  Poi- 
soning by,  515;  Ether, 
spirit  of.  878. 

Nitrogenous  foods,  70. 

Nitro-murlatic  acid,  813. 

Nose,  bleeding  from,  697; 
Foreign  substances  in, 
598;  Fractures  of,  551. 

Nose-bath,  754. 

Noxious  vapors,  apparent 
death  from,  509. 

Nurse,  activity  of,  768; 
Age  of,  767;  Education 
of,  769;  Habits  of,  768; 
Health  of,  767 ;  Strength 
of.  767;  Temper,  etc.,  of, 
767;  Wet,  446. 

Nursinz  bottles,  447 ;  Sick 
children,  453;  Sore 
mouth,  440 ;  Women, 
445. 

Nutmeg,  858. 

Nutrition  table,  70, 


GENERAL   INDEX. 

Nutritive  fluid,  796. 
Nux  vomica,  858. 
Nymphaea  odorata,  885. 
Nymphomania,  417. 

Oak,  white,  885. 
Oatmeal  gruel,  797 ;  Poul- 
tice, 905. 
Oats,  80. 
Obstruction   of   intestines, 

318. 
(Esophagus,  32. 
Oil    of    cajuput,    859;    Of 
mustard,   volatile,    856; 
Of  turpentine,  869. 
Oil-glands,  44;  Disordered, 

154. 
Oil-nut,  824. 

Ointments,  900-903,  931. 
Old  age,  and  its  diseases, 
496-508;    Diet     in,     76; 
Preservation    of   health 
in,  600. 

Oleaginous  foods,  79. 

Oleum  cajuputi,  859 ;  Mor- 
rhuas,  830;  Ollvae,  869; 
Riclni,  827 ;  Terebin- 
thincB,  869;  Tiglii,  834. 

Olive-oil,  859. 

Omentum,  34. 

Onion,  869;  Poultice,  906. 

Operations,  surgical,  prep- 
arations for,  519. 

Ophthalmia,  catarrhal,589 ; 
Purulent  (Egyptian), 
588;  Of  children,  689; 
Scrofulous,  690;  Tarsi, 
587. 

Opium,  869;  Camphorated 
tinct.  of,  918 ;  Liniment, 
896;  Poisoning  by,  515; 
Tinct.  of,  915. 

Opodeldoc,  liniment,  897. 

Orange  blossoms,  949. 

Orange-peel,  86C ;  Tinct.  of, 
914 ;  Whey,  795. 

Orbits,  52. 

Orchitis,  371. 

Organized  compounda,  16. 

Organs,  digestive,  '31;  Of 
hearing,  52;  Of  circula- 
tion, 37;  Of  secretion, 
41;  Of  sight,  50;  Respi- 
ratory, 36 ;  Vocal,  42. 

Origanum  vuigare,  860. 

Omus  Europcea,  854. 

Osmidrosis,  154. 

Osseous  tissue,  17. 

Otalgia,  696. 

Otitis,  596. 

Otorrhaea,595. 

Ovarian  disease,  774;  Tu- 
mors, 414. 

Ovaries,  384 ;  Inflamma- 
tion of,  390. 


975 

Ovaritis,  390. 
Ovum,  382. 

Oxalic  acid,  poisoning  by, 
615;  Deposits  in  urine, 
351,  359. 
Oxide    of    zinc    ointment, 

901. 
Pack,  half,  744  ;  Wet  sheet, 

742. 
Pail-douche,  748. 
Pain,  symptoms  indicated 
by,   130;   Sudden   disap- 
pearance of,  772. 
Painters'  colic,  322. 
Pallidness,    when    >-     bad 

symptom,  772. 
Palpitation,  of  heart,  288, 

427. 
Palsy,  179;   Diet  in,  784; 
Lead,    181;   Local,   181; 
Shaking,  181. 
Panada,  791. 

Panax  quinquefoiium,  838. 
Pancreas,  34,  291. 
Papaver  somniferum,  859. 
Papillae)  152. 
Papulous  scall,  149. 
Paralysis,  179. 
Paraphlegia,  180. 
Paregoric  elixir,  918. 
Parrilla,  yellow,  889. 
Paronychia,  572. 
Parotid  gland,  31. 
Parotitis,  228. 
Parsley,  860;  Comp.  infu- 
sion of,  895. 
Parsnips,  82. 
Partridge-berry,  861 ;  Comp. 

syrup  of,  911. 
Passive  congestion  of  liver, 

296. 
Patches,  colored,  on  skin, 

153. 
Patella,  dislocation  of,  567; 

Fracture  of,  658. 
Patent     and     proprietary 

medicines,  944-949. 
Patients,  how  to  examine, 

126. 
Peach,  861. 

Pear-leaf  wintergreen,  871. 
Pearlash,  puriiied,  866. 
Peas,  82. 

Pectoriloquy,  242. 
Pelvis,  fractures  of,  556. 
Pemphigus,  147. 
Pennyroyal,  861. 
Pepper,  red,  827;  Water, 

884. 
Peppermint,  861. 
Pepto-maugan,  360. 
Perennial  plants,  when  to 

gather,  808. 
Pericarditis,  281. 
Pericardium,  S?. 


'.'Bi'ti'.iu'ilt'ta'..*'*"  '■**" 


■MI»MlJ-B'>'-au.'.'»!»tllU«Bta3cafcft»« 


976 


GENEKAL   INDEX. 


Periods  of  life,  12b,  126. 

Peritoneum,  291;  Acute 
Intlammatlon  of,  312; 
-  Ch  ionic  inHammatlon  of, 
313. 

Peritonitis,  312, 313. 

Pernicious  latermittent  fe- 
ver, 471. 

Perpetual  calendar  for 
marriod  iHciios.  443. 

Persalt  of  iron,  847. 

Persimmon,  801. 

Perspiration,  106;  Symp- 
toms Indicated  by,  132. 

Perspiratory  tubes,  45, 106. 

Peruvian  bark,  862 ;  Tlnct. 
of,  918. 

Pessaries,  411. 

Petroleum,  863. 

Petroselinum  sativum,  &no. 

Phagademc  ulcers,  532. 

Pharmacy,  891. 

Pharyngeal  siiower  syr- 
inge, 917. 

Pharyngitis,  208,  212;  Fol- 
licular, 212. 

Pharynx,  32 ;  Inflammation 
of,  212. 

Philosophy  of  breathing, 
112;  Of  chest  sounds, 
232. 

Phlebitis,  580 ;  Chronic, 
581. 

Phlegmasia  dolens,  437. 

Phosphate  of  iron,  847. 

Phosphates,  comp.  syrup 
•     of,  911. 

Phosphatic  deposits  in  ur- 
ine, 349,  355. 

Phosphorus,  246,  863. 

Phrenitis,  165. 

Phthisis,  229. 

Physical  culture,  950-960. 

Physiological  laws,  64. 

Physiologists,  8. 

Phytolacca  deeandra,  865. 

Phytolaccin,  865. 

Pia  mater,  46;  Inflamma- 
tion of,  165. 

Picra,  907. 

Picroena  excelsa,  869. 

Pigeon-berry,  865. 

Pile-ointment,  900,  902. 

Piles,  C.25.  576;  During 
pregnancy,  426 ;  Oint- 
ment for,  902. 

Pills,  903. 

Pimpinella  anisum,  816. 

Pimples,  dry,  150 ;  Mattery, 
148 ;  Watery,  144. 

Pin-worms,  332. 

Pink-root,  863. 

Pinna,  62. 

Piper  angustlfolium,  866. 

Pipsissewa,  863. 


Pittacia  lentiscus,  548. 

Pityriasis,  150. 

Pix  liquida,  882. 

Plantain  (plantago  major), 
864. 

Plants  and  animals,  re- 
lation of,  115 ;  Medicinal, 
when  to  gather,  808. 

Plasters,  903. 

Plastic  lymph,  622;  Diet 
in,  786. 

Plethoric  headaches,  205; 
Causes  of.  202. 

Pleurisy  (pleurltis),  262; 
Diet  in,  786;   Root,  864. 

Plumbi  acetas,  850. 

Plumbum,  850. 

Plunge-bath,  749. 

Pneumonia,  266;  Broncho-, 
269 ;  Typhoid,  268 ;  Diet 
in,  785. 

Pneumothorax,  26C. 

Podophyllin,  853. 

Podophyllum  pelatum,  853. 

Poison  hemlock,  864 ;  Oak, 
865 ;  Ointment,  901. 

Poisoned  wounds,  545. 

Poisoning  accidents,  513. 

Poisons,  antidotes  of,  513 ; 
Vegetable,  515. 

Poke,  86S  ;  Ointment,  901. 

Poke-root  poultice,  906. 

Polygala  senega,  873. 

Polygonum  punctatum,884. 

Polypus,  576;  Of  heart, 
290 ;  Of  womb,  406. 

Polytrichum  juniperum, 
840. 

Pompholix,  147. 

Poplar,  882, 

Pores,  of  skin,  should  be 
kept  open,  107. 

Porridge,  mllk,793. 

Porrigo,  157. 

Position  of  patient,  impor- 
tance of.  772. 

Potassa,  866;  Acetate  of, 
866;  Bicarbonate  of,  866; 
Bitartrate  of,  866;  Car- 
bonate of,  866 ;  Chlorate 
of,  866;  Citrate  of,  867; 
Solution  of,  867;  Solu- 
tion of  arsenite  of,  577 ; 
And  soda,  tartrate  of, 
876;  Sulphate  of,  867; 
Tartrate  of,  867. 

Potassce  acetas,  866;  Ar- 
senitis,  liquor,  877;  Bi- 
carbonas,  866;  Blturtras, 
866;  Carbonas,  866;  Ci- 
tras,  867 ;  Citratls,  liquor. 
867 ;  Liquor,  867;  Nitras, 
868;  Sulphas,  867;  Tar- 
tras,  867. 

PotassU,   bromidum,  867; 


Oyanuretum,  868;  lodl- 

dum,  845 ;  Sulphuretuiu, 

868. 
Potassium,  867;    Bromide 

of,  867 ;  Cyanuret  of,  868 ; 

Suiphuret  of,  868. 
Potatoes,  82. 
Poultices,  905-906. 
Powders,  906-908. 
Pox,  360. 
Pregnancy,  bathw   during, 

740 ;  Prevention  of,  429 ; 

Treatmentof,425;  Tubal, 

418. 
Prejudice  and  antipathies, 

770. 
Preparations,  of  medicines, 

808  ;Pnarmaceutical,891. 
Prepared     calamine,    889; 

Chalk,  828. 
Presbyopia,  593. 
Prescriptions,  920. 
Preservation  of  old  people's 

health,  500. 
Pressure     of    the    atmos- 
phere, 112. 
Prickly    ash,  868;    Elder, 

868. 
Princes'  pine,  863. 
Prinos  verticillatus,  820. 
Private  organs,  symptoms 

affecting,  129. 
Probang,  now  superseded, 

217. 
Prognostics,  771. 
Progress  of  medicine,  9. 
Prolapsus  ani,  465;   Uteri, 

409. 
Pronouncing  dictionary,  969. 
Proofs  of  death,  807. 
Prophylaxis,  489. 
Propriety     of     imparting 

physiological  knowledge, 

420. 
Protoxide  of  iron,  847. 
Provisional  callus,  549. 
Prunus  Virgiuiana,  885. 
Prurigo,  161 ;  Of  vulva,  417. 
Pruritus,  153. 
Prussic  acid,  poisoning  by, 

516. 
Psoriasis,  149. 
Pteiea  lrifollat,a,  874. 
Pterocarpus      marsupium, 

849 ;  Santalinus,  870. 
Ptisan,  suet,  794. 
Ptosis,  588. 

Puerile  respiration,  233. 
Puerperal  fever,  438. 
Pulmonary  apoplexy,  259 ; 

Consumption,  233. 
Pulmonic    cherry    cordial, 

249. 
Pulse,  symptoms  indicated 

by,  131. 


etum,  808;  lodi- 
46 ;  Bulphuretum, 

n,  867;    Bromidi! 
Oyanuretof,868, 
ret  of,  868. 
82 

,  905-906. 
906-908. 

y,  batha  during, 
reventlon  of,  429 ; 
lentof ,425 ;  Tubal, 

and  antipathies, 

ions,  of  medicineg, 

larmaceutlcal.SOl. 

calamine,    889; 

828. 
lU,  593. 
:ions,  920. 
tion  of  old  people's 
,500. 
of    the    atmos- 

112. 

ash,  868;    Elder, 

pine,  863. 
erticlUatus,  820. 
organs,  symptoms 
Dg,  129. 
,  now  superseded, 

tics,  771. 
of  medicine,  9. 
IS  ani,  465;   Uteri, 

;ing  dictionary,  969. 
death,  807. 
ixis,  489. 

r     of     imparting 
logical  knowledge, 

e  of  iron,  847. 
lal  callus,  549. 
/'irginiana,  885. 
151;  Of  vulva,  417. 
153. 
icid,  poisoning  by, 

1,  149. 

■ifollata,  874. 
pus      marsupium, 
iantallnus,  870. 
suet,  794. 
88 

espiration,  233. 
I  fever,  438. 
>ry  apoplexy,  259; 
mption,  233. 
cherry    cordial, 

^mptoms  indicated 


Pumpkin  seeds,  860. 

Punctured  woundH,  643. 

Purges,  921. 

Purple  disease  (purpura 
hemorrhugica),  484; 
Spots,  773. 

Purtussis,  462. 

Purulent  ophthalmia,  588; 
Of  child leu,  589. 

Pussy-willow,  821. 

Pyaemia,  528. 

Pyrethrum  parthenlum, 
836. 

Pyrola  rotundifolia  (round- 
leaved;,  871. 

Pyrosis,  309. 

Quassia,  8G9. 

Queen  of  the  meadow,  869. 

Queen's  root,  869. 

Quercus    alba,  885;    Infec- 

torla,  837. 
Quinacetine,  946. 
Quinia,  sulphate   of,  862; 

Valerianate  of,  863. 

Rabies,  182. 

RamoUissement,  166. 

Rashes  on  children,  454. 

Recipes,  920-943. 

Rectum,  33,  291. 

Red  chickweed,  870;  C3o- 
ver,  870 ;  Iodide  of  mer- 
cury ointment,  901 ;  Pep- 
per, 827  ;  Oxide  of  lead 
plaster,  905 ;  Osier,  881 ; 
Root,  870;  Rose,  870; 
Saunders,  870;  Willow, 
881. 

Reduction  of  fractures, 
547. 

Refreshing  drinks  In  f» 
vers,  790. 

Refrigerants,  929. 

Rennet  whey,  794. 

Reproduction  of  life,  419; 
Of  lo^t  parts,  644. 

Resin  cerate,  892 ;  plaster, 
eorap.,  904. 

Resolution,  623. 

Respiratory  organs,  36. 

Rest  aud  sleep,  98. 

Restorative,  795 ;  Wine  bit- 
ters, 898. 

Retention  of  urine,  343 ;  An 
unfavorable  sign,  773. 

Retina,  51. 

Retroflexion  of  womb,  411. 

Retroversion  of  womb,  410. 

Rhamnus  cathartlcus,  S24. 

Rhateny,  870. 

Rheum  palmatum,  871 

Rheumatic  headaches,  206, 
20fi. 

Rheumatism,    acute,   496; 


GENERAL  INDEX. 

Chronic.  478;  Diet  in, 
784,  802. 

Rhubarb,  871 ;  Aromatic 
syrup  of,  910;  Comp. 
tinct.  of,  918;  Comp. 
powder  of,  908;  And 
potussa,  comp.  powder 
of,  908;  Aud  potassa, 
comp.  syrup  of,  912; 
Tinct.  of,  916. 

Rhus  glabruni,  880;  Toxi- 
codendron, 866. 

Ribc,  fracture  of,  655. 

Rice,  81 ;  Water,  789. 

Ricinus  communis,  827. 

Rickets,  467. 

Riding,  as  exercise,  97. 

Rigors,  772. 

Ringworm,  168. 

Rochelle  mUs,  876. 

Roman  baths,  107. 

Roots,  when  to  gather,  808. 

Rosa  gallica,  870. 

Rosemarinus  ofBcinallB,871. 

Rosemary,  871. 

Roseola,  143. 

Rose-rash,  143;  Bed,  870; 
Water  ointment,  901 ; 
Willow,  881. 

Rosin,  870. 

Rotting  of  teeth,  602. 

Round-leaved  pyrola,  871. 

Rubbing  wet  sheet,  745. 

Rubeola,  135. 

Rubus  villosus,  820. 

Rudbeckia  laciniata,  882. 

Rue,  872. 

Rules  for  using  water,  739. 

Rumex  crispus,  888. 

Running  and  leaping,  94. 

Rupia,  147. 

Rupture,  681. 

Ruptures  of  tendons,  569. 

Russian  and  Turkish  baths, 
803. 

Ruta  graveolens,  872. 

Rye,  81;  Spurred,  878. 

Saccharine  foods,  79. 

Sacral  plexus,  48. 

Saffron,  872. 

Sage,  872;  Tea,  790. 

Sago-gruel.  792. 

Sailing,  as  exercise,  96. 

Saint  Ignatius'  Bean,  879. 

Sal-ammoniac,  816. 

Salep  powders,  comp.,  791, 
792. 

Salicin,  886. 

Saline  mixture,  900. 

Salix  alba,  886;  Nigra,  821. 

Salpingitis,  415. 

Salt,  common,  876;  Qlau- 
ber's,  876;  Of  tartar, 
866.  •       .  . 


Saltness  of  the  ocean,  91. 
Saltpetre,  858;   Poisoning 

by,  515. 
Salt-rheum,  144. 
Salvia  oftklniillB,  872. 
Sambucus  Canadensis,  830, 
Sanguinatia     Cauadenuis, 

821. 
Sanguinarin,  821. 
Sapo,  875. 
Sarcoma,  675. 
Sarsaparilla,   872;    Comp. 

syrup    of,    912;     Falsa 

(wild),  875. 
Sassafras,  872. 
Savin,  873;  Cerate,  892. 
Scabies,  145. 
Scalds,  635. 

Scaly  eruptions,  149,  363. 
Scammony,  873. 
Scarification,  544. 
Scarlatina,  136;    Diet  In, 

783. 
Scarlet  fever,  136. 
Sciatica,  191. 
Scilla  maritima,  879. 
Sclerotic  coat  of  eye,  50. 
Scoke,  865. 
Scorbutus,  483. 
Scrofula,  480. 

Scrofulous  ophthalmia,  69C. 
Scrophularia  nodosa,  836. 
Scrotum,    blood    in,    580; 

Water  in,  579. 
Scullcap,  873. 
Scurvy,  483. 

Scutellaria  lateriflora,  873. 
Sea-bathing,  736. 
Seasickness,  310. 
Secale  cornutum,  878. 
Secretion,  organs  of,  41. 
Sedatives,  929. 
Seidlitz  powders,  873. 
Self-poUution,  375. 
Semen,  422. 

Semilunar  valves,  37 ;  Dis- 
ease of,  285. 
Sempervivum      tectorum, 

843. 
Senecin,  851. 
Senecio  aureus,  860. 
Seneka,  873;  Syrup  of,  911. 
Senna,  874 ;  Confection  of, 

893;  Comp.  infusion  of, 

896 ;  Comp.  syrup  of ,913 ; 

And  jalap,  tinct.  of,,  918. 
Sensations,  56 ;  Agreeable, 

57;  Kinds  of,  56:  Moral 

uses  of,  56;  Unpleasant, 

68. 
Septic    and    aseptic,  618; 

wounds,  538. 
Septicaemia,  438. 
Sermons,  reading  of,  216. 
Serous  tissae,  16. 


i 


978 


GENERAL   INDEX. 


Setting  of  fracturei,  547. 

Sex,  126. 

Sexual  diseases,  360-378; 
Prevention  of,  374. 

Shaking  palsy,  181. 

Sheep-laurtl,  866. 

Shingles,  146. 

Shoes,  tliln,  104. 

Short  oight,  r)92. 

Shoulder-blade,  tracturo  <>r, 
553 ;  Joint,  dlslouation 
of,  563. 

Shower-bath,  747. 

Shrinking  of  ihe  brain,  173. 

Shrubby  trefoil,  874. 

Sick,  care  of,  57  ;  Clilldron, 
nursing,  453 ;  Headache, 
201-207. 

Sick-room,  choice  of,  756 ; 
Beds  and  beddingu  i, 
768;  CleanllnesB  in,  760 ; 
Cookery  for,  789;  Dark- 
ening of,  761;  Domestic 
manageiment  of,  756 ; 
Fumigation  of,  762;  No 
cooking  In,  757;  Prej- 
udices and  antipathies 
in,  770;  Sofa  or  reclining 
chair  in,  757 ;  Tempera- 
ture of,  760;  Unhired  at- 
tendants in,769;  Ventila- 
tion of,  114. 

Sighing,  when  a  bad  symp- 
tom, 772. 

Sight,  organs  of,  50;  Long 
and  short,  592;  Weak- 
ness of,  691. 

Signs  and  abbreviations, 
810. 

Silk  clothing,  103. 

Simple  ointment,  892,  901; 
Syrup,  909. 

Slnapis  alba,  856. 

Singultus,  199. 

Sinus,  527.  v 

Sippets,  795. 

Sltz  bath,  750, 

Skin,  43,  134;  Care  of,  of 
the  aged,  603;  Color  of, 
disordered,  153 ;  Dis- 
eases, 134;  Nerves  of, 
disordered,  163;  Offlcea 
of,  105. 

Skull,  fractures  of,  551. 

Skunk-cabbage,  874. 

Sleep,  98;  Amount  of,  101 ; 
Disturbed,  200;  Natural 
position  for,  101;  Of 
children,  451;  Prepara- 
tion for,  101. 

Sleeping  apartment,  756 ; 
In  email  room,  113; 
Booms,  99;  Bedding  in, 
100;  Beds  in,  100;  Fire 
In,  99;    Nighlwlress  in, 


100;    Open   fireplace  in, 

99 ;    Open   windows    in, 

99;  Bmall,  113. 
Sleeplessness  of  the  aged, 

6U4. 
Slei)i;h-riding  as   exercise, 

97. 
Slippery  elm,  H76 ;  Poultice, 

906. 
Sloughing,  627. 
Sluice-bath,  748. 
Small-pox,  139;    Diet   in, 

783. 
Small  spikenard,  876. 
Smartweed,  884. 
Smilax  officinalis,  872. 
Snake-root,    873 ;    Canada, 

886 ;  Virginia,  884. 
Snakes,  bites  of,  645. 
Soap,  875. 
Soda,  bicarbonate  of,  876 ; 

Borate,  876;  Sulphate  of, 

876;    Sulphite    of,    876; 

Tartrate  of  and  potassa, 

876 ;      Soda-water     and 

milk,  795. 
Sodae,     bicarbonas,     876 ; 

Boras,  876;  Et  potassie 

tartras,     876 ;     Sulphas, 

876 ;  Sulphis,  876. 
Sodium,  875;  Chloride  of, 

876. 
Soft  cancer,  675. 
Solanum  dulcamara,  820. 
Solidago  rigida,  841. 
Solomon's  seal,  877. 
Soluble  tartar,  867. 
Soothing  inhalant,  244. 
Sore  mouth,  children's,  457 ; 

nursing,  440. 
Sore  nipples,  426,  442. 
Sore    throat,  clergyman's, 

212. 
Soup,  vegetable,  793. 
Spanish  flies,  877 ;  Cerate, 

892;  Liniment,  896;  Poi- 
soning by,  616. 
Spasm,  of  glottis,  461 ;  In 

stomach,  309. 
Spearmint,  877. 
Speculuui,  385. 
Spermaceti,  878;  Ointment, 

902. 
Spermatozoa,  422. 
Spiced  plaster,  904. 
Spiders,  bites  of,  545 ;  Web, 

878. 
Spigelia  Marllandica,  863. 
Spikenard,  small,  875. 
Spinal  cord,  47;   Diseases 

of,  176;  Inflammation  of, 

176. 
Spinal  nerves,  48. 
Spine,  deformities  and  ir- 
ritations of,  584. 


Spirit  of  nitric  other,  H58 
878;  Of  Ammonia,  aro- 
matic, 816. 

Spireea  tomentOKa,  841. 

Spleen,  34;  Acute  inliam- 
malion  of,  297;  Clironlc 
Influmniatloii  of,  297. 

Splenitii,  297. 

Sponge,  878. 

Sponge-4)aths,  752. 

Spotted  acne,  155. 

Sprains,  669. 

Spurred  rye,  878. 

So-ill,  87^9 ;  Syrup  of,  911 ; 
Vinegar  of,  919. 

Squinting,  593,  772. 

Squirting  cucumber,  886. 

St.  Anthony's  fire,  141. 

St.  Ignatius'  bean,  879. 

St.  Vitus'  dance,  187. 

Stagger-weed,  883. 

Star-grass,  879. 

Starch  and  sugar,  78. 

Statice  Caroliniana,  854. 

Sterility,  419;  Causes  of, 
423. 

Sterilization  jf  milk,  449. 

Stethoscopes,  230. 

Stiff  joint,  573. 

Stillingia  sylvatlca,  869; 
Comp.  syrup  of,  913. 

Stimulants,  929. 

Stings  of  insects,  545. 

Stomach,  32 ;  Affections  of, 
787;  Bile  in,  67;  Acute 
inflammation  of,  301 ; 
Chronic  inflammation  of, 
302;  Cramp  in,  427; 
Movement  of,  66 ;  Spasm 
or  cramp  in,  309,  427. 

Stomatitis,  erylhematic, 
457. 

Stone  in  bladder,  345,  354. 

Storax,  879. 

Strabismus,  593. 

Stramonium,  880 ;  Oint- 
ment, 901 ;  Poisioning  by, 
515. 

Stricture,  371;  Of  bowel, 
318. 

Structure  of  the  body,  14. 

Strychnine,  858 ;  Poisoning 
by,  516. 

Strychnos  nus  vomica. 
858. 

Stye,  587. 

Styptics,  540. 

Styrax  officinale,  879. 

Subacetate  of  lead,  cerate 
of,  891. 

Submaxillary  gland,  31. 

Succus  alterans,  945. 

Sudorific  tincture,  919. 

Suet  Ptisan,  794. 

Suffocation,  509. 


f  nitric  ether,  858 
Of  Ammonia,  aru- 
,  816. 

tomentosa,  8(1. 
34;   A('ut(>  Inllam- 
n  of,  297  ;  Clironlc 
imatloii  of,  2'.)7. 
s,  297. 

878. 
baths,  752. 

acne,  155. 

,  am. 
rye,  878. 

879 ;  Syrup  of,  911  j 
;ar  of,  919. 
ng,  593,  772. 
ig  cucumber,  885. 
bony's  fire,  141. 
itius'  bean,  879. 
is'  dance,  167. 
-weed,  883. 
iss,  879. 
and  Bugar,  78. 
Carollniana,  854. 
y,  419;    Causes  of, 

ation  Jt  milk,  449. 
copes,  230. 
nt,  573. 

;U    sylvatlca,    869; 
).  syrup  of,  913. 
ints,  929. 
of  Insects,  545. 
h,  32  ;  Affections  of, 
Bile  In,  67;   Acute 
amatlon     of,     301 ; 
lie  inflammation  of. 
Cramp     in,    427 ; 
iment  of,  66  ;  Spasm 
imp  in,  309,  427. 
itis,      erythematlc, 

bladder,  345,  354. 

879. 

mu3,  593. 
nium,     880 ;     Oint- 

901 ;  Poisoning  by, 

■e,  371;   Of    bowel, 

re  of  the  body,  14. 

line,  858 ;  Poisoning 

16. 

los     nux     vomica: 

il.     ' 
,540. 

ofBcinale,  879. 
tate  of  lead,  cerate 
I. 

:illary  gland,  31. 
alterans,  945. 
ic  tincture,  919. 
isan,  794. 
,tion,  509. 


Sugar  foods,  78. 

Sugar  of  lead,  poisoning  by, 

514. 
Sugar  of  milk,  247. 
Sulphate  of  zinc,  890. 
Sulphur,    880;    Ointment, 

(■omp.,e03. 
Sulphuric  acid,  813;   Poi- 
soning by,  515. 
Sumach,  b8U. 

Summer  complaint  of  in- 
fants, 463. 
Sunflower,  880. 
Sunstroke,  179. 
Supercarbonate    of     soda, 

876. 
Supertartrate   of    potasaa, 

866. 
Suppers,  late,  101. 
Suppression  of  urine,  342. 
Suppuration,  523,  526;  Of 

brulu,  167. 
Supra-renal  capsules,  dis- 
ease of,  337. 
Surgery,  natural,  531. 
Surgical  diseases,  517-607. 
Sutures,  540. 
Swallowing,  difficulty  of, 

772. 
Swamp-dogwood,     881; 

Milkweed,  881. 
Swathing,  427. 
Sweat-glands,     45 ;      Dis- 
ordered, 154. 
Sweating  process,  741 ;  In 

consumption,  773. 
Sweet  fern,  881 ;  Flag,  881 ; 
Gum,     881;      Oil,     859; 
'      Spiritsof  nitre,  858,878; 
Whey,  795. 
Swelling,  of  lunge,  259;  Of 
lower  limbs,  428;   Sud- 
den   disappearance    of, 
774. 
Swinging  as  exercise,  97. 
Sycosis,  156. 
Sympathetic  nervous  sys- 

tom,  48-50,  62. 
Symphytum  officinale,  831. 
Symplocarpus  foetidus,  874. 
Symptoms,  122  ;  Table  of, 

126,  132. 
Syncope,  199. 
Synovial     degenerations, 

571;  Membrane,  26. 
Syphilis,  360. 

Syringe,  laryngeal  shower, 
216;  Nasal  showor,  217; 
Pharyngeal  sho  .\  or,  217 ; 
Uterine,  390;  Mode  of 
using,  219. 
Syrups,  909,  913. 

Table,  exhibiting  the  differ- 
ence between  smail-pox, 


GKNEKAL  INDKX. 

varioloid,  scarlet  fever 
and  measles,  138,  139; 
Of  foods,  72,  79, 80 ;  Of 
symptoms  of  diseases, 
126-132. 

Tag-alder,  881. 

Tamarac,  comp.  tinct.  of, 
918. 

Tamarinds  and  whey,  795. 

Tannic  acid,  814. 

Tansy  (Tanacotum  vul- 
gara),  881. 

Tape-worm,  332. 

Tapioca,  882 ;  Jelly,  792. 

Tar,  882;  Ointment,  912; 
Plaster,  comp.,  904. 

Taraxacum,  835. 

Tartar  on  tlie  teeth,  603 ; 
Soluble,  867. 

Tartar-whey,  794. 

Tartaric  acid,  814. 

Tea  and  coffee,  88 ;  Cause 
headaches,  202 ;  Beef, 
793,  797;  Garfield,  94 j, 
947 ;  New  Jersey,  870 ; 
Sage,  872. 

Teeth,  30;  Care  of,  601; 
Cleaning  of,  606;  Com- 
position of,  31 ;  Cutting, 
difficult,  459;  Diseased, 
influence  of  on  the 
health,  605;  Filling,  604; 

•  First,  605 ;  Names  of,  30 ; 
Number  of,  30;  Origin 
of,  30;  Rotting  of,  602; 
Use  of,  31. 

Temperance,  87;  Good  te- 
sults  of,  87. 

Temperaments,  122,  123; 
Medication  and,  123, 124. 

Temperature  of  the  body, 
132;  Symptoms  Indfcated 
by,  132. 

Tendons,  ruptures  of,  669. 

Tetanus,  184. 

Tetter,  145;  Crusted,  148. 

Thigh-bone,  fractures  of, 
556. 

Thimbleweed,  882. 

Thomapple,  880. 

Thoroughwort,  882. 

Throat,  symptoms  affect* 
Ing,  128. 

Throat-diseases,  208-228; 
Curability  of,  224;  Worse 
at  night,  215;  Instru- 
ments for  treatment  of, 
216-221. 

Thyroid  cartilage,  42. 

Tic  douloureux,  190. 

Tight  dressing,  116. 

Tinctures,  812,  913-919. 

Tissues,  the,  16-18. 

Tobacco,  882. 

Toe-nail,  ingrowing,  697. 


979 


Tolu,  syrup  of,  911 ;  TInct 
of,  015. 

Tongue,  symptom  4  afTect- 
ing,  127. 

Tonics,  924;  And  cathar- 
tics, 023. 

Tonsilitis,  222,  223. 

Tonsils,  acute  inflammn- 
tlon  of,  22'J ;  Chronic  iu- 
flaramaiion  of,  223. 

Toothache,  603. 

Toothache  tree,  868. 

Tourniquet,  539. 

Towel  and  sponge  bath. 
752. 

Towel,  coarse,  in  bathing, 
111. 

Tracheitis,  209,  214. 

Trailing  arbutus,882;  comp. 
infusion  of,  895. 

Trance,  186. 

Traveling,  116;  For  con- 
Bumptrves,  254  ;  For  the 
poor,  118  ;  Means  of,  117  ; 
Seasons  for,  117. 

Treatise  on  pliysical  cul- 
ture, 950-960. 

Trees,  cultivation  of,  116. 

Trefoil,  shrubby,  874. 

Trichiasis,  687. 

Tricuspid  valves,  274. 

Trifolium  pratense,  870. 

Trillium  peuduium,  819. 

True  physician,  the,  12. 

Trumpet  weed,  869. 

Tubal  pregnancy,  418. 

Tubercular  consumption, 
233;  Eruptions,  363. 

Tulip-tree,  882. 

Tumors,  573;  Encysted, 
577;  Fatty,  575;  Of  brain, 
167;  Of  heart,  280;  Of 
ovaries,  414;  Of  womb, 
412. 

Turkey-corn,  883. 

Turkish  baths,  803. 

Turmeric,  883. 

Turn  of  life,  403. 

Turner's  cerate,  891. 

Turnips,  82. 

Turpentine  liniment,  897. 

Tissilago  farfara,  831. 

Twist  in  iKJwel,  318. 

Tympanitis,  321. 

Tympanum,  63 ;  Inflamma- 
tion of,  596. 

Typhoid  fever,  470 ;  Pneu- 
monia (lung-fever),  268. 

Ulceration,  623 ;  And  ulcers, 
631 ;  Of  bones,  570;  Of 
neck  of  womb.  386. 

Ulmus  fulva,  875. 

Unbolted  wheat  floor,  74. 

Unhired  attendants,  769. 


I, 


■, 


i 


uttkimi 


nj 


980 

Unlcorn-root,  879;  False, 
841. 

Tnion  by  flrat  intention, 
540. 

Unnatural  growth  of  bones, 
570. 

Upland  Cranberry,  818. 

Upper  arm-bone,  fractures 
of.  553. 

Urate  of  ammonia  in  urine, 
352 ;  Calculus,  354. 

Ureters,  35. 

Urethra,  35. 

Uric  acid  calculus,  354. 

Urinary  deposits,  305 ;  Or- 
gans, dlsnases  of  In  tho 
aged,  507;  System,  35. 

Urine,  characteristics  of, 
34fi;  Cystine  deposits  in, 
353  ;  Ex..rainatlon  of,346 ; 
Hippurlc-acid  deposits 
in,  332;  Inability  to  hold, 
344;  Oxalic  deposits  in, 
350;  Phosphatlcdeioslts 
in,  349;  Retention  of, 
343,773;  Sources  of,  345 ; 
Suppression  of,  342 ; 
Symptoms  indicated  by, 
131;  Urate  of  ammonia 
in.  352. 

Urinometer,  346. 

Urticaria,  143. 

Uterine  hydatids,  407. 

Uva  ursi,  818. 

Uvula,  elongation  of,  221. 

Vagina,  Inflammation   of, 

416. 
Valerian,   883;    American, 

888;  Ammoniated  tlnct. 

of.  919. 
Valeriana  officinalis,  883. 
Valerianate  of  iron,  848 ;  Of 

quinia,  863;  Of  zinc.  890. 
Value  of  foods.  70,  71,  72, 

79,  80. 
Valves,  mitral,  disease  of, 

285;  Semilunar,  disease 

of,   285;  And  tricuspid, 

37.  39. 
Varicocele,  584. 
Varicose    veins,    428,  581, 

646. 
VarioU,  139. 
Varioloid,  141. 
Varix,  581. 
Vaseline,  890. 
Vegetable    foods,    70,    84, 

778;  Poisons,  515;  Soup, 

793. 
Veins,  38;  Enlarged,  681; 

Inflammation    of,    580, 

581 ;  Enlarged  or   vari- 
cose, 581. 
Venereal  diseases,  360-378. 


GENERAL  INDEX. 

Ventilation,  60;  In  sick- 
room, 114,  758. 

Ventricles,  37,  274 ;  Dilata- 
tion of,  27H;  Enlarge- 
ment of.  276. 

Veratrin,  815. 

Varatrum  album,  885; 
Yirldo,  814. 

Verbascum  thapsus,  866. 

Verbena  hastata,  HH3. 

Verdigris,  poisoning  by, 
514. 

Vertigo,  200. 

Vervain,  883. 

Vesicles,  36. 

Vesicular  eruptions,  363. 

Vessels,  absorbent,  40. 

Viburnum  opulus,  842. 

Vinegar,  883 :  Whey,  794. 

Vinegars,  910. 

Virginia  snakeroot,  8H4 ; 
Comp.  Tlnct.  of,  919; 
Tinct.  of,  915. 

Vision,  Imperfect,  591. 

Vital  properties  of  th  e  body, 
18. 

Vitreous  humor,  51. 

Vitriol,  elixir,  915;  Poison- 
ing by,  515. 

Vocal  cords,  43;  Organs, 
42. 

Vomiting,  310. 

Vulva,  prurigo  of.  417. 

Wading  foot-baths,  753. 

Wafer  ash,  874. 

Wahoo,  884. 

Walking,  93;  Of  infants. 
452. 

Warm  baths  for  children, 
457;  Foot.  754. 

Warts  and  corns,  152. 

Wash-down  bath,  752 ;  Tub, 
751. 

Washes,  933. 

Water,  89-92,  779;  Acci- 
dents on,  512 ;  Ammonia, 
815;  Brash,  309 ;  Chemi- 
cal nature  of.  89;  Ctold, 
at  meals,  65;  Cure,  739; 
External  use  of,  251 ; 
Oruel.  791 ;  Horehoiind, 
884;  In  chest,  261;  In 
heart  case,  287 ;  In  the 
head,  174;  Impurlities 
in,  90;  Internal  use  of, 
741;  Lime,  851;  Mwluo 
operandi  of,  737 ;  Of  am- 
monia. 815 ;  Of  the  ocean, 
91 ;  Pipes,  lead,  90;  Prop- 
erties of,  90;  Pure,  es- 
sential to  health,  89; 
Ilain.91 ;  Bules  for  using. 
739 ;  Salt,  91 ;  In  scrotum, 
579;  Supply,  90;  Use  of. 


in  consumption,  251 ;  For 
wounds,  640, 

Waters,  me(licate<l,  897. 

Watery  pimples,  144. 

Wave  or  Hlulce  bath,  748. 

Wax,  HH6 ;  In  tht-  oar,  696. 

Weakness  of  sight,  501. 

Weaning,  450. 

Wens  577. 

Weights,  810 ;  French  deci- 
mal, 811. 

Wet  bandages,  741 ;  DrcBs, 
743;  Nurses,  44(1 ;  Khwt, 
folded,  744;  Sliot't  pack, 
742;  Sheet  ruiitiMig,  715. 

Wheat,  80;  Flour,  un- 
l)oltP(l,  74. 

Whey,  alum,  795;  Mustard, 
794;  Grange,  795;  Ren- 
net,  794;  .4weet,  795; 
Tartar,  794 ;  Vliie^ar, 
791;  With  tamarinds. 
795 ;  Wine.  795. 

White  hellebore,  S85 ;  Oint- 
ment, 902;  Indian  hemp, 
881 ;  Liquid  physic,  900; 
Oak,  885;  Pond  Illy,  885; 
Poplar,  882 ;  Swelling, 
571;  Vitriol,  poisoning 
by.  515 ;  Walnut,  824. 

Whitely  exerciser,  953. 

Whites,  393. 

Whitlow,  645. 

Whooping-cough,  462 ;  sud- 
den increase  of  par- 
oxysms in,  772 ;  Diet  in, 
787. 

Wild  cherry.  885;  Cherry 
bark,  syrup  of,  911;  Cu- 
cumber, 885 ;  Glngor. 
886;  Indigo,  886 ;  Indigo, 
ointment,  902;  Sarsapa- 
rilla.  875;  Snowball,  870; 
Turkey  pea,  883;  Wood- 
bine, 815 ;  Yam,  886. 

Willow,  black.  821 ;  White, 
886. 

Wiud-coHc,  320. 

Windows  In  sleeping- 
rooms,  99. 

Windpipe,  36 ;  Foreign 
bodies  in,  599;  Inflam- 
mation of,  214. 

W'ne  for  old  persons,  502; 
Of  American  ash.  947; 
Oi  comfrey,  comp.,  898; 
Of  golden  seal,  comp., 
898 ;  Of  ipecacuanha,89H; 
Whey,  795. 

Wines,  medicated,  898. 

Win^seed,  874. 

Winter,  fatty  foods  In.  75. 

Wlntergreen,886 ;  pear-leaf, 
871. 

Witcb-haxel,  886. 


nnaumptlon,  251 ;  For 
ludn,  640. 

1,  medicated,  897. 
y  pimples,  144. 
or  slulco  bath,  748. 
885  ;  In  th»«  our,  51)6. 
DOS!  of  sight,  691. 
Ing,  450. 
,577. 

Its,  810 ;  French  docl- 
,  811. 

andages,  741 ;  DroBB, 
;  Nuraes,  44t> ;  Klioet, 
fd,  744;  Shft'l  iPiick, 
;  Sheet  runti'iig,  715. 
t,  80;  Flour,  un- 
,pd,  74. 

,  alum,  795;  Mustard, 
;    Jrange,  795;   Rou- 
,    794;     Swt'tH,    795; 
tar,      794 ;     Vliiujjar, 
;    With     tamarinds, 
;  Wine,  795. 
I  hellebore,  885 ;  Olnt- 
it,  902;  Indian  hemp, 
;  Liquid  physic,  900; 
c,  885;  Pond  lily,  885; 
lar,     882 ;    Swelling, 
;    Vitriol,    poiaunlug 
515 ;  Walnut,  824. 
9ly  exerciser,  953. 
!S,  393. 
ow,  645. 

ping-cough,  462 ;  sud- 
i  increase  of  par- 
sins  in,  772;  Diet  in, 

cherry,  885;  Cherry 
k,  syrup  of,  911;  Cu- 
Qber,  885 ;  Ginger, 
;  Indigo,  886 ;  Indigo, 
tment,  902;  Sarsapa- 
a,  875;  Snowball,  870; 
[•key  pea,  883;  Wood- 
e,  815 ;  Yam,  886. 
w,  black,  821 ;  White, 

-colic,  320. 

0W8  In  eleeping- 
ms,  99. 

pipe,  36 ;  Foreign 
lies  in,  699;  Inflam- 
tlon  of,  214. 
for  old  persons,  502; 
American  ash,  947; 
comfrey,  comp.,  898; 
golden  seal,  uomp., 
;  Of  lpecacuanba,89Pi 
ley,  795. 

1,  medicated,  898. 
seed,  874. 

sr,  fatty  foods  in,  75. 
irgreen,  886 ;  pear-leaf, 

i-hasel,  886. 


Wolfsbane,  887. 

Womb  and  appendages, 
383,  422;  Cancer  of,  413; 
Falling  of,  400  ;  Falling 
over  of,  410;  Inllamiiia- 
tlon  of,  40H ;  Inllamma- 
tion  of  neck  of,  38((; 
Polypus  of,  406  ;  Sinking 
down  of,  424  ;  Tumors  of, 
412. 

Woolen  clothing,  103. 

Worm-powder,  908. 

Worms,  332. 

Wormseed,  887. 

Wormwood,  887. 

Wounds,  bleeding  from, 
639,  699;  Contused  and 
lacerated,  544;  Derange- 
ments from,   183;  Qun- 


OENKKAL   INDEX. 

shot,  545  ;  How  to  unite, 
540,  543;  Incised,  539; 
Of  various  kinds,  538; 
Poisoned,  545 ;  Punctur- 
ed, 543  r  Rules  for  exam- 
ining and  dressing,  541. 

Wrist,  dislocation  of,  565; 
Fracturi'H  of,  6G", 

Wry  neck,  586. 

Xanthoxylln,  868. 
Xanthozylum     fruxineum, 

868. 

Yam,  wild,  886. 
Yarrow.  888. 

Yeast,  888;  Poultice,  005. 
Yellow  dock,  888;    Comp. 
syrup    of,    913;    Fever, 


981 


495 ;     Jessamine,     888 ; 
Ladies'      slipper,      888 ; 
ParlllH,  889. 
Youth,  diet  in,  76. 

Zinc,  889;  Acetate  of,  889; 
Chloride  of,  889 ;  Iodide 
of.  889;  Oxide  of,  889, 
Precipitated  carbonate 
of,  889;  Sulphate  of,  890; 
In  poisoning,  515;  Vale- 
rianate of,  890. 

Zinci,  aciotas,  889 ;  Car- 
bonas  prrodpltas,  889; 
Clilorlduni,  MH9;  lodl- 
dum,  889;  Oxidum,  889; 
Sulphas,  890;  Valcrianas, 
890. 

Zingiber  omdnale,  838, 


rifeir«iiniiiaiiit"iAi'iwiiinWl*>ii^ll*wm*w  *>«  iw<Uifc«t[i<ni>HimiDif  nm ■iwMWhiminiiiil  i 


INDEX  TO  THE  HOMOEOPATHIC  DEPARTMENT. 


A  Brief  Treatise  on  Home- 
opathic    treatment     of 
diseases,  608. 
Abscesses,  643. 
Aconite,  720. 

Acute  inflammation  of  the 
spinal  cord,  618;  Of  the 
larynx  (laryngitis),  629; 
Of  the  liver,  663;  Bron- 
chial, 630. 

Affections  of  the  mind,  692. 

Agustia,  724. 

Ailments  at  the  age  of  pu- 
berty, 713 ;  Attending 
change  of  life,  714;  Dur- 
ing pregnancy,  715. 

Albumen,  for  poisoning, 
729. 

Amblyopia,  676. 

Ammoniacal  gas,  for  pel- 1 
sonlng,  730.  I 

Anasarca,  684. 

Anchylosis,  704. 

Aneurism,  704;  Of  the 
aorta,  652. 

Anorexia,  724. 

Ancsmia,  724. 

Anthrax,  642. 

Antidotes  to  medicines, 
611 ;  To  poisons,  726-731. 

Antimonium,  720. 

Antimony,  poisoning  with, 
727. 

Aphthae,  707. 

Apoplexy,  616.      ^ 

Arnica,  720. 

Arsenic,  poisoning  with, 
727. 

Arsenicum  album,  720. 

Ascites,  684. 

Asiatic  cholera,  662. 

Asthma,  632. 

Aversion  to  food,  724. 

Baldness,  614. 
Bathing,  611. 
Barbers'  itch,  649. 
Belladonna,  721. 
Bilious  remittent  fever,654. 


Black  tongue,  690. 
Black  vomit,  690. 
Bleeding  from  the  lungs, 

632. 
Bloody  urine,  636. 
Boils,  642. 
Brain  fever,  615. 
Bronchitis,  630. 
Bronchocele,  704. 
Bryonia,  721, 
Bunions,  670. 
Burns  and  scalds,  702. 

Calcarea  carbonica,  721. 

Camphor,  for  poisoning, 
729. 

Cancer  of  the  skin,  667 ;  Of 
the  liver,  666;  Of  the 
intestines,  667;  Of  the 
stomach,  666. 

Canker  of  the  mouth,  657. 

Cantharides,  poisoning  by, 
728. 

Capsicum,  721. 

Carbo.  veg.,  721. 

Carbuncle,  642. 

Cardialgia,  658. 

Cataract,  623. 

Cephalalgia,  613. 

Chamomilla,  721. 

Charcoal,  for  poisoning, 
730. 

Charcoal  gas,  poisoning  by, 
728. 

Chicken-pox,  655. 

Chilblains,  644. 

Child-bed  fever,  718. 

China,  721. 

Cholera  morbus,  662;  In- 
fantum, 708. 

Chorea,  621. 

Chronic  catarrh,  628 ;  Dys- 
entery, 661 ;  Laryngitis, 
629;  Pericarditis,  652; 
Rheumatism,  656. 

Chronic  inflammation  of 
the  bowels,  660;  Ot  the 
bronchia,  631;  Of  the 
pericardium,  651. 


982 


Clna,  721. 

Coal,    poisoning     by    the 

vapors  of,  731. 
Coffee,  for  poisoning,  729. 
Cold  fever,  687. 
Cold  in  the  head,  628. 
Colic,  706. 
Concussion   of    the   brain, 

700;  Of  the  chest,  700. 
Constipation,  662;    Of  the 

bowels,  717. 
Consumption,  632,  673. 
Convulsions,  709. 
Copper,  poisoning  by,  727. 
Corns,  643. 
Coryza,  628. 
Costiveness,  662. 
Coup  do  soleil,  616. 
Cramps    in    the    stomach, 

659. 
Croup,  630. 
Crying,  706. 
Cystitis,  634. 

Deafness,  625. 

Delirium,  615. 

Delirium  tremens,  620. 

Dentition,  708. 

Derangement  of  menstrua- 
tion, 713. 

Diabetes,  636. 

Dianhcea,  660. 

Diet  and  regimen,  612. 

Difficult  urination,  716. 

Dilatation  of  the  cavities  of 
the  heart,  652. 

Diphtheria,  680. 

Diseases  of  the  alimentary 
canal,  657 ;  Of  the  brain 
and  nerves,  615 ;  Of  the 
ear,  625 ;  Of  the  eyj  and 
lids,  622;  Of  the  head, 
613;  Of  the  skin,  642; 
Of  the  organs  of  circula- 
tion, 651 ;  Ot  the  organs 
generation,  638 ;  Of  the 
respiratory  organs,  628 ; 
Of  the  urinary  organs, 
634 ;  Involving  the  vari- 


MENT. 


isoning     by    the 

of,  731. 

r  poisoning,  729. 

r,  687. 

le  head,  628. 

n   of    the   brain, 
f  the  chest,  700. 
ion,  662;    Of  the 
717. 

lion,  632,  673. 
ns,  709. 

oisonlng  by,  727. 
i. 
iH. 

9S,  662. 
oleil,  616. 
n    the    stomach, 

). 

)6. 
!34. 

625. 
615. 
:remens,  620. 

708. 

ent  of  menstrua- 
3. 
636. 

660. 

•egimen,  612. 
rlnation,  716. 

of  the  cavities  of 
rt,  652. 
I,  680. 

if  the  alimentary 
57 ;  Of  the  brain 
ves,  615 ;  Of  the 
;  Of  the  eyj  and 
2;  Of  the  head, 

the  sliin,  642; 
rgans  of  circula- 
I ;  Of  the  organs 
ion,  638 ;  Of  the 
ory  organs,  628 ; 
urinary  organs, 
i^olving  the  vari- 


ous organs  and  reglon«4, 
653, 666 ;  Of  women,  713 ; 
Of  infants,  706. 

Dislocations,  701. 

Disorders  of  the  nose,  627. 

Dropsy  of  the  belly,  684 ; 
Of  the  brain,  685 ;  Of  the 
chest,  684 ;  Of  the  heart, 
684 ;  Of  the  joints,  704 ; 
Of  the  scrotum,  639,685  ; 
Of  the  womb,  635 ;  Ova- 
rian, 685. 

Dysentery,  661. 

Dysmenorrhoea,  714. 

Dyspepsia,  658. 

Dyspeptic  headache,  658. 

Ear,  diseases  of,  625 ;  in- 
flammation of,  625. 

if-arache,  625. 

.vczema,  648. 

Endocarditis,  651. 

Epastazis,  627. 

Epilepsy,  617. 

Epsom  salts,  for  poisoning, 
730. 

Eruptive  fevers,  655. 

Erysipelas,  655 

Excessive  menstruation, 
714. 

Excoriated  nipples,  717. 

Excoriations,  710. 

External  applications,  611. 

Extreme  emaciation,  709. 

Falling  of  the  womb,  640, 
719. 

False  pains,  716. 

Febris  petechialis,  687. 

Felons,  647. 

Ferrum,  721. 

Fever,  bilious,  654;  Cold, 
687;  Eruptive,  655;  In- 
flammatory, 653 ;  In- 
termittent, 654;  Putrid, 
688;  Remittent,  471, 654; 
Rheumatic,  656 ;  Scarlet, 
655;  Simple,  653;  Spot- 
ted, 687  ;  Typhoid,  653 ; 
Yellow,  654. 

Fig-warts,  667. 

Fistula  in  ano,  705. 

Fits,  617,  709. 

Forms  of  medicine  for  ad- 
ministration, 610. 

fractures,  702. 

Furunculi,  642. 

Gall  Stones,  C65. 
Gangrene,  668. 
Gastralgia,  658. 
Gastritis,  659. 
Gastrodynia,  659. 
Goitre,  704. 
Gonorrhoea!  sore  eyes,  623. 


HOMCEOPATHIO  INDEX. 

Gravel,  635. 

Grippe,  675. 

Hardness  of  hearing,  625. 

Headache,  613,  658. 

Heartburn,  658. 

Hectic  fever,  671. 

Hemorrhage  from  wounds, 

701. 
Hemorrhoids,  664,  719. 
Hernia,  701. 
Herpes,    6''.7;  Circlnnatus, 

646. 
Hiccough,  709. 
Hives,  646. 
Hydrocele,  639,  685. 
Hydrocephalus,  685. 
Hydrometra,  686. 
Hydrophobia,  691. 
Hydropsies,  684. 
Hydrothorax,  684. 
Hypochondria,  696. 
Hysteria,  691. 
Hysteric  derangement,  697. 

Ignatia,  722. 

Imbecility,  698.    . 

Immoderate  flow  of  sweet 
urine,  636. 

Imperfect  action  of  the 
valves  of  the  heart, 
652. 

Inability  to  talce  the  breast, 
706. 

Incontinence  of  urine,  636. 

Incubus,  690. 

Indigestion,  658. 

Induration  of  the  breasts, 
717. 

Infantile  diarrhoea,  706 ; 
Dysentery,  706 ;  Jaun- 
dice, 707. 

Inflammation  of  the  ar- 
teries, 652;  Of  the  I  lad- 
der, 634;  Of  the  bowels, 
660;  Of  the  ear,  625; 
Of  the  eyeUds,  622 ;  Of 
the  glands  under  the 
arms,  669;  Of  the  heart, 
651;  Of  the  inguinal 
glands,  669 ;  Of  the  iris, 
622 ;  Of  th&  kidneys,  637 ; 
Of  the  larynx,  629;  Of 
the  ovaries,  610;  Of  the 
pericardium,  651 ;  Of  the 
peritoneum,  660 ;  Of  the 
spinal  chord,  618;  Of 
the  spleen,  663;  Of  the 
stomach,  659;  Of  the 
testicles,  639;  Of  the 
tongue,  657;  Of  the  ton- 
sils, 657  ;  Of  the  urethra, 
638;  Of  the  vagina,  639; 
Of  the  vulva,  639;  Of  the 
windpipe,  630;  Of  the 
womb,  639. 


983 


Inflammatory    fever,  653; 

Rheumatism,  656. 
Influenza,  675. 
Injury  of  a  nei-vo,  700. 
Insidious  diseases,  686. 
Intermittent  fever,  654. 
Interrupted   menstruation, 

713. 
Invermination,  663. 
Ipecacuanha,  722. 
Iritis,  622. 
Iron-rust,    for    poisoning, 

730. 
Itch,  645. 
Itching  of  the  anus,  664; 

Of  the  sitiu,  645. 

Jaundice,  663. 

Kidneys,  inflammation  of, 

637. 
Kitchen-salt,  for  poisoning, 

730. 

Labor,  716. 

Lachesis,  722. 

Larynx,  inflammation    of, 

629. 
Lead,  for  poisoning  by, 727. 
Leucorrhoea,     641 ;     After 

conflnement,  719. 
List  of  remedies,  609. 
Liver,     inflammation     of 

663 ;  spots,  649. 
Lock-jaw,  619. 
Loss  of  memory,  621 ;   Of 

taste,  724 ;  Of  smell,  724. 
Lumbago,  656. 
Lumbar  abscess,  703. 
Lung  fever,  631. 
Luxations,  701. 

Maculae,  649. 

Magnesia,  for  poisoning, 
730. 

Malignant  pustule,  686. 

Mania  from  excited  'mo- 
tions, 693;  From  df-ores- 
slon  of  spirits,  693. ' 

Marasmus,  709. 

Measles,  655. 

Menorrhagia,  714. 

Mental  derangement,  692. 

Mercurius.  722. 

Mercury,  for  poisoning  by, 
727. 

Milk  (for  poisoning),  729; 
Crust,  710;  Fever,  716; 
Leg,  669. 

Miscellaneous  diseases, 
690. 

Monomania,  699. 

Morbid  emotions,  694. 

Morphine,  for  pc'soning  by, 
728. 


984 


HOMCEOPATHIC   INDKX. 


Hyeletis,  618. 
Mucous-vomiting,  659. 
Moss,  649. 

Nasal  polypus,  668. 
Nervous  deafness,  6Si6. 
Nettle-rash,  C55. 
Neuralgia,  620. 
Nightmare,  690. 
Night-sweats,  250. 
Nocturnal  enureeiB,  636. 
Nose-bleed,  627. 
Kux  vomica,  722. 

Obstruction  of  the  nose,  627. 
Olive-oil,  for  poisoning,  729. 
Opium,  722. 
Otorrhcea,  625. 
Ovarian  dropsy,  685. 
Ozcena,  627. 

Painful  menstruation,  714. 

Painter's  colic,  664. 

Palsy,  619. 

Paralysis,  619;  Of  the  eye- 
lids, 678. 

Parturition,  716. 

Passage  of  gall-stones,  666. 

Pericarditis,  651. 

Pharyngeal  sore  throat, 
657. 

Phlegmasia  dolens,  669. 

Piles,  664,  719. 

Pleurisy,  632. 

Pleuritis,  632. 

Pneumonia,  631. 

Poisons,  and  their  anti- 
dotes, 726-731. 

Polypus  of  the  nose,  627. 

Porrigo,  710. 

Potash  and  sweet  almond 
oil,  for  poisoning,  730. 

Prickly  heat,  710. 

Profuse  bleeding  from  the 
womb,  714. 

Protracted  grief,  693, 

Protrusion  of  the  intestine, 
663. 

Prurigo,  645. 

Prussia  acid,  for  poisoning 
by,  728. 

Pulmonary  consumption, 
632,  673. 

PulsatUla,  722. 

Putrid  fever,  688;  Sore 
throat,  657. 

Quinsy,  657. 

Rabies,  691. 
Rachitis,  703. 
Red  gum,  708. 
Relapsing  fever,  690. 


Religious  mania,  696. 
Remittent  fever,  654. 
Retention  of  the  urino,  635, 

708. 
Rheumatic  fever,  656 ;  Sore 

eyes,  623. 
Rraas  tox.,  723. 
Rickets,  703. 
Ringworm.    646;    Of    the 

sralp,  613. 
Rules  for  the  administra- 
tion of  medicines,  609; 

For  preserving  the  purity 

of  medlciues,  610. 
Running  at  the  cars,  625. 
Rupture,  701. 
Rush  of  blood  to  the  head, 

616. 

Salt  rheum,  647. 
Scabies,  645. 
Scald-head,  614. 
Scarlet-fever,  665;    Bash, 

665. 
Schirrus,  666. 
Sciatica,  666. 
Scrofula,  648. 
Scrofulous  sore  eyes,  622; 

Swelling  of  the  salivary 

glands,  711. 
Scurf  of  the  head,  711. 
Scurvy,  649. 
Sea-sickness,  869. 
Shingles,  668. 
Simple  fever,  653. 
Sleeplessness   of    Infants, 

712. 
Small-pox,  6r6. 
Snake  bites,  703. 
Snuffles,  707. 
Soap,  for  poisoning,  '729. 
Sore  mouth,  707;    Throat 

(quinsy),  657. 
Soreness     after    delivery, 

716;    Behind    the   ears, 

710. 
Specific  indications  for  rem- 
edies in  fevers,  720. 
Specks  on  the  cornea,  624. 
Spotted  fever,  687. 
Sprains,  700. 
Squinting,  624. 
Stammering,  621. 
Starch,  for  poisoning,  730. 
Stiff  joints,  704. 
Stings  of  i..Bect8,  702. 
Stone,  635;  Bruise,  670. 
Strabismus,  624. 
Strangury,  634. 
Strong  tea,  for  poisoning, 

730. 
St.  Vitus's  dance,  621. 
Stye,  622. 


Sugar,  or  sugar-water,  for 

poisoniuik;,    729. 
Summer  conipiaiut,  708. 
Sunstroke,  610. 
Suppression  of  tlif  lochia, 

718;   Of   the   milk,   717; 

Of  the  urine,  635. 
Surgical  diseases,  700 
Sweet  almonl  oil,  for  iioi- 

soning,  730. 
Swimming   of    the   head, 

613. 
Syphilis,  638. 
Syphilitic  sore  eyes,  623. 

Teething,  708. 
Tetanus,  620. 
Tetter,  6^7. 
Thrush,  707. 
Tinctures,  609. 
Tinea  capitis,  614. 
Toothache,  656. 
Torticollis,  704. 
Tracheitis,  630. 
Trismus,  619. 
Tumors,  removal  of,  702. 
Tussis    spasmodica,    (J31, 

678. 
Typhoid  fever,  653. 

Ulcerations  of  the  bone, 
703 ;  Of  the  womb,  640. 

Ulcers,  644;  Of  the  scalp, 
614. 

Varicose  veins,  646,  704. 
Varioloid,  655. 
Veratrum,  723. 
Vertigo,  613. 

Vinegar  for  poisoning,  729. 
Vomiting  of  blood,  659. 

Warts,  on  the  hands,  669 ; 

On  the  nose,  668. 
Waterbrash,  658. 
Watery  eyes,  624. 
Weak  memory,  697. 
Weakness  of  the  sight,  676. 
Wetting  the  bed,  636. 
White  swelling,  703. 
Whites,  641. 
Whitlow,  645. 
Whooping  cough,  631,  678. 
Wine,  for  poisoning,  730. 
Worms,  663. 
Wounds,  701. 
Wry  neck,  704. 

Yellow  fever,  654. 

Zinc,  or  white  vitriol,  for 

poisoning  by,  727. 
Zona,  668. 


ar,  or  sugar-water,  for 

)isonin|k;,    729. 

imer  complaiut,  708. 

stroke,  61G. 

pression  of  iho  lochia, 

L8;  Of  the  milk,  717; 

f  the  urine,  635. 

gical  diseases,  700 

set  almonJ  oil,  for  jioi- 

>nlng,  730. 

mming   of    the   head, 

13. 

hilis,  638. 

hilitio  8ore  eyes,  623. 

thing,  708. 

inus.  620. 

:er,  6^7. 

ush,  707. 

itures,  609. 

sa  capitis,  614. 

thache,  656. 

ticoilis,  704. 

:heitis,  630. 

mus,  619. 

lors,  removal  of,  702. 

sis    spasmodlca,    (iSl, 

■8. 

hold  fever,  653. 

rationa  of  the  bone, 
3 ;  Of  the  womb,  640. 
IS,  644;  Of  the  scalp, 
4. 

cose  veins,  646,  704. 

Oloid,  656. 

trum,  723. 

igo,  613. 

!gar  for  poisoning,  729. 

iting  of  blood,  659. 

ts,  on  the  hands,  669 ; 

1  the  nose,  668. 

erbrash,  658. 

ery  eyes,  624. 

k  memory,  697. 

kness  of  the  sight,  676. 

ting  the  bed,  636. 

te  swelling,  703. 

tes,  641. 

blow,  645. 

oping  cough,  631,  678. 

t,  for  poisoning,  730. 

tna,  663. 

nds,  701. 

neck,  704. 

)W  fever,  654. 

,  or  white  vitriol,  for 
isonlng  by,  727. 
\,  668. 


Mellins  Food 


FOR 


Infants  and  Invalids. 


Mellin's  Food  has  been  before  the  public 
for  over  Thirty  Years,  and  has  become  a 
household  word  in  every  family. 

Mellin^s  Food  fulfils  all  the  requirements  of 
a  perfect  food  for  Infants,  and  is  invaluable 
for  the  Invalid  and  the  Aged. 

Mellin's  Food  prepared  as  directed  (it  re- 
quires no  cooking)  is  the  best  food  for  Infants 
and  Invalids. 


My  experience  with  MELLIN'S  FOOD  for  a  number 
of  years  has  been  of  the  most  satisfactory  kind  and 
though  foods  have  come  and  gone  and  the  principles 
of  infant  feeding,  as  laid  down  in  the  text  books,  have 
been  radically  changed  several  times,  MELLIN'S 
FOOD  has  stood  the  test  and  seems  to  fulfil  the 
indications  more  nearly  in  the  majority  of  cases  than 
any  other  preparation. 

CHAS.  GRAEFE,  M.D.. 

March  28, 1806.  --    Sandusky,  Ohio. 


Write  to  us  and  we  will  send  our  book  ''The  Care  and  Feeding  of 
Infants,''  and  a  sample  bottle  of  MELLIN'S  FOOD  free  of  charge. 

DOLIBER-<KX3DALE  COMPANY, 
BOSTON,  MASS. 


-^,<*7/A^Z*7,A^^*7^A^\'>7tA-^^    r/Av^»r/A^~»7/Av^t7/AvN  t7/A\N»7/ A*.^  tT*  A*^»7*A*n  *7/ AvT*7/i4^>  t^.C 


'*.        '-.■  > 


5f?5^ 


HorsM's  Acid  Phosphate. 


('mquid.  ; 


> 


A  BRAIN  AND  NERVE  TONIC. 

This  is  not  a  compounded  patent  medicine,  but  a  preparat'on 
of  the  phosphates  of  potash,  iron,  lime,  phosphoric  acid,  etc.,  in 
solution,  and  is  recommended  and  prescribed  by  physicians  of  all 
schools. 


Indigestion,  Dyspepsia,  Eto.  Acid  Phosphate  promotes  digestion  without 
injury,  and  thereby  relieves  those  diseases  caused  by  indigestion  of  the  food. 

Nervousness,  Exhaustion,  Etc.  Acid  Phosphate  supplies  the  waste  of 
phosphates  caused  by  every  mental  and  physical  exertion,  imparting  new 
energy,  increasing  the  intellectual  and  physical  power,  aud  is  an  agreeable  and 
teneficial  food  and  tonic  for  the  brain  and  nerves. 

Headache.  Acid  Phosphate,  by  its  action  on  the  digestion,  and  as  a 
nerve  food,  relieves  the  headache  arising  from  indigestion  and  nervousness. 

Tired  Brain.  Acid  Phosphate  acts  as  a  brain  food,  increasing  the  capacity 
for  mental  labor,  restoring  the  tired  brain,  and  imparting  new  energy  to  that 
organ. 

Abuse  of  Alcohol.  Acid  Phosphate  is  of  great  benefit  in  the  prostration 
consequent  upon  the  abuse  of  alcohol,  restoring  the  nerves  to  their  normal 
condition. 

Weakened  En  'rgy.  Acid  Phosphate  acts  as  a  nutrient  to  the  cerebral 
and  nervous  systems  'ving  vigor  and  renewed  strength  where  there  has  been 
exhaustion. 

Ill  Effects  of  Tobacco.  Acid  Phosphate  neutralizes  the  nicotine,  thereby 
relieving  the  immediate  ill  effects  of  tobacco. 

Sleeplessness.  A  small  dose  in  water,  taken  just  before  retiring,  produces 
the  most  refreshing  sleep. 

Seasickness.  Acid  Phosphate,  taken  regularly,  materially  relieves  and 
often  prevents  this  dreaded  disease. 

Night  Sweats.  Acid  Phosphate  has  commonly  given  speedy  benefit  in 
night  sweats,  and  is  useful  in  all  wasting  and  debilitating  diseases. 

A  Delicious  Drink  is  made  by  adding  a  teaspoonful  of  Acid  Phosphate 
to  a  tumbler  of  water,  and  sweetening  to  the  taste.  It  harmonizes  with  such 
stimulants  as  may  be  necessary  to  take. 


FOR  SALB    BY  AIiLi   DBALIURS  IN  MBDICINBS. 

Send  for  descriptive  pamphlet.  Prepared  under  the  direction  of  Prof.  K.  If. 
Horsford,  by  the  Rumford  Chemloal  Worlu,  Providence,  R.  I.,  U.  S.  A.*  M.  D. 
ARNOLD,  Treaaurer. 

BEWMRe  OF  IKITATIOm. 


Lfe  0  '^2 


phate. 


i 


NIC. 

'«/  a  preparation 
loric  acid,  etc,  in 
physicians  of  all 


tes  digestion  witliout 
estion  of  the  food, 
ipplies  the  waste  of 
ion,  imparting  new 
is  an  agreeable  and 

digestion,  and  as  a 
md  nervousness. 
:reasing  the  capacity 
:  new  energy  to  that 

fit  in  the  prostration 
ves  to  their  normal 

ient  to  the  cerebral 
here  there  has  been 

he  nicotine,  thereby 

re  retiring,  produces 

erially  relieves  and 

\  speedy  benefit  in 

seases. 

of  Acid  Phosphate 

rmonizes  with  such 


[NES. 

ictlon  of  Prof.  B.  IT. 
•  If  U.  S.  Af  K.  D. 


llf  Ii*» 


iVfii 


M 


V  "•' 


